Communities with Local Smoking Ordinances Experience Greater Decline in Smoking Prevalence

July 23, 2019


Do local smoke-free ordinances affect the prevalence of smoking in covered populations? A new study from the University of Kentucky College of Public Health says yes. Dr. W. Jay Christian, assistant professor of Epidemiology at the University of Kentucky College of Public Health, is the first and corresponding author of “Effect of Local Smoke-Free Ordinances on Smoking Prevalence in Kentucky, 2002–2009”, published in the Southern Medical Journal . Co-authors are Ms. Courtney J. Walker, Dr. Bin Huang, and Dr. Ellen Hahn.


Many local communities in Kentucky, a state with one of the highest smoking prevalence rates in the United States, have enacted smoke-free ordinances that prohibit smoking in workplaces and enclosed buildings open to the public. Research has shown that such ordinances are clearly beneficial for public health, but their influence on smoking prevalence in the populations they cover has been unclear.

To investigate the impact of smoke-free ordinances on smoking prevalence, investigators used a database of smoke-free ordinances maintained by the Kentucky Center for Smoke-Free Policy, along with survey data from the Kentucky Behavioral Risk Factor Surveillance System, and US Census data. They estimated the proportion of Kentucky adults living in counties with smoke-free ordinances of varying strength; examined bivariate associations between smoke-free ordinances and smoking prevalence; and fit regression models that adjusted for various county-level demographic, socioeconomic, and geographic factors.

The researchers found that smoking prevalence was approximately 5 percent lower in counties with smoke-free ordinances, even after adjusting for other relevant factors, including a trend in decreasing prevalence throughout the study region. There was a slight dose–response effect related to the strength of smoke-free ordinances after adjustment for these covariates. Smoke-free ordinances appear to have a modest effect on smoking prevalence across the span of several years.

The findings of this study demonstrate that although smoking prevalence fell throughout the state during the study period, counties with smoke-free ordinances experienced a greater decline. The authors conclude that future research should examine the strength of smoke-free ordinances in greater detail to better understand their influence on smoking prevalence.




The University of Kentucky College of Public Health is a catalyst of positive change for population health, with a mission to develop health champions, conduct multidisciplinary and applied research, and collaborate with partners to improve health in Kentucky and beyond.