Community Characteristics Associated With Smokefree Park Policies in the United States

Abstract

Outdoor smokefree (SF) policies have the potential to decrease secondhand smoke exposure and denormalize smoking. In order to inform dissemination and evaluation of this emergent tobacco control strategy, this study examined the prevalence of SF park policies in the United States and the community-level characteristics associated with enactment of such policies. Counties with existing SF park policies in one or more jurisdictions were identified using passive surveillance data from the American Nonsmokers' Rights Foundation (ANR). ANR data were validated in a random subsample of counties. County-level characteristics were obtained from public data sources and included population demographics, socioeconomic status (SES), urbanicity, and voter affiliation. State-level tobacco control variables included presence of indoor SF policies and adult smoking prevalence. General estimating equations were used to identify predictors of having a SF park policy while accounting for clustering of counties within states. Eleven percent (n = 355) of counties in the United States (n = 3,143) had at least 1 jurisdiction with a SF park policy. The odds of a county having a SF park policy decreased as the percentage of older residents, recent movers, and smokers increased, and the odds increased as the percentage of Democratic voters increased. Odds were higher for counties with higher SES versus low-SES counties and urban/suburban versus rural counties. SF park policies are currently limited to relatively few jurisdictions, and there is evidence of disparities in adoption of these policies. Public health practitioners should focus promotion of SF park policies on low-SES communities with children and youth and rural areas.