Diffusion of Tobacco Control in North America

Tobacco control has grown enormously across advanced industrial countries over the past two decades. This article assesses the process of the diffusion, by networks, of innovations in tobacco control both within Canada, sometimes considered a world leader in tobacco control, and across the border with the United States. Advocacy groups, both governmental and nongovernmental, have had a role in spreading ideas about tobacco control from one jurisdiction to another, on both the federal and state/provincial level. In contrast to the usual North American pattern of public policy leadership by the United States, followed by Canada, in tobacco control the identity of the leader and follower varies, as does the level at which leadership is exercised.