1. BACKGROUND
   1. General:

      Community organizations are effective change-agents for altering the community perceptions of tobacco use as an acceptable behavior. The decision of individuals to use or not use tobacco is heavily influenced by acceptability and approval of the community. As a result, changing community norms through community partnerships is a key strategy of tobacco control.

      By forming partnerships locally and state-wide, community organizations increase their ability to change the knowledge, attitudes, and behaviors of New Jerseyans relating to tobacco use. Programs which encourage and empower communities to alter the public use of tobacco are effective in "denormalizing" tobacco use. Through policy changes relating to municipal ordinances and business practices, communities can also reduce exposure to ETS and decrease youth access to tobacco.

      Community partnerships have the opportunity to support all five goals of a comprehensive tobacco program:

      Goal 1:	To decrease acceptability of tobacco use
      	Increase awareness of negative effects of smoking in community and personal settings
      	Increase number of local policies and ordinances restricting tobacco use and access in public place
      	Increase the number of non-smoking workplaces in NJ including restaurants and bars
      	Increase the number of schools with smoke-free campuses and smoke-free school sponsored events
      Goal 2:	To decrease youth initiation of tobacco
      	Increase the number of publicly funded community activities aimed at decreasing tobacco use among youth through age 24
      	Increase compliance of local vendors with State and Federal laws prohibiting sale of tobacco products to minors
      	Increase overall number of merchants who do not carry tobacco or tobacco related products
      Goal 3:	To increase the number of users who initiate treatment
      	Increase the number of organizations offering nicotine treatment programs
      	Increase awareness of the availability of nicotine treatment programs
      	Increase the number of individuals accessing nicotine treatment programs
      Goal 4:	To reduce exposure to ETS
      	Increase awareness of the harmful effects of smoking in community and personal settings
      	Increase number of local policies and ordinances restricting tobacco use and access in public place
      	Increase the number of non-smoking workplaces in New Jersey including restaurants and bars
      Goal 5:	To reduce disparities related to tobacco use and its effects among different population groups
      	Increase knowledge of minority populations that they are the targets of tobacco marketing
      	Ensure that community tobacco control programs include minority groups and target minority populations and groups at highest risk

   2. Current Programs in New Jersey:

      As part of its current Tobacco Control Program, DHSS supports a number of community-based programs to reduce tobacco use in New Jersey:

      • ASSIST (American Stop Smoking Intervention Study for Cancer Prevention) is a public health demonstration project funded by the National Cancer Institute (NCI) in partnership with the American Cancer Society (ACS) and seventeen selected state health departments. Its purpose is to demonstrate that the widespread, coordinated application of the best available strategies to prevent and control tobacco use will significantly accelerate the downward trend in smoking and tobacco use. In New Jersey DHSS provides grants to six regional "Clean Air Coalitions" with local membership consisting of representatives from schools, workplaces, health care systems and the community at large. Program strategies include working with community groups to portray smoking as unattractive, thereby preventing children from initiating tobacco use; advocating ways to reduce ETS in local communities through volunteer groups; educating physicians and other health care workers on strategies to help patients quit smoking; and working with community leaders to develop and enforce tobacco related policies. These strategies have been directed toward the following groups: youth, blue-collar workers, women of child-bearing age, and racial/ethnic minorities. After September 29, 1999 the CDC became the funding source for this initiative. Funds will continue to support the six local coalitions as well as several statewide initiatives which have been developed during the eight years of ASSIST.

      • DHSS, Division of Addiction Services works cooperatively with many other community groups, voluntary organizations, and coalitions including New Jersey Breathes, the American Cancer Society, New Jersey Division, the American Lung Association of New Jersey, the American Heart Association, New Jersey Affiliate, NJ GASP (Group Against Smoking Pollution), Heureka (an agency with an agenda that includes promoting tobacco-free pharmacies), and the NCADD Affiliate Network (National Council on Alcoholism and Drug Dependence). In the past year successes of these alliances have included municipal ordinances which have banned cigarette vending machines; an increase in no smoking policies in workplaces and restaurants; an increase in enforcement of existing no smoking policies in businesses and public places; and, a decrease in the average rate of illegal sales of tobacco to minors. In addition, New Jersey Breathes, a statewide coalition of anti-tobacco advocates and voluntary organizations with representation from the DHSS Tobacco Control Program, was instrumental in doubling the State Excise Tax on tobacco last year from $.40 per pack to $.80 per pack. In the first year of the increased tax, sales of cigarettes with tobacco stamps decreased by 12% in New Jersey.

   3. Other States and Best Practices:

      California and Massachusetts, leaders in implementing policy changes relating to tobacco, have both included community coalitions in their comprehensive plans. In particular, California has benefitted from strong statewide racial and ethnic coalitions. Community coalitions have been instrumental in the adoption of an increasing number of local ordinances or other provisions restricting smoking in public places. The success of these partnerships has resulted in decreases in ETS. Other states including Oregon have used their partnerships for adult and youth education relating to ETS, smoking cessation programs, and educating judges and retailers.37

2. PROPOSED APPROACH

   This section outlines the proposed approach to implementing the Community Partnerships component of the overall plan including selecting the target populations, establishing basic principles, and creating opportunities for public/private partnerships.

   1. Target Population:

      Community Partnerships will be expected to target youth, young adults, seniors, community leaders, faith communities, local health departments, employers, retailers, restaurant owners, smokers, non-smokers, and persons identifying with a particular racial, ethnic, professional, and/or personal group.

   2. Basic Principles:

      As the program begins to develop, it is important to incorporate the following basic principles:

      1. Local, regional, and statewide coalitions will be identified and where needed, new ones will be developed. Coalitions can be based on geography and/or other self-identified affiliations such as race, ethnicity, age, or profession.
         
      2. Coalitions will be required to have diverse membership, including youth. Youth should be full members of the coalitions and be involved in all aspects of the decision making process and activities. The Office of Minority Health will assist coalitions on how to recruit minority organizations and individuals to serve on these coalitions.
         
      3. Goals and objectives to be addressed by these coalitions should be specific and limited. Individual coalitions should not attempt to accomplish all goals and objectives. Acceptable activities will be defined and specified.
         
      4. Community-based coalitions should be linked to other youth activities.38

   3. Opportunities for Public/Private Partnerships

      Community partnerships can include members from local, regional and national organizations as well as members of the community. Some of the organizations which may be included are the following:

      1. employers in the community;
         
      2. local retailers, restaurant owners;
         
      3. college administrations;
         
      4. school administrations;
         
      5. sport/entertainment industry;
         
      6. health and professional organizations (e.g. American Cancer Society, American Lung Association, American Hospital Association, American Academy of Pediatrics, American Dental Association, hospitals);
         
      7. local public agencies, including local health departments;
         
      8. non-profit and civic organizations;
         
      9. faith communities;
         
      10. trade unions; and,
          
      11. youth groups.

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