2002 National Conference on 2002 National Conference on Tobacco or HealthTobacco or Health

Thursday, 21 November 2002: 1:30 pm – 3:00 pmHilton San Francisco Union Square 5&6

EVAL-351: Effective Programming at the Local Level – Influencing Policy for Statewide Impact

Effective Programming at the Local Effective Programming at the Local Level – Influencing Policy for Level – Influencing Policy for

Statewide ImpactStatewide Impact

Thursday, 21 November 2002Thursday, 21 November 20021:30 pm – 3:00 pm1:30 pm – 3:00 pm

Hilton San Francisco Union Square 5&6Hilton San Francisco Union Square 5&6

Session OverviewSession Overview

Vanessa NewburnVanessa NewburnUniversity of Wisconsin-MadisonUniversity of Wisconsin-Madison

Department of Population Health SciencesDepartment of Population Health Sciences

Guiding Community Planning and Evaluation Efforts in Guiding Community Planning and Evaluation Efforts in Tobacco Control: Predicting Future Rates of Smoking Tobacco Control: Predicting Future Rates of Smoking

During PregnancyDuring Pregnancy

Session SpeakersSession Speakers

Nina Alesci, MPHNina Alesci, MPHBlue Cross Blue Shield of MinnesotaBlue Cross Blue Shield of Minnesota

Center for Tobacco Reduction and Health ImprovementCenter for Tobacco Reduction and Health Improvement

Quitting Smoking: Nicotine Addiction in Minnesota, a Quitting Smoking: Nicotine Addiction in Minnesota, a Collaborative Research Report Building a Statewide Collaborative Research Report Building a Statewide

Business Case for Tobacco Cessation ProgramsBusiness Case for Tobacco Cessation Programs

Session SpeakersSession Speakers

Seth Emont, Ph.D., M.S.Seth Emont, Ph.D., M.S.Consultant, Abt Associates Inc.Consultant, Abt Associates Inc.

Using “Snapshots” to Document State- and Local-Using “Snapshots” to Document State- and Local-Level Tobacco Control Efforts for Policy MakersLevel Tobacco Control Efforts for Policy Makers

Session SpeakersSession Speakers

Effective Programming at the Local Level – Effective Programming at the Local Level – Influencing Policy for Statewide ImpactInfluencing Policy for Statewide Impact

Learner ObjectivesLearner Objectives

Describe collaboration among key tobacco control partnersDescribe collaboration among key tobacco control partnersCharacterize the population of smokers targeted in the three different Characterize the population of smokers targeted in the three different studiesstudiesProvide a process to capture quantitative and qualitative changes in Provide a process to capture quantitative and qualitative changes in statewide and local tobacco control programming that can be used to statewide and local tobacco control programming that can be used to inform policy makers and build a business case for offering tobacco use inform policy makers and build a business case for offering tobacco use cessation resourcescessation resourcesUtilize local data to set community-specific goals for tobacco controlUtilize local data to set community-specific goals for tobacco control

Using Snapshots to Document State Using Snapshots to Document State & Local Level Tobacco Control & Local Level Tobacco Control

Efforts for Policy MakersEfforts for Policy Makers

Seth EmontSeth EmontPeter FinnPeter Finn

Sherry MillsSherry MillsLinda TruittLinda Truitt

Abt Associates Inc.Abt Associates Inc.

Cheryl WieseCheryl WieseDavid WeisserDavid WeisserIan NewmanIan Newman

University of Nebraska University of Nebraska - Lincoln- Lincoln

Judy MartinJudy MartinJeff SoukupJeff Soukup

Tobacco Free NebraskaTobacco Free NebraskaNE Health & Human NE Health & Human

Services SystemServices System

Tobacco Free Nebraska:Tobacco Free Nebraska:Program SummaryProgram Summary

Nebraska legislature enacted LB1436 in March Nebraska legislature enacted LB1436 in March 2000 (as a result of the MSA)2000 (as a result of the MSA)$7 million/year over 3 years$7 million/year over 3 years$1 million from CDC$1 million from CDC

Tobacco Free Nebraska:Tobacco Free Nebraska:Program GoalsProgram Goals

Prevent the initiation of tobacco use among Prevent the initiation of tobacco use among young peopleyoung peopleEliminate exposure to second hand smokeEliminate exposure to second hand smokeIdentify and eliminate disparities related to Identify and eliminate disparities related to tobacco usetobacco useTo promote tobacco use cessation among To promote tobacco use cessation among adults and youthsadults and youths

0

5

10

15

20

25

30

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

% S

mok

ers

% S

mok

ers

Trends in Cigarette Smoking Among AdultsNebraska & United States, 1990-2000

Source: CDC, Behavioral Risk Factor Surveillance System, 1990-2000

NebraskaNebraska

NationNation

Tobacco Use in NebraskaTobacco use among adults

21% smoke cigarettes 22% of men and 21% of women smoke cigarettes 8% of men use smokeless tobacco

Tobacco use among youth 29% smoke cigarettes 10% use smokeless tobacco 12% smoke cigars 26% of high school aged youths who have never smoked are at risk of initiating smoking

Selected health effects of tobacco useEstimated annual health care costs of treating tobacco-related illness in Nebraska: $390 millionEstimated number of Nebraskans who die each year from smoking: 2,600Estimated number of Nebraska youth who are projected to die prematurely from smoking: 35,492

Tobacco Free Nebraska Program Tobacco Free Nebraska Program Initiatives and Funding LevelsInitiatives and Funding Levels

$1,279,000

$1,050,000

$840,000

$840,000

$700,000

$700,000

$520,000$371,000$350,000$350,000 Statewide Programs

Enforcement

Administration

Teen Tobacco Project

Surveillance

Cessation

Media

Youth Empowerment

Outreach

Communities

Total Funding = $7 million

Tobacco Free Nebraska Starts Media Campaign

School/Community Intervention CountySchool/Community Planning CountyOutreach to all Minority Populations

Key:

Community, School, & Outreach GranteesCommunity, School, & Outreach Grantees

By County, Nebraska -- Fall 2000By County, Nebraska -- Fall 2000

Scottsbluff

Lincoln

Dawson Buffalo Hall

Adams

Gage

Lancaster

Cass

Sarpy

Douglas

Madison

Platte Colfax

*

* NAF*

* Charles Drew Health Charles Drew Health CenterCenter

**WinnebagoWinnebago

MacyMacy

*

*1. Asian Comm &1. Asian Comm & Cultural CenterCultural Center2. Malone2. Malone CommunityCommunity CenterCenter3. Indian Center, 3. Indian Center, Inc.Inc.4. Hispanic Center4. Hispanic Center

*NAF’s main office is in North Platte, but NAF provides services statewide

*NAF*

NAF**

*Santee

08/27/01

York

PolkKeith

Knox

AdamsAdams BuffaloBuffalo CassCass

ColfaxColfax DawsonDawson DouglasDouglas

GageGage HallHall KeithKeith

LancasterLancaster Lincoln Lincoln MadisonMadison

PlattePlatte SarpySarpy ScottsbluffScottsbluff

YorkYork

Local Tobacco Control CoalitionsLocal Tobacco Control Coalitions

Tobacco Free Nebraska Evaluation TeamTobacco Free Nebraska Evaluation Team

Bureau of SociologicalResearch

Tobacco Free NebraskaTobacco Free NebraskaEvaluation Advisory PanelEvaluation Advisory Panel

Monica EischenMonica Eischen, Office on Smoking and Health, Centers , Office on Smoking and Health, Centers for Disease Control and Preventionfor Disease Control and PreventionPebbles Fagan, Ph.D.Pebbles Fagan, Ph.D., National Cancer Institute, , National Cancer Institute, National Institutes of HealthNational Institutes of HealthJean Forster, Ph.D.Jean Forster, Ph.D., Director, Prevention and Policy , Director, Prevention and Policy Program, University of MinnesotaProgram, University of MinnesotaKaren Gerlach, Ph.D.Karen Gerlach, Ph.D., Senior Program Officer, The , Senior Program Officer, The Robert Wood Johnson FoundationRobert Wood Johnson FoundationEric WiesenEric Wiesen, Office on Smoking and Health, Centers for , Office on Smoking and Health, Centers for Disease Control and PreventionDisease Control and Prevention

Why Monitor the Tobacco Free Why Monitor the Tobacco Free Nebraska Program?Nebraska Program?

To monitor progress toward the program’s goals;To monitor progress toward the program’s goals;To demonstrate whether a particular program activity is To demonstrate whether a particular program activity is effective;effective;To learn how to improve the program;To learn how to improve the program;To ensure that only effective programs are maintained;To ensure that only effective programs are maintained;To ensure that resources are not wasted on ineffective To ensure that resources are not wasted on ineffective programs; andprograms; andTo document to program funders that their money is To document to program funders that their money is being well-spentbeing well-spent

Adapted from the Centers for Disease Control and Prevention Office on Smoking and Health “Introduction to Evaluation for Comprehensive Tobacco Control Programs”, November 2001.

Tobacco Free NebraskaTobacco Free NebraskaA State “Snapshot” Progress ReportA State “Snapshot” Progress Report

Tobacco Free Nebraska State SnapshotTobacco Free Nebraska State SnapshotRationaleRationale

Behavior/attitudinal changes take timeBehavior/attitudinal changes take timePolicy makers can’t wait that longPolicy makers can’t wait that longQualitative information complements Qualitative information complements quantitative measures of change monitored quantitative measures of change monitored through surveillance systemsthrough surveillance systems

Tobacco Free Nebraska: SnapshotTobacco Free Nebraska: SnapshotPurposePurpose

Provides interested parties with updated Provides interested parties with updated information on statewide and local tobacco information on statewide and local tobacco control efforts (on a periodic basis)control efforts (on a periodic basis)Highlights program successes and challengesHighlights program successes and challengesSnapshots can be theme-basedSnapshots can be theme-basedUsed internally as an accountability scorecardUsed internally as an accountability scorecard

Tobacco Free Nebraska: SnapshotTobacco Free Nebraska: SnapshotState and local snapshots -- highlights complementary State and local snapshots -- highlights complementary activities at state and local levelsactivities at state and local levelsDeveloped by an independent evaluation teamDeveloped by an independent evaluation teamOriented towards qualitative changes in tobacco control Oriented towards qualitative changes in tobacco control programming & evaluationprogramming & evaluationWritten for policy makers as key audience (but also useful Written for policy makers as key audience (but also useful to update partnering organizations and the public)to update partnering organizations and the public)Easily communicates main messagesEasily communicates main messagesKey stakeholders’/partners’ perspectives are incorporatedKey stakeholders’/partners’ perspectives are incorporated

Tobacco Free Nebraska:Tobacco Free Nebraska:State Snapshot “Recipe”State Snapshot “Recipe”

Executive summaryExecutive summaryEpidemiology of tobacco use in the stateEpidemiology of tobacco use in the stateProgram goals and strategyProgram goals and strategyProgram organizationProgram organizationHighlights tobacco control milestonesHighlights tobacco control milestonesModeled after other successful state initiativesModeled after other successful state initiativesFollows CDC Follows CDC Best PracticesBest Practices Guidelines GuidelinesDescription of local/community-based achievementsDescription of local/community-based achievementsUpdates statewide tobacco control componentsUpdates statewide tobacco control componentsHighlights program successes and challengesHighlights program successes and challengesProvides recommendations for program improvementProvides recommendations for program improvementResources for further informationResources for further information

Develop outlineDevelop outlineDraft interview guideDraft interview guideDetermine who to interviewDetermine who to interviewSynthesize findings (qualitative, quantitative, notable quotes)Synthesize findings (qualitative, quantitative, notable quotes)OptionalOptional: Focus group with staff: Focus group with staff

State Snapshot: 4 Easy StepsState Snapshot: 4 Easy Steps

Start to Finish: about 8-12 weeksStart to Finish: about 8-12 weeks

Anatomy of the SnapshotAnatomy of the Snapshot

Anatomy of the Snapshot (continued)Anatomy of the Snapshot (continued)

Anatomy of the Snapshot (continued)Anatomy of the Snapshot (continued)

FederalFederal

StateState

LocalLocal

Anatomy of the Snapshot (continued)Anatomy of the Snapshot (continued)

Anatomy of the Snapshot (continued):Anatomy of the Snapshot (continued):Notable QuotesNotable Quotes

““Public health has been elevated to a level that has not Public health has been elevated to a level that has not been seen in this state for a long time.”been seen in this state for a long time.”-- Dr. Richard Raymond, Chief Medical Officer, HHSS-- Dr. Richard Raymond, Chief Medical Officer, HHSS

““Tobacco Free Nebraska has served as the coordinator of Tobacco Free Nebraska has served as the coordinator of [tobacco control] activities in the state, and not many of the [tobacco control] activities in the state, and not many of the efforts would have taken place otherwise.”efforts would have taken place otherwise.”-- Kelly Madcharo, Associate Executive Vice President, -- Kelly Madcharo, Associate Executive Vice President, Nebraska Medical AssociationNebraska Medical Association

Program success storiesProgram success storiesProgram challengesProgram challengesProgram recommendationsProgram recommendations

Anatomy of the Snapshot (continued)Anatomy of the Snapshot (continued)

How Has the Snapshot Been UsedHow Has the Snapshot Been Usedby Tobacco Free Nebraska?by Tobacco Free Nebraska?

Posted on websitePosted on websiteDisseminated to tobacco control coordinators Disseminated to tobacco control coordinators and legislatorsand legislatorsUsed as part of strategy for proposed 50Used as part of strategy for proposed 50¢ ¢ excise tax increaseexcise tax increaseKey tool for lobby teamKey tool for lobby teamUsed internally to provide program updatesUsed internally to provide program updates

Statewide Support for 50-Cent Statewide Support for 50-Cent Cigarette Tax HikeCigarette Tax Hike

70 6673 68

0

20

40

60

80

100

PercentagePercentage

Source: Nebraska State Paper, February 4, 2002

For Immediate ReleaseFor Immediate Release April 11, 2002April 11, 2002Contact: Tony Iallonardo 202.296.5469Contact: Tony Iallonardo 202.296.5469

Nebraska’s Higher Cigarette Tax Will Save Lives, Nebraska’s Higher Cigarette Tax Will Save Lives, Reduce Health Care Costs and Raise Much-Needed Reduce Health Care Costs and Raise Much-Needed

RevenueRevenue

Statement by William V. Corr, Executive Vice President Campaign Statement by William V. Corr, Executive Vice President Campaign for Tobacco-Free Kids for Tobacco-Free Kids

Washington, DC - Nebraska’s leaders have taken an important Washington, DC - Nebraska’s leaders have taken an important step toward protecting the state’s kids and taxpayers from the step toward protecting the state’s kids and taxpayers from the devastating toll of tobacco by increasing the cigarette tax by 30 devastating toll of tobacco by increasing the cigarette tax by 30 cents a pack for the next two years. This iscents a pack for the next two years. This is

Source: Campaign for Tobacco-Free Kids, 2002Source: Campaign for Tobacco-Free Kids, 2002

State Snapshot Local Snapshot

Three Nebraska Local “Snapshots”Three Nebraska Local “Snapshots”

Tobacco Free Hall CountyTobacco Free Hall CountyMetropolitan Omaha Tobacco Metropolitan Omaha Tobacco Awareness CoalitionAwareness CoalitionThe Nebraska Native American The Nebraska Native American Tobacco CoalitionTobacco Coalition

Next Steps...Next Steps...

State Snapshot 2002State Snapshot 2002Local SnapshotsLocal SnapshotsSpecial Snapshot on Youth Special Snapshot on Youth EmpowermentEmpowerment

For More Information...For More Information...

Contact Seth Emont, Peter Finn, Heather HandelContact Seth Emont, Peter Finn, Heather Handel –– Abt Associates Inc.Abt Associates Inc.Contact Cheryl Wiese, Dave WeisserContact Cheryl Wiese, Dave Weisser –– UN-LUN-LContact Jeff SoukupContact Jeff Soukup - TFN - TFNFor an electronic copy of the report, please visit:For an electronic copy of the report, please visit: http://www.hhs.state.ne.us/tfnhttp://www.hhs.state.ne.us/tfn