State tobacco control expenditures and tax paid cigarette sales.

This research is the first nationally representative study to examine the relationship between actual state-level tobacco control spending in each of the 5 CDC's Best Practices for Comprehensive Tobacco Control Program categories and cigarette sales. We employed several alternative two-way fixed-effects regression techniques to estimate the determinants of cigarette sales in the United States for the years 2008-2012. State spending on tobacco control was found to have a negative and significant impact on cigarette sales in all models that were estimated. Spending in the areas of cessation interventions, health communication interventions, and state and community interventions were found to have a negative impact on cigarette sales in all models that were estimated, whereas spending in the areas of surveillance and evaluation, and administration and management were found to have negative effects on cigarette sales in only some models. Our models predict that states that spend up to seven times their current levels could still see significant reductions in cigarette sales. The findings from this research could help inform further investments in state tobacco control programs.

Identifying and responding to technical assistance and training needs in tobacco prevention and control.

The Master Settlement Agreement generated expectations that significant, long-term funding would be available to the 46 participating states in reparation for the health costs incurred by tobacco use. Facing intense pressure to use anticipated funds for effective programming, states and national organizations considered how to supply the technical assistance and training at the state and local levels. This article reviews assessments by the American Legacy Foundation, the Tobacco Technical Assistance Consortium, and selected states of the current needs for support, technical assistance, and training in tobacco prevention and control. Key findings indicated the need for information, information exchange, mentoring, and training targeted to new staff, with advanced skill sets for experienced staff. As future funding is uncertain, all these organizations are exploring innovative ways to maintain infrastructure and programming at the state and local levels. Training and technical assistance can be the solution to sustaining impetus in the movement.