The national tobacco landscape is rapidly changing as a result of federal policy reform; action is taking place at the state level as well. During the past year, I have had the privilege of directing a state project called “Minnesota Decides: A community blueprint for tobacco reduction”. This project has led to the creation of a statewide action plan for addressing tobacco use. This plan is influencing the debate over how to steward state tobacco settlement dollars. To date, outcomes include goals and action steps that are being embraced in various settings across the state as set forth in the plan by a cross section of Minnesotans. What makes this project different is the unique blend of public and private cooperation and input that led to its creation.

Tobacco use in Minnesota remains at epidemic proportions, according to the Minnesota Department of Health. One in every six deaths is tobacco related. Nineteen Minnesotans die every day as a result of tobacco use. Annual direct and indirect costs are estimated at more than $1.3 billion. For a state that prides itself on the health of its citizens, it is very disheartening to know that 42% of students in grade 12 (age 17–18 years) smoke on a regular basis. Tobacco use clearly is a major concern among Minnesotans—a concern no longer limited to public health. Health plans (such as Blue Cross and Blue Shield of Minnesota), health care providers, educators, law enforcement agencies, local government agencies, communities of faith, the non-profit sector, and businesses in Minnesota are increasingly invested in the problem.

Minnesota Decides is a public/private response to this broad base of concern about the tobacco epidemic. It is also a response to an opportunity. Because of tobacco's changing political landscape in this country, we now have an opportunity to …