|
7
<br /> The strongest, most innovative, and most effective tobacco control policies have most often
<br /> originated at the local level [3,6,10,11]. This is especially true in the area of smoke-free policy
<br /> [3,6,10,11]. Smoke-free policies have often been adopted at the state level only after being
<br /> implemented in a critical mass of communities within a state [6]. In other words, communities have
<br /> played the role of innovators, adopting and implementing important public health policies and
<br /> demonstrating that they are feasible and effective [3,6,11]. In addition, local smoke-free policies are
<br /> especially effective in changing public attitudes towards tobacco use in ways that discourage youth
<br /> from initiating use and encourage adult tobacco users to quit [3,4,6,11]. This is true because these
<br /> policies change environmental and social cues in the everyday community settings where people live,
<br /> work, and play [3,4,6,11].
<br /> Preemptive legislation at the state level prevents this from happening [3,6,10,12,13,14,15]. State
<br /> preemption prohibits communities from enacting laws that are more stringent than or that vary from
<br /> state law [12,13,14,15]. Instead of setting the floor for community public health protections,
<br /> preemptive state laws impose a ceiling on these protections [12,13,14,15]. This prevents
<br /> communities that wish to provide their residents with a higher level of public health protection from
<br /> doing so [12,13,14,15]. Preemption also prevents communities from tailoring policies to fit local
<br /> conditions and needs [12,13,14,15]. In addition,preemption prevents communities from going
<br /> through the process of debating proposed local tobacco control policies, a process which itself
<br /> educates residents about tobacco issues and changes public attitudes, independent of the policies
<br /> themselves [12,13,14,15]. Besides depriving communities of the opportunity to experience the
<br /> benefits of local tobacco control policies,preemption prevents communities from documenting these
<br /> benefits —a step which often leads to the adoption of similar policies in other communities and,
<br /> ultimately, at the state level.
<br /> A number of authoritative scientific reports have highlighted the negative impact of preemptive state
<br /> laws on local public health protections. For example, the Guide to Community Preventive Services
<br /> concluded that"In many states, preemption is a major barrier to the implementation of effective
<br /> tobacco prevention policies and programs. It is a direct obstacle to the adoption of local clean indoor
<br /> air ordinances and to local efforts to restrict youth access to tobacco products from commercial
<br /> sources" [10]. Similarly, the 2000 Surgeon General's Report on Reducing Tobacco Use found that
<br /> "A local strategy can usually impose more stringent smoking restrictions than statewide legislation
<br /> does" [3].
<br /> In recognition of the damaging effects of preemption and the importance of community tobacco
<br /> control policies, both the Healthy People 2010 and the Healthy People 2020 objectives, which are
<br /> developed by the Department of Health and Human Services to set the national public health agenda
<br /> for each decade, include an objective calling for the elimination of all state laws that preempt local
<br /> tobacco control policies [16].
<br />
|