Tobacco prevention in rural areas - 8/28/07

Q: Washington State is wondering if there are other states that have looked at the uniqueness of doing tobacco prevention in the rural areas of their state.  If they have, what did they find and did they develop a plan based on this work that they would be willing to share with us?  Thanks for your assistance!

A:

1. Alabama: Alabama does not have anything formal to provide Washington, but our coordinators have a lot of experience in working in rural areas. If they have specific questions, I would be glad to arrange for our folks to participate in a conference call with them.
    
2. Kansas: Kansas is predominately rural so it is critical to mobilization and implementation of local tobacco use prevention efforts, that staff is located throughout the state. To better serve the rural communities in Kansas, the Kansas Tobacco Use Prevention Program has located six outreach coordinators across the state in Kansas Department of Health and Environment district offices.  Kansas's rural use of smokeless tobacco is high 15.7%, in comparison to our urban use of 5.1%. Living and working in the funded communities, the staff are best able to assess the local climate and choose the methods for progress in tobacco use prevention.  Staff who understand local culture are the bridge between state and local objectives and rural implementation. Training and technical assistance, recruitment, identifying influential decision makers and communities readiness for clean indoor air initiatives, monitoring funding appropriations, and assisting with garnering media exposure are a few of the activities that the outreach staff accomplish. Our recent successes include:
    
   • Establishing policy changes for tobacco free days at county fairs.
   • Furthering our Smokeless Does Not Mean Harmless initiative
   • Our upcoming Spit Tobacco Summit and the
   • Integration with oral health professionals to promote cessation
      
   If you would like more information please contact the Kansas Tobacco Use Prevention Program at 785-296-8127.  Clarence Cryer, Jr., Director.
    
3. Nevada: Nevada is beginning its Tobacco Disparities strategic planning process with our statewide work group, completing the first in a series of meetings and will most likely be addressing how to lower the rates of tobacco use in our rural areas in Nevada.  It will be a while before this plan is finalized, but when it is we will be most happy to share it with Washington as they were so helpful in getting our disparities work off the ground in Nevada at the third Disparities Workshop(Dave).
    
4. Ohio: Attached is a summary on focus groups recently conducted in Ohio, and two were conducted in SE Ohio among Communities of Color.  Southeastern Ohio is a rural area and is a priority area for the OTPF (Ohio Tobacco Prevention Foundation) and for the Ohio Dept. of Health (Tobacco Program included). Tracey O’Dell of the OTPF has done much work in this area and can share much information with others.
    
   • OH Final Report
      
5. West Virginia (1): West Virginia four years ago looked at this very subject, and developed a very successful regional tobacco prevention network.  It's emphasis has been in:
    
   • forming local tobacco prevention coalitions in EVERY county,
   • passage of locally promulgated and enforced clean indoor air regulations;
   • public support of additional tobacco prevention efforts (IE Cessation and quitline services), and
   • addressing at risk, special populations at the community level.
      
   Unfortunately, there is 'not just a plan' that we can put on paper for this unique, ever- evolving regional network - But WV would be happy to give TA and share our experiences with Washington!!
    
6. West Virginia (2): West Virginia has 55 counties and very few cities that have populations of over 20,000. We have lots of small towns with very low population. Years ago, with ASSIST funding, we could barely afford to give $15,000 to counties who would apply, and then that would not even guarantee that you'd get the efforts of one person working about 2 days per week in tobacco prevention, and they certainly couldn't be considered "experts" at the local level. In 1999 we piloted the concept of regional coordinators who could be the local tobacco prevention experts for programming, but also for media communications.  This pilot was successful, so we expanded it to what we call our network of 10 Regional Tobacco Prevention Coalition Coordinators, who are 100% in tobacco prevention. Each RTPCC is hired by a fiscal agent that we contract with, and each RTPCC has a region of 4-6 counties. They can drive to any location in their area in about 1.5 hours.  They are required to establish/maintain at least one local coalition in each county. Up to this point each coalition would focus on passage of CIA regs and making them stronger, but some counties have already achieved CIA regs with 100% workplace protection, that some coalitions are transitioning into other program issues: cessation/Quitline, media, schools/youth, at-risk populations.  From my observations, the RTPCCs are a high-quality group of folks who have bonded well with each other, and we even find them mentoring the new ones as we experience light turnover among the ten.  I have been with this program for 11 years and I am happy to say that I was involved in conceptuallizing this structure.  For our state it is working out tremendously well.  For inquiries on more detail, contact Garland Holley, Program Manager for CIA. In addition, our FY08 project to reach African Americans will use the new Community Tobacco Cessation program from the Health Education Clearinghouse. Our contractor will provide training for "lay counselors" so they can be a resource for individual African American adults who are trying to quit smoking. These lay counselors will absolutely be working with African American adults in rural WV.
    
7. Wyoming: Our Hospital has a No Smoking/Tobacco Free Policy throughout the Hospital Building and Campus.

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