“It’s tempting to go it alone when leading a change initiative. There’s no one to dilute your ideas or share the glory, and it’s often just plain exciting. It’s also foolish.” “A Survival Guide for Leaders” by Ronald A. Heifetz and Marty Linsky TABLE OF CONTENTS Welcome Hear the voices Paving the way A mile-marker in clean indoor air . . . Reflections—past and present Get the facts from ttac! Back by popular demand! A resource year in review Just out this month! Coming soon! Resources and links Special thanks ttac exchange staff

Remarkable . . . there’s just no other word for it. This past year has been another mile-marker for tobacco control, with tremendous strides and fantastic disappointments. It hasn’t been easy—it never is and probably never will be. But I think it’s meant to be that way—keeping us on our toes and able to recognize and taste the rich desserts of success.

We are on the cusp of a major period of change in tobacco control, and we need to be ready to bring it on. The last decade and a half has taught us well, but I believe it’s time to move forward. I’m not suggesting that we abandon the successes or how and why we achieved them. What I am suggesting is that tobacco control needs to change it up a bit.

Real and sustainable change requires skill in management and conflict; it requires strength and resilience; it requires shared leadership and empowerment. Let’s make tobacco control part of the everyday lexicon. Let’s look forward to the opportunities and challenges that lie ahead. Let’s move beyond just looking for the right answers and make sure we are asking the right questions. Let’s keep it fresh.

At this critical time let’s take what we know and what we have built to make another big push to achieve real and sustainable change in tobacco control.

Dearell Niemeyer, MPH
Director, Tobacco Technical Assistance Consortium

 

• Asian Americans and Pacific Islanders
• African Americans
• Our local partners

Asian American and Pacific Islanders
ttac asked Rod Lew, of the Asian Pacific Partners for Empowerment and Leadership (APPEAL) what he thinks Asian American and Pacific Islander communities will be facing, in tobacco control this year.

Top three challenges facing Asian Americans and Pacific Islanders in tobacco control
 
From your organization's perspective, what are the top three challenges you will be facing, in tobacco control this year?

1. The first is how to sustain tobacco control in the Asian American and Pacific Islander communities over the next several years. APPEAL’s capacity building efforts on tobacco control have begun to take root in our communities and finding additional resources, advocates and leadership will be critical in this next period.
    
2. Next is the addressing of health (and particularly tobacco-related) disparities. The public health community and many federal health agencies have been talking about disparities for several years and I think we’ve created some momentum about the issue of parity. But the real test will be whether we will actually see changes, and I mean systemic changes, as it relates to eliminating disparities and advancing parity in tobacco control. We will be looking to mainstream tobacco control groups, on both the national, state and local levels, to implement recommendations on parity in their initiatives and organizations.
    
3. The global impact of tobacco is something that we, as American tobacco control advocates, need to pay more attention to. The numbers of those impacted by tobacco in Asia, Latin America, Africa and others continue to rise—it’s no coincidence that the tobacco industry (including Philip Morris, BAT, and Japan Tobacco) has expanded their efforts in these parts of the world. The next couple of years will be also critical as countries begin the process to try to ratify the Framework Convention on Tobacco Control. APPEAL has partnered with non-governmental organizations in Asia and the Pacific, but there is very little money available for transnational tobacco control work.

APPEAL’s focus
 
Has the focus of your organization’s work in tobacco control shifted in recent years?

For the most part, APPEAL has continued our comprehensive capacity building, advocacy and leadership development efforts but are expanding our reach into newer AAPI communities across the country and the Pacific. While, advancing parity in the tobacco control movement continues to be important, we will be building and revitalizing our AAPI community support and advocacy/leadership on tobacco control. For example, APPEAL has begun partnering with national AAPI organizations, like Japanese American Citizens’ League (JACL), that have not traditionally done health work. JACL made a historic decision by refusing tobacco industry monies, so we are working together to address common. Additionally, we will be supporting social justice work on tobacco by grassroots and local AAPI community organizations.

A “don’t miss” for 2004

Our focus in 2004 is on leadership. To this end, APPEAL will be holding its 10th Anniversary National Leadership Summit and convening several other leadership programs to provide support in launching the next generation of tobacco control leadership in the AAPI community. For more information on the Summit, visit APPEAL at: http://www.appealforcommunities.org/index2.php

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African Americans
Read on for what Sherri Watson Hyde, Executive Director of the National African American Tobacco Prevention Network (NAATPN) sees as hot button issues for African Americans in tobacco control this year.

Top three challenges facing African Americans in tobacco control
 
From your organization's perspective, what are the top three challenges you will be facing, in tobacco control in 2004?

• Making our message about tobacco use prevention a vital component in the African American community
• Getting African American youth and young adults (college age) to understand and accept the dangers of tobacco use
• Tackling the multitudes of new tobacco marketing strategies emerging in the African American community.

NAATPN moves with the times
 
Has the focus of your organization's work in tobacco control shifted in recent years?

Yes, NAATPN not only seeks to address tobacco use by demographic (age, gender), and community interest (youth trends, or faith interests in community), but also holistically as a part of improving the overall health and wellness of all African Americans.

Specifically:

• we are launching a national media campaign (involving 4 nationally known celebrities) to deliver the message of dangers of tobacco use to millions of African Americans;
• we’ll be hosting 8 regional networking forums to provide the community direct access to expertise and resources that may help address growing tobacco use and other health concerns;
• we’re developing numerous online resources that will be available to provide additional information and support to those seeking to learn more about tobacco control and tobacco use prevention; and
• we’ll be launching a national leadership development institute to help train others in tobacco control and tobacco use prevention…and much more.

What NAATPN can’t do without in 2004
 
What are the resources NAATPN can't do without in 2004?

• Ongoing Community Communication/Networking/Outreach Resources—Black media (newspaper/radio/magazines), strong community entities (churches, community businesses, community organizations) will continue to be NAATPN’s mainstay for tapping into the community…we would not be effective without strong linkages to such entities.
   
• NAATPN membership—they are the key to helping us to learn and address holistically all of the needs (including tobacco control) of the African American community…we have over 350 members and look forward to expanding that in 2004.
   
• NAATPN Staff and Resources—we are finding that the needs are vast. It will take the ‘village’ to carry our message and institute the health and wellness changes we seek. We currently have three regional coordinators working across the United States and a national organizer assisting us with another of our key campaigns and helping us to forge relationships with other organizations with similar interests.

For more information on NAATPN, visit them at http://www.naatpn.org or call toll free 1-800-4NAATPN.

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Our local partners
ttac asked our partners at the local level to share their thoughts on the key challenges and resources for 2004.

Here’s an overview of what we heard . . .

Funding, funding, funding—Getting and maintaining adequate funding is a theme that echoed throughout ttac’s interviews with local partners. Whether for entire programs or the enhancement and implementation of services or activities, funding (including shortages in partner organizations) is at the top of the list of challenges and priorities in 2004.

Check out Fighting Back on Budget Cuts developed by the Praxis Project. This toolkit features how-to information on budget research and analysis, understanding state and local budget processes, developing an alternative budget, media messaging, organizing and more.

Priority populations—Issues which impact priority populations resonated with our local partners. We heard of the ongoing need for culturally appropriate intervention curricula, language specific materials, and strategies for outreach to priority communities. And a need for clarity and consensus on what the tobacco control community means by ‘diversity’ and ‘inclusivity’ and concrete strategies that they can use to make a difference.

See The Praxis Project Web site for links to organizations, fact sheets, and tools to support work with many priority populations. Also check out The Praxis News and Notes newsletter.

Keeping it going—Our local partners recognize the ongoing challenge in tobacco control to keep the ideas fresh, the interest up, and the creative juices flowing . . . for the sake of programs and staff. We heard from nearly each interviewee that funding aside, the one resource they simply can’t live without is staff.

For ideas on staff revitalization and teambuilding, see The Nonprofit Good Practice Guide. This Web site includes a compilation of links to articles, books, videos, and other resources on Staff Development and Organizational Capacity.

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ttac visited with DeKalb County Georgia, and the State of Mississippi to talk about significant accomplishments they achieved this past year.

• DeKalb County, Georgia amended and strengthened a 1992 no-smoking ordinance to ban smoking inside all public buildings.
• Mississippi is a national leader in protecting kids from tobacco.

DeKalb County, Georgia
In December 2002, County Commissioners, amended and strengthened a 1992 no-smoking ordinance to ban smoking inside all public buildings of unincorporated DeKalb County, Georgia—including restaurants and day-care in private residences. This was the first county-wide policy in Georgia, to ban smoking in public places.

ttac spoke with Kathleen Collomb, Coordinator of the Tobacco Use Prevention Unit, DeKalb County Board of Health, about the Prevention Alliance for Tobacco Control and Health (PATCH), a community coalition formed to address tobacco use prevention and cessation in DeKalb County, Georgia. PATCH spear-headed the successful effort to amend and strengthen the DeKalb Clean Indoor Air Ordinance.

The golden key of success—Investing extensive time and effort into building a coalition and solidifying relationships.

“Our coalition and committee meetings were based on a model of listening and dialogue—using Paulo Freire’s method of creating critical consciousness—as well as education, empowerment, commitment and engagement.

• Coalition members were educated on the effects of secondhand smoke and the benefits of clean indoor air.
• Exercises were designed for members to practice point/counterpoint arguments and talking points.
• Coalition members were afforded multiple opportunities for participation—not all members can attend monthly meetings, but all members can contribute something based on their time and resources.”

Sage advice—Focus on understanding human relationships and thinking politically and strategically.

“Give yourself lots of time to build your coalition and really hone in on understanding the dynamics of human relationships and interactions. Grassroots organizing is not rocket science, but it does require careful and consistent nurturing.

Think politically and strategically from the beginning. When we first formed our coalition, we knew our ultimate objective: To pass a strengthened clean indoor air ordinance for DeKalb County. We kept our eyes on the prize and then mapped out our course to claim it.”

Gaining ground using data—Be science savvy . . . use data wisely.

“In April 2002, an independent tobacco and secondhand smoke opinion poll of 400 DeKalb County registered voters was conducted. This poll indicated that the majority of DeKalb voters supported banning smoking in the workplace and public buildings (including restaurants). We strategically withheld the results of this poll until it was politically advantageous to us—in our case, just prior to the commissioners’ vote. Data can be a very powerful tool, but it is important to know when and how it should be used.”

Resources DeKalb County, Georgia couldn’t do without . . .

• Americans for Nonsmokers Rights Foundation (ANR) Web site for clean indoor air ordinance and secondhand smoke information.
• The Community Toolbox at the University of Kansas assisted us in building our coalition and mobilizing our community.

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Mississippi
Mississippi is a national leader in protecting kids from tobacco. It has reduced smoking rates by nearly one-half among public middle school students, and nearly one-third among public high school students, through its comprehensive youth tobacco prevention program.

ttac spoke with Sharon Garrison, Public Relations Manager of The Partnership for a Healthy Mississippi, to gain insight into what makes this program tick.

The golden keys to success—Adequate funding, community involvement, and youth ownership.

“We are fortunate—we have committed funding to the program. Beyond funding, however, we enjoy broad community support and involvement from nearly every sector. This support helps maintain program stability and keep funding secure. But perhaps most importantly, our program has been successful because our youth have taken ownership of the program. They are very involved in the development of the program, make key decisions, and lead the way in many initiatives. We would simply not have the success we have had without the input and participation of our youth.”

Words of wisdom for those striving to reduce youth smoking—Involve youth and non-traditional groups from the start.

“Without their input, the program would fall flat. The success of the program is embedded in the creatvity and innovation of our youth and the buy-in from the broader community.”

A set of challenges—Keep it real.

“The success of the program brings its own unique challenges. As smoking rates decline among our youth, we are challenged with

• projecting where our rates will plateau;
• keeping our programs fresh and interesting;
• finding ways to keep tobacco relevant so that it stays high on competing agendas; and
• fighting funding complacency, to protect what we have.”

A resource Mississippi can’t do without . . .
“The obvious answer is our people. Beyond resources in Mississippi, we find the Campaign for Tobacco Free Kids indespensible to our work. Their Web site is well-organized and their fact sheets and talking points are excellent. We would have a much more difficult time doing our work, without their great work.”

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This year, we celebrate the 30th Anniversary of the beginning of the nonsmokers’ rights movement and the 10th Anniversary of California’s Smokefree Workplace Law. Cynthia Hallett, of Americans for Nonsmokers' Rights, gave ttac permission to pull key excerpts from a prepared presentation, for this article.

The beginning of a movement
In the mid 1970s, the clean indoor air movement emerged, with:

• local citizens bonding together to reduce exposure to cigarette smoke in 1974,
• local citizens working with the Berkeley City Council to introduce a local ordinance in 1976, and
• the passage of the first local ordinance in 1977 creating nonsmoking sections in restaurants.

A little history about trends
Local ordinances emerged in the United States in a particular geographic pattern, with ordinances appearing first in the West and then the East Coast (CA, MA, OR, New England states). The next wave of ordinances emerged in the middle of the states, in localities in West Virginia, Colorado, Montana and Texas, and we see the trend for current activity to be in the South East, in places like Fayetteville (AR), Lexington (KY), Jackson (MS), and Gwinnett County (GA).

Clean air successes have generally begun with the passage of ordinances at the local level, progressing over time to state laws. The benefits of the ‘local to state’ progression are that it:

• makes it easier to mobilize public support;
• provides for more comprehensive and stronger protections from secondhand smoke;
• offers more accessible and accountable enforcement mechanisms; and
• involves public education and grassroots organizing—leading to changes in attitudes and social norms.

Although one benefit of a state law is to cover most of the population at once, you do run the risk of passing a preemptive state law that would take away the rights of local governments to issue stronger laws.

Science of secondhand smoke
In 1986 Surgeon General’s Report, “The Health Consequences of Involuntary Smoking,” changed the argument and focus of the movement.

• For every eight smokers the tobacco industry kills, it takes one nonsmoker with them. Source: (Glantz, S.A. & Parmley, W., "Passive Smoking and Heart Disease: Epidemiology, Physiology, and Biochemistry," Circulation, 1991; 83(1): 1-12; and, Taylor, A., Johnson, D. & Kazemi, H., "Environmental Tobacco Smoke and Cardiovascular Disease," Circulation, 1992; 86: 699-702)
   
• Even a half hour of secondhand smoke exposure causes heart damage similar to that of habitual smokers. Source: (Otsuka, R., et al. "Acute Effects of Passive Smoking on the Coronary Circulation in Healthy Young Adults," Journal of the American Medical Association, 286: 436-441, 2001)
   
• Just 30 minutes of exposure activates blood platelets (resulting in “sticky blood”) which leads to heart attacks. Source: (Burghuber, O., et al. "Platelet sensitivity to prostacyclin in smokers and non-smokers," Chest, 90: 34-38, 1986.)

The benefits of ‘smokefree’
The are a number of benefits to smokefree policies. Clean indoor are policies not only reduce exposure to secondhand smoke, but they reduce tobacco consumption as well.

• Ordinances with strong workplace smoking restrictions significantly reduce workers’ reported exposure to secondhand smoke. Source: (Pierce, J.P.; Shanks, T.G.; Pertschuk, M.; Gilpin, E.; Shopland, D.; Johnson, M.; Bal, D., "Do smoking ordinances protect non-smokers from environmental tobacco smoke at work?," Tobacco Control 3: 15-20, 1994.
   
• A study of San Francisco bar employees found improvements in their lung function following implementation of California’s smokefree bar law. Source: (Eisner, M.D.; Smith, A.K.; Blanc, P.D., "Bartenders' respiratory health after establishment of smoke-free bars and taverns," Journal of the American Medical Association 280(22): 1909-1914, December 9, 1998.)
   
• Smokers in smokefree workplaces have lower consumption rates than smokers in workplaces without smoking restrictions. Source: (National Cancer Institute (NCI), "State and local legislative action to reduce tobacco use. Smoking and Tobacco Control Monograph 11," Bethesda, MD: U.S. Department of Health and Human Services (DHHS), National Institutes of Health, National Cancer Institute (NCI), August 2000.

What does the future hold?

• Although 30 percent of the U.S. population protected, 70% are still exposed
• People of color are disproportionately exposed
• More local ordinances, followed by comprehensive state laws
• Ongoing attacks from tobacco companies
• More nonsmokers protected from exposure to secondhand smoke!

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ttac asked Greg Connolly, DMD, MPH, Harvard School of Public Health, and Scientific Advisor, Massachusetts Department of Public Health, for his thoughts on the tobacco control of yesterday and tomorrow.

“The 40th anniversary of the first Surgeon General’s Report on Smoking and Health . . . so much has happened since its release in January of 1963.

• The release was marked with news stories that predicted the demise of the tobacco industry, but over the next few decades the industry adapted to the changing environment and thrived. Unfortunately, little progress was made in translating the findings of the report into programs and policies at the national, state or local level over until the 1990’s.
   
• During the 1990s the public health community seized the agenda and through public and private lawsuits, tax referenda in California, Massachusetts and others states and aggressive local advocacy for clean air, the tobacco industry was sent reeling.
   
• Ten years ago the first national conference on tobacco and health was attended by 300 people and opened in a Boston auditorium filled with the stale smell of smoke from the night before. This year its tenth anniversary was held in a smokefree Boston (bars included), and 3,000 people gave the mayor of the City a standing ovation for his leadership on clean air.

Although many states have cut their programs this past year, over a half of billion dollars is still being spent at the state and local level for tobacco control. No one would have dreamed in the 60’s that such resources would come.

Yet, this year brings old and new challenges . . .

• The biggest is maintaining and even restoring funding from the Master Settlement Agreement payments to the states to ensure that the reason why the states sued is fulfilled. Alternatively, learning to live with fewer resources that are spent smarter is a priority.
   
• New threats are with us. The tobacco companies have introduced a plethora of new “safer” tobacco products not in Washington, D.C. but in Dallas, the Midwest and Indianapolis. In the absence of FDA legislation state health departments and attorney generals must join together to prevent smokers from being misled to think that these products are any safer than their “Light” predecessors.
   
• Great progress has been made on clean indoor air in some states but the entire nation must ensure clean air for its citizens. Those states that have passed laws should evaluate their benefit to worker health and business in the hospitality industry.
   
• In the absence of FDA regulation of tobacco products states should join together and pass new legislation would regulate tobacco products as drugs and mandate truly safer products within a specified time.

It’s been forty years since the first Surgeon General’s Report. Little progress was made during the first thirty, but in the last decade we accomplished much. In this decade we need to accomplish even more and make smoking history.

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• Link here to learn about the United Communities Against Tobacco Abuse (UCATA) and their model for advocacy.
   
• Link here to view Making Clean Indoor Air a Reality: Post Legislation Enactment Preparation Checklist

In case you missed them, here they are again . . .
So many terrific resources were produced by and for the tobacco control community in 2003. ttac exchange has decided to lift up a few of them, in case you missed them the first time around.

Click on any of these topics to learn about some of the 2003 practical resources developed by tobacco control national partners and organizations:

• Cessation
• Counter-marketing/Media
• Policy
• Priority populations
• Training
• Youth prevention

Cessation

Employers’ Smoking Cessation Guide: Practical Approaches to a Costly Workplace Problem
This new guide helps employers enact affordable, effective smoking cessation programs in their companies.

Pathways to Freedom: Winning the Fight Against Tobacco
CDC’s Office on Smoking and Health released an update to its well-known guide promoting tobacco cessation. The booklet addresses issues specific to African Americans such as targeted advertising campaigns and historical, cultural, and socioeconomic influences.

Smokefree.gov
The National Cancer Institute launched a new web site to promote smoking cessation developed from evidence-based research. The site provides a variety of media to help smokers quit, offers cessation materials for special populations, and is free of commercial sponsorship.

The Next Generation California Tobacco Control Alliance (NGA): Online Cessation Center
NGA launched a new web site designed to assist health care professionals in delivering smoking cessation services to their patients. The site offers one-stop-shopping access to a variety of resources and materials that are useful in practitioners’ day-to-day practice, including the new guide, Health Care Provider’s Tool Kit for Delivering Smoking Cessation Services.

Countermarketing/Media

Designing and Implementing an Effective Tobacco Counter-Marketing Program
CDC developed this manual to help state tobacco control programs develop tobacco counter-marketing campaigns. The manual outlines the process for developing and implementing a successful program and includes lessons learned from successful campaigns.

Making Health Communication Programs Work--Updated
The National Cancer Institute updated its 1989 guide for developing health communication programs (the "pink book"). The Pink Book emphasizes a practical approach, with the understanding that one communications plan does not fit all and each plan should be tailored to the individual needs and size of an organization.

Policy

Protect Local Control
Americans for Nonsmokers' Rights launched this new web site to help smokefree advocates and policymakers protect the right to pass local smokefree policies and/or to counter tobacco industry-influenced state legislation that restricts local authority to pass smokefree laws.

Smoke-Free Laws: Implementation, Enforcement and Compliance
This list compiled for a Smokeless State Initiative includes resources to help draft strong smokefree law enforcement provisions, develop an evaluation plan, establish enforcement protocols, and conduct an information and education campaign. It also includes sample implementation materials from California, Delaware, and New York.

Strategic Thinking on State Tobacco Tax Increases
This document, developed by the SmokeLess States initiative, is designed to assist public health advocates in recognizing and weighing the strategic decisions that must be made before beginning a campaign to increase tobacco taxes at the state level.

Taking Action against Secondhand Smoke: An Online Toolkit
CDC’s Office on Smoking and Health released this online toolkit on secondhand smoke in public places, workplaces, and in the home. The toolkit focuses on health effects of secondhand smoke, coalition building, community assessment and material development.

Priority populations

College Tobacco Prevention Resource
This new TTAC Web site provides practical information, ideas, and guidance to college leaders involved with tobacco prevention to assist with the creation of effective campus tobacco policies and programs. The site includes strategies for comprehensive college tobacco prevention, recommended steps for taking action on campus, case studies, and more.

Pathways to Freedom: Winning the Fight Against Tobacco
CDC’s Office on Smoking and Health released an update to its well-known guide promoting tobacco cessation. The booklet addresses issues specific to African Americans such as targeted advertising campaigns and historical, cultural, and socioeconomic influences.

Praxis News and Notes
The Praxis Project launched its newsletter on health justice. Available on its web site.

The National Partnership to Help Pregnant Smokers Quit
This new site includes information and resources to help pregnant smokers quit. Material is provided for healthcare providers, pregnant smokers, and policymakers on a range of cessation issues including state quitlines, policy, and legislation.

Training

Basics of Tobacco Control – Pathways to Change
ttac released this training resource designed to provide easily accessible information, advice, strategies, and tools for developing, implementing, and sustaining effective tobacco control programs. The free resource can be accessed via CD-ROM or online on the ttac Web site.

Youth prevention

“Got A Minute” Social Marketing Kit
CDC launched this new social marketing campaign to help less-involved parents become more involved with their pre-teens, a behavior that appears to act as a protective factor against the lure of tobacco. The campaign’s kit on CD-ROM, which is available at no cost, includes prototype materials such as print ads, radio spots, a presentation, and a brochure.

Streetheory
The American Legacy Foundation launched this new web site for youth tobacco control advocates. Developed by and for youth, Streetheory brings it all together to help youth put knowledge into action.

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• Prevalence of Cigarette Use Among 14 Racial/Ethnic Populations--- United States, 1999--2001
  This MMWR reports data collected from the National Survey on Drug Use & Health (NSDUH) conducted in 1999, 2000, and 2001 to provide a first-ever snapshot of national smoking prevalence data among 14 ethnic/racial groups in the United States.
   
• State Medicaid Coverage for Tobacco-Dependence Treatments--- United States, 1994--2002
  This MMWR indicates that while the number of state Medicaid programs offering any form of tobacco-dependence treatments increased from 2001 to 2002, comprehensive coverage for recommended treatments remains low.
   
• State of Tobacco Control: 2003 Report Card
  The American Lung Association report card shows many states are failing to protect the public with proven tobacco policies.
   
• Tobacco Control in the Wake of the 1998 Master Settlement Agreement
  This New England Journal of Medicine special report finds that the Master Settlement Agreement has actually motivated states to ensure a profitable tobacco industry.

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New Interactive Learning modules on the ttac Web site
Over the past 10 months, ttac has been collaborating with researchers at The Cooper Institute’s, Center for Health Communication in Golden, Colorado, to produce a set of online learning modules for community tobacco control staff and volunteers. These learning modules have been extracted from the Colorado Tobacco Control Partners Web site and edited for national use.

Beginning February, 2004, the interactive modules will be available on these important topics:

• Tobacco Basics
• Build a Coalition
• Policy Advocacy
• Media Advocacy

Look for these topics to be added soon:

• Planning and Evaluation
• Eliminating Disparities

Logon on to ttac’s Web site at http://www.ttac.org in February and pass the word about this invaluable resource!

Reaching Higher Ground: A guide for preventing, preparing for, and transforming conflict for tobacco control coalitions
Well-intentioned tobacco control advocates often find themselves struggling with difficult and contentious issues. Too often our efforts to work in coalitions and partnerships seem like a waste of time, or worse, become destructive and painful.

It doesn’t have to be this way. This Guide provides practical advice for working in coalitions and partnerships that resolve real problems, while strengthening relationships. The tools and strategies described in this book can make any collaborative undertaking more successful, by approaching problems and people in ways that impart dignity and respect. It is possible to grow in community, through conflict, by engaging one another in ways that reach not only common ground, but higher ground.

The Guide will be distributed electronically and soon will be available on the ttac Web site: http://www.ttac.org. For more information: ttac@sph.emory.edu.

The Power of Proof: An Evaluation Primer
How well does your program actually help to reduce tobacco use? How can health professionals, funding sources, and those who benefit directly from the program’s accomplishments recognize the hard won successes? The answer to these and other questions is simple . . . demonstrate your program’s effectiveness through evaluation.
ttac produced The Power of Proof, a nine part series of online educational tools, to help tobacco control professionals demonstrate the success of their programs through evaluation. This series is designed to give those new to evaluation, and those wanting to brush up on their skills, access to a collection of introductory information, tools, and resources from experts in the field.

Beginning with the release of Part 1: Setting the Stage in February 2004, this series will soon be available on the ttac Web site http://www.ttac.org, and through electronic distribution. For more information, please contact ttac at: ttac@sph.emory.edu.

Medicaid and Cessation Resource
The National Partnership to Help Pregnant Smokers Quit and the Center for Tobacco Cessation are finalizing a collaborative package describing the health and health care cost savings if all state Medicaid beneficiaries who use tobacco are provided coverage for tobacco treatment.

Based on overwhelming clinical evidence, all Medicaid beneficiaries who smoke can benefit from the coverage of tobacco cessation counseling and drugs, in both fee-for-service and managed care programs. The package provides materials addressing issues of critical importance to the Medicaid program, including the health and economic costs and benefits of coverage, snapshots of states activities, a special section on pregnancy and cessation, and links to additional information.

These materials will be initially aimed at State Medicaid Directors and other State Health Agency Officials in order to work toward ensuring all Medicaid beneficiaries have access to evidence-based, cost-saving tobacco cessation treatments. The packages are expected to be mailed at the end of February 2004, and will be available online.

For more information, contact Sara Hutchinson at the Center for Tobacco Cessation at Sara.Hutchinson@cancer.org.

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• Year End Reviews for 2003
• Essentials for 2004
    - Tobacco Control Policy and Advocacy
    - Funding and Sustaining Programs
    - Community Organizing/Coalition Building
    - Priority Populations
    - Tobacco Data Sources
    - Tobacco Control Journals
    - Newsletters and Listservs

Year end reviews for 2003

Number of Ordinances with 100% Smokefree Workplaces, Restaurants, and Bars: Enactment by Year
See this Americans for Non-Smokers Rights’ fact sheet, to find out which communities enacted 100% smokefree ordinances in 2003.

State of Tobacco Control 2003
The American Lung Association’s (ALA) report card provides an overview of state legislative activity through January 1, 2004. Included are tobacco control laws in the areas of tobacco prevention and control spending, smokefree air, cigarette taxes, and youth access.

Essentials for 2004

Tobacco control policy and advocacy

Americans for Nonsmokers’ Rights (ANR)
ANR’s Web site is a comprehensive resource on issues related to clean indoor air, including model policies, tools, and fact sheets. ANR tracks smokefree ordinances passed at the local level.

Smokeless States National Tobacco Policy Initiative
The Smokeless States Web site provides practical information on policy issues, including clean indoor air and tobacco tax initiatives.

For a comprehensive list of additional resources, see Essential Resources on Advocacy and Legal issues on the ttac Web site.

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Funding and sustaining programs

Fighting Back on Budget Cuts
Developed by The Praxis Project, this toolkit features how-to information on budget research and analysis, understanding state and local budget processes, developing an alternative budget, media messaging, organizing and more.

Sustainability Toolkit: 10 Steps to Maintaining Your Community Improvements
The Center for Civic Partnership developed this toolkit which provides information on making strategic decisions to maintain program sustainability.

Sustaining Success: Educating Key Audiences about Tobacco Prevention
This toolkit is designed to help state and local tobacco control program managers continually educate and inform the public, media, and policymakers about their tobacco control program and its accomplishments.

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Community organizing/Coalition building

Center for Civic Partnerships: Tips, Tools and Resources
Find tips and links to additional resources on a number of community building issues, such building and maintaining collaboratives, community organizing, and facilitation.

Community Tool Box
The Tool Box provides over 6,000 pages of practical skill-building information on over 250 different topics on promoting community health and development.

A Survival Guide for Leaders
This "survival guide" is an enhanced edition of an Harvard Business Review article offering a number of techniques for leaders in the midst of a change initiative. Available for purchase at http://harvardbusinessonline.hbsp.harvard.edu/

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Priority populations

• See Organizations that Represent Priority Populations on the ttac Web site.
   
• For additional resources, see Essential Resources on Priority Populations on the ttac Web site.

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Key data sources

Behavioral Risk Factor Surveillance System
This annual survey sponsored by the Centers for Disease Control and Prevention (CDC) tracks health risks of adults in the states. The 2002 data on adult smoking is available in this MMWR, State—Specific Prevalence of Current Cigarette Smoking Among Adults—United States, 2002

Monitoring the Future
Monitoring the Future is an annual survey of substance use-related behaviors and attitudes of secondary school students, college students, and young adults. The latest 2003 survey finds continued decline in teen smoking.

National Health Interview Survey (NHIS)
The NHIS is a multi-purpose health survey conducted annually by the CDC. The 2001 data on adult tobacco use prevalence is available in the MMWR, Cigarette Smoking Among Adults --- United States, 2001

National Youth Tobacco Survey (NTYS)
In collaboration with CDC, the American Legacy Foundation (Legacy) developed the NYTS to measure tobacco-related beliefs, attitudes and behavior of youth. The latest national results can be found in the MMWR, Tobacco Use among Middle and High School Students --- United States, 2002. Additional information and reports are available in the Research and Publication section of Legacy’s Web site.

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Essential journals

Tobacco Control
This quarterly journal covers a comprehensive range of research and issues relevant to the tobacco control community. Articles older than 1 year are accessible free online. Free e-mail contents alerting service is available.

Nicotine and Tobacco Research
This quarterly is the official journal of the Society for Research on Nicotine and Tobacco. Free e-mail contents alerting service is available.

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Sign up to stay current

Center for Tobacco Cessation E-Newsletter
The latest trends in cessation research, media, and policy are covered in the Center for Tobacco Cessation’s bi-weekly e-newsletter. View back issues online.

Preventing Chronic Disease (NEW)
CDC launched this quarterly peer-reviewed electronic journal to provide a forum for public health researchers and practitioners to share study results and practical experience. The first issue was released on December 15, 2003 and includes a feature on the Mississippi Tobacco Control Program.

Smokefree.net: E-Mail Lists
Join one of the many free public discussion lists or mailing lists to stay connected with others in the tobacco control community.

Tobacco.org
Sign up for daily updates on tobacco control news that can be customized by subject and geographic region.

Tobacco Control Tribune
This American Lung Association e-newsletter includes updates on tobacco control initiatives, advocacy, and legislative rulings.

Tobacco Free Press
The Association of State and Territorial Health Officials Tobacco Prevention and Control Project e-newsletter highlights state activities in youth prevention, cessation, and secondhand smoke. The bimonthly includes tobacco control news, new resources, and upcoming events. View archived issues online.

ttac e-publications!
If you don’t already subscribe to the exchange or extra!, join today by sending an e-mail to subscribe@ttac.org with ‘subscribe’ in the subject line.

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Donna Archuleta
California Rural Indian Health Board, Inc.
American Indian Tobacco Education Network
916/929-9761
Donna.archuleta@mail.ihs.gov

Kelli Bliss
Program Consultant
Tobacco Control Section
California Department of Health Services
916/449-5481
kbliss2@dhs.ca.gov

Kim Clarke
Prevention Specialist
Tacoma Pierce County Health Department
253/798-4704
kclarke@TPCHD.org

Kathleen Collomb
Tobacco Use Prevention Unit Coordinator
DeKalb County Board of Health
404/508-7759
kcollomb@gdph.state.ga.us

Gregory Connolly
Harvard School of Public Health
Scientific Advisor, Mass. Dept. of Public Health
Gregconn@ix.netcom.com

Carla Freeman
Regional Grant Liaison Officer
Smokeless States Program
702/242-1083
carla_freeman@ama-assn.org

Sharon Garrison
Public Relations Manager
The Partnership for a Healthy Mississippi
601/362-0740
sharon.garrison@healthy-miss.org

Lisa Hedberg
Community Organizer
Illinois Coalition Against Tobacco
American Heart Association, Greater Midwest Affiliate
312/346-4675, x6630
lisa.hedberg@heart.org

Cynthia Hallett
Executive Director
Americans for Nonsmokers' Rights
American Nonsmokers' Rights Foundation
(510) 841-3045

Sherri Watson Hyde
Executive Director
National African American Tobacco Prevention Network (NAATPN)
407/708-1811
shyde@naatpn.org

Rosanna Jackson
Program Consultant
Tobacco Control Section
California Department of Health Services
916/449-5465
rjackso4@dhs.ca.gov

Sharon Ketchum
Prevention Team Leader
Maricopa County Tobacco Use Prevention Program (Arizona)
602/372-8438
sharonketchum@mail.maricopa.gov

Rod Lew
Director
Asian Pacific Partners for Empowerment and Leadership (APPEAL)
510/272-9536
rodlew@aapcho.org

Christopher Murray, MSW
Project Coordinator, LGBT SmokeFree Project
The Lesbian, Gay, Bisexual and Transgender Community Center
212/620-7310, x.259
cmurray@gaycenter.org

Melva Fager Okun, DrPH
Quit Now NC! Coordinator
NC Prevention Partners
919/843-4455
melva@ncpreventionpartners.org

Vanessa Salinas
Coalition Coordinator
Smokefree Anchorage
907/263-2068
Vanessa.salinas@cancer.org

Raul “Lou” Salazar
AITEN Health Education Specialist II
916/929-9761 x1513
California Rural Indian Health Board, Inc.
raul.salazar@mail.ihs.gov

Barbara Warren
Director of Organizational Development, Planning and Research
National Association of Lesbian, Gay, Bisexual, and
Transsexual Community Centers
212/620-7310
barbaraw@gaycenter.org

Snip Young
The Cooper Institute
Center for Health Communication
syoung@denver.cooperinst.org
720-216-6618

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Aliki P. Weakland, MPH, MSW
  Editor

Alison Sipler, MPH, CHES
  Managing Editor

Samantha Helfert, MLS
  Information Specialist

JoAnn Weiss, MA, MPH
  Writer/Researcher

Lisbeth Klau, MPH
  Writer/Researcher

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