They had some tough questions: Would we become embroiled in controversial issues like the legalization of drugs? Would we become entangled with law enforcement? How would the corporations that produce and sell tobacco and alcohol products react? How would we steer through the complicated issues of personal choice when legal products are involved? Further, how would we deal with the fact that alcohol is apparently healthy at some doses? What could all this controversy do to the Foundation’s reputation?
    Some trustees did not want to include tobacco and alcohol because they are legal substances with powerful industries behind them, but others argued that since they take a heavier toll than illegal drugs, there was no public health justification for omitting them. Tobacco caused the most consternation, but a handful of trustees pushed hard for it, drawing heavily on the public health data.
   Finally, a compromise was crafted. Our efforts to combat substance abuse would include alcohol and tobacco, but those efforts were to focus initially on youth, for whom the substances are illegal. It was tough sledding getting there, and we almost didn’t make it. But ultimately, for the first time in its history, RWJF had a goal that focused on the health part of its mission.

SIX STRATEGIES
Our initial focus on youth naturally led us to emphasize substance abuse prevention and treatment. Early on in this endeavor we recognized that we would only make significant gains if the nation focused more on substance abuse prevention and treatment than on combating the illegal drug trade. So we have worked to build capacity and support for prevention and treatment efforts in six ways.

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