opportunities for adult smokers, and the establishment of smoke-free public places. A high-profile mass-media advertising campaign with the tagline “It’s time we made smoking history” not only served as the statewide umbrella initiative but kept the tobacco-control issue paramount in the minds of the public and policy makers alike (Koh et al., 2005). Furthermore, the campaign promoted a free statewide quitline that linked callers to bolstered cessation services at the local level.

In November 2008, the Massachusetts Department of Public Health and the Massachusetts Department of Veterans Services jointly launched a free 8-month program to encourage veterans to quit smoking. Veterans and their families are asked to call the state 1-800-Try-to-Quit line. After a simple medical screening over the telephone, those eligible will receive tailored counseling by telephone, a free 4-week supply of nicotine patches, and a Quit Kit with tips on quitting and informational resources. The goal is to combine nicotine-patch therapy with counseling and support by trained specialists to maximize the chances of quitting in this high-risk population. Because the program is new, outcomes are not yet known.

Despite tremendous challenges in maintaining and sustaining funding for the MTCP, the state witnessed a drop in cigarette consumption (statewide number of packs sold) by nearly half from 1992 to 2004 (Koh et al., 2005). However, a cautionary lesson comes from Massachusetts. Despite the considerable success achieved in tobacco control, funding for the MTCP was cut by 95%—from a high of about $54 million per year in 2000 to just $2.5 million in fiscal year 2004—although funding for the program has since increased somewhat. The drastic reductions in the state’s investment to prevent and reduce tobacco use may translate directly into higher smoking rates (especially in children) and more smoking-related disease, death, and ultimately, costs.

CDC’s Best Practices for Comprehensive Tobacco Control Programs—2007 describes capacity-building under administrative and management functions for comprehensive tobacco control by states. The literature uses different terms to discuss capacity-building, but the message is the same. CDC highlights the need for states to build capacity and the associated administrative and management activities; it suggests that at least 5% of total annual program funds be used to support program capacity and infrastructure components (see Table A-1).

Increased funding of state tobacco-control programs has a favorable effect on reducing tobacco use by both youth and adults (Farrelly et al., 2003). An evaluation of state-level tobacco-program expenditures on youth smoking, as part of the Monitoring for the Future project, found that if states had spent on tobacco control the minimum amount recommended by CDC, the prevalence of smoking among 8th-,



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