Permanent, positive cultural change, as in the case of tobacco control, is the gold standard for progress in public health. In a 2012 article in the Journal of Environmental and Public Health, Mowery et al. reported on the impacts of state preemption of local smokefree laws. While Mowery’s study adds to the evidence that preemption can have a number of negative consequences, perhaps its most important finding concerns social norms change. The authors found that state preemption can interfere with the positive social norms change associated with the consideration and passage of local ordinances because preemption may deny residents opportunities experienced during “the discussion, adoption, and implementation of smoke-free ordinances, and to undergo the resulting shifts in social norms.”
Mowery and his colleagues found support for their findings in the tobacco industry’s own internal documents – a highly reliable source because of the industry’s vast resources and sophistication. In public, the industry argues that preemption is needed for “uniformity” and to provide a “level playing field” for businesses, but in secret they acknowledge their real fear – that grassroots movements for local smokefree laws “will lead to reduced social acceptability of smoking and decreased cigarette sales.”
The study authors conclude, “[i]t is important that practitioners and advocates working on other public health issues fully understand the benefits of local policymaking…” We agree and believe what is true in this case for tobacco control is also true across other public health issues.
Recognizing the power of local policy campaigns and broader grassroots movements is especially important because other strategies to change social norms have often failed. For example, DARE (Drug Abuse Resistance Education), one of the most popular drug prevention projects of all time, comprised a series of weekly “lessons” presented by uniformed police officers. It seemed to be a logical approach to changing young people’s attitudes and behavior regarding drug abuse. However, rigorous evaluations of the DARE program found that it had no impact on adolescents’ use of cigarettes, alcohol, or other drugs.
Extensive investments have also been made in social marketing to change social norms, notably in efforts to prevent alcohol-related problems among young people. Again, social marketing (defined by CDC as using “marketing principles to influence… behavior in order to improve health or benefit society”) seems like a reasonable way to change social norms. Unfortunately, many such programs have failed to change problematic behaviors, let alone change social norms in a significant or lasting way.
Mowery and his co-authors confirm the important role local grassroots campaigns play in promoting social change. The airline smoking ban illustrates how large-scale grassroots movements can create deep cultural change on the national (and even international) level. In a recent case study, Grassroots Change documented how the grassroots movement of flight attendants and passengers beat the tobacco industry in Washington and permanently changed society in the process.
Lessons from the airline smoking ban can help build effective movements to address other public health problems. To learn about the key benefits and building blocks of a national grassroots movement, see our new airline smoking ban case study and timeline.
Source: Paul D. Mowery, Steve Babb, Robin Hobart, Cindy Tworek, and Allison MacNeil, “The Impact of State Preemption of Local Smoking Restrictions on Public Health Protections and Changes in Social Norms,” Journal of Environmental and Public Health, vol. 2012, Article ID 632629, 8 pages, 2012. doi:10.1155/2012/632629