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Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
Tel: 1-800-CDC-INFO
(1-800-232-4636)
TTY: 1-888-232-6348
E-mail: tobaccoinfo@cdc.gov
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2000 Surgeon General's Report—Reducing Tobacco Use
Comprehensive Programs
Disclaimer
Highlights
Rationale for Comprehensive Intervention
- Statewide programs have emerged as the new laboratory for developing
and evaluating comprehensive plans to reduce tobacco use.
- Initial results from statewide tobacco control programs are encouraging,
particularly in per capita declines of tobacco consumption.
- State findings also suggest that youth behaviors regarding tobacco
use are more difficult to change than adult ones.
- People do not make behavior choices in isolation, but rather in
a larger, complex context that includes the family, community, and culture;
the economy and physical environment; formal and informal government
policy; and the prevailing legal atmosphere. Programs to reduce tobacco
use will be most effective if they address all the components that may
influence the individual’s behavior choices.
- There are several advantages to shifting from an approach that targets
the individual to a population approach that uses social, policy, and
environmental strategies.
- First, by recognizing that many environmental determinants of health
behavior are not under the direct control of the individual, the population
approach avoids blaming persons who fail to change their behavior.
- Second, many individual efforts may fail to reach those in greatest
need. Because many of these strategies are most effective with better-educated,
wealthier persons, the disparities in health between population groups
may widen.
- Third, making regulatory and policy changes can be more cost-effective
than conducting numerous interventions to modify individual behavior.
CDC's National Tobacco Control Program
- In May 1999, CDC launched the National Tobacco Control Program (NTCP),
bringing the various federal initiative activities into one national
program. In fiscal year 2000, the NTCP distributed $59 million for comprehensive
tobacco control efforts in all states, the District of Columbia, seven
U.S. territories, and Native American tribal organizations.
- CDC recommends four program goals in its comprehensive framework for
statewide programs
- Prevent initiation of tobacco use among young people.
- Promote quitting among adults and young people.
- Eliminate exposure to environmental tobacco smoke (ETS).
- Identify and eliminate health disparities among population groups.
- Each program goal would be fully addressed by implementing four program
components:
- Community interventions, which include diverse entities such as
schools, health agencies, city and county governments, and civic, social,
and recreational organizations
- Countermarketing, which includes using media advocacy, paid media,
pro–health promotions, and other media strategies to change social norms
related to tobacco use
- Program policy and regulation, which addresses such issues as minors’
access, tobacco pricing, advertising and promotion, clean indoor air,
product regulation, and tobacco use treatment
- Surveillance and evaluation, which includes monitoring the tobacco
industry’s promotional campaigns, evaluating the economic impact of
ETS laws and policies, conducting surveys of public opinion on program
interventions, and making ongoing refinements that lead to more effective
prevention strategies
-
The elimination of health disparities among population groups remains
a challenge due to the lack of culturally appropriate programs of proven
efficacy. However, in recent years, a number of people and organizations
with more diverse backgrounds have assumed a greater role in efforts to
reduce tobacco use. Particularly in view of the tobacco industry’s targeted
marketing to women, young people, and racial/ethnic populations, such heightened
activity is critically important for ensuring that nonsmoking becomes the
norm within diverse communities.
- To be effective, comprehensive programs should include campaigns that
include the following:
- Target young people and adults with complementary messages
- Highlight nonsmoking as the majority behavior
- Communicate the dangers of tobacco while providing constructive
alternatives
- Use multiple nonpreachy voices in a complementary, reinforcing
mix of media and outdoor advertising
- Include grassroots promotions, local media advocacy, event sponsorships,
and other community tie-ins
- Encourage youth empowerment and involvement
Disclaimer: Data and findings provided on this page reflect the content of
this particular Surgeon General's Report. More recent information may exist
elsewhere on the Smoking & Tobacco Use Web site (for example, in fact sheets,
frequently asked questions, or other materials that are reviewed on a regular
basis and updated accordingly).
Page last updated August 9, 2000