Communities are organizing into coalitions with the goal of reducing tobacco use, particularly among youth. Adolescents could make effective and persuasive anti-tobacco advocates in their respective communities, but their attitudes about tobacco advocacy and their perceptions of their own abilities as advocates are unknown. Therefore, the present project assessed attitudes and self-perceptions about anti-tobacco advocacy in 159 high school students attending a tobacco advocacy conference. After the meeting, they completed the Anti-Tobacco Advocacy Questionnaire, which has five factors (Activism, Personal Commitment, Banning Advertisements, Tobacco Morality and Peer Pressure to Use Tobacco). Overall, these high school students were moderately positive about anti-tobacco advocacy; girls more so than boys. Further, they were very positive about their own commitment to avoid tobacco and willingness to speak to others personally, but only moderately positive about their activism abilities. An implication is that community coalitions that include youth might want to focus on building their activism skills as they guide them in managing their youthful energy and enthusiasm.

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Though parents who smoked in high school and those who did not agreed that children are targeted and should be banned from tobacco use, parents who did not smoke in high school believed it more strongly. Parents who had a history of smoking changed more on the issue of banning, perhaps because they had more room to change. The study concluded that media campaigns can change parents' attitudes.

Tobacco settlement money can be allocated to nonprofit organizations or government agencies. Both have advantages and disadvantages. Nonprofit organizations may have relatively (a) more efficiency/flexibility, but less accountability; (b) narrower focus, but less experience; (c) more ability to advocate, but more obligations; (d) more independence from tobacco industry influence, but less funding; and, (e) more public trust, but less visibility. The present case study of the Partnership for a Healthy Mississippi focuses on six interconnected areas: education (school and community), raising awareness, advocacy, service, enforcement, and research. In 1999 and 2000, tobacco use declined in Mississippi, even compared to neighboring states. This unique partnership's multifaceted approach to social change probably facilitated this decline.

To further understand school nurses' tobacco policy beliefs and attitudes toward tobacco companies, a convenience sample of 53 school nurses completed questionnaires about anti-tobacco policies and attitudes toward tobacco companies. Overall, these nurses strongly agreed with tobacco policies such as banning youths from wearing clothing with a tobacco logo to school and fining restaurant owners who permit smoking. In addition, these nurses on average were negative toward tobacco companies. For example, they thought that tobacco companies and advertising leads to youth tobacco use. However, this group of school nurses thought that youths were basically neutral toward tobacco companies. Considering their professional experience with tobacco prevention at school, school nurses would be logical designers of tobacco prevention school interventions. An implication of these results is that school nurse education should include policy and activism components.