|
|
|
Comprehensive Programs
Fact Sheet
RATIONALE FOR COMPREHENSIVE INTERVENTIONS
- 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:4
- 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;
and
- surveillance
and
evaluation,
which
includes
monitoring
the
tobacco
industry’s
promotional
campaigns,
evaluating
the
economic
impact
of
ETS
laws
and
policies,
con-ducting
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
non-smoking
becomes
the
norm
within
diverse
communities.
To be effective, comprehensive programs should include campaigns that:
- 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
non-preachy
voices
in
a
complementary,
reinforcing
mix
of
media
and
outdoor
advertising;
- include
grassroots
promotions,
local
media
advocacy,
event
sponsorships,
and
other
community
tie-ins;
and
- encourage
youth
empowerment
and
involvement.
|
|
