Communicating Program Outcomes to Encourage Policymaker Support for Evidence-Based State Tobacco Control

Abstract

Tobacco use, the leading cause of preventable death in the U.S., can be reduced through state-level tobacco prevention and cessation programs. In the absence of research about how to communicate the need for these programs to policymakers, this qualitative study aimed to understand the motivations and priorities of policymakers in North Carolina, a state that enacted a strong tobacco control program from 2003–2011, but drastically reduced funding in recent years. Six former legislators (three Democrats, three Republicans) and three lobbyists for health organizations were interviewed about their attitudes towards tobacco use, support of state-funded programs, and reactions to two policy briefs. Five themes emerged: (1) high awareness of tobacco-related health concerns but limited awareness of program impacts and funding, (2) the primacy of economic concerns in making policy decisions, (3) ideological differences in views of the state’s role in tobacco control, (4) the impact of lobbyist and constituent in-person appeals, and (5) the utility of concise, contextualized data. These findings suggest that building relationships with policymakers to communicate ongoing program outcomes, emphasizing economic data, and developing a constituent advocacy group would be valuable to encourage continued support of state tobacco control programs.

Reactions to smoke-free public policies and smoke-free home policies in the Republic of Georgia: results from a 2014 national survey

“…Research should examine the processes that impede the adoption of comprehensive public smoke-free policies and voluntary adoption of such policies in personal settings in Georgia. Relatedly, determining ways in which community engagement and coalition building can be fostered are critical in advancing smokefree policy legislation (Schmidt et al 2014). For public health practitioners, our findings suggest that Georgians are supportive of public smoke-free policies.…”

“…One might be that constituents are not highly engaged with their lawmakers (Berg et al 2015c), which is critical in advancing tobacco control legislation (Flynn et al 1997). This is particularly important given the importance of lobbying for influencing public policy, whether the influence comes from the public health community or the tobacco industry (Schmidt et al 2014;Berg et al in press). Another explanation may stem from policymakers' misconceptions about the negative health impacts of SHSe or the economic and public health benefits of smoke-free policies (Flynn et al 1998;Thrasher et al 2015;Berg et al in press).…”

Tobacco Taxes in the Southeastern US States: Views from Former Legislators

“…As such, engaging constituents with policymakers is critical. 21 Moreover, concerns were raised about the impact of increased tobacco taxes on state economies and particularly in relation to people crossing state borders to buy cigarettes at lower prices. However, legal border crossing to purchase cigarettes and avoid tobacco taxes has been found to be infrequent and have little economic impact.…”

Reactions to Cigarette Taxes and Related Messaging: Is the South Different?

“…21 Alternatively, legislators may have misconceptions regarding the economic impact of tobacco taxes. 22-24 The decreased likelihood of supporting tobacco control legislation in these regions also could reflect the fact that the personal values and attitudes of legislators are major determinants of voting decisions. 25 In one study, Oklahoma legislators reported that personal beliefs accounted for 63% of all voting decisions.…”

“…20 Moreover, lobbying, from both the public health side and the tobacco industry, plays a key role. 20,22 …”