Church leaders' tobacco opinions: send materials, not money.

In addition to personnel challenges,faith-based organizations (FBOs) face tangible challenges to implementing tobacco use prevention programs, such as finding materials that fit within their mission and financial backing to support the program. The present project surveyed 71 FBO leaders about these challenges with two open-ended questions that asked what would help and hinder them from delivering a tobacco prevention program, and Likert questionnaires on advocacy, efficacy, impact, policy, burnout, and morality. On what would help them deliver a tobacco prevention program, the most common answer was materials, about half of present FBO leaders gave this answer. On what would interfere, the most common answer was nothing, with about one quarter giving this answer; and, the next most common answer was not having materials with about one sixth giving this answer. The survey was brief (2 pages), and the sample size was small (71). Having the appropriate tobacco prevention materials was clearly a concern for present, mostly African American faith-based leaders, who reported that they needed materials more than they needed money, volunteers, or other forms of assistance.

Collecting health data with youth at faith-based institutions: lessons learned.

Faith-based organizations (FBOs) are ideal for health promotion but can present unique challenges in data collection. The present initiative included 6 years of awards to mostly small, rural, predominantly African American FBOs to conduct tobacco prevention lessons for youth in Grades 4-6 while they were attending summer Vacation Bible School. In 2005, these awards included $1,500 disbursed to 64 geographically diverse FBOs who had never before received this funding. Lessons learned include the following: Plan for evaluation in every aspect of the project; pilot-test everything; use reminders judiciously; make backup plans at every step; personally collect data in a nonthreatening way; and safeguard data entry. Evaluation requires extensive time, money, and effort; so, in both the intermediate and the long run, this extra work is worth it.

Church leaders' tobacco opinions: send materials, not money.

In addition to personnel challenges,faith-based organizations (FBOs) face tangible challenges to implementing tobacco use prevention programs, such as finding materials that fit within their mission and financial backing to support the program. The present project surveyed 71 FBO leaders about these challenges with two open-ended questions that asked what would help and hinder them from delivering a tobacco prevention program, and Likert questionnaires on advocacy, efficacy, impact, policy, burnout, and morality. On what would help them deliver a tobacco prevention program, the most common answer was materials; about half of present FBO leaders gave this answer. On what would interfere, the most common answer was nothing, with about one quarter giving this answer; and, the next most common answer was not having materials with about one sixth giving this answer. The survey was brief (2 pages), and the sample size was small (71). Having the appropriate tobacco prevention materials was clearly a concern for present, mostly African American faith-based leaders, who reported that they needed materials more than they needed money, volunteers, or other forms of assistance.

Sustaining tobacco control coalitions amid declining resources.

Mississippi is unique among the 50 states in settling a lawsuit against tobacco companies earlier than the Master Settlement Agreement, devoting a relatively high amount of per capita funding on tobacco control, and avoiding tobacco-control budget cuts. Using a social-ecological approach combining insider and outsider strategies, tobacco-prevention coalitions in Mississippi succeeded in sustaining funding despite serious obstacles. Lessons learned included taking specific actions to embed themselves in the local community, wisely aligning with legislators, choosing courageous and effective champions, and ensuring that people are keenly aware of their existence and efforts. In using these strategies, tobacco-prevention coalitions in Mississippi have become an institution of the community and in so doing helped sustain their funding.

Faith-based leaders' opinions before and after a youth tobacco prevention workshop.

To determine if religious leaders' (N = 253) opinions changed after a 1-day workshop on integrating a "Students Working Against Tobacco" educational program into Sunday school or other youth programs at church, participants, most of whom were African-American, completed a pretest and posttest survey. Leaders' opinions regarding their expertise in this area reflected more confidence following the workshop. Both before and after the workshop, they were firm in their belief that tobacco prevention programs have an impact and that tobacco use could be prevented. Surprisingly, their belief that tobacco use is a morality issue changed from neutral to mild agreement. Given the responsiveness of participants, faith-based leaders are promising vehicles for delivering tobacco use prevention messages.

School nurses' opinions about the prevention of tobacco use.

To further understand school nurses' tobacco policy beliefs and attitudes toward tobacco companies, a convenience sample of 53 school nurses completed questionnaires about anti-tobacco policies and attitudes toward tobacco companies. Overall, these nurses strongly agreed with tobacco policies such as banning youths from wearing clothing with a tobacco logo to school and fining restaurant owners who permit smoking. In addition, these nurses on average were negative toward tobacco companies. For example, they thought that tobacco companies and advertising leads to youth tobacco use. However, this group of school nurses thought that youths were basically neutral toward tobacco companies. Considering their professional experience with tobacco prevention at school, school nurses would be logical designers of tobacco prevention school interventions. An implication of these results is that school nurse education should include policy and activism components.

Three years of evaluating community tobacco prevention coalitions: lessons learned.

Though challenging, evaluation is essential for successful coalitions. In three years of annual evaluations of 30 tobacco prevention coalitions, lessons learned involve contracts, people (leaders, board members, oversight staff), and entire coalitions. Contracts should adjust within limits, include all work requirements, promote networking, and link directly to evaluation. Leaders need quarterly meetings and no numbers assigned to their performance. Board members, even youth, must be involved. Program monitors need practical or public health experience to provide encouragement with firmness. Fiscal monitors need financial acuity, fair-mindedness, communication skills, and a firm contract foundation. Program evaluators need people skills, program evaluation experience, and a coalition history. Coalitions improve nonlinearly, with awareness activities diminishing and programmatic activities increasing, so evaluation should evolve also. Oversight agencies are influential, so should restrain from introducing many new requirements and avoid blindsiding leaders. Best evaluations are cooperative, collegial dialogs between evaluator(s) and the entire coalition.

Programmatic evaluation of college initiatives to reduce tobacco use.

College students are particularly vulnerable to tobacco initiation and use, but college prevention services are rare and often unevaluated. The present project evaluated 27 tobacco use prevention initiatives on college campuses in one southern U.S. state. Each initiative included one 20 hour/week on-campus student coordinator, a faculty or staff advisor, and a monitor. An outside evaluator rated each initiative on compliance with seven activities and five administrative necessities. Most (22) initiatives nearly met, met, or exceeded expectations, but five were noncompliant. Initiative scores correlated positively with students' and advisors' ratings, but were unrelated to the on-campus coordinator's sex, longevity in office, or past tobacco prevention experience. Though limited by not including a rating of the quality of the interventions, this program evaluation provided college tobacco prevention initiatives with an overall rating and specific feedback on how to improve, and allowed each initiative to tailor programs to its specific campus.

Public education campaign heightens awareness that youth model authorities' tobacco use.

To evaluate whether people changed their views about acceptability of authority figures smoking after an anti-tobacco initiative, randomly selected southeastern U.S. voters (801 in 2001; 806 in 2002) responded to a 20-minute telephone interview. Acceptability attitudes held steady: most (80.8%) said that any authority figures' smoking in front of youth is unacceptable, with women, minorities, and never-smokers even surer than their counterparts. However, there was a change in 2002, with respondents more strongly recognizing that youth model adults' tobacco behaviors and attitudes. An implication is that media campaigns may benefit from emphasizing that youth model adults' tobacco use.

Anti-tobacco messages from different sources make a difference with secondary school students.

Mass media campaigns are often effective in reducing tobacco use, but research has typically focused on these campaigns without considering other sources of anti-tobacco information. The present study examined whether the number of sources of anti-tobacco information (family, sports, and other community events, advertisements, and the Internet), made a difference in use and attitudes of high school students. A representative sample of 1,151 students in grades 6 to 12 in one southeastern state were interviewed at school on cell phones provided by researchers. They reported on average 2.49 of the 4 sources of anti-tobacco information. Students who heard anti-tobacco messages from a variety of sources of information were less likely to use tobacco than students who heard anti-tobacco messages from few sources. Never-users, nonsmokers, and relatively younger youth reported more sources than ever-users, smokers, and relatively older youth. Surprisingly, those who reported more sources labeled smokers as attractive more than those who reported fewer sources. Although having a variety of sources of anti-tobacco messages is associated with less tobacco use, an implication of present results is that anti-tobacco information needs to convey the point that using tobacco is ugly.

Nonprofit organizations versus government agencies to reduce tobacco use.

Tobacco settlement money can be allocated to nonprofit organizations or government agencies. Both have advantages and disadvantages. Nonprofit organizations may have relatively (a) more efficiency/flexibility, but less accountability; (b) narrower focus, but less experience; (c) more ability to advocate, but more obligations; (d) more independence from tobacco industry influence, but less funding; and, (e) more public trust, but less visibility. The present case study of the Partnership for a Healthy Mississippi focuses on six interconnected areas: education (school and community), raising awareness, advocacy, service, enforcement, and research. In 1999 and 2000, tobacco use declined in Mississippi, even compared to neighboring states. This unique partnership's multifaceted approach to social change probably facilitated this decline.

Joys and tribulations of faith-based youth tobacco use prevention: a case study in Mississippi.

Faith-based health promotion initiatives are resurging in popularity among health promoters and providers, but few programs are systematic, large-scale, and funded at the state level. One exception is an initiative by the Partnership for a Healthy Mississippi (PHM), a nonprofit organization funded by tobacco settlement monies. PHM funded churches and other faith-based organizations to implement a grassroots youth tobacco use prevention program to coincide with other community- and school-based efforts. In the 2-year evolution of this faith-community health partnership, PHM experienced both successes and challenges. This article outlines the history of tobacco use prevention and control programs within Mississippi's faith community, provides a brief case study of two churches, and makes 10 recommendations based on lessons learned.

Adolescents' attitudes and self-perceptions about anti-tobacco advocacy.

Communities are organizing into coalitions with the goal of reducing tobacco use, particularly among youth. Adolescents could make effective and persuasive anti-tobacco advocates in their respective communities, but their attitudes about tobacco advocacy and their perceptions of their own abilities as advocates are unknown. Therefore, the present project assessed attitudes and self-perceptions about anti-tobacco advocacy in 159 high school students attending a tobacco advocacy conference. After the meeting, they completed the Anti-Tobacco Advocacy Questionnaire, which has five factors (Activism, Personal Commitment, Banning Advertisements, Tobacco Morality and Peer Pressure to Use Tobacco). Overall, these high school students were moderately positive about anti-tobacco advocacy; girls more so than boys. Further, they were very positive about their own commitment to avoid tobacco and willingness to speak to others personally, but only moderately positive about their activism abilities. An implication is that community coalitions that include youth might want to focus on building their activism skills as they guide them in managing their youthful energy and enthusiasm.

Media campaign influences parents' opinions about their children and tobacco.

UNLABELLED: The study assessed the effectiveness of a media campaign in convincing parents that children are targeted by the tobacco industry and that children should be banned from tobacco use. An 800-parent sample survey was conducted prior to a statewide anti-tobacco campaign, and another survey sample of 790 parents was conducted afterward. THE RESULTS: Though parents who smoked in high school and those who did not agreed that children are targeted and should be banned from tobacco use, parents who did not smoke in high school believed it more strongly. Parents who had a history of smoking changed more on the issue of banning, perhaps because they had more room to change. The study concluded that media campaigns can change parents' attitudes.

Ethnic similarities and differences in early elementary teachers' responses to tobacco prevention.

To explore ethnic differences in teachers' responses to tobacco prevention, 604 teachers, 26.6% of whom were African American (AA), attended an initial workshop, and 502 completed a four-week follow-up. Class sizes were equivalent, but AA teachers reported teaching relatively more AA students and fewer White students. On initial and follow-up questionnaires, AA teachers less often reported that their school had a tobacco-free policy. At follow-up, both groups reported using tobacco prevention materials and thought that they helped students. Despite less organizational support, AA teachers were as positive as White teachers about tobacco prevention for their K-3 students.