Passing a Smoke-Free Law in a Pro-Tobacco Culture: A Multiple Streams Approach

Lisa W. Greathouse, Chizimuzo T.C. Okoli, Ellen J. Hahn, Todd A. Warnick, Carol A. Riker

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


This article describes a case study of the policy development and political decision-making process involved in the enactment of Lexington, Kentucky’s smoke-free law. The multiple streams framework is used to analyze the development of the law in a seemingly unlikely and challenging political environment. Proponents developed a dissemination research plan targeted at policy makers and the public to demonstrate the need for a comprehensive law. The existence of a strong coalition of health care providers and health care systems including the board of health, as well as long-standing tobacco control expertise and a strong legal team, were essential ingredients for success. A deliberate strategy to expose the tobacco industry was effective in preparing policy makers for the opponents’ policy arguments. As expected, a hospitality industry association was formed to oppose the ordinance, resulting in a legal challenge that delayed enactment of the law.

Original languageEnglish
Pages (from-to)211-220
Number of pages10
JournalPolicy, Politics, and Nursing Practice
Issue number3
StatePublished - Aug 2005


  • no-smoking laws
  • policy development
  • secondhand smoke
  • tobacco policy

ASJC Scopus subject areas

  • Leadership and Management
  • Issues, ethics and legal aspects


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