Case Studies from Community Coalitions

Abstract

Policies that shield people from the harm of tobacco exposure are essential to protect the health of the population. Coalitions have often led the way in safeguarding community health by promoting social norm change though policy adoption. In some states, tobacco control laws are weak, in part because of a tobacco industry tactic of prohibiting or pre-empting communities from enacting ordinances that are more protective. In spite of strong state-level preemptions, local coalitions in Oklahoma have implemented hundreds of voluntary policies in tobacco control that have improved the protection and health of their communities while not violating preemption. Three case studies of policy change are presented that exemplify the key approach of local coalitions working with strong allies and informed decision makers to establish tobacco-free businesses, schools, and outdoor recreational areas. In each of the cases, the policy changes surpassed the protection provided by the state laws and inspired additional policy changes. The key strategies and lessons learned may help tobacco control coalitions in other states limited by preemption to garner more support and momentum for important policy changes within their communities and states.

A public health advocacy approach for preventing and reducing gambling related harm

“…The development of a coalition within the proposed framework forms the basis from which further steps are implemented and is critical to reform successes. 38,39 Steps 3 and 4 are concerned with issue framing and message dissemination. Issue framing is important in determining whether a population acknowledges and implements actions to address a given issue.…”

“…8,36,37 Coalitions have been important in the implementation of various public health reforms. [37][38][39] In tobacco, community and government-led coalitions have been fundamental to the implementation of control policies. Australian examples include ACOSH, Cancer Councils, the Heart Foundation and AMA to reduce smoking, and the Australian-based Tackling Tobacco Program, a partnership between community organisations to reduce smoking among low socioeconomic groups.…”

Youth Advocates’ Perceptions of Tobacco Industry Marketing Influences on Adolescent Smoking: Can They See the Signs?

“…There is power in youth sharing their experiences and calling for policy changes through their own stories and voices [13] . Such changes can happen when facilitated by programs that help youth develop and express their desires to improve their environment [30] .…”

“…Drawing upon their own experiences and perspectives of tobacco industry marketing influences, youth tell their story and call for actions. Several counter-tobacco industry campaigns conducted by youth have been quite successful in reducing youth smoking and promoting changes within the communities [12] – [13] . Such youth empowerment programs were designed to address youths' lack of knowledge and sense of control to generate prevention alternatives and action [14] .…”

Voluntary Smoke-Free Measures Among Oklahoma Nightlife Owners: Barriers and Facilitators

“…One conceptualization intended for use in health promotion delineates intrapersonal, interpersonal, institutional, community, and policy levels in order of proximity to the individual (McLeroy, Bibeau, Steckler, & Glanz, 1988). Since preemption limits policy-level actions that promote smoke-free environments, interventions in Oklahoma have had to concentrate on community- and institutional-oriented efforts, such as voluntary smoke-free policies (Douglas et al, 2015) enacted by businesses themselves. Social ecological theory also emphasizes that health promotion influences are reciprocal and that a change at levels close to the individual can precipitate changes at the levels farther out.…”