The intersection of urban planning and public health frameworks offers significant potential for addressing tobacco-related health disparities in California. Municipal comprehensive plans are underutilized instruments for health policy impact across the State's diverse communities. Our preliminary analysis of 482 California municipalities revealed an inverse relationship between existing tobacco control language in comprehensive plans and adoption of standalone tobacco control ordinances. This inverse relationship shows a significant implementation gap between public health goals and policy outcomes.
The passage of Senate Bill 1000 (2016) established mandatory environmental justice elements within comprehensive plans, creating an avenue for addressing health disparities through urban planning. Given this framework, our study examines a novel approach to tobacco control through Hayward, California's newly adopted Environmental Justice Element (2023), which incorporates smoke-free housing objectives into its comprehensive plan. Our study evaluates Hayward's integration of smoke-free multiunit housing policies into its comprehensive plan and subsequent ordinance adoption.
Moreover, we use a natural experiment design and compare smoke-free housing policies in Hayward and Fairfield, matched California cities that adopt contrasting implementation approaches. Hayward has included smoke-free housing language into its comprehensive plan, while Fairfield maintains traditional standalone ordinances. This natural policy laboratory allows us to evaluate the effectiveness of: 1) comprehensive plan integration of tobacco control measures vs. 2) conventional ordinance-based approaches.
To assess impact, we will track policy adoption and implementation metrics for smoke-free housing. Supporting indicators will include health outcomes (asthma incidents, emergency department visits) and behavioral changes (cessation attempts and substance use patterns). This research addresses a critical public health challenge: in the U.S., 29 million residents of smoke-free homes remain exposed to secondhand smoke from adjoining units, with disproportionate impacts on communities of color and low-income populations. In Hayward, where 67% of renters are minorities and 49% are Hispanic/Latino ethnicity, this study will provide crucial insights into how comprehensive planning mechanisms can advance belonging through built environment interventions. The long-term goal is to provide new knowledge facilitating widespread implementation and sustained utilization of evidence-based tobacco control strategies through urban design.