Smoke-free spaces over time: a policy diffusion study of bylaw development in Alberta and Ontario, Canada

Abstract

Policy diffusion is a process whereby political bodies 'learn' policy solutions to public health problems by imitating policy from similar jurisdictions. This suggests that diffusion is a critical element in the policy development process, and that its role must be recognised in any examination of policy development. Yet, to date, no systematic work on the diffusion of smoke-free spaces bylaws has been reported. We examined the diffusion of municipal smoke-free bylaws over a 30-year period in the provinces of Alberta and Ontario, Canada, to begin to address this gap and to determine whether spatial patterns could be identified to help explain the nature of policy development. Bylaw adoption and change were analysed within local, regional, and provincial contexts. Geographical models of hierarchical and expansion diffusion in conjunction with the diffusion of innovations framework conceptually guided the analyses. Study findings contribute to a broader understanding of how and why health policies diffuse across time and place. Policy development can be a powerful mechanism for creating environments that support healthy decisions; hence, an understanding of policy diffusion is critical for those interested in policy interventions aimed at improving population health in any jurisdiction.

Relationships between community characteristics and municipal smoke-free bylaw status and strength

“…Thus, regulatory activity at the higher level of jurisdiction (province) may play a part in policymaking in lower jurisdictions (municipalities); e.g., decision-makers may become stalled by debates of jurisdictional propriety over SHS regulation. In a policy diffusion study [21], rates of municipal smoke-free bylaw adoption dropped substantially in years where there was tobacco control policy activity at the provincial level, regardless of whether or not the provincial activity was directly related to smoke-free spaces. Thus the importance of provincial tobacco control context for local smoke-free bylaw development is another critical point for those in public health working with these issues.…”

“…Further, a diffusion of innovation perspective suggests that decision-makers often utilize policies that have been successfully implemented in other jurisdictions [17,19,20]. This possibility was investigated in a separate study conducted by Nykiforuk et al [21] exploring patterns of bylaw diffusion across municipalities and health regions. This study found that geographic diffusion and adopter (community) characteristics worked in concert with local, provincial and national tobacco control activities to explain bylaw adoption patterns across provinces.…”

Cancer beliefs and prevention policies: comparing Canadian decision-maker and general population views

“…Government decision-makers could be reassured (based on KAB findings) that, in fact, most policy influencers in the province along with the general public supported such a policy, then they may act on the issue without fear of upsetting constituents. A deeper understanding of public support patterns can then be used by advocates to support strategic policy diffusion across a region or state [80][81][82].…”

Chiropractic Care and Public Health: Answering Difficult Questions About Safety, Care Through the Lifespan, and Community Action

“…143 Mandatory vaccination programs, smoking bylaws, and seat belt legislation are examples of initiatives where individual freedoms have been limited in the interest of the public good. [144][145][146] The chiropractic profession encourages its members' responsibility to public health promotion, 1,10 and this is recognized in several codes of ethics. [138][139][140] For example, the Canadian Chiropractic Association's Code of Ethics and conduct guides its members to "accept full share of the chiropractic profession's responsibility to society in matters relating to spinal and public health, health education, and legislation affecting the health or well-being of the citizens of the community."…”