Community characteristics associated with smoke-free park policies in the u.s

Background: Smoke-free park policies are recommended to limit exposure to secondhand smoke and denormalize smoking, especially in areas frequented by children and youth. The number of policies has increased in the past several years but it is not known whether communities with policies differ from those without policies. Methods: All counties in the United States were included (n=3143). Counties were classified as having a smoke-free park policy if any jurisdiction within the county had a policy according to a passive surveillance database of tobacco control policies. County- and state-level characteristics were obtained from publicly available data sources. Generalized estimating equations were used to model odds of having a policy while accounting for clustering of counties within states. Results: About 10% (n=308) of counties had at least one jurisdiction with a smoke-free park policy, but more than 40% of the population lived in these counties. After controlling for all significant predictors, odds of having a policy decreased as the percentage of older residents, recent movers, and smokers increased, and increased as the percentage of Democratic voters increased. Additionally, odds were higher for higher-socioeconomic status (SES) versus low-SES counties and for urban/suburban versus rural counties. Smoke-free park policies were not associated with state-level indoor smoke-free policies. Conclusions: Areas with higher proportions of children and youth – who are most likely to benefit from smoke-free park policies – were more likely to have such policies. However, efforts are needed to promote policies among low-SES and rural communities, which suffer disproportionately from tobacco-related problems.