Smoke-free policy implementation: theoretical and practical considerations

Policy Polit Nurs Pract. Aug-Nov 2014;15(3-4):81-92. doi: 10.1177/1527154414562301. Epub 2015 Jan 8.


Secondhand smoke exposure is a major public health issue, increasing the risk of cardiovascular and respiratory diseases and cancer. Although best practices for adopting smoke-free policy are well understood, there is limited research on the effective implementation of smoke-free policy. This article presents theoretical and practical considerations for smoke-free policy implementation in three Kentucky communities guided by the Institutional Analysis and Development (IAD) Framework. Although both Danville and Lexington-Fayette County, Kentucky have comprehensive smoke-free policies, Danville had more effective implementation, as well as better outcomes. Further study is needed to understand the critical elements of smoke-free policy implementation and their association with population outcomes. The IAD is a promising model to guide the study of both policy adoption and implementation.

Keywords: Institutional Analysis and Development Framework; policy implementation; smoke-free policy.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Health Policy / legislation & jurisprudence*
  • Health Promotion / organization & administration
  • Humans
  • Kentucky
  • Male
  • Policy Making
  • Program Evaluation
  • Public Health
  • Regional Health Planning / organization & administration*
  • Smoke-Free Policy / legislation & jurisprudence*
  • Tobacco Smoke Pollution / adverse effects
  • Tobacco Smoke Pollution / prevention & control*


  • Tobacco Smoke Pollution