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Health Education Research Advance Access originally published online on October 18, 2007
Health Education Research 2008 23(4):709-722; doi:10.1093/her/cym054
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions{at}oxfordjournals.org

Do local tobacco regulations influence perceived smoking norms? Evidence from adult and youth surveys in Massachusetts

William L. Hamilton1,*, Lois Biener2 and Robert T. Brennan3

1 CNU Associates, Lincoln, MA 01773, USA
2 Center for Survey Research, University of Massachusetts, Boston, MA 02125, USA
3 Department of Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA 02115

* Correspondence to: Lois Biener, Center for Survey Research, University of Massachusetts Boston, 100 Morrissey Boulerard, Boston, MA 02125, USA. E-mail: cnu_hamilton{at}comcast.net

Smoking behavior has been shown to be influenced by individuals’ perceptions of social norms about smoking. This study examines whether local regulations regarding clean indoor air and youth access to tobacco are associated with residents’ subsequent perceptions of smoking norms. Data came from Massachusetts surveys of adults and youths and from records of local tobacco control policies. Indices of perceived smoking norms were based on perceived smoking prevalence and perceived community acceptance of smoking. Multilevel models tested the association between perceived norms and the presence of strong local regulations in four policy domains (restaurant smoking bans, smoking restrictions in other venues, enforcement of laws prohibiting sales to youths and youth-oriented marketing restrictions). The model controlled for town voting results on a tobacco tax referendum, which served as a measure of antismoking sentiment pre-dating the regulations. Results showed that youths perceived community norms to be significantly more ‘antismoking’ if they lived in a town that had strong regulations in at least three of the four domains. For adults, having strong regulations in as few as one to two domains was associated with perceiving community norms to be significantly more antismoking. Implementing and publicizing local regulations may help shape perceptions of community smoking norms.

Received on January 27, 2007; accepted on July 9, 2007


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