Comprehensive Tobacco Control Programs
Comprehensive tobacco control programs are wide-reaching, coordinated efforts to prevent and reduce
the use of tobacco. The Centers for Disease Control and Prevention (CDC) describes key components of
comprehensive tobacco control programs including state
and community-level interventions, mass-reach
health communications interventions, and cessation
Comprehensive tobacco control programs have been effective in increasing tobacco cessation and decreasing the
prevalence of tobacco use and the incidence of tobacco-related diseases. This model is recommended by the
to Community Preventive Services.
The CDC developed Best
for Comprehensive Tobacco Control Programs, a resource for communities implementing this model. CDC
lists the following goals for a comprehensive tobacco control program:
“Prevent initiation among youth and young adults.
Promote quitting among adults and youth.
Eliminate exposure to secondhand smoke.
Identify and eliminate tobacco-related disparities among population groups.”
Communities seeking to design a comprehensive tobacco control program may need to consider
implementing the following components:
Community programs. While comprehensive tobacco control programs are often managed
at the state level, they require strong support at the community level in order to reach individuals
in rural settings. Community engagement is essential to supporting tobacco-free norms and making
meaningful changes to the way that tobacco is marketed and sold in local jurisdictions.
Advocacy and policy changes. Program planners may need to advocate for policy
changes in order to achieve the goals of a comprehensive tobacco control program. This could include
smoke-free policies in schools, businesses, and other organizations or taxes on cigarette sales.
Cessation programs. In order to promote quitting among adults and youth, program
planners should incorporate cessation activities into their comprehensive program. This could involve
working with insurers to increase coverage of cessation services and nicotine replacement therapies,
working with healthcare organizations to ensure that physicians are conducting screenings and
providing counseling for tobacco use, and referring tobacco users to a quitline.
Mass-reach communications campaigns. Communications campaigns may focus on a wide-range of
tobacco-related issues, including preventing initiation of tobacco products, promoting quitting among active
users, and educating users about the importance of screening for tobacco-related diseases.
School-based programs. School-based programs ensure that children and young adults receive
anti-tobacco messaging, education about the risks of tobacco use, and information about tobacco cessation.
Point of retail sale and enforcement programs. These programs may focus on stopping the
sale of tobacco in certain businesses, such as pharmacies, and enforcing existing laws that prohibit the
sale of tobacco to minors.
Surveillance and evaluation programs. The CDC states that surveillance and evaluation are
critical components of a comprehensive tobacco control program. These activities will help program planners
determine whether the program is achieving its goals.
Examples of Comprehensive Tobacco Control Programs
Baby & Me - Tobacco Free Program
addresses the need to reduce smoking among pregnant women. The Chautauqua County Department of Health
provided Baby & Me – Tobacco Free to pregnant women in Chautauqua County, New York and two other rural
counties, Cattaraugus and Allegany. The Chautauqua County Coordinator partnered with the New York State
Tobacco Control program in order to offer this program to 17 other New York State counties.
Tobacco Free Florida is a comprehensive
tobacco education and prevention program that is administered by the Florida Department of Health's Bureau
of Tobacco Free Florida. The state program provides funding to counties to implement evidence-based
practices from the Guide to Community
Preventive Services and the CDC's Best
Practices for Comprehensive Tobacco Control Programs.
The health departments in
rural Jefferson and Madison
County in Florida elected to implement community mobilization interventions (which involved
establishing community-wide advisory committees); developed policies to increase the price of tobacco
products and require that retailers move tobacco products behind the counter; and developed mass
anti-tobacco media campaigns directed at teens and adults.
Montana Tobacco Use Prevention Program
(MTUPP) has implemented programs to reduce tobacco use in Montana. These include an American
Indian Commercial Tobacco Quit Line where American Indian populations can connect with Native
Coaches and receive cessation counseling, the Montana
Tobacco Retail Mapper that provides information about point-of-sale strategies that retailers use to
advertise tobacco and maps the distance between schools and tobacco retailers, and a partnership with the
Montana High School Rodeo Association to promote tobacco-free
rodeo events. MTUPP has a YouTube
page with videos that describe its programs and anti-tobacco advertising.
Tobacco Control Program has a long history of success utilizing several different types
initiatives to achieve their goals. These include the Tobacco
Tax and Health Protection Act which allocated 20% of the tobacco tax to go towards funding
tobacco control efforts. Other programs include a statewide media campaign bringing awareness to
deceptive marketing strategies used by tobacco companies, local prevention programs targeting
specific demographics, and a data-driven surveillance and evaluation component.
Considerations for Implementation
Comprehensive tobacco control programs require substantial funding to carry out program
Community Guide states that “increases in program funding are associated with increases in program
effectiveness.” The CDC describes the
minimum and recommended funding levels for comprehensive tobacco control programs in Best
Practices for Comprehensive Tobacco Control Programs. The minimum level describes the amount required
to allow a state to fund and sustain a program ($2.3 billion across all states), while the
recommended level also accounts for funds needed to attain resources that will have the greatest impact on
reducing the use of tobacco ($3.3 billion across all states). For information about funding individual tobacco
control and prevention programs, see Module 5.
Due to their wide-reaching and comprehensive scope, comprehensive tobacco control programs require
extensive collaborations with partners at the state, community, and local level. Depending on the
focus of the program, communities may need to form partnerships with national research organizations,
business owners, schools, advocacy groups, local and state health departments, healthcare providers,
and media organizations. Coalition
building across sectors is particularly important when trying to create policy changes.
Program Clearinghouse Examples
Resources to Learn More
Texas Tobacco Prevention Pilot Initiative:
Processes and Effects
This article describes a study on the effects of an anti-smoking comprehensive community program and
media campaign on teen tobacco use and attitudes toward smoking.
Author(s): Meshack, A.F., Hu, S., Pallonen U.E., McAlister, A.L., Gottlieb, N. & Huang,
Citation: Health Education Research, 19(6), 657-68