Tobacco use is the single most preventable cause of death and disease in the United States, causing more than 440,000 premature deaths annually. We can dramatically reduce the health and economic burden of tobacco use by employing proven tobacco control and prevention strategies. Policy interventions offer the greatest opportunity to influence decisions regarding tobacco use at the societal level. Tobacco control policy can drive social, environmental, and systems changes, and has a substantially greater impact than interventions that target individuals. A policy approach engages the larger community and empowers it to establish healthy social norms. Health departments, the primary governmental institutions charged with protecting the health of the public, play many different roles in advancing policy. The National Tobacco Control Program funds state health departments to educate the public and decision makers regarding evidence-based policy strategies. This article outlines those strategies, critical success factors, and challenges associated with policy-based interventions.

The National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention funds a program to boost progress in reducing the prevalence and incidence of multiple chronic diseases and their associated risk factors. This article describes the program, State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity and Associated Risk Factors, and Promote School Health, and the program’s action model, design, and administration and management structure. This program is based on 4 domains of public health action: 1) epidemiology and surveillance, 2) environmental approaches, 3) health care system interventions, and 4) community programs linked to clinical services. The 4 domains of public health action leverage data to inform action, support healthy choices and behaviors, strengthen delivery of clinical preventive services, and help Americans better manage their health.

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