This chapter describes SmokeLess States®: National Tobacco Policy Initiative, one of the largest investments made by the Robert Wood Johnson Foundation, with $99 million authorized in grants since 1992. Primarily, grants were awarded to non-governmental organizations, with the intention that they would educate the public and policy-makers about the tobacco problem. Two features about the program are significant: (1) the Foundation encouraged its grantees to be activists; (2) advocacy was emphasized to bring about policy change. The program relied heavily on three major health voluntary organizations: the American Cancer Society; the American Heart Association and the American Lung Association. They provided financial support and, in particular, funds to help lobbying efforts which the Foundation could not support directly. In addition to insight on the effects of advocacy, this chapter offers a window into the role of coalitions in bringing about social change. The program ended in 2004 and its lasting impact has yet to be determined.
Due to recent successes in securing state and local restriction on smoking in public places and restricting youth access to tobacco products, the tobacco movement is in a precarious position. It needs to secure its successes while avoiding public retrenchment. In this paper, Jacobson and Banerjee describe just where the movement is in terms of change and the threats it faces for the future. They also conclude with suggestions intended to infuse the tobacco control movement with a broader sense of purpose and mission.
By referring to the familiar trans-theoretical model of change, the authors report that the tobacco movement is in a maintenance stage, which calls for social reinforcement, retention of political backing, consolidation of successes and implementation and enforcement.
But, they say, there are a number of reasons to be concerned that the tobacco control movement could share the fate of other social movements in being unable to build on its success. In the report, the authors elaborate on the following possible threats:
- That there is an
inevitable tendency to say "we've won" while
there are other battles to confront.
- That the tobacco control
movement has become highly professionalized,
which may crowd out the volunteers needed to
sustain the movement.
- That the movement is subject to fragmentation.
Realizing these threats, Jacobson and Banerjee say the new tobacco control strategy should encompass a focus on voluntary non-smoking strategies, use human rights rhetoric to its advantage and strengthen the public health voice to be more effective in political battles.
In essence, the authors focus on strengthening tobacco control as a social movement rather than relying on professional advocates. They also argue that the movement should shift its focus from legislative activity to securing voluntary non-smoking policies among local businesses.
