Objective: We estimated the reduction in number of hospitalizations for acute myocardial infarction and stroke as well as the associated health care costs resulting from reducing the number of smokers in the US federal workforce during a 5-year period.
Methods: We developed a 5-year spreadsheet-based cohort model with parameter values from past literature and analysis of national survey data. We obtained 2015 data on the federal workforce population from the US Office of Personnel Management and data on smoking prevalence among federal workers from the 2013-2015 National Health Interview Survey.
Background: Since the passage of Proposition 99, California's comprehensive tobacco control programme has benefited from a localised policy adoption process that allows for the innovation and diffusion of strong local tobacco control policies throughout the state.
Methods: The policy adoption continuum is described in the context of California's smoke-free workplace movement, and the influence of policy-driven tobacco control initiatives on social norms, behaviour and the public's health was examined.
Results: The Smoke-free California policy adoption continuum reflects a general approach for policy innovation and diffusion that builds social acceptance and influences social norms, while minimising unintended consequences and creating best practices in tobacco control.