To understand why some states have enacted relatively stringent laws to control smoking in public places while others have not, we examined the political evolution of tobacco control initiatives in six states: New York, Minnesota, Florida, Illinois, Texas, and Arizona. Taken together, the case studies demonstrate the difficulties inherent in enacting strong statewide tobacco control legislation. More important, several unmistakable themes emerge from these case studies, shedding light on the barriers to greater legislative success. These themes include the manner in which the legislative debate is framed by antismoking advocates and the tobacco industry, the relative dearth of leadership provided by medical and health organizations, the role of public opinion, and the complex interaction that exists between statewide antismoking legislation and local antismoking ordinances. Understanding how these issues affect legislative outcomes may help antismoking advocates enact future statewide tobacco control initiatives. It may also present lessons applicable to future battles over other public health legislation.

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