Adoption and compliance in second-hand smoking bans: a global econometric analysis

We examine the determinants governing both countries' enactment of smoking bans in public places and their ability to successfully put these bans into effect. Using a large sample (N = 99-184) of low-, middle- and high-income countries, econometric techniques are used to estimate the influence of several variables on cross-national variations in the adoption and compliance of second-hand smoke laws (2010). We find similarities in the determinants of adoption and compliance. Yet more notable are the differences, with several political economy factors which have a statistically significant influence on countries' level of compliance with existing smoke-free laws in public places found not to consistently influence their propensity to adopt bans in the first place. Possible explanations for this discrepancy are that governments are motivated to adopt smoking bans for reasons other than protecting the health of their citizens and that the real costs of smoking bans are predominantly borne at the compliance stage. More effort needs to be made to ensure that governments realize their existing policy commitments through effective enforcement of bans.