For more than a decade, the Oklahoma Tobacco Settlement Endowment Trust and Oklahoma State Department of Health have collaborated to implement best practices in tobacco control through state and community interventions, including legislated and voluntary policy approaches, health communication, cessation programs, and surveillance and evaluation activities. This partnership eliminates duplication and ensures efficient use of public health dollars for a comprehensive tobacco control program based on a systems and social norm change approach. The purpose of this paper is to briefly describe strategies to reduce tobacco use despite a rare policy environment imposed by the presence of near-complete state preemption of tobacco-related law. Key outcome indicators were used to track progress related to state tobacco control and prevention programs. Data sources included cigarette excise tax stamp sales, statewide surveillance systems, Oklahoma Tobacco Helpline registration data, and local policy tracking databases. Data were collected in 2001-2013 and analyzed in 2012 and 2013. Significant declines in cigarette consumption and adult smoking prevalence occurred in 2001-2012, and smoking among high school students fell 45%. Changes were also observed in attitudes and behaviors related to secondhand smoke. Community coalitions promoted adoption of local policies where allowable, with 92 ordinances mirroring state clean indoor air laws and 88 ordinances mirroring state youth access laws. Tobacco-free property policies were adopted by 292 school districts and 309 worksites. Moving forward, tobacco use will be prioritized as an avoidable health hazard in Oklahoma as it is integrated into a wellness approach that also targets obesity reduction.

Using community-based best practices in tobacco control while focusing on social norm change, CX counties experienced positive changes in smoking-related attitudes and behaviors. This study expands the evidence base for statewide tobacco control programming and underscores the value of community-based tobacco control programs.

Policy at the local level is a critical component of comprehensive tobacco control programs. This study examined the relationships of individual and social factors with support for tobacco-related public policy using cross-sectional data (n = 4461) from adults participating in a statewide survey. Weighted multivariate, multinomial logistic regression examined associations between individual and social factors and support for tobacco-free city properties and support for limiting the number of stores that sell tobacco near schools. Oklahomans were more likely to favor policies that create tobacco-free city properties than policies that limit the number of stores that sell tobacco near schools. While non-smokers were most likely to favor both policies, support for both policies was greater than 50% among current smokers. Knowledge of secondhand smoke (SHS) exposure harm and female gender were predictors of support for both policies and among current, former, and never smokers. Rural-urban status was a predictor of support among former smokers and never smokers. Tobacco use among friends and family was only a predictor among never smokers’ support for limiting the sale of tobacco near schools. This study demonstrates that level of support differs by policy type, individual smoking status, as well as among subpopulations, and identifies critical elements in the theory of change for tobacco control programs.

This study demonstrates the campaign's impact on tobacco-related attitudes, knowledge, and behaviors among both tobacco users and non-users.

financial pressures, difficult choices made when stretching limited income, difficulties in improving one's situation and emotional stresses and frustrations when living on a limited budget. The majority of interns (88%) successfully met the TMPSC and 75% utilized alternative forms of food access (ex. food pantries, soup kitchens, gardening). Conclusions and Implications: The TMPSC provides interns with a social simulation experience to prepare and sensitize them for working in Maine, the state that has the third highest rate of very low food security in the United States.