Advancing Tobacco Control Through Evidence-Based Programs

National Leadership

• Surveys

• Research

• Programs
  
  

Reducing rates of tobacco use requires a partnership between the federal government and states. Several federal agencies have conducted studies whose results can provide a foundation for state action, including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Agency for Health Care Policy and Research (AHCPR). These and other federal entities have produced and disseminated important information about the extent of tobacco use, the impact of tobacco use, and the effectiveness of various interventions to reduce tobacco use.

Surveys
Federally supported surveys of tobacco use include the Behavioral Risk Factor Survey, the National Health Interview Survey, the Youth Risk Behavior Survey, and the Youth Tobacco Survey conducted through CDC; the tobacco use supplement to the current population survey being conducted by the Bureau of Census, with support from NIH and CDC; the Monitoring the Future Study conducted through NIH; and the National Household Survey on Drug Abuse conducted through SAMHSA.

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Research
The federal government also has sponsored research on the health impact of tobacco use, the determinants of tobacco use, and interventions to reduce tobacco use. Most of this research has been supported by NIH's National Cancer Institute (NCI); however, research into tobacco use has also been supported by other federal entities, including the National Institute on Drug Abuse, the National Institute of Child Health and Development, and the National Heart, Lung, and Blood Institute. Besides supporting disease-specific research, NCI has supported smoking-prevention and smoking-cessation intervention studies, including mass media and school trials and large-scale demonstration projects such as COMMIT and ASSIST. CDC also supports applied research through its Prevention Research Centers; this research focuses on identifying population segments disproportionately affected by tobacco use and on reducing or eliminating these disparities.

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Programs
In addition to providing research and survey data that can help states design and implement tobacco control programs, various federal entities also directly support state programs. For example, SAMHSA implements the Synar regulation to reduce youth access to tobacco products through state-level compliance activities; AHCPR has published clinical practice guidelines on smoking cessation and has worked with a variety of health care organizations to ensure that the guidelines are implemented; and CDC supports several programs to prevent and reduce tobacco use, including the National Tobacco Control Program, which in FY 1999 funded efforts in all states and territories and the District of Columbia to establish core tobacco use prevention and reduction programs. CDC has also developed several educational and media programs that can be used in tobacco control efforts, including the Media Campaign Resource Center, which makes high-quality antismoking advertising materials available for use by states and organizations.

Private organizations are also playing an increasing role in tobacco control. The Robert Wood Johnson Foundation/American Medical Association's SmokeLess States program, for example, directly funds policy-focused interventions and approaches by private, nonprofit organizations. The American Legacy Foundation, an independent national public health foundation, is another important source of funding for state tobacco control programs. Created by the 1998 Master Settlement Agreement between participating states and the tobacco industry, the foundation aims to reduce rates of tobacco use and ETS exposure, reduce disparities in access to prevention and cessation services, and increase smoking-cessation rates. Although numerous national organizations have undertaken critical activities to curb tobacco use, the success of tobacco control interventions will ultimately depend on the state and local agencies that devise and implement them.

Following is a list of some of the national organizations that can aid in state and local tobacco control efforts:

Action on Smoking and Health: www.ash.org

Advocacy Institute: www.advocacy.org

American Cancer Society: www.cancer.org

Americans for Nonsmokers' Rights: www.no-smoke.org

American Heart Association: www.americanheart.org

American Legacy Foundation: www.americanlegacy.org

American Lung Association: www.lungusa.org

Agency for Healthcare Research and Quality: www.ahrq.gov

Campaign for Tobacco-Free Kids: www.tobaccofreekids.org

Environmental Protection Agency: www.epa.gov

National Cancer Institute: www.nci.nih.gov

CDC: www.cdc.gov/tobacco

Robert Wood Johnson Foundation/American Medical Association SmokeLess States program: www.ama-assn.org/ama/
pub/category/3230.html

Substance Abuse and Mental Health Services Administration: www.samhsa.gov

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