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Health Education Research, Vol. 14, No. 4, 519-531, August 1999
© 1999 Oxford University Press

Applying a contingency model of strategic decision making to the implementation of smoking bans: a case study

Marc C. Willemsen, André Meijer1 and Marleen Jannink

Department of Health Education and Promotion, and
1 Department of Health Organization Policy and Economics, Maastricht University, Maastricht, The Netherlands

Correspondence to: M. C. Willemsen, Dutch Foundation on Smoking and Health (Stivoro), PO Box 84370, 2508 AJ The Hague, The Netherlands

A model of strategic decision making was applied to study the implementation of worksite smoking policy. This model assumes there is no best way of implementing smoking policies, but that `the best way' depends on how decision making fits specific content and context factors. A case study at Wehkamp, a mail-order company, is presented to illustrate the usefulness of this model to understand how organizations implement smoking policies. Interview data were collected from representatives of Wehkamp, and pre- and post-ban survey data were collected from employees. After having failed to solve the smoking problem in a more democratic way, Wehkamp's top management choose a highly confrontational and decentralized decision-making approach to implement a complete smoking ban. This resulted in an effective smoking ban, but was to some extent at the cost of employees' satisfaction with the policy and with how the policy was implemented. The choice of implementation approach was contingent upon specific content and context factors, such as managers' perception of the problem, leadership style and legislation. More case studies from different types of companies are needed to better understand how organizational factors affect decision making about smoking bans and other health promotion innovations.


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