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diffusion of innovations, health policy, public health, tobacco smoke pollution



  1. Deverell, Michelle MPH
  2. Randolph, Catherine BA
  3. Albers, Alison PhD
  4. Hamilton, William PhD
  5. Siegel, Michael MD, MPH


Objectives: The objectives of this study were to examine the diffusion of smoke-free restaurant regulations and identify socioeconomic and racial/ethnic disparities in health protection from secondhand smoke exposure in restaurants.


Methods: We examined the relationship between adoption of local smoking regulations by restaurants for each of the 351 cities and towns in Massachusetts and a number of individual variables over nine time points, starting when there were no 100% smoke-free restaurant regulations and ending with the eventual imposition of the statewide ban on smoking in restaurants and bars


Results: We found that over the 10 years before the statewide ban went into effect, only 36 percent of the total population was covered by local regulations that protected them from secondhand smoke exposure in restaurants. We also observed a substantial disparity in protection based on educational status, with up to 7 percentage points fewer nongraduates protected by local smoke-free restaurant regulations.