DESCRIPTION: (Applicant's Description) The prevalence of tobacco use
prevention public policies has increased dramatically in the past decade.
However, very few businesses in rural communities comply with these public
policies. A recent study revealed that 68% of tobacco outlets in rural
communities in central Missouri do not comply with the state law banning
tobacco sales to minors. Another study found that approximately 60% of
businesses in rural communities in central Missouri do not comply with the
state clean indoor air law. A survey in southeast Missouri revealed that
more than 50% of police chiefs, city managers, and mayors are unaware that a
state law exists restricting public smoking. This research study will
evaluate the effectiveness of two different community organization models
for advocating local compliance with federal and state tobacco use
prevention policies (i.e., tobacco sales to minors and clean indoor air). A
second component of the project will examine the effects of local compliance
with tobacco use prevention policies on smoking rates among tenth grade
students. Development of the two policy advocacy approaches has been guided
by the locality development and social action models of community
organization. The two models characterize the social and political contexts
in which policy advocacy occurs and identify the intervention strategies
that are needed to promote compliance with tobacco use prevention policies.
A controlled study design will be used to evaluate the effectiveness of the
interventions. Forty rural communities will be randomly assigned to one of
five groups (Intervention I - Locality Development for Tobacco Sales to
Minors, Intervention II - Social Action for Tobacco Sales to Minors;
Intervention III - Locality Development for Clean Indoor Air; Intervention
IV - Social Action for Clean Indoor Air; or Control). Outcome measures will
be assessed at baseline and after a three year intervention phase. The
evaluation also will characterize changes in intermediate outcomes (i.e.,
coalition empowerment, local law enforcement, school tobacco use
environment, and media coverage) that may explain the success or failure of
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