About NYTCP Funded Partners

Grant programs administered by the New York Tobacco Control Program
(Bureau of Tobacco Use Prevention and Control, NYS Department of Health)

Text exerpted from the 4th Annual Independent Evaluation Report, RTI International, August 2007

 

Overview of Community Partnerships

NYTCP funds 29 Community Partnerships to mobilize communities to change norms which in turn reduces tobacco use. Community Partnership strategies have evolved over time, with efforts since 2004 focusing on decreasing the social acceptability of tobacco use by

• reducing the amount of tobacco advertising in the retail environment;
• decreasing tobacco industry sponsorship and promotion; and
• promoting the adoption of policies prohibiting tobacco use in outdoor areas, such as playgrounds, parks, beaches, and building entranceways.

Information is entered monthly into CAT [the web-based Community Activity Tracking system], which documents activities related to advocating with decision makers, paid media, community education, and policies and resolutions that have been adopted. The CAT system also captures data on policy changes, challenges encountered, and factors that contributed to successes. To assess the impact of efforts to reduce tobacco advertising in the retail environment, we relied on the Retail Advertising of Tobacco Study (RATS) that provides statewide data on the amount of indoor and outdoor advertising and the percentage of stores with promotions for cigarettes. Accurately assessing the impact of the Partnerships on sponsorship and promotion is more challenging because we do not yet have a system to track the true extent of tobacco industry sponsorship and promotion statewide. We do capture the number of related policies and resolutions that have been adopted by targeted organizations, but it is difficult to put these changes into perspective without a more systematic system for capturing the extent of the problem. Community Partnerships also report in the CAT system the number of local ordinances and resolutions that have been adopted in their communities. Support for these policies is also captured in the ATS. We assess the potential impact of Community Partnership efforts on programmatic objectives by reviewing available qualitative and quantitative process data and outcome data.

Description of Community Partnership Activities

At the direction of the NYTCP leadership, Community Partnerships have increasingly focused their efforts on decreasing the social acceptability of tobacco as a proportion of their reported activities. The shift away from activities aimed at eliminating exposure to SHS resulted from a decrease in effort advocating for smoke-free laws in the wake of the 2003 Clean Indoor Air Act and a lack of available evidence-based strategies for promoting smoke-free homes (with the exception of mass media). Remaining efforts focus on statewide paid media to educate the public about the dangers of exposure to secondhand smoke and limited efforts to advocate for smoke-free multi-unit dwelling policies. In addition, the Community Partnerships shifted their focus away from promoting cessation and toward the Advertising, Sponsorship, and Promotion (ASP) Statewide Initiative.

Partnership activities to decrease the social acceptability of tobacco use are grouped within the statewide “ASP” initiative to reduce or eliminate tobacco company advertising (A), sponsorship (S), and promotion (P) of tobacco products. The decreased social acceptability of smoking that occurred as a result of antismoking campaigns during the latter half of the 20th century has consistently been cited as a factor in the concomitant drop in tobacco use during this period.Within the goal of decreasing the social acceptability of tobacco use, Community Partnerships conduct a variety of activities, including

• advocating with cigarette retailers to decrease tobacco advertising in the retail environment;
• encouraging community organizations to adopt policies prohibiting tobacco industry sponsorship;
• educating bar owners, event planners, and venues on reasons to establish policies to prohibit tobacco promotion; and
• advocating for adoption of policies prohibiting tobacco use in outdoor areas, including parks, playgrounds, and building entryways.

The first three sets of activities constitute the ASP activities and represented a new direction for community mobilization in New York when it began in January 2005. As noted in previous IERs, the ASP initiative is an effort to counter important tobacco industry influences. However, it also represents a new frontier as few states have developed and implemented such a comprehensive effort to curb tobacco industry influence. As a result, there is not an extensive evidence base of interventions for NYTCP to draw on. Therefore, it will take time to develop and fully implement this new initiative. At its inception, it was expected that Community Partnerships would go through a period of planning and training, followed by a period of initial implementation when Partnerships would begin to explore what strategies might prove to be effective.

» For a listing of Community Partnerships statewide, click here

 

Overview of Youth Partner Activities

Reality Check Youth Action Programs (Youth Partners) engage youth to lead community action against tobacco and advocate for tobacco-related policies. For fiscal year 2006–2007, Youth Partners focused almost exclusively on two objectives:

• Eliminate smoking and tobacco imagery from movies rated G, PG, and PG-13 that contain smoking or tobacco product placement.
• Increase the number of magazines and newspapers that have a written policy prohibiting acceptance of tobacco company, retailer or product advertising.

Some Youth Partners also worked with county fairs, local event organizers, community organizations, and event venue representatives to encourage the adoption of policies prohibiting tobacco industry sponsorship and promotion. Youth Partners’ increased focus on smoke-free movie efforts (see Exhibit 5-22) is responsible for the doubling of activities classified under the goal of preventing the initiation of tobacco use in the past fiscal year. Their other primary focus area is on decreasing the social acceptability of tobacco use. The following sections describe Youth Partner activities, performance, and outcomes. Initially, Youth Partners put the majority of their energy into conducting broad-based education and recruitment activities. The change in strategies is seen in Exhibit 5-23, with a shift from community education to relying primarily on advocacy efforts, with some activities focused on community education and paid media.

For a listing of Youth Partners statewide, click here 

 

Overview of Cessation Center Initiative

NYTCP funds 19 Cessation Centers that focus on one primary objective: to increase the number of health care provider organizations that have a system to screen all patients for tobacco use, provide brief advice to quit at all visits, and provide assistance to quit successfully. Brief advice to quit smoking by a health care provider significantly increases the odds that a smoker will quit (Lancaster and Stead, 2004). Cessation Centers use the Public Health Service’s clinical practice guideline on treating tobacco use and dependence to guide their work. This document provides a framework for cessation interventions with health care providers, recommending consistent identification and treatment of tobacco use, as well as implementation of organizational policies and systems to institutionalize cessation practices (Fiore et al., 2000). Comprehensive tobacco control programs can help ensure that health care organizations implement systems to support the guidelines and that providers are educated on effective systems and practices and provided with materials to facilitate implementation of the guideline’s recommendations.

Cessation Centers advocate with health care administrators and providers to incorporate the clinical practice guideline into their policies and systems. They also encourage providers to (1) treat tobacco use and dependence, (2) promote Medicaid patients’ use of New York State’s Medicaid coverage of pharmacotherapy for smoking cessation, and (3) refer tobacco users to the New York State Smokers’ Quitline. In the following sections, we describe Cessation Center efforts to institutionalize tobacco use identification and intervention in health care organizations across New York State. To evaluate their progress, we describe health care provider organization changes during the first two years of the Cessation Center initiative. These changes are documented by the following short-, intermediate-, and longterm key outcome indicators:

• awareness of and contact with Cessation Centers,
• awareness of the New York State Smokers’ Quitline and Medicaid cessation benefits,
• written clinical guidelines for diagnosing and treating tobacco dependence treatment (hospitals) or a tobacco treatment standard of care for primary care practices,
• presence of systems that screen all patients for tobacco use and prompt providers to provide brief advice to quit, and
• provision of brief advice to quit.

Institutionalized clinical practice guidelines should result in more smokers being advised to quit by health care professionals and offered effective treatment. Therefore, we examine Adult Tobacco Survey (ATS) data to assess changes in the percentage of smokers who report that they were asked if they use tobacco, advised to quit, and provided assistance to quit. We consider whether Cessation Centers have made measurable progress over the past year and weigh the potential for impact, concluding with recommendations to maximize their effect.

For a listing of Cessation Centers statewide, click here

 

School Policy Partners Overview

In fall 2001, NYTCP funded eight pilot School Policy Partners to conduct tobacco control activities in schools. These grants ended in 2005 when a new procurement resulted in 31 contracts. School Policy Partners work with schools and school districts, providing technical assistance, guidelines, and support needed to develop, implement and enforce comprehensive tobacco-free policies. Despite near-universal school district policies prohibiting tobacco use and a state law that prohibits smoking in school buildings and on school grounds, New York schools are not yet tobacco-free.

A work group within NYTCP developed recommendations for school policies that included policies prohibiting tobacco use among students, staff, and visitors in school buildings, on school grounds, at school-sponsored events, and in all school vehicles. In addition, policies should require appropriate signage, mandate access to cessation resources, and include enforcement procedures. Not all school district policies currently meet these criteria. In addition, self-reported data from the New York Youth Tobacco Surveys (YTS) suggest that neither school district policies nor state law are being fully enforced; in 2004 and 2006, approximately one-third of middle school students and three-fourths of high school students reported seeing other students smoking on school grounds, and approximately 40% of students reported seeing adults smoking on school grounds.

The community-based approach to tobacco control is based on the observation that embedding antitobacco norms into the community environment is an intervention with wider reach than an intervention targeted at individuals (Vollinger et al., 2005), and worksite smoking bans are a core component of this approach (Bauer et al., 2005; Vollinger et al., 2005). The NYTCP School Policy Partners initiative focuses on making schools a tobacco-free worksite because schools are a core community institution. Changes that occur there become integrated into the community and sustained well beyond the time of the original intervention. Because schools are a central part of community life, the cues for behavior change that tobacco-free policies convey are consistently disseminated into the community.

The extant literature provides evidence that comprehensive, well-enforced tobacco-free school policies will reduce smoking among students, faculty, and administrators. Studies of worksite policy (Fichtenberg and Glantz, 2002; Bauer et al., 2005; Farrelly, Evans, and Sfekas, 1999; Brigham et al., 1994) and school policy (Rohde et al., 2001; Kumar, O’Malley, and Johnston, 2005; Evans-Whipp et al., 2004, 2007; Leatherdale and Manske, 2005; Wakefield et al., 2000; Turner and Gordon, 2004) demonstrate that smoke-free policies reduce the prevalence of smoking. Of particular importance, studies also indicate that nuances in implementation of school policies such as strictness of monitoring, allowances for staff smoking, closed campus policies, and provision of cessation services for students and staff, can enhance or reduce program effectiveness (Kumar, O’Malley, and Johnston, 2005).

For a listing of School Policy Partners statewide, click here