Enforcement of tobacco purchase, use, and possession laws in four Kentucky communities.

This case study examined the implementation and enforcement of the purchase, use, and possession (PUP) laws for tobacco in four Kentucky communities. Purposive and snowball sampling were used to identify 44 adult key informants. Qualitative, semistructured phone interviews assessed knowledge about PUP laws, enforcement, effects of the laws on teen tobacco use, and perceptions about the laws. Seven themes were identified: enforcement not a priority, unaware of enforcement authority, spotty enforcement, other sources of tobacco, minimum penalties, confusion about compliance checks, and schools as de facto enforcers. One community went beyond the statutory requirements of the law and created more stringent penalties for violating the use and possession law, and it also had low illegal sales rates. These laws may be more effective if they are enforced strictly with a meaningful penalty and a clear enforcement strategy.

Public opinion and smoke-free laws.

Public support for Lexington-Fayette County, Kentucky's smoke-free law, perception of health risks from exposure to secondhand smoke (SHS), smoking behaviors, and frequency of visiting restaurants, bars, and entertainment venues were assessed pre- and post-law. Two cohorts of noninstitutionalized adults (N = 2,146) were randomly selected and invited to participate in a 10- to 15-min telephone survey. Public support for the smoke-free law increased from 56% to 63%, and respondents were 1.3 times more likely to perceive SHS exposure as a health risk after the law took effect. Although adult smoking and home smoking policy did not change post-law, adults frequented public venues at least as much as before the law. Lexington adults favored the smoke-free legislation despite living in a traditionally protobacco climate. The smoke-free law acted as a public health intervention as it increased perception of risk of heart disease and cancer from SHS exposure.