We certainly agree with Hahn et al. that the ultimate goal is for residents of the Appalachian region to be protected by comprehensive, anti-preemptive statewide smoke-free laws, but we evidently disagree about the best strategy to reach that goal. ¹

Although we do not intend to downplay the determined efforts and tremendous accomplishments of local advocates in parts of Appalachia, our study found that years of local advocacy for smoke-free laws have produced only modest results. Moreover, the communities that have successfully passed comprehensive smoke-free laws have tended to be those with relatively high socioeconomic profiles, likely further exacerbating the health disparities that already exist within the region.