Independent evaluation of the California Tobacco Education Program.
OBJECTIVE
To monitor the implementation of tobacco control programs and research in accordance with California's Proposition 99, approved by the voters in 1988, which increased the state's cigarette tax by 25 cents and designated one quarter of the increased revenue-approximately $100 million per year-to develop statewide media campaigns and to fund local health departments, community-based organizations, schools, and agencies working with high risk populations.


METHODS
The authors evaluated the extent and the effectiveness of the implementation independently with standardized forms developed to track any tobacco-related information and activities, local media campaigns, changes in local policies and ordinances, training sessions, and prevention and cessation programs. Activities were reported on the forms to the authors monthly or quarterly.


RESULTS
The evaluation indicated that local health departments, community-based organizations, and other group produced an exceedingly high volume of diverse tobacco control activities throughout the state. They reached a variety of ethnic groups and high risk populations with their programs. The data also show that local health departments and competitive grantees responded with an overall shift in their approach to tobacco control and moved from interventions focused primarily on individual people to broader, more community- and environment-oriented interventions. Additionally, analysis of the wholesale tobacco tax revenues revealed that per capita purchasing continued to decline in California at a rate greater than in the rest of the United States.


CONCLUSIONS
The evaluation demonstrated that Proposition 99 accomplished much of what it set out to do-reducing tobacco prevalence, reaching out to underserved populations, and heightening the awareness of the dangers of environmental tobacco smoke.
Elder
J P
JP
San Diego State University, USA. jelder@mail.sdsu.edu
Edwards
C C
CC
Conway
T L
TL
Kenney
E
E
Johnson
C A
CA
Bennett
E D
ED
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D003153:Community Health Services / Q000458:organization & administration*; D006266:Health Education / Q000458:organization & administration*; D006306:Health Surveys; D006801:Humans; D008402:Mass Media; D015995:Prevalence; D015397:Program Evaluation; D012907:Smoking / Q000191:economics / Q000453:epidemiology / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D013660:Taxes