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State & Local Programs On Smoking and Health 7 TIMN 0139689 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Office on Smoking and Health

State & Local Programs On Smoking and Health ® ® :..~p .,,, , ,, ,___ .~~ e~ e3e A Office on Smoking and Health U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES TI1 0139690

Preface "State and Local Programs on Smoking and Health," produced by the Office on Smoking and Health, presents descriptions of programs designed to reduce smoking among the American population and thereby reduce the premature death and disability associated with cigarette smoking. The programs include cessation clinics, prevention efforts aimed at children and adolescents, school-based programs, community and patient education, worksite programs, mass media campaigns, and individual self-help and counseling. This volume is offered as a guide to services available directly to smokers who are seeking assistance in quitting smoking, and also as a referral resource for physicians and other health professionals who serve patient populations. Prevention and information program descriptions provide valuable information to those individuals, organizations, and communities who have established or are seeking to establish smoking cessation and intervention programs. This volume is intended to serve as a bridge between existing programs with common interests, as a resource for information exchange, and as a means of providing information to individuals wishing to undertake smoking control activities In their communities. The first edition of this directory, published in 1982, iisted 436 programs; this edition lists over 800 individual programs. They are listed alphabetically by State and organization in Part 2. The name and address of the sponsoring organization, the program title, the name and telephone number of a contact person or persons, and In most cases, a brief abstract describing the objectives of the program, methods and materials used, and evaluation mechanisms employed are provided. Among the program descriptions are many local replications or modifications of programs that have been developed and disseminated by major national organizations. Factors that make the local versions of the natbnal programs unique are outlined in the abstracts. The national programs are described in detail in Part 1, and cross- references are provided with the relevant abstracts in Part 2. This volume attempts to catalog local activities in smoking and health and must be considered selective in its coverage. Information on programs in your area not listed in this volume can be obtained by contacting local voluntary agencies, county medical societies, State and county health departments, or community hospitals. Commercial smoking cessation programs are often listed in the Yellow Pages of your telephone directory under the heading "Smokers Information and Treatment Centers." The Office on Smoking and Health plans to publish this directory of State and local programs on a regular basis, every 2 years. If you or your organization would like to contribute to this future effort, please write to State and Local Programs, Office on Smoking and Health, Stop 1-10, Park Building, 5600 Fishers Lane, Rockville, Maryland 20857. TIMN 0139691

TABLE OF CONTENTS PART 1. National Program Descriptions ............................................................................1 American Cancer Society ..........................................................................................1 Smoke-Free Young America by the Year 2000 ........................................................ 1 FreshStart Quit Smoking Program ..........................................................................2 American Lung Association .......................................................................................2 Smoking Cessation .............................................................................................2 Smoking Prevention ............................................................................................3 Protecting the Rights of Nonsmokers .....................................................................4 American Heart Association Smoking Intervention Programs .............................................4 School Site .................................................................................................... ..4 Let's Talk About Smoking ...................................................................................4 Save a Sweet Heart ...........................................................................................5 Worksite .................................................................................................... ......5 Health Care Delivery Site ....................................................................................5 Seventh-Day Adventist Church ...................................................................................6 The Breathe-Free Plan to Stop Smoking-The Revised Five-Day Plan ...........................6 U.S. Department of Health and Human Services ...........................................................6 Office on Smoking and Health ..................................................................................6 Scientific and Technical Information Program ...........................................................7 Public Information Program ..................................................................................7 School Programs ...............................................................................................8 Coordination .................................................................................................... .8 Other Federal Resources in Smoking and Health ..........................................................8 National Cancer Institute .....................................................................................8 National Heart, Lung, and Blood Institute ................................................................9 National Institute of Child Health and Human Development ...................................... 10 Center for Health Promotion and Education ........................................................... 11 . TIMN 0139692

Primary Grades Health Curriculum Project ............................................................. 11 Teenage Health Teaching Modules ........ ....................... . .. ......... .............. .. ....... • ... 11 Combined Health Information Database . . . . . . . . .. . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . ... .. . . . . . . . . . . .... . • . . 12 Office of Disease Prevention and Health Promotion ................................................ 12 PART 2. Program Summaries by State ........................................................................... 13 Alabama .................................................................................................... ....13 Alaska .................................................................................................... ....... 14 Arizona .................................................................................................... ...... 15 Arkansas .................................................................................................... .... 16 California .................................................................................................... ...18 Colorado .................................................................................................... ....32 Connecticut . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . . . . ..... 34 Delaware .................................................................................................... ...38 District of Columbia ..........................................................................................38 Florida .................................................................................................... ....... 40 Georgia .................................................................................................... .....46 Hawaii .................................................................................................... .......49 Idaho .................................................................................................... ........50 Illinois .................................................................................................... .......51 Indiana .................................................................................................... ......57 Iowa .................................................................................................... ......... 60 Kansas .................................................................................................... ......62 Kentucky .................................................................................................... ....64 Louisiana .................................................................................................... ...66 Maine .................................................................................................... ........ 68 Maryland .................................................................................................... ....69 Massachusetts ................................................................................................72 Michigan ....................... : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Minnesota .................................................................................................... ..85 iv TIMN 0139693

Mississippi .................................................................................................... ..90 Missouri .................................................................................................... .....90 Montana .................................................................................................... ....92 Nebraska .................................................................................................... ...93 Nevada .................................................................................................... ...... 95 New Hampshire ...............................................................................................96 New Jersey .................................................................................................... 97 New Mexico ................................................................................................. 102 New York .................................................................................................... 103 North Carolina ............................................................................................... 114 North Dakota ................................................................................................ 115 Ohio .................................................................................................... ....... 116 Oklahoma .................................................................................................... 121 Oregon .................................................................................................... .... 122 Pennsylvania ................................................................................................. 123 Rhode Island ................................................................................................ 129 South Carolina .............................................................................................. 130 South Dakota ................................................................................................ 131 Tennessee ................................................................................................... 132 Texas .................................................................................................... ...... 134 'Utah .................................................................................................... ....... 138 .................................................................................................... ... 139 Vermont Virginia .................................................................................................... .... 140 Washington .................................................................................................. 142 West Virginia ................................................................................................ 146 Wisconsin .................................................................................................... 148 Wyoming ......................:............................................................................. .. 150 v TiMS 0139694

Part 1 National Program Descriptions Part 1 contains detailed descriptions of smoking cessation and prevention programs in use in different locations across the country. These programs were developed and disseminated by various organizations, including the American Cancer Society, the American Lung Association, the Seventh-Day Adventist Church, and the U.S. Department of Health and Human Services, Office on Smoking and Health. All of the programs described are listed and identified in Part 2 under the appropriate local organizations. Additional Federal resources in smoking and health are also described at the end of Part 1, beginning on page 8. AMtRICAN CANCtR sOCIeTY Every year, the American Cancer Society's 58 divisions and 3,100 local units reach millions of adults and young people with smoking education, prevention, and cessation programs. In addition, millions of pamphlets, posters, and exhibits on smoking are distributed. Smokers are specially targeted in November by the Great American Smokeout, in April by the annual Cancer Crusade, and throughout the year by mass media efforts and physician counseling. Educational programs and "FreshStart" quit smoking clinics are conducted on the local level in the context of a broader comprehensive smoking control program that also includes, among other things, mass media efforts, legislative initiatives, professional education, and response/referral systems. Heavy emphasis is placed on preparing others (e.g., hospitals or industry) to assume primary responsibility for helping smokers to quit. Education in the prevention of smoking is carried out principally in the schools, because young people presumably have not yet established the smoking habit. Programs begin in the elementary schools, where students are just learning about their bodies and good health habits, and continue through high schoot. Among the most widely disseminated smoking prevention programs developed by the American Cancer Society (ACS) are these: "An Early Start to Good Health," a series of teaching units designed to promote positive health behavior in kindergarten through third grade. "ACS Health Network," a followup series to An Early Start to Good Health, designed for students in grades four through six. "Healthy Decisions," software with accompanying users manual, help cards, and leaders guide for students in fourth through sixth grades, designed to allow youth to practice decisionmaking. "Health Myself," a series of teaching units designed to be incorporated into language arts, science, and social studies classes for students in intermediate grades, focusing on the impact of societal influences on smoking behavior. The ACS also has packaged and disseminated two smoking cessation programs-one for adults and one for teens. Snoka-Fr.. Young Am.rica by ths Y.ar 2000 In support of the Surgeon General's call for a Smoke-Free Society, the American Cancer Society has committed its resources to work for the goal of a Smoke-Free Young America by the Year 2000. The society will expand program efforts to 1 TIMN 0139695

reach specific target groups that are highly appealing from the standpoint of potential for smoking control. The following are target groups: Vocational-technical high school students Health care professionals Expectant parents Pre-school children Early adolescents. Targeted program materials based on the application of prevention and cessation techniques currently believed to have the most potential for success will be available to support increased program activity. Additionally, the American Cancer Society is part of a collaborative effort with the American Heart Association and the American Lung Association. The objective of the three-agency effort is to break down barriers to effective collaboration on the local level and to provide social support and reinforcement to nonsmoking young Americans. This objective will be accomplished through voluntary and legislative actions, public education activities, and public relations campaigns. Fir.shstart Quit Smoking Program The FreshStart program is designed for four 1-hour group sessions taking place over a 2-week period. FreshStart is an active, programmatic approach to quitting. The program contains all of the essential information and strategies a participant needs in order to stop smoking permanently. Planning ahead Is a key concept of the program. A FreshStart Faciiitator's Guide, which Is aistep-by-step manual for facilitating a FreshStart group, is available. A summary agenda is given for each session, followed by a detailed presentation of all of the program content. A FreshStart Participant's Guide is also available. The guide is designed to accompany participation in a FreshStart group. However, it is fully self-expianatory and can be used by individuals stopping on their own. For further information contact: Local units of the American Cancer Society or American Cancer Society 90 Park Avenue New York, NY 10016 (212)599-8200 AMEqiCAN LUNG AssOC1ATtON Toward the goal of making NO SMOKING the social norm in this country, the American Lung Association (ALA) and its 139 affiliates nationwide conduct a comprehensive range of programs and activities dealing with smoking cessation, prevention, and the protection of nonsmokers' rights. Smoking Cossation Local ALA affiliates provide a variety of comprehensive smoking cessation programs for individual or group use in the community and in workplace settings. "Freedom From Smoking (R) Self-Help Manuals." This a set of two colorful, extensively illustrated guides to the quitting process, "Freedom From Smoking (R) In 20 Days," a nuts-and-bolts, day-by-day approach to quitting, and "A Lifetime of Freedom From Smoking (R)," helps smokers reinforce and maintain their new nonsmoking lifestyle. 2 TIMN 0139696

"Freedom From Smoking (R) Clinics." For smokers who prefer a group approach, most ALA affiliates offer this extensive, nationally developed 7-week course led by trained staff or volunteers. Participants receive class instruction and supplementary written and audiotape materials on developing quitting strategies; dealing with recovery symptoms; managing stress through relaxation and assertiveness techniques; controlling weight; and avoiding recidivism. Some ALA affiliates also sponsor followup maintenance groups for ex-smokers. "In Control," a Freedom From Smoking (R) Video Program. In the summer of 1985 ALA introduced a new video approach to quitting smoking that individuals with VCRs can use at home, which can also be used in groups at work, physicians' offices, and other settings. Baseball star Steve Garvey and a psychologist host a 2-hour video program consisting of 13 segments to be shown separately. Users also receive a 136-page Viewers Guide and a 20-minute audiotape with motivational and relaxation messages. The videotape is available in VHS, BETA, or 3/4 inch versions; ALA affiliates also have special guides on using the program in group setangs and physicians' offices. "Freedom From Smoking (R) At Work." ALA staff have been trained to help companies develop a comprehensive approach to reducing smoking at the workplace. Two manuals, "Taking Executive Action" and "Creating Your Company Policy," are available to management and employees to help them develop effective policies on smoking. The Freedom From Smoking (R) self-help, clinic, and video programs can be adapted to the workplace, and company personnel can be trained to lead them. Special posters are available to help kick off a companywide campaign on smoking. Smoking Provsntion The American Lung Association is a strong supporter of comprehensive school health education as a means of convincing children not to smoke and to adopt healthy lifestyles. ALA cooperated with the U.S. Department of Health and Human Services Centers for Disease Control in the development of the comprehensive Primary Grades Health Curriculum Project (PGHCP) for children in kindergarten through third grade. (See description of "Growing Healthy," the combined name for the PGHCP and its sister School Health Curriculum Project for grades four through seven, under U.S. Department of Health and Human Services Centers for Disease Control, page 11.) ALA affiliates also offer other nationally and locally developed smoking education modules and a variety of films, posters, and written materials for classroom use. Most ALA affiliates offer the following: "Octopuff in Kumquat." The American Lung Association's animated feature film designed to present positive health values to 4- to 8-year-old children, "Octopuff ' is a full-color 9-minute film that tells the story of an imaginary character named Octopuff who, despite protests from the elders and the children, introduces smoking to the village of Kumquat. Solutions to the resuiting environmental problems and Octopuff's subsequent reformation are effected by the intervention of the village ch*dren. A teacher's guide is available to suggest suppiementary classroom actrvities. "Lungs Are for Lffe." These school kxtig health education modules that give lessons on smoking, air poilution, and lung physioiogy include teacher's guides, spirit masters, posters, and other aids. Separate modules are available for kindergarten tixough fourth grade. "Marijuana: A Second Look." This highly motivational program uses the cast of the popular television show "Fame" to inform 9-, 10-, and 11-year-oids and theif parents of the dangers of marijuana smoking. A packaged classroom kit includes a teaching guide for teachers and youth leaders, a parents magazine, a "Fame" FAN-tastic post er/magazine for students, and posters, buttons, and stickers. "Biofeedback Smoking Education Project (BIOSEP)." Many ALA afTdiates offer this classroom program for students in grades 7 through 12, which was originally developed by the New Hampshire Lung Association. Students conduct laboratory tests on themselves, using sophisticated laboratory equipment loaned to schools by their American Lung Association affiliate. Carbon monoxide levels, pulse rates, skin temperatures, and hand tremors are compared in smoking and nonsmoking students. Smokers are measured before and after smoking a cigarette in the classroom. BIOSEP allows students to see firsthand the negative physiologic effect of smoking on fellow students who may 3 TIMN 0139697

have no outward signs of poor health. This immediate feedback provides a stimulus for behavior modification that long-term health threats may not provide. It can also reinforce nonsmoking behavior in nonsmokers. "Smoking and Pregnancy Program." ALA has developed information kits for pregnant women and health care providers that discuss the health effects of smoking on the pregnant woman and her baby. For the pregnant woman, a five-piece information kit, available in English or Spanish, provides a "mini flip chart" on how cigarettes affect her baby and why quitting smoking during pregnancy will reduce these health risks, a pamphlet that answers common questions about smoking and pregnancy, and "I Quit Smoking Because I Love My Baby" stickers and signs. For the health care provider, a 10-piece information kit (available in English) provides a counseling handbook, a flip chart for use in counseling patients, two full-color posters, and "Because You Love Your Baby" tent cards. Protscting th• Rights of Nonsmok.rs The American Lung Association and its affilitates also conduct public education campaigns involving the distribution of written materials (such as the ALA leaflet "Second-Hand Smoke: the Facts"), media public service announcements and appearances, and legislative and other public policy activities to increase public awareness of the hazards of involuntary or "secondhand" smoking, and protect the right of nonsmokers to breathe smoke-free air. ALA affiliates are able to assist companies develop and implement effective policies on smoking. Many ALA affiliates have also been instrumental in the development and enactment of State and local legislation to restrict smoking in public places. At the national level, the American Lung Association, in conjunction with the American Cancer Society, American Heart Association, and other members of the National Interagency Council on Smoking, has established the Coalition on Smoking OR Health, a national public policy project that seeks national legislative and regulatory action on smoking. The Coalition on Smoking OR Health and its sponsoring organizations were instrumental in obtaining the passage and enactment of new Federal warning labels on cigarette packages and advertising. The American Lung Association, American Cancer Society, and American Heart Association are also collaborating at both the national and the local level on a series of activities designed to promote a "Smoke-Free Young America by The Year 2000." For further information contact American Lung Association 1740 Broadway New York, NY 10019 (212)315-8700 AMiERICAN HeART ASSOCIATION SMOKING IINTSRYtNT1ON PROGRAMS The smoking intervention programs of the American Heart Association are designed to prevent young people from starting and to help those smokers who want to quit. These programs are promoted in three primary delivery sites, schools, places of work, and health care delivery sites. Program modules are developed by the National Center and field tested for 1 or more years to determine if they are effective. Modules with a demonstrated benefit are packaged and delivered to affiliates for implementation at the priority sites. School 8its Two modules are currently available for implementation in the schools and a third is under development "Let's Talk About Smoking" is targeted for the first year of secondary school and "Save A Sweet Heart" for senior high school. L.t's Talk About Smoking The "Let's Talk About Smoking" module is designed to prevent the onset of smoking among children at the critical point (sixth and seventh grades) when many are beginning to experiment with cigarettes. The focus of the intervention is to make young people aware of the pressures to smoke and teach them skills to resist these pressures. The effectiveness of the module was confirmed in a 1-year study of seventh grade students. 4 TIMN 0139698