The influx of tobacco settlement money has generated unprecedented potential to address the public health problem of tobacco use.1 In states such as California, Massachusetts, and Florida, where resources have been allocated to tobacco control efforts, much has been achieved.2 Yet a recent survey of state legislatures found that less than 10% of settlement funds are designated for smoking prevention.3 With this level of funding, existing blueprints for comprehensive tobacco control, such as the Centers for Disease Control and Prevention's (CDC's) “best practices,” are beyond the reach of most states.4
The CDC, through the Louisiana Office of Public Health, funds the Louisiana Tobacco Control Program's Research and Evaluation Center (LTCP-REC). LTCP-REC's purpose is to provide resources to the general public, health care providers, educators, and state-funded tobacco initiatives; identify and distribute educational materials; offer technical assistance in design, implementation, and evaluation of community-based tobacco control programs; provide tobacco use prevention and cessation information and referrals via telephone and community outreach; assist with media campaigns; and provide information on model policies and state legislation.
LTCP-REC's operating budget for 1998–1999 was approximately $42 000 in direct costs, not including personnel. When resources are scarce and objectives are broad, opportunities are created through partnerships. For example, LTCP-REC initiated a pilot program in New Orleans public schools using the American Lung Association's “Teens Against Tobacco Use,” a school-based smoking prevention program led by teenagers. Twenty-one youths were trained to deliver 4 presentations to elementary school children assigned to in-school suspension for disciplinary reasons.5 This program was expanded, with American Lung Association sponsorship, in spring 2001. After a review of publications revealed a need for prevention materials for young adult African Americans, LTCP-REC conducted focus groups in collaboration with the Center for Substance Abuse Prevention to identify and develop anti-tobacco messages for African Americans aged 18 to 24 years.6
Strategic planning provides maximum flexibility and responsiveness. LTCP-REC began providing tobacco control education before all the resources were in place:
The first educational presentation was held on August 29, 1998; 72 presentations had been made by July 2000. The experience provided immediate feedback about priorities, needs, and current challenges.
LTCP-REC's newsletter, first published in May 1999, has grown from an initial distribution of 400 to 1277 (1000 posted, 277 e-mailed) by July 2000. It includes sections on local initiatives, national news, legislative updates, and statistical information.
Surveys and focus groups of providers and smokers were conducted to assess cessation services in Louisiana.7 Expansion was achieved by implementing small projects on multiple fronts.
Development of a tobacco control resource center requires networking, identification of communication channels, and management of educational materials (Table 1 ▶). Early progress indicators for LTCP-REC show positive feedback from clients, partners, and mailing list recipients; increasing recognition of LTCP-REC; growth in the number and extent of outreach and evaluation activities; and wider distribution of materials.
TABLE 1.
—Strategies to Develop a Tobacco Control Resource Center
| Activity | Description | Example |
| Networking | Sharing information, facilitating service provision, and working collaboratively with strategically positioned individuals, institutions, and organizations (state and national) | Hosted a conference covering the rationale for and barriers to tobacco control, implementation of control strategies, and treatment of nicotine addiction, attended by 58 individuals from a variety of disciplines and institutions; proceedings from the conference were summarized and distributed to participants, policymakers, and service agencies |
| Use of communication channels | Disseminating educational messages and materials (oral, written, electronic, and audiovisual) to groups of people and receiving their input and feedback | Allowed direct access for interested residents and enhanced customer responsiveness via a toll-free number (1–877-KICK-NIC) and Web site (http://www.lsuhsc.edu/centers/cancer/tobacco) |
| Management of educational materials | Evaluating suitability of materials and monitoring their use; stocking, purchasing, distributing, lending, and compiling materials into packets | Used a database to monitor available materials and their acquisition and distribution; standardized content analysis of tobacco control materials has informed purchasing and distribution decisions.8 |
Acknowledgments
Funding is provided by the Centers for Disease Control through the Louisiana Office of Public Health.
The authors would like to acknowledge the following individuals who have contributed to the development and implementation of the LTCP-REC activities described in this article: Diane Hargrove-Roberson, Josie White, Shawn Williams, and Betty Jo Lovell.
All authors contributed to the conceptualization of the project, the compilation of lessons learned, and revision of the article. The team was led by S. M. Thomas. E. B. Schuler-Adair coordinated the project. S. Cunningham, M. Celestin, and C. Brown identified activities and extracted data.
Peer Reviewed
References
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