Background: Mississippi is one of only seven states without any type of statewide law restricting smoking in private indoor workplaces, restaurants, or bars. The negative health effects associated with exposure to secondhand smoke have been well documented. Research is emerging related to the impact of local smoke-free policy on Mississippi's economic and population health. Methods: Systematic literature review of current research related to both the fiscal and physical effects of smoke-free policy. Results: A 2010 study revealed substantial reductions in heart attacks in two Mississippi cities following the implementation of smoke-free ordinances: a 22.7% reduction in heart attack admissions in Starkville (compared with a 14.8% reduction among non-residents) and a 13.4% reduction in heart attack admissions (compared with a 3.8% reduction among non-residents) were reported. Because of the small number of heart attack admissions, additional data are required to determine statistical significance. Peer reviewed studies have yet to show any negative impacts of smoke-free policy on the hospitality industry. Analysis of Mississippi Tourism and Economic Development (TED) tax revenues showed that in the 12 months after enacting municipal smoke-free ordinances, TED tax revenues were 10.3% higher in smoke-free communities, compared with TED tax revenues in communities without smoke-free ordinances. Discussion: While the body of literature specific to Mississippi is small, study results mirror what dozens of larger studies with statistical significance have shown in other populations. A state-wide smoke-free law could positively impact the economy and health status of Mississippians.