Utilizing a tobacco report card tool to influence policy changes and create healthy communities in Santa Clara County

Santa Clara County residents with very low income smoke at twice the rate of people with above-median income. Low-income communities are exposed to higher incidence of pro-tobacco influences due to higher concentration of tobacco retail outlets. The 2007-2010 Tobacco Report Card Project was developed with the goal to counter pro-tobacco influences and reduce availability of tobacco products to youth in the entire community through policy change. The evaluation design included quasi-experimental outcome and process data collection activities. Outcome data collection included store observational surveys, law enforcement surveys, municipal code and policy record review surveys. Cities were graded on a 100-point scale in four key areas: level of compliance with current advertising requirements, strength of tobacco control policies, level of enforcement of tobacco sales to minors' laws, and community education efforts. Each city's final grade was publicized in a media release two times over the three-year project period. 11 of the 13 targeted intervention cities improved their grade by at least one grade level over the first year baseline. Cities improved their grade by: adopting new policies that require annual licensing of retailers; restrict tobacco sales near schools; increasing enforcement of tobacco sales to minor's laws by 61.5%; improving compliance of window coverage restrictions by 6.0% and required signage posting by 9.7%; and becoming 100% compliant with self-service display ban. Utilizing the media to publicize the Tobacco Report Card results was crucial in getting cities to take immediate action to improve their grade performance, to create healthier communities.