Adoption and Compliance in Second-Hand Smoking Bans: A Global Econometric Analysis

Abstract

Objectives: We examine whether the factors which lead governments to enact smoking bans in public places are similar to those which shape their willingness or ability to successfully put them into effect. Methods: Using a large sample (N=99 to 184) of low-, middle- and high-income countries, econometric techniques are used to estimate the influence of a number of variables on cross-national variations in the adoption and compliance of second-hand smoke laws (year=2010). Results: We show that several political economy factors which impact countries’ level of compliance with existing smoking bans in public places – namely, income per capita, smoking prevalence, tobacco production and public health expenditure – are not consistent predictors of their propensity to adopt bans in the first place. Possible explanations for this discrepancy are that governments are motivated to adopt smoking bans for reasons other than protecting the health of their citizens and that the real costs of smoking bans are predominantly borne at the compliance stage. Conclusions: More effort needs to be made to ensure that governments realize their existing policy commitments through effective enforcement of bans.