文章基本信息

标题：Boards of Health as Venues for Clean Indoor Air Policy Making
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作者：Joanna V. Dearlove ; Stanton A. Glantz
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2002
卷号：92
期号：2
页码：257-265
语种：English
出版社：American Public Health Association
摘要：Objectives. This study sought to determine the tobacco industry's strategies for opposing health board actions and to identify elements necessary for public health to prevail. Methods. Newspaper articles, personal interviews, and tobacco industry documents released through litigation were reviewed. Results. Twenty-five instances in which the tobacco industry opposed health board regulations were identified. It was shown that the tobacco industry uses 3 strategies against health boards: “accommodation” (tobacco industry public relations campaigns to accommodate smokers in public places), legislative intervention, and litigation. These strategies are often executed with the help of tobacco industry front groups or allies in the hospitality industry. Conclusions. Although many tobacco control advocates believe that passing health board regulations is easier than the legislative route, this is generally not the case. The industry will often attempt to involve the legislature in fighting the regulations, forcing advocates to fight a battle on 2 fronts. It is important for health boards to verify their authority over smoking restrictions and refrain from considering nonhealth factors (including industry claims of adverse economic impacts) so as to withstand court challenges. In the United States, many states and localities have boards of health that can issue regulations to protect public health independent of legislative approval. Most health boards are also designed to be insulated from the political pressures experienced by legislators, and often the regulations they issue must be based solely on health considerations. Most boards are appointed for fixed terms (only 29% of boards have elected members 1 ), so members are generally not subject to reelection concerns or susceptible to the influence of campaign contributions. 2– 4 These facts, combined with the overwhelming evidence that secondhand smoke causes disease in nonsmokers, 5– 8 make health boards a logical venue to issue tobacco control measures. There are 3 main strategies the tobacco industry uses against health board smoking regulations: “accommodation” (public relations campaigns to accommodate smokers in public places), legislative intervention, and litigation. (These strategies are in addition to the industry's overarching strategy of state preemption, which removes the authority of local governmental bodies to issue tobacco control policies. 9– 15 ) Although boards of health are designed to be insulated from political pressures, the industry, in certain of its strategies, relies on politics to oppose health board regulations. 16, 17 In the present article, we examine the tobacco industry's strategies and provide case studies. Despite industry opposition, some boards of health have successfully passed and defended regulations, while others have had their regulations repealed, amended, or weakened. Successful regulation of secondhand smoke by a board of health requires that the board acquire the public support necessary to withstand the political attack that the tobacco industry will mount, derive its authority from a statute and associated case law that will permit it to withstand a legal challenge by the tobacco industry, and carefully craft the regulation in anticipation of such a challenge.