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NACCHOs Tobacco Control Guidelines: Successful Use of the Recommendations presented by Dawn M. Dunn, MPH Program Administrator Santa Barbara County Public.

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Presentation on theme: "NACCHOs Tobacco Control Guidelines: Successful Use of the Recommendations presented by Dawn M. Dunn, MPH Program Administrator Santa Barbara County Public."— Presentation transcript:


2 NACCHOs Tobacco Control Guidelines: Successful Use of the Recommendations presented by Dawn M. Dunn, MPH Program Administrator Santa Barbara County Public Health Dept.

3 Presentation Overview Share successful use of CDC/ NACCHOs Guidelines in Santa Barbara County. Showcase results from local tobacco control efforts. Discuss future implications of their use. Respond to questions and answers.

4 Advocate to use local MSA funds for their intended purposehealth & tobacco control. MSA funds can be used for any purpose. Successfully compete against other high priority projects. Address active opposition from the County Executive Officer. The Challenge

5 Utilize the strength of the existing community tobacco control coalition. Leadership and staff at Public Health Department join forces. Learn from the experiences of others who had been successful. Develop a strategy and an extended partnership. The Process

6 The passage of Proposition 99 (the original CA tobacco tax) mandated the creation of a community coalition. The CA Tobacco Control Program anticipated that a grass-roots community group would be needed. A coalition, with its autonomy and diversity, can take actions that some agency representatives cannot. Provides broad-based support. The Community Coalition

7 In 1998, the Master Settlement Agreement (MSA) was reached between 47 states Attorney Generals and the tobacco industry. The MSA paid billions of dollars to states to compensate for unreimbursed medical care for treating tobacco-related illnesses. MSA payments are general funds dollars and may be allocated for any expenditure; they are not earmarked to fund health programs. The Tobacco Settlement Story

8 California and New York are the only two states whose counties receive monies directly. In SB County, approximately 4 million dollars is received annually. The Tobacco Settlement Story (continued)

9 TIMING WAS CRITICAL TO OUR SUCCESS Understood that the anti-tobacco coalition alone, would be insufficient to influence the Board. Recruited for, and created an expanded coalition, known as the Health Partnership, with a diverse broad-base of support. Steps to Securing the $$

10 Santa Barbara County Medical Society Local Hospitals Santa Barbara Community Clinics Santa Barbara League of Women Voters Santa Maria League of Women Voters CEASE (Coalition Engaged in a Smoke-Free Effort) American Lung Association American Cancer Society American Heart Association Santa Barbara Regional Health Authority Santa Barbara City College The Health Partnership

11 CEASE (Coalition Engaged in a Smoke-Free Effort) Santa Barbara Council on Alcoholism and Drug Abuse Tri-County Regional Team UCSB-Student Health Services Santa Barbara and Ventura County Dental Societies SEIU 620 Lompoc Valley Community Healthcare Council Santa Maria Health Council Human Services Association Faith Initiative of Santa Barbara County Latinos for Better Government The Health Partnership (continued)

12 Planned strategies within the Health Department. Secured unwavering commitment from the Public Health Director. Learned from other counties experiences. Conducted a teleconference with a county that had been successful in securing these funds. Assessed allies and opponents. Key opponents included the County Administrator & other county departments. Steps to Securing the $$ (continued)

13 Framed the issue from our perspective: Stuck to the intent of the lawsuit, knowing that selling the issue on the tobacco treatment and prevention platform was key to our success. Educated on the benefits of prevention.. Appealed to lawmakers emotions, not solely relying on the facts. Understood that all change occurs in a political and social context. Steps to Securing the $$ (continued)

14 And the Funding Goes to Tobacco & Health

15 CDC Best Practices for Comprehensive Tobacco Control Programs released in 1997 NACCHO Guidelines replace CDC Best Practices in 2001. Using NACCHO Guidelines

16 Publications perfectly timed to be used to secure MSA funds. Disseminated Best Practices to local elected officials. Used NACCHO Best Practice recommendations to set tobacco control funding priorities. Using NACCHO Guidelines INVEST 25% of MSA $$ in TOBACCO CONTROL

17 Realities of Tobacco Use in Santa Barbara County Recommendation to Invest 25% of the Settlement Monies in Tobacco Control Program CategoryDollars Allocated in 1 st Year PercentCDC Guideline (minimum- maximum) Media Campaign$ 245,00029%$200,000-$600,000 Cessation and Adjunct Support$135,00017%$555,500 Enforcement$ 55,0007%$172,000-$320,000 Youth and Special Populations Outreach/ Intervention Includes subcontractors/CBOs $ 210,00026%$280,000-$800,000 Evaluation, Administration and Surveillance$ 170,00021%$211,125-$341,325 TOTAL: $815,000100%$1,418,625- $2,616,825

18 The table on the previous slide shows the format used annually to ask for the funds. A two-page needs paper was presented, with needs and program solutions. Customized funding recommendations to local needs and program and community strengths. Used the comprehensive approach to tobacco control established by CA TCP as a guide along with CDC/ NACCHO recommendations. Using NACCHO Guidelines (continued)

19 School-based recommendations were not followed for several reasons. Local schools networks and programs in tobacco prevention presented challenges. Funding levels were insufficient to fully fund this aspect of the program. Allowed agencies to apply for grant funds to do augment their services or activities. Assisted with grant applications Funded other CBOs already working in the schools. Using NACCHO Guidelines (continued)

20 Salaries and administrative costs have are above recommendations. Considered to give monies to CBO to reduce costs, but community supports County playing this role. Adjust programming as funding decreases. Managing grantees has proved both rewarding and challenging. Showing prevention program results is difficult. Media and outreach activities are always under attack. The Guidelines Modified

21 Received one of the largest per capita allocation of tobacco settlement dollars. Established an Advisory Committee to make funding recommendations to the Board. Avoided a cumbersome RFP allocation process to award local MSA funds. Created an endowment for 20% of the funds annually. Local MSA Outcomes

22 Funding Allocation Graph

23 Helped over 3,000 people with their attempts to quit smoking. Funded between 7-12 agencies/individuals to provide services. Reimburse financially eligible clients for FDA- approved pharmaceuticals. FY 07-08 quit rates were 51% at 3 months and 39% at 6 months. Local MSA Outcomes (continued)

24 Provided outreach and education to over 10,000 youth and young adults annually. Funded local CBOs, the County Education Office, schools, colleges and the university. These groups provided prevention, cessation, and evaluation activities. Funded enforcement efforts. Increased compliance with smoke-free bar law Decreased sales to minors from 38% to 11% Local MSA Outcomes (continued)

25 Developed and placed numerous local media campaigns: Aimed at young adult tobacco use Reducing cigarette butt litter Promoting specific cessation services and creating a positive climate for quitting. Campaign recall rates at 53%, with 63% stating that the campaign would affect their behavior. Local MSA Outcomes (continued)




29 Program funding levels cut from 25% to 15% over the years, with more cuts anticipated. County costs continue to escalate. Specific shortfalls in other critical programs threaten continued tobacco control funding. Political will and climate, coupled with the dismantling of the TSAC Advisory Committee, make future funding tentative at best. Next StepsRough Road Ahead

30 Best practices and data to prove that tobacco control works, assist local programs in making their case for comprehensive programs! Best Practices and Data Needed

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