Progress in Chronic Disease Prevention State Coalitions for Prevention and Control of Tobacco Use

In October 1989, the Association of State and Territorial Health Officials (ASTHO) collected information on state* coalitions for prevention and control of tobacco use from all 50 states and the District of Columbia (1). State representatives for prevention and control of tobacco use submitted information describing their coalition's membership, history, funding, and activities. This report summarizes the basic characteristics and key activities of these coalitions.

As of December 31, 1989, 47 states had coalitions that addressed prevention and control of tobacco use. Hawaii, Kentucky, Mississippi, and South Carolina did not have state-level coalitions. Of the 47 coalitions, 44 concentrated exclusively on prevention and control of tobacco use; the remaining three also addressed other chronic diseases. In 1963, Colorado established the first state tobacco-related coalition; most (28) states established coalitions after 1984. Twenty coalitions reported receiving funding**, and 10 of these reported receiving in-kind state support for clerical and administrative needs (Table 1).

All coalitions included a representative from the state public health agency as well as other health professionals (e.g., physicians, nurses, health researchers, and/or hospital administrators). Coalition members represented volunteer, community, policy-relevant, and education groups. In some states, coalitions also included economists (Florida, Michigan, and Vermont), military officials (Alabama, Alaska, and Delaware), representatives from the tobacco industry (Maine), vendor organizations (Indiana and Vermont), youth groups (Maine, Massachusetts, Montana, New York, and Vermont), sports groups (Delaware, Michigan, and Vermont), and veterans groups (Alabama, Minnesota, and Vermont).

The most frequently reported coalition activities were 1) providing public education and information (34 states), 2) lobbying for antitobacco legislation (25 states), 3) educating health-care professionals (21 states), 4) developing and implementing a state plan for tobacco control (18 states), and 5) conducting research and evaluation (12 states) (Table 2). Other reported activities included promoting a Smoke-Free Class of 2000 (cosponsored by the American Lung Association, the American Heart Association, and the American Cancer Society (ACS)) (Illinois, Minnesota, and New Hampshire), advising the state health department (New York and Ohio), and anti tobacco advertising (Colorado). Reported by: State specialists for prevention and control of tobacco use. KM Marconi, PhD, Public Health Applications Br, National Cancer Institute; GC Bennett, MPH, Health Education Br, National Heart, Lung, and Blood 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: Direct community involvement is essential to achieve a smoke-free society by the year 2000. State coalitions for prevention and control of tobacco use bring together a broad range of persons and organizations to reach a common goal: reducing the prevalence of tobacco use. Coalitions can amplify state resources by involving community groups, volunteer organizations, advocacy groups, educators, and representatives of target populations. Leadership from physicians and other health officials is needed to ensure the success of community coalitions.

State coalitions for prevention and control of tobacco use should set specific, measurable objectives that enhance the strength and credibility of the coalitions' immediate plans, as well as maintain support for long-term public health efforts (2). Coalitions should provide direction for the development of state plans for prevention and control of tobacco use, enlist political and constituent support, ensure input from special target groups, and provide technical expertise in advising policymakers. These issues are discussed in more detail in the Guide to Public Health Practice: State Health Agency Tobacco Prevention and Control Plans (3).

The American Stop Smoking Intervention Study (ASSIST), sponsored by the ACS and the National Cancer Institute (NCI), National Institutes of Health (NIH), will provide additional funding to approximately 15 states or large municipalities to support coalition initiatives for prevention and control of tobacco use (1). Agencies working through a national network of state public health professionals to increase public health efforts to prevent and control tobacco use at the state level include ASTHO; CDC's Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion; and NCI and the National Heart, Lung, and Blood Institute (NHLBI), NIH (4).

Additional information on developing tobacco-related coalitions is available in With Every Beat of Your Heart, published by NHLBI (5), and Smoke Fighting: A Smoking Control Movement Building Guide, published by ACS (2).

References

1. CDC. State tobacco-use prevention and control plans. MMWR 1990;39:133-6.

2. American Cancer Society. Smoke fighting: a smoking control movement building guide. Washington, DC: Advocacy Institute, 1987.

3. 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.

4. Silver J. Network development. In: Proceedings of the ASTHO Conference on the Public Health Practice of Tobacco Prevention and Control. Rockville, Maryland: US Department of Health and Human Services, Public Health Service, CDC, 1990.

5. National Heart, Lung, and Blood Institute. With every beat of your heart. Bethesda, Maryland: US Department of Health and Human Services, Public Health Service, National Institutes of Health, 1989; DHHS publication no. (NIH)89-2641. *For purposes of this report, the District of Columbia is counted as a state. **Includes grants, donations, membership fees, and funds from state and other governmental sources.

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