State Tobacco Control Plans: What is the Strategy behind the Plan?

Background: Health advocates and administrators across the U.S continue to develop and revise state-level strategic plans to prevent tobacco use and promote cessation. There is little known about the differences and similarities in plan development across states and the change in approaches over the course of time as states revise their plans. The purpose of this study is to review the current and historical approaches to controlling tobacco use at the state level as documented in published tobacco control plans.

Methods: Websites for the 50 departments of health were searched for published tobacco control plans. Additionally, an internet-based search was completed using tobacco and variations of the following terms: control, prevention, strategies, comprehensive plan and strategic plan. Each plan was then reviewed to assess: content areas, special populations, measurable outcomes, timeline for action, intended audiences and steps for implementation.

Results: Approximately 50% of states in the U.S. have developed strategic plans for tobacco control. Adherence to recommendations from the CDC is a common thread throughout the plans. Most plans address clean indoor air, restrictions on youth access to tobacco, and cessation; fewer plans address disparities and tobacco tax increases. There is also significant variation in the level of specificity in the plans, including recommendations for implementation and measurable indicators of success.

Conclusion: Given a decline in tobacco control funding and a sustained demand for tobacco use prevention and cessation services, state tobacco control programs must be efficient in planning and organizing tobacco control activities in order to maintain these programs.