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Multiple Streams Approach to Tobacco Control Policymaking in a Tobacco-Growing State

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Abstract

Smokefree policies (SFPs) have diffused throughout the US and worldwide. However, the development of SFPs in the difficult policy environment of tobacco-producing states and economies worldwide has not been well-explored. In 2007, Tennessee, the third largest tobacco producer in the US, enacted the Non-Smoker Protection Act (NSPA). This study utilizes the multiple streams model to provide understanding of why and how this policy was developed by triangulating interviews with key stakeholders and legislative debates with archival documents. In June 2006, the Governor unexpectedly announced support for SFP, which created a window of opportunity for policy change. The Campaign for Healthy and Responsible Tennessee, a health coalition, seized this opportunity and worked with the administration and the Tennessee Restaurant Association to negotiate a comprehensive SFP, however, a weaker bill was used by the legislative leadership to develop the NSPA. Although the Governor and the Tennessee Restaurant Association’s support generated an environment for 100 % SFP, health groups did not fully capitalize on this environmental change and settled for a weak policy with several exemptions. This study suggests the importance for proponents of policy change to understand changes in their environment and be willing and able to capitalize on these changes.

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Acknowledgments

We would like to thank the ETSU Foundation for providing the funds for this research and the Department of Health Services Management and Policy, College of Public Health, and the Division of Health Affairs, ETSU, for logistical support. Additionally, we would like to thank all the people who volunteered to participate in this study. The research was supported by a grant from the ETSU Foundation (c0610.10 sd) and the National Cancer Institute grant CA-61021. The funding agencies have no involvement in the conduct of the research and the writing of the manuscript.

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Authors and Affiliations

  1. Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, S. Dossett Drive, Lamb Hall, P.O. Box 70264, Johnson City, TN, 37614, USA

    Hadii M. Mamudu

  2. New Delhi, India

    Sumati Dadkar

  3. Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA

    Sreenivas P. Veeranki

  4. Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University, S. Dossett Drive, P.O. Box 12993, Johnson City, TN, 37614, USA

    Yi He

  5. Center for Tobacco Control Research and Education, University of California, San Francisco, 530 Parnassus Ave, Suite 366, San Francisco, CA, 94143-1390, USA

    Richard Barnes & Stanton A. Glantz

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  1. Hadii M. Mamudu
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Correspondence to Hadii M. Mamudu.

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Mamudu, H.M., Dadkar, S., Veeranki, S.P. et al. Multiple Streams Approach to Tobacco Control Policymaking in a Tobacco-Growing State. J Community Health 39, 633–645 (2014). https://doi.org/10.1007/s10900-013-9814-6

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