Changes in local short-term outcomes of policy, school, and community activities before and after the shutdown of the Minnesota Youth Tobacco Prevention Initiative

Introduction: Ideally, the comprehensive tobacco control (CTC) activities of policy action, school-based prevention, and community mobilization lead to short-term outcomes that ultimately prevent youth smoking. Very few CTC evaluations monitor success achieving local short-term outcomes; no studies test their sustainability. This study tracks implementation of short-term outcomes during the 2000 to 2003 Minnesota Youth Tobacco Prevention Initiative (MYTPI) and tests their sustainability after its shutdown. Methods: The Minnesota Adolescent Community Cohort is a population-based, observational study designed to evaluate the MYTPI. The study sampled 60 of 129 Minnesota geo-political units signifying local communities, and 3,636 Minnesota youth nested in them. From 2000 to 2005, cohort data were collected from youth access and smoking ban policy reviews, a youth access enforcement survey, a school administrator survey, and a youth survey. Piecewise and other growth curve models tested eight local short-term outcomes for increases in these various measures during the program and for lack of change after the shutdown. Results: During the MYTPI, five local short-term outcomes indicated increases in implementation: school-based prevention (proven curricula, student groups), community-mobilization (home smoking bans, advocacy participation), and only one policy initiative (recreational/outdoor smoking bans). However, this growth stopped or slowed after the shutdown. The remaining three outcomes of policy initiatives either remained flat (indoor smoking bans, youth access ordinances) or declined (youth access enforcement) during MTYPI and after its shutdown. Discussion: MYTPI successfully implemented potentially less controversial educational and community-mobilization strategies, but was less successful in implementing social environmental policy change.