1. Strategies for Success

2.  Implementing tobacco control programs locally is a process that requires community members’ time and effort. 1.Engage stakeholders. 2.Develop a strategic plan. 3.Implement the program. 4.Evaluate the program. 5.Sustain programs.

3. Strategies for Success Engaging Stakeholders

4. Strategies for Success  Community mobilization “is the process of working collaboratively with and through groups of people affiliated by geographic proximity, special interest, or similar situations to address issues affecting the wellbeing of those people.” Engaging Stakeholders Fawcett et al., 1995

5. Strategies for Success Parent Organizations Parent Organizations Business Community Business Community Tribal Councils Tribal Councils Faith-Based Organizations Faith-Based Organizations Neighborhood Associations Neighborhood Associations Teachers and Other Education Professionals Teachers and Other Education Professionals Community Mobilization (State and Local) Concerned Citizens Concerned Citizens Community Leaders Community Leaders Youth Groups Youth Groups Local Boards of Health Local Boards of Health Local Health Departments Local Health Departments Professional Associations Professional Associations Medical Community Medical Community Engaging Stakeholders

6. Strategies for Success Engaging Stakeholders

7. Strategies for Success

8.  Strategic plans are roadmaps to your organization’s destination.  Strategic plans include (among other items)—  Set of goals and objectives.  Strategies for achieving the goals.  Funding sources.  Evaluation methods. Developing a Strategic Plan

9. Strategies for Success Implementing the Program

10. Strategies for Success Evaluating the Program

11. Comprehensive Programs Sustaining State Programs for Tobacco Control: Sustaining the Program

12. Comprehensive Programs COLORADO Sustaining the Program: A Success Story

13. Sustaining the Program Examples of Hindrances to Adequate Funding:  Lobbying by tobacco companies.  Political climate of “hands-off” approach to government.  State budget deficits. Comprehensive Programs

14. Overcoming Funding Difficulties  Have a well-written strategic plan that partners and politicians can easily buy into.  Always look out for new sources of funding.  Follow procedures in Best Practices.  Have diverse, skilled, and active leaders.  Evaluate your program, so you have evidence of success. Sustaining the Program Comprehensive Programs

15. Strategies for Success CDC’s Best Practices for Comprehensive Tobacco Control Programs Centers for Disease Control and Prevention, Office on Smoking and Health

16. Strategies for Success Preventing Initiation among Youth and Young Adults

17. Strategies for Success Preventing Initiation among Youth and Young Adults

18. www.thetruth.com Preventing Initiation among Youth and Young Adults Strategies for Success

20. Promoting Quitting Among Adults and Youth

21. Strategies for Success Each Year:  70% of U.S. smokers report a desire to quit.  Almost 50% of people who have ever smoked have quit. Quitting often requires several attempts over a span of a few years. Promoting Quitting Among Adults and Youth CDC, Office on Smoking and Health

22.  Smoke-free policies motivate smokers to quit. Strategies for Success Promoting Quitting Among Adults and Youth

23. The Health Consequences of Smoking, Surgeon General’s Report, 2006 Strategies for Success   Quitting smoking has immediate and long-term benefits, reducing risks for diseases caused by smoking and improving health in general. Promoting Quitting Among Adults and Youth

24. Comprehensive approaches use a combination of these options and are systems-based: ♦ Brief clinical interventions ♦ Counseling ♦ Nicotine replacement therapy (NRT) ♦ Prescription NRT and medication Science-Based Treatment Options Strategies for Success Promoting Quitting Among Adults and Youth

25. Effective cessation outreach should include —  Payment by a third party (Managed care organization or health insurance).  Communication through multiple means.  Training for health care providers.  Worksite and health center programs. Strategies for Success Promoting Quitting Among Adults and Youth

26. Strategies for Success Successful strategies:  Increasing the unit price for tobacco products.  Organizing mass media campaigns in combination with other interventions.  Reducing smokers’ out-of-pocket costs for cessation therapies.  Multi-component interventions that include telephone support. Promoting Quitting Among Adults and Youth

27. Strategies for Success Clinical Practice Guideline “Treating Tobacco Use and Dependence” Provides recommendations for brief and intensive clinical interventions and implementing effective treatment programs. Promoting Quitting Among Adults and Youth

28. Strategies for Success Eliminating Exposure to Secondhand Smoke

29. What are the benefits of a smoke-free environment? Strategies for Success: Smoke-free Air

30. Strategies for Success Regulatory Efforts  Mandated by ordinance  Legal consequences for noncompliance  Consistent and permanent for locality  Precedent set by other localities  Campaign target: city councils and mayors Voluntary Efforts  Not mandated  No consequences for noncompliance  Useful as educational campaign  Can be used against passing regulations  Campaign target: restaurants and businesses Americans for Nonsmokers’ Rights Eliminating Exposure to Secondhand Smoke

31. Strategies for Success: Smoke-free Air What has been successful or unsuccessful in your community?

32. Strategies for Success Start on the local level. Work on a traditional council-based campaign. Develop a written campaign plan. Agree on a bottom line. Reach out. No law is better than a weak or ineffective one. American for Nonsmokers Rights and Tobacco Control Partners Eliminating Exposure to Secondhand Smoke

33. Strategies for Success Eliminating Exposure to Secondhand Smoke Tobacco Technical Assistance Consortium

34. Americans for Nonsmokers’ Rights Smoke-free environments Avoid the “minors only” trap... ♦ Secondhand smoke is dangerous to everyone. ♦ Smoke-free policies are to protect the public and employees. ♦ “Minors only” is difficult to enforce. Strategies for Success Eliminating Exposure to Secondhand Smoke

35. Smoke-free environments Avoid the “ventilation” trap... ♦ No ventilation system can remove the dangers of secondhand smoke. ♦ All employees deserve smoke-free workplace. ♦ Businesses have to make large capital investment. ♦ It will be more difficult to pass stronger legislation in the future. Americans for Nonsmokers’ Rights Strategies for Success Eliminating Exposure to Secondhand Smoke

36. Smoke-Free Environments Avoid the “smoke-free hours” trap...  Employees deserve consistent protection.  Mixed messages lead to confusion and low compliance.  Enforcement becomes difficult and taxing. Strategies for Success Eliminating Exposure to Secondhand Smoke

37. Smoke-Free Environments Avoid the “hardship” trap... ♦ Don’t allow permits, licenses, and tax incentives – they imply financial losses will accompany smoke-free policy. ♦ Smoke-free laws have been shown to increase sales tax income. Strategies for Success Eliminating Exposure to Secondhand Smoke Americans for Nonsmokers’ Rights

38. Strategies for Success Preemption  When a state law conflicts with federal law, the federal law preempts — or trumps — the state law.  When a state law conflicts with a local ordinance, state law preempts the local ordinance. Americans for Nonsmokers’ Rights Eliminating Exposure to Secondhand Smoke

39. Preemption in Tobacco Control Local ordinances (laws) —  Are easier to enact.  Have better compliance and enforcement.  Contribute to societal rejection of tobacco.  Are more difficult for big tobacco to combat. Americans for Nonsmokers’ Rights and National Cancer Network Eliminating Exposure to Secondhand Smoke Strategies for Success

40. “...At the town meeting, we’re almost always killed. At the board of health level, we do better. At the city council level, we do very well. And at the state level we do great.” Eliminating Exposure to Secondhand Smoke

41. Tobacco industry tactics against preemption are REAL. “We introduce legislation of our own to scatter the resources of antis.” From memo by Tina Walls, Vice President, State Government Affairs, Philip Morris. Americans for Nonsmokers’ Rights Strategies for Success Eliminating Exposure to Secondhand Smoke

42. Strategies for Success Identifying and Eliminating Disparities

43. Strategies for Success Questions to ask yourselves:  How do we plan to reach out to populations with tobacco-related disparities?  Who from those populations can serve as spokespersons?  What activities and program strategies are effective with each of these populations? Identifying and Eliminating Disparities

44. To make a difference is not a matter of accident, a matter of casual occurrence of the tides. People choose to make a difference. Maya Angelou

45. Communities of Excellence Restrictions on tobacco ads Identifiable tobacco control funds/staff High taxes on tobacco No sales of tobacco to minors Public education campaigns Cessation services Tobacco-free public places and worksites Detailed plan of action Monitor & counter tobacco influence Tobacco-free school campuses Communities of Excellence Plus in Tobacco Control

46. Conclusion We know what works... What works are comprehensive programs that use a public health approach:  Increase excise taxes on tobacco.  Enact and enforce smoke-free air laws.  Provide systems-based cessation services. When we apply what we know works...we can realize our own potential.

47. Review

48. Public Health Approach  Locate resources and data to help with planning and communication.  Understand the benefits of using credible resources.  Understand the public health approach to reducing tobacco use.  Know of effective policy interventions. Review Credible Tobacco Control Resources

49. Comprehensive Programs Strategies for Success  Define the components of a comprehensive tobacco prevention and control program.  Understand elements of science-based tobacco control programs. Review  Understand how to implement strategies at the community level for successful outcomes.  Understand how to sustain your tobacco control programs.

50. Tobacco Technical Assistance Consortium Rollins School of Public Health Emory University Atlanta, Georgia To Contact: ttac@sph.emory.edu Phone: 404-712-8474