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State Tobacco-Use Prevention and Control Plans
In October 1989, the Association of State and Territorial
Health Officials (ASTHO) surveyed health agencies in all 50
states and the District of Columbia to assess activities related
to control of tobacco use. The survey focused on the extent to
which planning efforts met criteria listed in Guide to Public
Health Practice: State Health Agency Tobacco Prevention and
Control Plans (1).* Respondents submitted copies of existing
plans for tobacco-use prevention and control. This report
summarizes the analysis of specific plans to control tobacco use
(free-standing plans) or plans that form a discrete section on
tobacco-use-control in a more general health-planning document.
Plans were evaluated in terms of the following components: 1)
involvement of a tobacco-and-health coalition or advisory group
comprising representatives from both the private and public
sectors; 2) inclusion of an analysis of state-specific
tobacco-use behavior; 3) presentation of detailed objectives and
specific strategies for reducing tobacco use in the state; 4)
presence of an outline of a specific workplan identifying
individuals and organizations responsible for implementing the
plan; 5) description of outcome evaluation measures, including
tobacco-use surveillance systems; 6) description of process
evaluation measures of program/plan activities (e.g., integrity
of programs and models); and 7) presence of state funding for
reducing tobacco use (Table 1).
As of December 31, 1989, 12 states (Colorado, Massachusetts,
Michigan, Minnesota, Nebraska, New Jersey, North Dakota, Oregon,
Pennsylvania, Utah, Vermont, and Virginia) had published plans
for tobacco-use prevention and control (Table 1). Minnesota
published the first plan in 1984, and five states (Colorado,
Michigan, New Jersey, Vermont, and Virginia) published their
plans during 1989. Alabama, Connecticut, Idaho, Illinois,
Indiana, and Rhode Island reported that smoking prevention was
included in their general plans for health service. Colorado,
North Dakota, and Utah have plans as part of the Rocky Mountain
Tobacco-Free Challenge, an eight-state effort to reduce the
prevalences of tobacco use and chronic diseases associated with
tobacco use (2).
All the state plans addressed the seven critical components of
planning as well as high-risk populations, health care, smoking
cessation issues, worksite policies, public education activities,
and school and adolescent program strategies. Nine of the 12
states with plans funded activities for tobacco-use prevention
and cessation. Workplans to implement listed objectives and
process measures were the most frequently omitted critical
elements.
Of the nine plans that included state-specific assessment of
tobacco-use behavior, six assessed adolescent smoking prevalence,
and eight assessed adult smoking prevalence (Table 2). Seven
states included an economic analysis, including tax data or other
economic issues. Four states included state legislation and
policies in their plans, and three included using state/local
resources for tobacco-use prevention and control.
Reported by: KM Marconi, PhD, JW Colborn, MS, National Cancer
Institute, National Institutes of Health. Program Svcs Activity,
Office on Smoking and Health, Center for Chronic Disease
Prevention and Health Promotion, CDC. Editorial Note
Editorial Note: Elements essential to the control of tobacco use
include comprehensive planning, evaluation, funding, and
community support. The ASTHO survey provides baseline information
for measuring progress in these areas during the 1990s. This
information will be particularly important in 1993, when the
National Cancer Institute and the American Cancer Society will
sponsor the American Stop Smoking Intervention Study (ASSIST)
(3). This multistate effort will provide funding, coordination,
training, and evaluation for tobacco-use prevention and control
in 20 geographic areas (which could include entire states or
large metropolitan areas) through 1998.
One indication of the growth in state-based tobacco-use-control
activities is the number of states that reported developing plans
to address this problem. Ten additional states (Arkansas,
Delaware, Maine, Missouri, New Mexico, Ohio, Rhode Island, Texas,
West Virginia, and Wisconsin) are expecting to publish plans.
Tobacco use is a public health problem that may be approached
at the state level through community involvement. A conference on
the Public Health Practice of Tobacco Prevention and Control on
March 8 and 9, 1990, in Houston will address these issues. This
conference will provide state-based tobacco-control specialists a
forum for information exchange and technical assistance on a wide
range of tobacco-control activities. These activities will direct
the national efforts toward a smoke-free society by the year
2000. Further information on the conference is available from
ASTHO at (703) 556-9222 or CDC at (770) 488-5701.
References
Association of State and Territorial Health Officials/National
Cancer Institute. Guide to public health practice: state health
agency tobacco prevention and control plans. McLean, Virginia:
Association of State and Territorial Health Officials, 1989.
CDC. State-based chronic disease control: the Rocky Mountain
Tobacco-Free Challenge. MMWR 1989;38:749-52.
CDC. Trends in lung cancer incidence--United States,
1973-1986. MMWR 1989;38:505-6, 511-3.
*Copies are available from the National Cancer Institute, 9000
Rockville Pike, Building 31, Room 10A24, Bethesda, MD 20892; or
the Technical Information Center, Office on Smoking and Health,
Center for Chronic Disease Prevention and Health Promotion, CDC,
5600 Fishers Lane, Park Building, Room 1-16, Rockville, MD 20857.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices. **Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.Page converted: 08/05/98
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