October 2005

Grant Results

National Program

SmokeLess States(R) National Tobacco Policy Initiative

SUMMARY

From mid 2001 through mid 2004, the Coalition for a Tobacco Free Arkansas, with first the American Lung Association and then the American Cancer Society as the lead organization, conducted statewide activities to reduce tobacco use, particularly among children and youth.

The project was part of the Robert Wood Johnson Foundation (RWJF) national program SmokeLess States®.

Key Results
Among the results of the project are the following:

  • Arkansas increased its cigarette excise tax from 34 to 59 cents per pack.
  • Arkansas made headway in establishing smoke-free communities and facilities: Highfill, Fayetteville and Texarkana passed smoke-free workplace ordinances. Little Rock International Airport, the War Memorial Stadium, the Little Rock Zoo and the University of Arkansas for Medical Sciences implemented smoke-free policies.

Funding
RWJF provided $1,179,496 for this project. Arkansas also received two grants from the program's Special Opportunities Grant Fund. Other sources — including the Arkansas Department of Health and the American Cancer Society — contributed $945,000 to support lobbying and other activities; no RWJF funds were used to support lobbying. (See Appendix 1 for a list of additional funders.)

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THE PROBLEM

In 1999, 43.2 percent of high school students in Arkansas smoked in the last month and 23.3 percent were frequent smokers, according to the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention. In 1997, among adults, 28.5 percent smoked, compared to 23.2 percent of adults in all states. The state's health statistics reflected this high tobacco use:

  • Arkansas had the second highest rate of lung cancer and the 11th highest rate of heart attacks in the nation, according to the Campaign for Tobacco-Free Kids.
  • Annual tobacco-related health care expenditures exceeded $600 million, according to the Arkansas Department of Health.

The Coalition for a Tobacco Free Arkansas, a network of statewide organizations with a shared mission to prevent the use of tobacco, was established in 1992. Since then, the coalition has worked at the grassroots level to increase public awareness of the negative effects of tobacco use. Activities included adult advocacy programs and tobacco programs for youth (e.g., an annual teen summit on tobacco).

By 2000, the coalition's membership included more than 30 organizations and 800 people; organizational members included the American Academy of Pediatrics, the American Cancer Society, the American Heart Association, the American Lung Association and Arkansans for Drug-Free Youth.

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RWJF STRATEGY

In February 1991, the RWJF Board of Trustees established three new grantmaking goals; goal number three, as outlined in the Foundation's 1990 annual report, was "to promote health and prevent disease by reducing harm caused by substance abuse."

After exploring the landscape of tobacco prevention and control — at both the state and federal levels — RWJF program staff concluded that a private-sector voice was needed in the arena of tobacco control.

To fill the gap in private-sector tobacco-control activities identified by RWJF staff, the RWJF Board of Trustees in April 1993 authorized up to $10 million for a four-year program, SmokeLess States: Statewide Tobacco Prevention and Control Initiatives, to support statewide efforts to reduce tobacco use, particularly among children and youth. In 2000, the program's name was changed to SmokeLess States: National Tobacco Policy Initiative to reflect the focus on tobacco control advocacy only. The program closed in May 2004.

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THE PROJECT

In 1999, before becoming a SmokeLess States project, the Coalition for a Tobacco Free Arkansas received a grant from the SmokeLess States Special Opportunities Grant Fund to develop a plan for using Arkansas' funds from the Master Settlement Agreement for a tobacco prevention and cessation program (the national program office gave grants from the Special Opportunities Grant Fund to states both in and outside of the program; many states outside of the program later became program states).

The coalition worked on this plan with the Arkansas Department of Health, the Arkansas Center for Health Improvement, the Arkansas Medical Society and the University of Arkansas for Medical Sciences. In November 2000, 64 percent of Arkansas voters voted in favor of using Master Settlement Agreement funds for this program.

Arkansas received its SmokeLess States grant in 2001, when the program was in its second phase (2000–2004), which focused exclusively on working to change tobacco policy. The Coalition for a Tobacco Free Arkansas worked first with the American Lung Association (grant ID# 041928) as the lead organization and then with the American Cancer Society (under ID# 046088, a transfer grant). It focused on promoting clean indoor air and increasing the cigarette excise tax. The coalition hired additional staff, developed a media plan, and worked on promoting a statewide smoking ban for restaurants and local smoke-free ordinances.

The coalition raised $945,000 in additional funds for its activities (see Appendix 1 for a list of additional funders). All lobbying activities were supported by matching funds.

The coalition's key activities included:

  • Developing an interactive advocacy Web site and launching a "public call to action" campaign on the statewide restaurant smoking ban initiative. Via the Web site, the coalition educated the public about the initiative and helped people communicate with their elected officials. As a result, people sent more than 1,000 messages to elected officials in support of the statewide restaurant smoking ban. Paschall and Associates, a public relations firm in Little Rock, Ark., worked with the coalition on this.
  • Working on clean indoor air campaigns with local coalitions:
    • The Coalition for a Tobacco Free Arkansas worked on campaigns to pass smoke-free ordinances with eight local coalitions in Bryant, Fayetteville, Heber Springs, Jonesboro, Little Rock, North Little Rock, Pine Bluff and Texarkana (with matching funds).
    • The Coalition for a Tobacco Free Arkansas provided technical assistance and mini-grants ($5,000 to $25,000, for a total of $85,000) for initiatives related to clean indoor air to 13 coalitions in Benton County, Blytheville, Bologna, Camden, Fort Smith (two coalitions), Heber Springs, Helena, Independence County, Jonesboro, Little Rock, Marion County and Wynne.
  • Conducting a poll on increasing the cigarette excise tax, which found that 65 percent of Arkansas voters either strongly favored it (56 percent) or somewhat favored it (9 percent).
  • Public education activities such as eight educational meetings to assist communities with introducing local clean indoor air ordinances in Batesville, Fayetteville, Fort Smith, Helena, Hot Springs, Little Rock, Old Washington and Pine Bluff; an annual statewide tobacco prevention and education conference; and media campaigns about the dangers of secondhand smoke.
  • Youth activities such as an annual teen tobacco-prevention meeting and regional meetings on the dangers of smoking, and training youth to serve as tobacco control advocates.

During the SmokeLess States project, Arkansas received two additional grants from the SmokeLess States Special Opportunities Grant Fund for:

  • Advocacy efforts to increase the cigarette excise tax ($160,000, 2003).
  • Media work in Fayetteville to advocate for the passage of a local smoke-free ordinance ($60,000, 2003).

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RESULTS

Project staff reported the following key project results to RWJF:

  • Arkansas increased its cigarette excise tax by 27.5 cents, from 31.5 per pack in 1994 to 59 cents per pack in 2004. It also raised the tax on other tobacco products by 7 percent, in 2003.
  • Arkansas made headway in establishing smoke-free communities and major facilities:
    • Fayetteville, Highfill and Texarkana passed smoke-free workplace ordinances in 2002, 2003 and 2004, respectively.
    • Little Rock International Airport, the War Memorial Stadium and the Little Rock Zoo implemented smoke-free policies in 2003. Originally, the Little Rock Municipal Airport Commission intended to build airport smoking lounges, however, with guidance from the coalition, the commission voted to go smoke-free.
    • The University of Arkansas for Medical Sciences went smoke-free in 2004.
  • The Coalition for a Tobacco Free Arkansas was unable to achieve a statewide smoking ban for restaurants due to lack of support by the governor and pressure from the tobacco and hospitality industries.
  • By the end of the project, the Coalition for a Tobacco Free Arkansas included more than 30 health care, membership and social service organizations, local tobacco-prevention coalitions, state government agencies, and more than 1,800 people. In addition to the American Cancer Society, the American Heart Association and the American Lung Association, coalition partners included Arkansans for Drug-Free Youth, the Arkansas Branch of the American Academy of Pediatrics, Arkansas Hospital Association, Arkansas Medical Society, Arkansas' Nurses Association, Arkansas' Pharmacists Association and the March of Dimes.
  • The coalition established a strong youth component, with funding from the Arkansas Department of Health and the Centers for Disease Control and Prevention. The coalition held an annual Teen Summit on Tobacco beginning in 2001 that drew more than 500 youth. Project staff hosted four regional training sessions to teach youth how to advocate on behalf of tobacco control and four regional meetings in elementary and junior high schools to educate more than 3,000 students about the dangers of tobacco use and secondhand smoke.
  • The Coalition for a Tobacco Free Arkansas encouraged the development of local coalitions devoted to tobacco prevention and control and helped create a constituency in the state that embraced tobacco prevention and control. The number of local tobacco prevention and control coalitions increased from 12 to more than 80. The number of workplaces and restaurants that were interested in going smoke-free and that eventually went smoke-free increased significantly. For example, the Arkansas Health Department implemented a smoke-free policy and Tyson, one of the country's largest poultry producers, implemented a smoke-free work policy for its facilities nationwide.

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ASSESSMENT

The University of Arkansas College of Education and Health Professions assessed the coalition's impact on local tobacco-prevention coalitions and its work with youth (2004). Assessors conducted a Web-based survey of local coalitions (55 of 73 coalitions responded) and surveyed 314 youth (35 after youth regional training sessions and 279 after Teen Summit 2003).

Findings

  • More than 50 percent of local tobacco-prevention coalitions in the state that participated in the assessment reported that smoke-free legislation at the local level continues to be one of the major goals in their strategic plans. Among their greatest accomplishments in this policy area was gaining support from community leadership for their efforts.
  • More than 90 percent of respondent coalitions reported that preventing youth access to tobacco products continues to be a priority in their strategic plans. Among their greatest accomplishments in this policy area was gaining the support of school administration, student leaders and the students themselves.
  • Respondent coalitions asked for assistance from the Coalition for a Tobacco Free Arkansas for smoke-free activities (just over 23 percent) and youth access policy efforts (8 percent).
  • One-fourth of respondent coalitions indicated that lack of funding was a significant obstacle to pursuing local tobacco-prevention legislation.
  • Local coalitions are most likely to look toward the Coalition for a Tobacco Free Arkansas for funding and training assistance.
  • At least 60 percent of youth surveyed gave the youth regional training sessions the highest rating (4 on a scale of 1–4) and nearly 60 percent of youth surveyed gave the Teen Summit 2003 the highest rating (4) on all variables.

Communications

The Coalition for a Tobacco Free Arkansas established a Web site with information about the coalition, its partners, tobacco prevention legislation and smoke-free dining in the state. The Web site encourages viewers to become active in tobacco prevention and control efforts.

The project also developed a newsletter (ARFRESHAIR), which was published quarterly and disseminated to approximately 2,000 people and organizations. In collaboration with local tobacco-prevention coalitions, the project sponsored regional educational and advocacy meetings across the state. Project staff made presentations on the project to more than 70 groups, including rotary clubs, churches, boys and girls clubs, and school districts. Staff developed and disseminated many publications, including a how-to manual on media advocacy and fact sheets. See the Bibliography for details.

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LESSONS LEARNED

  1. Coalitions should seek members that enthusiastically embrace their mission. The Coalition for a Tobacco Free Arkansas found that it was important to examine the philosophies of potential collaborators to ensure that they were compatible with the mission, goals and objectives of the coalition before forging relationships. (Donald/Project Director)
  2. A coalition's membership should reflect the population of the communities it represents. The Coalition for a Tobacco Free Arkansas sought out communities of color and other diverse groups to create a coalition that represented Arkansas. This enabled the coalition to succeed in much of its work. (Donald/Project Director)
  3. To keep a project steadily moving forward, it is critical to fill any vacant staff position as quickly as possible and with a candidate whose expertise and experience matches the job description. Arkansas was without a project director for nearly five months and the project stagnated during this time period. (Donald/Project Director)

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AFTER THE GRANT

The Coalition for a Tobacco Free Arkansas became a 501(c)3 nonprofit organization in May 2004. The coalition continues to focus its advocacy efforts on clean indoor air locally and statewide. The coalition secured $175,000 in funding from the Arkansas Department of Health to support its activities in 2005. Other funding sources include foundation grants and corporate donations.

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GRANT DETAILS & CONTACT INFORMATION

Project

Coalition for a Tobacco Free Arkansas

Grantee

American Lung Association of Arkansas (Little Rock,  AR)

  • Amount: $ 1,179,496
    Dates: June 2001 to May 2004
    ID#:  041928

Grantee

American Cancer Society, Mid-South Division (Birmingham,  AL)

  • Amount: $ 956,370
    Dates: June 2002 to June 2004
    ID#:  046088

Contact

Katherine Donald
(501) 687-0345
kdonald@arfreshair.com

Web Site

http://www.arfreshair.com

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Other Cash and In-Kind Funders to the Coalition for a Tobacco Free Arkansas

Cash Contributions

  • Arkansas Department of Health, $600,000
  • American Cancer Society, $267,000
  • American Heart Association, $48,000
  • Campaign for Tobacco Free Kids, $30,000

In-Kind Contributions

  • American Cancer Society
  • American Heart Association
  • American Lung Association
  • Arkansas Academy of Pediatrics
  • Arkansans for Drug Free Youth
  • Campaign for Tobacco Free Kids
  • Lisa Ferrell, J.D.

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Survey Instruments

"Tobacco Smoke-Free Workplace Survey," J. Kelley Research, fielded January 2004.

"Tobacco Issues Survey," Opinion Research Associates, fielded statewide January 2003.

Audio-Visuals and Computer Software

Saving Arkansas Lives, a 14-minute videotape on the prevalence and impact of tobacco use among Arkansans. Little Rock, Ark.: Coalition for a Tobacco-Free Arkansas, 2000.

World Wide Web Sites

www.arfreshair.com provides information on tobacco-control issues, secondhand smoke, calls to get involved with advocacy, and tobacco-prevention and education tools. Little Rock, Ark.: Coalition for a Tobacco Free Arkansas, 2002.

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Report prepared by: Karin Gillespie
Reviewed by: Lori De Milto
Reviewed by: Molly McKaughan
Program Officer: Karen Gerlach
Program Officer: Michelle Larkin

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