title: A statewide movement to promote the adoption of tobacco-free school policies.
abstract: BACKGROUND
  Since most tobacco users become addicted to nicotine as teenagers, prevention efforts for youth remain central to comprehensive prevention programs. National and state efforts that encourage adoption and enforcement of comprehensive tobacco-free school (TFS) policies can lead to significant reductions of youth tobacco use. In 2003, North Carolina (NC) Health and Wellness Trust Fund grantees began to focus statewide on the adoption of and compliance with TFS policies in NC schools. This study examined 46 NC districts that passed TFS policies between 2003 and early August of 2005 to see what factors were important in policy passage in order to support the continued promotion of TFS policy adoption across the state.
  
  
  METHODS
  Detailed interviews were conducted with 118 key informants who were intimately involved with passage of their school districts' TFS policies, and results were coded and analyzed for common themes.
  
  
  RESULTS
  The study found several strategies key to adoption of TFS policies: effective leadership from organizations and individuals in positions of influence, grassroots organizing from community coalitions and youth groups, and communication strategies that optimally position policy adoption and compliance.
  
  
  CONCLUSIONS
  States that have not yet achieved TFS policy adoption can focus on leadership development, grassroots organizing, and improved communication to advance their advocacy efforts.
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC 27599-7595, USA. shelley-summerlin-long@med.unc.edu
authors.forename: Shelley K
authors.initials: SK
authors.lastname: Summerlin-Long
authors.forename: Adam O
authors.initials: AO
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003256:Community Participation / Q000379:methods*; D005260:Female; D006291:Health Policy; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007857:Leadership; D008297:Male; D012574:Schools / Q000458:organization & administration*; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*; D014029:Tobacco Use Disorder / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution