Relationship between Community Support for Youth Tobacco Cessation and the Availability of Youth Smoking Cessation Programs

Background: The relationship between the availability of public-health programs in communities and the attainment or improvement of associated health-outcomes is well established. Less studied is the relationship between community-level factors and the availability of public health programs. This paper explores the relationship between community support for youth tobacco cessation and the availability of youth smoking cessation programs across 408 counties in the US. Methods: In 2003, the Helping Young Smokers Quit (HYSQ) project randomly sampled 408 US counties, in proportion to the size of their youth population. Through snowball sampling, over 10,000 key informants were interviewed. In addition to helping identify youth smoking cessation programs, key informants answered questions regarding perceptions of the importance of youth smoking as a problem in their county among both community leaders and the general population. Structural equation modeling was used to analyze the relationship between the number of the programs found in a county and community prioritization of youth smoking cessation, controlling for other county-level characteristics and the number of initial key informants. Results: Three or more programs were found in 26% of the 408 counties, two programs in 12%, one program in 24%, and no programs in 38%. Community support, size of the county's youth population, the number of initial key informants, and per capita state tobacco control expenditures were all positively and significantly related to the number of programs found in a county. Discussion: Comunity support for youth smoking cessation is a robust correlate of availability of youth smoking cessation programs.