Creating tobacco control policy at the local level: implementation of a direct action organizing approach

This article describes the community activation and policy change process in seven Minnesota communities involved in the Tobacco Policy Options for Prevention (TPOP) study. The study's intervention employed a direct action organizing model, which relies on mobilizing large numbers of people to alter decision making and leverage the power of elites. As part of the organizing process, TPOP organizers and teams made 1,319 personal contacts with community members, generated 309 media stories, and initiated 445 public events related to tobacco use. These actions resulted in the establishment of comprehensive tobacco ordinances in all seven communities. The authors discuss the goals, training, activities and political factors relevant to four phases of the TPOP intervention: information gathering and team recruitment, community awareness building and ordinance development, preparing for city council, and ordinance establishment and enforcement. Included are suggestions for practitioners interested in using policy change and community-based advocacy to resolve public health problems.