The quarter that changed the world - most expensive restaurant dishes in the world

California Department of Public Health (United States of America)CDPH)
California Tobacco Control Program (CTCP)
One of the longest.
Run a comprehensive tobacco control program in the United States, which was generated by the 1988 Vote initiative, which increased by 25-
A us tax on each pack of cigarettes and a proportional tax on other tobacco products.
In order to reduce the use of tobacco, the programme adopted the method of changing social norms.
Methods review business, structure, evolution, program dissemination and results.
The continuous implementation of the results program has reduced the number of adult smoking per capita by more than 60% from 22, and the adult smoking rate has decreased by 35% from 22.
7% from 1988 to 13. 8% in 2007.
From 1988 to 2004, the incidence of lung and lung cancer in California has dropped by nearly four times the rate of decline in other parts of the United States, and the program is related to medical cost savings of $86 billion.
Smoking rates among 12-17-year-olds are the second lowest in the country.
Conclusion The method of changing social norms is effective in reducing tobacco consumption, adult smoking and adolescent smoking.
This led to a decline in tobacco production.
Related Diseases and Related to savings in medical expenses.
In considering the effectiveness of the CTCP, the accompanying information is that it should be treated as a uniform scheme rather than a collection of independent interventions.
The design and implementation of the programme is one that complements and strengthens each other.
Its effectiveness depends on its overall strategy, not on any part of the intervention.
California Tobacco Control Program (CTCP)
One of the longest.
On November 1988, a voting initiative called proposal 99 implemented a comprehensive tobacco control program in the United States, an increase of 25-
Starting from January 1, 1989, a % tax will be levied on each pack of cigarettes, and taxes on other tobacco products will increase accordingly.
1 2 this tax is designated for public health programs to prevent and reduce tobacco use, provide health care services, and fund tobacco
Research on environmental protection resources. Programme-
The mandated legislation in the health education section is both visionary and prescriptive.
It set an ambitious goal to achieve a 75% reduction in tobacco consumption within 10 years, authorizing the application of the latest research results and requiring the implementation of the programme, to demonstrate an understanding of the role of community norms in influencing individual tobacco use.
It sets out positive timelines and detailed requirements for local health sector, community input, assessment and national oversight.
In general, these tasks provide accountability for timely implementation and measurable results, and justify the population --
The basis of the strategy, the flexibility of programme development and the basis for defending programmes from political intervention.
The leaders of the two state health departments played an important role in the early success of the CTCP.
These are Dr. Kenneth Kaiser, the director, and Dillip Bal, the chief of cancer control.
Both are at risk.
Adopt a leadership style that inspires internal and external resources.
Dr. Kizer established an administrative department.
Reset level working group
Quick start Proposition 99-Design basic state business process
Funding programmes.
Dr. Bal used his federal government and university relations network to design key project components and quickly formed a team that was good at working with stakeholders who were able to complete their tasks by the deadline. The risk-
The launch of the media event in April 10, 1990 reflected the essence of Dr. Kizer, which was bold and immediately controversial.
It directly challenged the tobacco industry and defined the campaign
About smokers.
Later in the month, Dr. Kizer provided congressional testimony setting out the "non-traditional counter-
Will use the "hard advertising" smoking campaign.
In his testimony, he demonstrated the promise of "opening up a new path" and the tolerance for making mistakes as the campaign progressed.
4 Financial Year (FY)
1989-1990, $95 was allocated for CTCP. 3 million.
Through the "budget law" and later legislative compilation, many
Annual expenditure authority is provided to allow three years to spend allocations for any given year.
This funding, realized with the voluntary assistance of WHO, is a key element of tcp resilience that can protect core infrastructure and senior staff during budget fluctuations.
The budget of the CTCP has fluctuated significantly over the past 20 years.
These fluctuations are shown in Figure 1.
Figure 1 budget for the California Tobacco Control Program 1989-1990 to 2008-2009 for the fiscal year ($millions).
In 1992, the $16 million media campaign was removed from the budget, but it was restored when the California Lung Association sued California.
However, in fiscal 1995 to 1996, tcp's allocation was reduced to $36.
6 million. transfer funds to cover immunization and child insurance programmes.
The annual base allocation for the local health sector is US $, reduced to US $10 000 and is required to cost 1-
The third is about the publicity of the perinatal period.
These transfers have led to a split between public health programs within the state health department.
More importantly, the relationship between California and voluntary care has become tense, eventually filing a series of lawsuits against California on 1994 and 1995.
The court ruled that budget transfers and other legislative operations carried out to reduce the percentage allocated for the prevention and cessation of tobacco use in proposal 99 were illegal.
In fiscal 1996-1997, the transfer began to resume.
The legal action taken by voluntary health agencies ultimately prevented the weakening of tcp effectiveness.
In fiscal 2001-2002, when the funds were securitized to address the national budget deficit, the funds allocated due to the total settlement agreement with tobacco companies were canceled.
Willingness of voluntary health agencies to file lawsuits, their presence in the national oversight council and local alliances, and ensuring that multiple parties
The annual expenditure authorization is an investment in the programme, which remains key to the sustainability of the programme.
The programme infrastructure includes media campaigns and state and community interventions, including interventions.
The media campaign conveyed this message, while community interventions carried out advocacy campaigns and state interventions built the capacity of community projects.
Assessment/oversight activities measure the implementation and effectiveness of interventions provided by the state administration to manage the human capital of the programme.
A supervisory committee authorized by legislation provides advice to the CTCP.
It publishes an overall plan every three years to guide the implementation of the overall plan and to summarize progress towards achieving the overall plan objectives.
Figure 2 describes major activities and programme achievements for the period 1988-2008.
Figure 2 schedule of major events and achievements of the California Tobacco Control Program: 1988-2008.
Media activities generate ideas through the use of paid advertising and public relations activities
Trigger advertising and news campaigns to promote the dangers of tobacco use, the health impact of secondhand smoke, marketing strategies in the tobacco industry and the availability of smoking cessation assistance.
General market-
Specific and priority population
Carry out specific activities.
The state and community intervention component includes :(1)
A statewide competitive grant program that provides direct services and/or training and technical assistance (
Stop quitting, community organization help, for example); (2)
Local health departments implementing integrated programmes; and (3)community-
Competitive grant projects based on a single project
A problem-centered campaign or focus on a select group (
Hispanic/Latino).
A mix of local health departments and competing-funded communities and statewide grant programs provides diversity and balance.
The local health sector, as the foundation of the national public health infrastructure, has continuity, while competitive grant projects are cyclical.
One benefit of funding each health sector is the creation of the large number of staff needed for several key policy issues across the state.
The local health sector is often at risk.
Adverse climate because they report to the elected board, as shown in figure 3.
Instead, the community
In the absence of political intervention, there is more freedom of innovation in headquarters institutions.
Statewide projects reduce duplication by standardizing, improve quality, increase accessibility and create cost efficiency for services by increasing purchasing power and reducing administrative costs.
Figure 3 Oroville Mercury Register, March 24, 1992: Health officials in chesterward Butte County banned participation in tobacco regulation.
In 2001, the China Tobacco Control Commission incorporated the use of outstanding Community tobacco control indicators and assets into procurement.
Indicators reflecting environmental measures (
Degree of tobacco --
Industry sponsorship activities).
Assets are measures to promote and sustain tobacco control efforts (
The level of community activity that adults support tobacco control).
They are used to set priorities and set goals and activities.
Evaluate/Monitor tcp for a series of monitoring and evaluation activities.
Including the assessment of media activities (
See page 38th-43, Cowling et al)
Community programme (
Modayil et al, see Page 31-37), school-
Tobacco use prevention programme (
Park et al, see Page 44-51)
Marketing monitoring of tobacco industry (
Roeseler et al, see page 21st-30).
The statewide assessment approach has evolved from relying on external experts to building internal and local capabilities.
This change improves the ability of CTCP to adapt to environmental changes and to use the assessment and monitoring work of emerging technologies.
Locally, the evaluation adopts an approach of empowerment.
At least 10% of the budget will be used for evaluation in 11 projects. A university-
The Evaluation Center, headquartered in the evaluation center, provides assistance to local projects and ratings the quality of local assessment reports disseminated through the e-library system.
12 logic model of program logic model ctcp (figure 4)
Identify the four programme priority areas that constitute media and community intervention and illustrate the hypothetical causal pathways that link programme efforts to outcomes.
These areas are (1)
Reduce exposure to second-hand smoke that limits smoking in public and private places; (2)countering pro-
Tobacco effects designed to increase tobacco prices and curb the effects of tobacco marketing, campaign donations, smoking in movies; (3)
Through efforts to ban the sale of tobacco to minors, reduce the supply of tobacco, eliminate the free distribution of tobacco products, and limit the sale of tobacco products; and (4)
Provide smoking cessation services through the California Smokers Helpline (Helpline)
Expand support for the cessation.
Figure 4 California Tobacco Control Program/paradigm of change in social norms as a logical model.
Program ideology of the National Cancer Institute in 1989 (NCI)
The draft standards for comprehensive smoking prevention and control were initially used as the basis for CTCP work, but the idea and framework of the programme changed based on experience in implementing these standards across the state.
Through the infrastructure and logical model of the programme, 13-16 is a commitment to five core beliefs :(1)
A comprehensive approach to social norm change is more effective in reducing tobacco use than for individuals who focus on smoking; (2)
Predatory marketing and promotional practices in the tobacco industry must be resisted; (3)
Programmes must focus on the community level, as local leaders are most responsible and sensitive to their communities; (4)
Programme efforts must reflect the multicultural nature of California and address health inequalities; and (5)
Continuous change should be driven by evaluation.
While infrastructure, policy priorities, media information and assessment measures are constantly changing over time, adapting to external conditions (
Results of budget, political management and assessment)
The commitment to core beliefs is deeply embedded in the operation of the organization.
These beliefs are rooted in delegated legislation that enables the programme to repeatedly divert pressure seeking to eliminate anti-corruption
Shift the focus of the programme to youth campaigns and policies that punish young people for owning tobacco, transfer funds to support smoking cessation classes, 1-
To reduce the local project evaluation requirements, shoot the nicotine patch giveaway promotion.
The change of social norms is the core of the Communist Party of China's programmatic thinking and the concept of social norms.
The goal is to change the broad social norms surrounding tobacco use and indirectly influence current and potential future tobacco users at population levels by creating a social and legal environment, in this environment and legal environment, the use of tobacco has become less ideal,
The focus of this approach is on changing the norms of the community rather than changing the behavior of individuals.
As new people, businesses and organizations enter the community, they inherit, adopt and comply with established tobacco use norms.
13 14 17 18 while highlighting the approach to changing social norms, the cessation of services was also supported.
The fight against exposing the tobacco industry and combating the tobacco industry is a highlight of the programme's ideology.
The media campaign exposed the marketing practices of the tobacco industry, while community intervention (
Please see Roeseler et al and Francis et al in this appendix)
Implement policies that regulate tobacco sales, distribution and marketing.
The first ad of the media campaign boldly announced the project's intention to the tobacco industry, saying, "it will be a media campaign on the media campaign --
As much publicity and health.
It will talk about a common community opportunity and a common community threat.
There was never something like it. 19Anti-
Industry Information is the main tool against professionals
Influence of tobacco
They make smokers angry and rebellious about the tobacco industry using flashy advertising and nicotine addiction to manipulate them.
While stimulating personal interest in quitting smoking, they should also hold the tobacco industry accountable.
California smokers have a very negative attitude towards the tobacco industry, and over the past 12 months and 1 month they have a 70% chance of trying to quit smoking.
Compared with those with lower scores for negative attitudes towards the tobacco industry, the likelihood of a withdrawal intention in the next 6 months has increased by 6 times (
Zhang et al in this supplement).
The tobacco industry has repeatedly tried to suppress the opposition of media campaigns.
Advertising industry.
Figure 5 shows a memorandum from the Tobacco Institute in April 18, 1990 outlining their strategy to intervene in the media campaign.
On 1994, James Johnston, chairman of Renault, asked the National Health Department to stop advertising nicotine sound bytes.
In the ad, tobacco executives testified in Congress about the addictive nature of cigarettes, and the words below their testimony repeat the word "oath.
23 on April 2003, Reynolds and Lorillard filed a lawsuit against California in an attempt to prevent
Industry ads based on these ads bias jurors and prevent fair jury trials in class action.
None of these efforts succeeded.
Figure 5 memorandum of the Tobacco Research Institute of April 18, 1990.
The third belief is that policy efforts must be focused on the ground.
Strategically, this is critical because, thanks to the tobacco industry's contribution to the state's movement, the State Council is a hostile environment for tobacco control efforts
Elected officials
26-28 in addition, the CTCP authorization legislation, through its mandate to the local health sector and funding to the community, identifies an organizational structure conducive to work at the local level
Based on organization.
29 narrow thinking promotes the concept that communities should have full autonomy as each community knows their needs best.
However, the CTCP recognizes that the strategy of changing social norms is controversial.
Many communities would rather fund smoking cessation classes than address the problem of workplace or tobacco industry exposure to secondhand smoke --
Sponsored the rodeo competition in the county playground.
CTCP seeks to balance the need for local autonomy and the need for evidence by the state
This foundation-based approach will create critical mass around some key policies and will be supported by the statewide media campaign.
Combining this broad statewide approach to agenda setting with local policy priorities, the important factors for success are :(1)
Involve stakeholders and experts in designing local policy activities; (2)
Provide training and technical assistance; (3)
Establishing local alliances; (4)
Support for media activities across the state; and (5)
Educated elected officials make informed decisionsmaking.
The needs assessment and planning framework for communities of Excellence also helps to form a broad statewide agenda while allowing local communities to identify their priorities, goals and the best ways to achieve them.
As a result of building local policy momentum, it indirectly affects and shapes national policies (
Francis et al in this addition).
In 1990, little progress was made in tobacco control policies;
However, second-hand smoke information and policies for media campaigns --
Centralized training has changed local policies.
The wave of local policy has pushed the passage of clean indoor air legislation in 1994 states.
Free bar and full buffet in 1998
2004 service display ban on tobacco products.
31. 32 as the programme matures, an unexpected benefit of this approach is the election of former City Council members of the state legislature that demonstrate leadership in tobacco control locally.
For example, former MP Juan Vargas, as a member of Parliament for the United States of America, successfully supported tobacco advertising restrictions targeting children.
As a state councillor, he enacted a law on smoking in the playground in 2002.
33 investments in the establishment of local alliances, local capacity and cooperation with local elected officials have generated dividends, which cannot be achieved if emphasis is placed at the national level.
The fourth belief that reflects the multicultural nature of the population that constitutes the core ideology of the CTCP is the recognition that the program must reflect the multicultural nature of California and address
Existing tobacco
Related health inequalities.
Historically, tobacco companies have used the unique social and cultural environment of different groups of people through targeted marketing strategies, and tobacco control efforts have not met many of these target groups.
34 The CTCP recognizes that different communities in California do not live in isolated islands, but are influenced by the general trend of life in California, but at the same time, we are also aware of the need to motivate and attract specific groups of people, A meticulous approach to language and culture is needed.
Therefore, the dual perspective of multi-culture is synchronized with the promotion of tailor-made interventions.
The media campaign complements the efforts of the general market
Advertising and outreach activities related to language and culture.
Within the National and Community intervention programme component, the dual approach of multicultural and well-targeted continues to develop.
Since 1992, quitline numbers in English and Spanish have added four Asian language lines in 1994.
Each line has a mass media campaign in a specific language.
In 35. 1990, four statewide ethnic networks were established with the aim of exchanging best practices and lessons learned in response to a large number of community projects that finance these groups.
To 2004, similar efforts have been made for populations grouped by features other than race/ethnicity but also experienced tobacco
Related health inequalities and goals.
Seven statewide priority population partnerships have been established to provide training and technical assistance to local projects, and carry out a statewide publicity campaign against major ethnic/ethnic groups, labor, low socio-economic groups and lesbians for gay, bisexual and transgender people (LGBT)community.
Starting in 2007, the declining budget has been unable to sustain a strong complement to these seven partnership projects and communities --
Priority population projects;
From 1990 to 2009, the number of competitive grant projects decreased from 148 to 50.
The analysis of the partnership program found that combining statewide advocacy activities with training and technical assistance was not the best practice.
Some partnership projects, in their advocacy role, criticized local projects, while others were underserved the community.
While criticism may be valuable, it has had a chilling effect on projects seeking training and technical assistance.
36 This finding resulted in separate funding for advocacy activities from the provision of training and technical assistance services.
Priority population training and technical assistance services were merged into a single statewide program in 2008 with flexible organizational structure designed to address cross-bordercutting (
Poor culture, low level of culture)
Emerging populationSpecific needs (
Mental illness).
The integrated service also attracts different individuals and organizations across the country, including experts and peersto-
Peer training and technical assistance.
In contrast, previous models rely on California
Provide a repository of expertise for each specific population.
The monitoring also included multicultural and targeted population measures.
The California Tobacco Survey, an adult telephone survey conducted every three years, provides a large enough sample to be analyzed by race/ethnicity, sexual orientation and economic status. Population-
Specific monitoring studies increased the California Tobacco Survey and conducted surveys in the Chinese, Koreans, Asian Indians, LGBT and California --
Military population.
37-41 surveys are being conducted on rural Indian/Alaska indigenous populations in Vietnam and the United States.
The last belief in using the evaluation results to drive the core idea of the continuous change CTCP is its value to the evaluation.
It is considered critical to programme accountability and is deeply rooted in organizational practice.
Data is constantly being used to improve interventions, monitoring methods, and business operations as shown in several articles in this appendix.
Program Innovation for a long time
The terminology of delegated legislation focuses on the freedom to allow experiments.
This startup environment has led to innovation such as telephone.
Based on smoking cessation counseling and smoking
Free Bar policy in the 1990 s
Recently, it stimulates more and more outdoor smoke.
Free Beach and a variety
Unit housing regulations, and the first US regulation to ban the sale of tobacco products by pharmacies in San Francisco in 2008.
42-46 in business, it promotes the application of technology to improve the management of local program data, evaluation of media activities and testing of advertising concepts, and to develop advertising ideas using social media.
In 2001, in order to improve the contract management, the online tobacco information system was launched.
This customized network
Based on the system to promote the unified data collection, real production
Improved quality and transparency of work.
The system search function increases the accessibility of the project work plan and promotes collaboration.
Population, 2005-based web-
Media assessments were conducted through the group.
This method is less costly and more flexible than the telephone survey previously used.
The deployment of the survey can easily be synchronized with the location rotation of the media campaign, and data collection is also completed faster, which enhances the ability to link specific advertising to changes in population attitudes.
This allows the program to compare the intensity of various advertisements before the next placement rotation and improve the effectiveness of media intervention.
In 2008, the use of this method was expanded to include the testing of advertising concepts. The web-
Panel offers more testing of advertising concepts for rural and Hispanic/Latino adults with face-to-
Facing the focus group.
It is used to test the suitability of the Spanish advertising concept for the general market and to test the healthcare provider ads created in New York.
In 2007, CTCP launched a game to become a hero. Create. Direct. Save Lives. Anti-
Collect tobacco ads from California
Film schools, video competition websites and professional institutions.
From nearly 50 entries, 19 shortlisted entries were selected through the competition website and received more than 1 million visits.
The award-winning advertisement was broadcast on TV show American Idol in 2008.
48. an important consideration for the dissemination of CTCP persistence in programmes is the dissemination of programmes by using shaping strategies to share knowledge capital and influence public health practices.
Shaping Strategies has a transformative impact on their own organization, redefining and reshaping industries and practices.
49 CTCP 1998, model of change: California's experience in tobacco control identifies the vision of a comprehensive tobacco control programme, information was provided on the best practices of the CDC comprehensive tobacco control programme and the programmes subsequently implemented nationwide.
1 17 partnerships with national and international organizations have reduced the cost and effort of others choosing to join the social norm change strategy through training, while assessing the results, advertising and data collection tools inspire confidence in its viability.
As a result, California's model of change in social norms has been widely disseminated, affecting public health practices other than smoking and gaining credibility, making it more difficult for critics to cancel the program.
National and international partnerships with Centers for Disease Control and Prevention have greatly contributed to communication (CDC)
American Cancer Society NCI-Home Office (ACS-NHO)and the WHO.
Clean indoor air workplace legislation, telephone lines and media activities reflect the three major interventions widely disseminated.
California's early experience in clean indoor air legislation provides a tool for jurisdictions eager to enact similar legislation. A CDC-funded smoke-
NCI-free bar case studyPeer monograph
Reviewing the literature and advertising helps others to pass legislation on clean indoor air.
50 51 CTCP also played an important role in establishing telephone lines nationwide.
1998 training sponsored by ACS
NHO disseminated lessons learned from quitline administrators in the US, Australia and Europe.
52 between 2000 and 2004, cooperation with CDC and NCI resulted in the dissemination of resources describing the basis of telephone theory
Based on stop, operational considerations and their role in the demographic context --
Based on the stop policy.
Telephone calls were provided in all 50 states, the District of Colombia and five US territories as of 2007
Based on smoking cessation services.
The media campaign in California is the third biggest contribution.
Media activities involve a large amount of resource investment in the development, testing, production and delivery of advertising concepts.
Sharing advertising ideas is financially meaningful, saving scarce money for placement.
CTCP has contributed more than 300 multilingual ads to the CDC media campaign resource center for dissemination.
These advertisements are used by the World Health Organization, Australia, Belgium, Canada and Germany in more than 20 states and in the world (
C. personal communications, Douglas, 2009).
The success of the SuccessCTCP project can be evaluated from various angles, the most important of which is that it has received a large amount of funds in nearly 20 years, although the funds have fluctuated greatly.
The documentation for the effectiveness of the CTCP is very extensive and covers a range of measures, many of which are described elsewhere in this supplement.
For the purpose of this article, in long-term and short-
The term results determined in the logical model related to the following :(1)population-
Measures based on smoking behavior; (2)
Prevent second-hand smoke; and (3)
Changes in the environment around smokers. Population-
Based on the measure of smoking behavior, it can be said that the most objective measure of changes in smoking behavior at the population level is the number of cigarettes sold in the state.
Compared with the United States minus California, California's per capita cigarette consumption is shown in figure 6.
California's per capita consumption at the time of its 99 proposal in fiscal 1988-1989 was 123 bales, down 20% from the average level in its remaining states.
Fiscal 2006-2007, down more than double
In his thirties, less than one year old
Half of the rest.
Figure 6 per capita cigarette consumption for adults in California and the United States, 1984-1985 to 2006-2007.
The reason for the decline in cigarette consumption this year is the decrease in smoking prevalence (from 22.
7% from 1988 to 13. 8% in 2007)
Stay away from daily smoking, especially heavy smoking every day.
Of the smokers in 2005, there were 28.
There are occasionally 3% people (non-daily smokers)and only 7.
Compared with 16, 2% of people smoke more than 25 cigarettes a day. 4% in 1990.
54 these trends in smoking behavior translate into a decrease in tobacco --Related Diseases
From 1988 to 2004, the rate of decline in lung cancer incidence was almost four times the rate of decline in the rest of the USA55 56 (figure 7).
While some of these reductions can be attributed to changes in smoking behavior prior to CTCP, a large part of CTCP's efforts are related to them.
57 A similar accelerated decline in heart disease.
58 these changes in smoking behavior resulted in an estimated decrease of $86 billion in health care costs for the period 1989 to 2004.
Figure 7 Age of lung and trachea-
The adjusted incidence of cancer was 1988-2004.
Over the past half century, changes in smoking behavior have left a surplus smoking population of vulnerable groups, raising the question of whether tobacco control efforts are effective for these populations.
Table 1 shows the change in the prevalence of CTCP smoking in the past 20 years, as well as the percentage change in smoking prevalence per major ethnic/ethnic group by gender.
These changes are in comparison with national changes.
View this table: View the change in smoking prevalence among California adults by race/ethnicity and gender, 1990-2005 in California, smoking prevalence decreased by about 1
For the quarter of each ethnic/ethnic group of men, the percentage of women, except for Asian/Pacific Islander women, declined slightly more than that of men.
59. While differences in smoking prevalence among these ethnic/ethnic groups remain, the impact of CTCP on smoking prevalence is very consistent, indicating that it affects both vulnerable and vulnerable groups.
In contrast, data across the United States showed a smaller change in prevalence for each group.
Changes in smoking prevalence over 34 years of age
California's annual intervals are larger than the whole country, both African-American and African-American, and annual intervals are absolute and percentage changes
White Hispanic
Differences in smoking prevalence between African-Americans and African-Americans
In the United States, 2005 of the data, the Hispanic white population is relatively small, which reflects the narrowing of the differences in smoking behavior among different ethnic groups in the United States, but the narrowing of this gap is the result of a significant decrease in smoking prevalence among white people under 15 years of age.
The gap between African-Americans is not an increase in decline.
Prevention of smoking in adolescents and youth is an important success of CTCP, but continuous efforts are critical.
Every year, a new crop of children enters adolescence and is the target of the tobacco industry. Even short-
Long-term mistakes in effective prevention work or failure to respond to new tobacco industry promotion initiatives may lead to significant changes in the initiation of smoking among adolescents, such as the initiation of smoking among adolescents nationwide1990s.
Figure 8 compares the prevalence of smoking among adolescents in California and across the country between 2000 and 2006.
Although there are differences in research design between data sources, the smoking rate among adolescents in California has been low compared with the whole country.
62. In addition, the prevalence of smoking among young people (ages 18–24)
Also dropped from 22.
4% from 2000 to 17. 2% in 2007.
The increase in the prevalence of smoking among adolescents between 2004 and 2006 in figure 8 is of concern and needs to continue to focus on programme intensity and coverage.
Download new tabDownload powerpointFigure month 30-
Daily smoking rates in California and the United States (9th–12th grade)
Students 2000-2006
Protection of secondhand smoke exposure has led to and benefited from a wave of normative, regulatory and legislative changes in places where smoking is unacceptable.
Programme content and a positive agenda
During the early project year, media activities accelerated the wave of existing smoking restrictions, eventually leading to the first statewide ban on smoking in restaurants, bars and workplaces. In 2007, 75.
8% of California people agree that smoking is prohibited in the dining area of outdoor restaurants and in 85 restaurants.
3% agree to limit smoking in outdoor public areas within the apartment and apartment complex.
54 to 2005, almost all indoor workers in California reported smoking
Free workplace and 78.
It is reported that 4% of California people smokefree home. 54 In 2006, 55.
1% of young people reported that they did not smoke with one person for the past seven days, aged 73.
9% reported that no one had smoked in the car for the past seven days.
54. Changes in the smoking environment have affected all aspects of smoking behavior, which is a core component of CTCP and is widely responsible for most of the success of the project.
One aspect of this success is the increasing local regulation of tobacco sales.
To 2009, 80 local decrees licensed tobacco sales, an increase from only one in 1998, and 144 local decrees prohibited
Service tobacco sales, compared with 27 in 1994.
63 64 denial has also had a profound impact on smokers and may be the reason for a paradox in California's experience.
Logically, those who are most likely to quit have achieved quitting, the remaining smokers will be more addicted and the efforts to control tobacco will be more resistant.
In contrast, Figure 9 shows the proportion of California smokers considering quitting smoking in the next 30 days and the next 6 months.
In the same year that smoking prevalence has fallen sharply, interest in quitting smoking in the future has increased, not decreased.
This comparison shows that even smokers who are most vulnerable to tobacco control information quit smoking, CTCP has successfully increased their interest in quitting smoking.
This also shows the current population.
Intervention-based work continues and shifts to more individuals
In order to continue to reduce smoking rates, it is not necessary to adopt a basic and intensive smoking cessation strategy.
Figure 9 proportion of smokers considering smoking cessation in California (1994–2007).
Figure 10 also demonstrates CTCP's ability to change the environment to reduce smoking among smokers, which shows a change in the percentage of first-time smokers reported within 30 minutes of waking up in California.
Over time, the decline in this indicator may reflect a decline in addiction among California smokers, and may also reflect a growing number of smokers who smoke
Free home, so it's harder to smoke soon after waking up.
Both explanations reflect a measure of programme success, but the more important lesson is that the overall benefits that the various components of the programme may generate are far greater than the sum of their independent impacts.
Download figure 10 in the new tabDownload powerpoint the proportion of smokers who first smoked within 30 minutes of waking up.
Discussing the sustainability of ctcp goes beyond happiness
The Tobacco Control Programme, which was funded, achieved remarkable results.
California has a common history with programs in other states.
Funded, used evidence
In an atmosphere of recession, litigation and tobacco industry intervention, based on methods, presentation results and operations.
However, unlike other successful national programmes that have been dismantled, 65-69 National Technical cooperation programmes continue to be dynamic and their communities remain at the center of national policy innovation.
42-46 63 taking into account the effectiveness of the CTCP, the accompanying information is that it should be considered as a uniform scheme rather than a collection of independent interventions.
The design and implementation of the programme is a mutually reinforcing and enhanced programme of various components whose effectiveness depends on its integrated strategy, not on any part of the intervention.
Prior to the CTCP, tobacco control efforts focused primarily on changes in individual behavior.
However, in order to create substantial public health benefits, various interventions must be taken to make significant changes in population levels.
Strong interventions with little influence have little impact on incidence, while weaker interventions that affect a large number of smokers will have a cumulative impact on incidence.
The social norm change strategy adopted by CTCP uses this concept.
It helps smokers in California to quit smoking or reduce consumption and protect non-smokers
Smokers smoke from second-hand smoke and prevent tobacco use with personal infeasible contact and influence
Focused strategies in view of the programme budget.
In 10 years, the China Tobacco Control Commission has not reached its goal of reducing tobacco consumption by 75%.
However, meaningful results have been achieved :(1)
The proportion of adult smokers who smoke more than 25 cigarettes per day decreased by 56%; (2)
Per capita consumption of adults decreased by 61%; (3)
The smoking rate among adults decreased by 35%; (4)
A sharp decline (>25%)
Smoking prevalence among all major ethnic/ethnic groups, except for Asia Pacific Islander women; (5)
The second low prevalence of smoking among adolescents aged 12-17 nationwide; (6)
The rate of decline in lung and lung cancer is almost four times that of the rest of the country; and (7)
The cost of medical care is $86 billion.
Despite these successes, 22 states have stronger state clean indoor air laws, $0 in California.
87 tobacco tax ranks 31 in the country, and tobacco use is still high in several demographic groups.
In 2007, legislation to strengthen the national clean indoor air law was rejected.
Between 2005-2007, several attempts to increase tobacco taxes failed.
The measures include the 2006 vote initiated by Governor Schwarzenegger and the 2007 health care reform legislation.
71 72 these failures are due to the requirement that the legislative tax increase must be approved by two persons
In both houses, lobbying by the tobacco industry and cooperation with hospitals are all in their thirties in voting measures, which provides negative campaign material for the use of taxes.
71. 73 in 2009, the increase in several tobacco taxes was pending, including a bill written by Senator Padilla, who was an advocate for tobacco control among members of the Los Angeles City Council.
74 75 the lack of success in strengthening state clean indoor air legislation and increasing tobacco taxes has strengthened the programme's strong focus on local communities.
California has more local regulations in five communities.
The unit residential complex designated its units from 25% to 100% as smoke-
Free and 2007 total ban in Chico City
Selling all tobacco products on public and private property is an example of local efforts to gradually control tobacco.
CTCP taking into account the future, reducing the difference between smoking rates and narrowing the population grouping is a priority.
Expanding partnerships with those who serve socially and economically vulnerable groups is critical to the success of these efforts.
Using social norms change strategies, increasing the price of tobacco products, reducing exposure to second-hand smoke, increasing the provision and use of smoking cessation services, and taking advantage of the opportunities provided by the prevention of household Smoking and Tobacco Control Act 77, is part of the agenda for the future.
This will be done by considering and exploring the policies described in Box 1.
8 78 Box 1 the future of California Tobacco Control considers the establishment of a tobacco tax linked to inflation and the minimum retail price of tobacco products set for manufacturers to prevent geographic price manipulation, in order to reduce the targeting of population and market in the tobacco industry, store type and season.
8 78 in accordance with the First Amendment and the tobacco control legislation of the Food and Drug Administration, limit the time, place and manner of tobacco advertising or marketing.
77 Population development-
California's smoking cessation program has expanded the coverage and utilization of smoking cessation benefits, especially among socially and economically disadvantaged groups.
8 strengthen and conduct Health and Human Services Partnership campaigns among organizations and institutions serving the most vulnerable social and economic groups, such as mental health systems, alcohol and drug treatment providers, licensed housing for children and adults, food assistance programmes, housing assistance programmes and employment assistance.
Seek a unified policy on secondhand smoke, receiving charitable and smoking cessation support from the tobacco industry.
8. formulate policies to prohibit free or low-cost distribution
Under the First Amendment and the Food and Drug Administration tobacco control legislation, cost tobacco products, coupon offers, rebate offers, gift certificates, gift cards or other similar offers are offered for tobacco products.
8 build 100% smoke-
Free indoor workplace standards for all workplaces governed by state, county, city and tribal governments.
8 Use local tobacco retail licenses and licenses to eliminate tobacco retail where direct health care services are provided, reducing the density of tobacco retailers.
8. formulate policies to limit smoking in multiple units
The apartment has a balcony and a terrace.
8 establish
Tobacco advertising fairness principle standard for the purchase, promotion and other retail marketing of tobacco products, which will establish a reversal of 1: 1 or 3: 1
Tobacco ads for each pro
Tobacco advertising.
78 requirements for establishing sunshine or disclosure (
Public demands for similar political campaigns)
Require disclosure of payments from tobacco manufacturers/wholesalers/distributors to retailers (
Incentives, repurchases and promotions, for example).
78 this article adds that the California Tobacco Control Program is one of the longest-running comprehensive tobacco control programs in the United States.
The factors that add to the sustainability of the programme are a clear vision with a focus on a long-term perspective, risk taking, external public support, a well-integrated programme ideology, which is evidence --
A top balance based on innovative approaches
Bottom down-
In terms of operational operations and measuring programme effectiveness, a shaping strategy was adopted to disseminate programmes and accountability.
The programme demonstrates the effectiveness of the social norm change approach in reducing cigarette consumption, smoking prevalence among adults and youth, and in protecting non-smoking
People who smoke second-hand smoke can save medical expenses by reducing lung cancer.
Thank you to the California Department of Public Health for your valuable comments from Tonia Hagaman, head of local programs and advocacy activities for the California Tobacco Control Program.
Centers for Disease Control and Prevention.
Best practices for comprehensive tobacco control programs2007.
Atlanta: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Smoking and Health Office, 2007. ↵Bal DG.
Design an effective statewide tobacco control programCalifornia. Cancer 1998; 83:217–21.
Section 104370 of California health and safety regulations (d-f), 104385 (c)(5), 104420 (4)(F), and 104425 (c)(3). ↵Kizer KW.
About California
On April 30, the smoking media campaign was submitted to the US House Energy and Commerce Committee subcommittee on Hazardous Materials Transportation, 1990. (
Visit June 2, 2009).
Glantz SA of Balbach ED.
Tobacco War: War within California.
University of California, Berkeley and Los Angeles: University of California Press, 2000.
Siegel M. novorini T.
California legend of tobacco control
Health Affairs 199615:58–72.
California Health and Safety Code section 104365-14370.
Supervisory Committee on tobacco education and research.
Investment in tobacco is on the verge of extinction
Free shipping to California-master plan.
Sacramento, California: Supervisory Committee for tobacco education and research, 2009. (
Visit June 26, 2009).
Department of tobacco control, California Department of Health Services.
Excellent community in tobacco control.
Module 1: Introduction to community of excellence.
Sacramento, CA: CDHS/TCS, 2006.
Department of tobacco control, California Department of Health Services.
Excellent community in tobacco control.
Module 2: conduct community needs assessment for excellence.
Sacramento, CA: CDHS/TCS, 2006.
Feltman DM, Kafka SJ, Rangers, AFetterman DM.
Empowerment evaluation: An Introduction to Theory and Practice.
In: Feltman DM, Kafka SJ, Wanderer A.
Self-authorization assessment knowledge and tools
Assessment and Accountability.
Thousand Oaks, California: Sage, 1996: 3-48.
Cowtang H, cowl, Koumjian K, etc.
Build Comprehensive Evaluation capacity of local projects.
Evaluation of 2002 New Directions; 95:39–56.
National Cancer Institute.
Monograph No. smoking and tobacco control1.
S. strategy to control tobacco use: Blueprint for public health action in the 1990s.
Bethesda, MD: Department of Health and Human Services, National Institutes of Health, National Institute of Cancer, 1991 NIH Publication No. 92-3316.
National Cancer Institute
Monograph Number on tobacco control16.
Help shape the future of tobacco prevention and control.
Bethesda, Maryland: Department of Health and Human Services, National Institutes of Health, National Cancer Institute, National Institutes of Health, bar 2005, National Institutes of Health05-5645.
Globe DG, Lloyd JC, Roeseler A, etc.
Take California as an example
J. Clin Oncol 2001; 19:69–73.
Howard Robach la
Pitini B, angle JB, et al.
Independent evaluation of the California Tobacco Control Program: The relationship between project exposure and results, 1996-1998. AJPH 2002; 975–83.
Department of tobacco control, California Department of Health Services.
Changing patterns: experience in California Tobacco Control.
Sacramento, California: Department of Health Services, California, 1998.
National Cancer Institute
National Cancer Institute
Population-based smoking cessation: Minutes of meetings on smoking cessation affecting the general population.
No. 12 monograph on Smoking and Tobacco Control.
Bethesda MD: Department of Health and Human Services, National Institutes of Health, National Institute of Cancer, 2000 NIH bar. No. 00-4892.
California Department of Health Services.
Tobacco control department.
The first is smoke. now it's a mirror.
Sacramento, California, United States of America: California Health Service Department, April 11, 1990.
Consulting services in poppoza. Anti-
Focus group on tobacco advertising concept testing.
Written by ground zero advertising agency representing California Tobacco Control. November 2007.
Hershey JC, Niederdeppe J, Evans W, etc.
"Truth" theory: How anti-industry Sports affect smoking behavior among teenagers.
Mental health 2004; 24:22–31.
OpenUrlCrossRef Kumar Malmgren KL.
Anti-California
Tobacco advertising
Philip Morris: The Tobacco Institute. 18 Apr 1990. (
Visit June 26, 2009).
Barbach Ed in glazsa.
Tobacco control advocates must demand high-quality media advocacy;
California experience.
Control 1998; 7:397–408.
OpenUrlAbstract/free full Text archir. J.
Renault tobacco. J.
Renault tobacco store Co. , Ltd.
Lorillard Tobacco Company v. Diana M.
Bonta, director of the California Department of Health Services and Dileep G.
Bar, acting section chief, tobacco control, Department of Health Services, California.
April 1 2003 of ban and declared of relief complaints. (
Visit February 2009).
Ibrahim JK, glantsa.
The tobacco industry strategy against the tobacco control media campaign.
Control 2006; 15:50–8.
OpenUrlAbstract/free full text glglantz SA good luck to me.
The contribution of the tobacco industry campaign is influencing California's policy making. JAMA 1994; 272:1176–82.
F. , Glantz SA of OpenUrlCrossRefPubMedWeb Science solar Monardi.
Will the contribution of the tobacco industry campaign affect national legislative acts? AJPH 1998; 88:918–22.
OpenUrlPubMedWeb of science
Shame friends of Big Tobacco in California
Control 1996; 5:189–91.
Section 104375 of California health and safety regulations (h)– (p);
104380, 104385, 104390.
Department of tobacco control, California Department of Health Services.
Excellent community in tobacco control.
Module 4: develop a plan for tobacco control intervention and evaluation.
Sacramento, CA: CDHS/TCS, 2006. ↵Adams CF. Smoke-
Free California: democracy and public health.
Version 1998 of Natl Civ; 87:311–16.
Adams FA.
Health Community and Public Policy: four successful cases.
Representative of public health 2000; 115:212–15.
Scientific openurlcross pubpubmedweb general Capitol building. com. (
Visit October 11, 2008).
Department of Health and Human Services.
Tobacco use by ethnic/ethnic minorities in the United States
African-American, American Indian and Native Alaska, Asian-American, Pacific Island and Hispanic: general surgeon's report.
Atlanta, Georgia: Department of Health and Human Services, Centers for Disease Control and Prevention.
National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health, 1998.
Department of tobacco control, California Department of Health Services.
California smoker helpline: case study.
Sacramento, California: Department of Health Services, California, 2000
Department of tobacco control, California Department of Health Services.
Changes in the delivery of advocacy campaigns and training/technical assistance service models related to priority populations --
Brief on formative research and key findings.
Sacramento, California, United States of America: Department of Health Services, California, January 23, 2007.
Carl K. , Beals M. , carbaom T.
Survey of Chinese tobacco use in California2004.
Sacramento, California: Department of Health Services, California, 2005. (
Visit June 26, 2009).
Carl K. , Beals M. , carbaom T.
Korean tobacco use survey in California2004.
Sacramento, California: Department of Health Services, California, 2005. (
Visit June 26, 2009).
Vicky McCarthy WJ, sofa, single D, etc.
India Tobacco Use Survey in Asia, California2004.
Sacramento, California: Department of Health Services, California, 2005. (
Visit June 26, 2009).
Goodbye, Gruskin E, Greenwood G, etc.
California tobacco use survey for lesbian, gay, bisexual and transgender people-2004.
Sacramento, California: Department of Health Services, California, 2005. (
Visit June 26, 2009).
Crawford R. , Olsen C. , Thompson B. et al.
Active tobacco use survey in California2004.
Sacramento, California: Department of Health Services, California, 2005. (
Visit June 26, 2009).
Center for Tobacco policy and organization.
Comprehensive regulations on second-hand outdoor smoke, November 20. (
Visit July 1, 2009).
Clean air project in California.
Southern California community with smoke
Free Beach, February, 2007. (
Visit July 1, 2009).
Center for Tobacco policy and organization.
Policy and organization matrix of local smoke
The free housing policy was 2008 per cent in October. (
Visit July 1, 2009).
Center for Tobacco policy and organization.
Comparison of the regulations on non-smoking units on October 20. (
Visit July 1, 2009).
Code of the City and County of San Francisco, article 19J: it is forbidden for pharmacies to sell tobacco products, August 7, 2008. (
Visit June 26, 2009).
Augustyniak B, fine, Aguero, etc.
The role of information professionals in creating business management systems.
Information Outlook 2005; 9:12–7.
Be a scroll hero-create. direct. save lives. (
Visit June 25, 2009).
Hagel J Brown JS Davidson L
Shaping Strategy in a world of constant chaos. Harv Bus Rev. (
Visit September 9, 2008).
Wingwingo C, Kiser D, Boschert T, etc.
Eliminate smoking in bars, pubs and gambling clubs: California
Freedom of work. A case study.
Sacramento, California, USA: Department of tobacco control, Department of Health Services, California, 2001.
National Cancer Institute
Monograph No. smoking and tobacco control10.
Effects of exposure to environmental tobacco smoke on health: a report by the California Environmental Protection Agency.
Bethesda, MD: Department of Health and Human Services, National Institutes of Health, National Institute of Cancer, National Institutes of Health bar. No. 99-4645. 1999.
The California Department of Health Services, the Tobacco Control Department, and the American Cancer Society, the National Office of the family.
Knowledge training on smoking cessation. 1998 Aug 28-29.
Centers for Disease Control and Prevention.
Telephone lines: resources for development, implementation and evaluation.
Atlanta, Georgia: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, smoking and health office, Final edn, September 20.
California Department of Public Health Tobacco Control Program (2009).
California Tobacco Control Update 2009
Voice of Germany, light SL, Schlag R, etc.
Decreased incidence of lung cancer-
California, 1988-1997MMWR 2000; 49:1066–9.
Barnoya J of Glantz.
The California Tobacco Control Program is associated with a decline in lung cancer incidence.
Control of Cancer causes 2004; 15:689–95.
JM, Dinno A, Glantz SA of openurlcrossrefpmedweb Science ascend Lightwood.
The impact of the California Tobacco Control Program on personal health care spending. PLoS Med 2008; 5:e178.
Fittenberg CM, grants SM.
The California Tobacco Control Program is associated with a decline in smoking and heart disease mortality.
N. Engl J. Med 2000; 343:1772–7.
Openurlcross fpubmedweb Science-
Dr. Bai MM, Trinidad, etc.
California Tobacco Control Program: can we keep going?
Results of the California Tobacco Survey, 1990-2005 Vl. 2.
La Jolla, California: University of California, San Diego. 2008.
Centers for Disease Control and Prevention.
Tobacco use in adultsUnited States. MMWR 2005; 55:1145–8.
National Cancer Institute.
On Smoking and Tobacco Control
14. Changes in the prevalence of smoking among adolescents.
Where is it, why.
Bethesda, MD: Department of Health and Human Services, National Institutes of Health, National Institute of Cancer, NIH Publication No. 02-5082. 2002.
Department of Health and Human Services.
Administration of drug abuse and mental health services (SAMHSA);
Office of Applied Research. (June, 2008).
National estimates of drug abuse from 2005-2006 National Drug Use and Health Surveys.
Appendix C, Table C.
14 cigarette usage by age group and country in the past month: 2004-2005 and 2005-2006 NSDUHs. (
DHHS Publication No. SMA 08-
NSDUH Series H-4311-33). #C-14 (
Visit February 24, 2009).
Center for Tobacco policy and organization.
Matrix of regulations on authorization of tobacco retailers, 2009. (
Visit July 9, 2009).
Americans of the Non-Smokers Rights Foundation.
Database of local tobacco control regulations.
Regulations on youth access
Report dated December 2007.
Berkeley, California: American Foundation for the rights of non-smokers.
MS, Glantz.
Failure to defend the successful state tobacco control program: a policy lesson for Florida.
No. 2000 public health; 90:762–7.
Scientific OpenUrlPubMedWeb koh HK, CM judge, Robins H et al.
The first decade of the Massachusetts tobacco control program.
Representative of public health 2005; 120:482–95.
OpenUrlPubMedWeb glk of science, Glantz S.
Prudent costs: 1997-2007 of Oregon tobacco industry's political impact and tobacco policy making.
US: Center for Tobacco Control Research and Education.
Tobacco control policy formulation, 2007, Oregon. (
Visit November 10, 2008).
Ibrahim tsoukalas TH, Ibrahim JK, Glantz SA.
Tobacco politics in Minnesota.
US: Center for Tobacco Control Research and Education.
Tobacco Control Policy formulation :(March 1, 2003). Paper MN2003. (
Visit November 10, 2008).
↵ Tung G Glantz S.
Now the air is fresh, but the future is hazy: the political influence of the tobacco industry in Ohio and the tobacco policy formulation 1997-2007.
US: Center for Tobacco Control Research and Education.
Tobacco Control Policy, May 22, 2007.
Ohio 2007(
Visit November 10, 2008). Schwachengel.
General Assembly Act 1467 (DeSaulnier)
Information was rejected on October 14, 2007. (
Visit July 3, 2009).
Barnes hong M, Barnes RL, Glantz G.
California Tobacco Control 2003-2007: missed opportunities.
Center for Tobacco Control Research and Education. San Francisco.
San Francisco, California: Medical School.
University of California, October, 2007.
California Senate staff analysis of Bill 1x1 of Congress. 2008 Jan 8. (
Visit July 3, 2009).
Center for Tobacco policy and organization.
Tobacco money in California politics: campaign donations and lobbying spending by tobacco interests
2009 annual report June, 2008
2008 election cycle. (
Visit July 3, 2009).
Steinberg D. de. Sunier M and others.
Parliamentary acts 600 and 2009 of June 9. (
Visit July 2009).
Tobacco costs could hit businesses: blocking sales to minors would be the project's target.
Los Angeles business magazine, July 26, 2004. (Visit 2009).
Chapter 9 of Chico Municipal regulations. 18.
Non-sales distribution of non-smoking tobacco or cigarettes. (
Visit 2009, April 8). ↵H. R. 1256.
The Family Smoking Prevention Law of June 6, 2009. (
Visit July 2009).
Roger Feighery E, Rogers, Ribisl K.
Summary of the summit on tobacco retail price manipulation policy strategy.
Sacramento, California: California Department of Public Health, California Tobacco Control Program, 2009.
There is no competitive interest.
The source of the entrustment and peer review;
External peer review.