P.L. 99-252 and the roles of state and local governments in decreasing smokeless tobacco use

Evaluation of the impact of the Comprehensive Smokeless Tobacco Health Education Act of 1986 (P.L. 99-252) will help determine the level of progress being made to reduce smokeless tobacco use and will help determine changes or new strategies needed to prevent or reduce smokeless tobacco use. Indicators of progress made toward implicit goals and explicit provisions of P.L. 99-252 are proposed as appropriate for local, state, and federal government health agencies to address. Examples of roles that can be played by health agencies relative to implicit goals of the law are drawn from experiences of public health professionals in Ohio and other states. These roles relate to work with the media, research and evaluation, surveillance activity, support for development of materials and implementation of programs, and funding for community educational programs. Indicators to measure impact of explicit provisions of the law focus on provisions specified in the public education section of the law. Proposed indicators involve monitoring the development and availability of programs, materials and media, monitoring research and dissemination of findings, and monitoring technical assistance and grants available. Possible measurement and evaluation strategies are discussed. Survey methodology seems most suitable for monitoring level and type of anti-smokeless tobacco activity in which health agencies engage and for determining awareness of resources available through the law.