Table 2A

Overview of evaluation approach and reported outcomes of statewide comprehensive tobacco control programmes to 1999 (part 1)

California Massachusetts Arizona Oregon Florida
Evaluation elementsOngoing cross sectional population surveys of adults and teens; Cohort study of teens; Tracking of per capita consumption; Early fragmented documentation of uptake of services; Recent more detailed evaluation of programme elements.Ongoing population surveys of adults and teens; Cohort studies of teens and adults; Tracking of per capita consumption; Documentation of uptake of services, programme and policies.Surveys of recall and appraisal of campaigns; Tracking of per capita consumption; Population surveys of teens and adults. Standardised reports on programme implementation, placement of mass media, quitline calls; Surveys of store advertising/promotions, clean indoor air and youth access policies; Tracking of per capita consumption; Surveys of adult and teen smoking.Information system to track number and type of activities undertaken; Teen and adult surveys to assess recall of campaign and beliefs and attitudes; School surveys to assess smoking behaviour; Monitoring of smoking in teenage mothers; Surveys of law enforcement personnel.
Mass media campaign recall and recognitionHigh levels of campaign awareness among adults and teenagers.41 44 45 Increasing majority of adolescents have seen and heard campaign advertising and recognise campaign theme.57 1998: 2/3 teens, pregnant women and adults reported seeing advertising in last 30 days.64 74% of adults and 84% of teens recall at least one campaign advertisement.69 Sept 1998: 28% of teens reported seeing one advertisement each day and 66%, at least one each week.76 Jan 1999: 48% of adults aware of Truth campaign.77
Tobacco industry advertising and promotions: awareness and participation90% teens exposed to pro-smoking messages.41 1993-96: teen ownership of promotional items increased from 9% to 14%.41 1996: 8% newspaper issues contained pro-tobacco advertising, 13% public events sponsored by tobacco companies.48 1993-96: high but stable levels of exposure to pro-tobacco advertising on billboards (80%), magazines (74%), and on clothing (74%).57 1996: 31% of 12–17 year olds owned promotional item.57 1998: store advertising highly prevalent.59 Not yet reportedNot yet reportedMarch 1999: 56% of stores had tobacco advertising less than 3 feet from the ground.78 Other data not yet reported.
Beliefs and attitudesMajority support in 1996 for a range of tougher measures to regulate the industry.41 Very high levels of agreement by smokers that smoking harms their own health and that ETS causes disease.41 Teens who recall campaign advertising express attitudes consistent with campaign intent.53 Nearly all adults understand smoking is unhealthy, see few benefits to smoking and view industry with scepticism.56 Change data not yet reported.Change data not yet reported.Teens more likely to be unfavourably disposed to tobacco industry at follow up.68 69
Program uptake and dissemination1992-94: 10,000 multi-session community programmes provided.421995-96: 116 community programmes funded, 40% countering pro-tobacco, 19% reducing exposure to ETS, 19% reducing youth access, 15% on cessation /prevention, 8% other.46 52% of 8th grade teachers offered at least one tobacco prevention lesson in 1995-96.46 Over 3200 local programme staff trained to conduct cessation counselling.53 In fiscal year 1997, 500,000 education items distributed.53 Funding provided to 282 boards of health, 66 primary health care cessation programmes, 45 youth leadership programmes, 33 special population programmes, 19 local coalitions.53 27% of teenagers had visited the mobile interactive exhibit called “the Ashkicker” which demonstrates dangers of smoking.64 Other uptake data not reported.By 1998-99, all counties had local coalitions, 24 school prevention projects were being implemented, all 9 Native American tribes and 5 organisations representing ethnic groups received funds for prevention and education, and 5 demonstration projects serving pregnant women and other patient groups were underway.69 Feb 1999: 8000 youth had participated in anti-tobacco activities.78 Jan 1999: approved CDC smoking prevention curricula implemented in over 100 schools.78
Environmental and policy changeFailed retailer compliance checks fell from 52% in 1994 to 22% in 1997,47 but no change in perceived access by teens.43 48 Increase in % smoke free workplaces and smoke free homes.41 No change in perceived compliance by teens with school bans.41 43 1994-97: Failed retailer compliance checks fell from 48% to 8%, but teens more likely to obtain from social sources.53 57 58 1993-97: smoking bans more common in workplaces, restaurants, homes and other public places, but no change in compliance with school bans.53 57 58 Change data not yet reported.1995-98: Failed retailer compliance checks fell from 38% to 28%.70 Change data not yet available for other policies.March 1999: 12000 citations issued for possession by underage youth.78