SMOKING AND HEALTH A National Status Report 2nd Edition A Report to Congress U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health Rockville, Maryland 20857 DHHS Publication No. (CDC) 87-8396 (Revised 02/90) FOREWORD Cigarette smoking is the chief preventable cause of death in our society. It is directly responsible for some 390,000 deaths each year in the United States, or more than one of every six deaths in our country. The number of Americans who die each year from diseases caused by smoking exceeds the number of Americans who died in all of World War Il, and this toll is repeated year after year. Public health officials know these figures well. But it is important that all Americans realize the heatth consequences, and the cost consequences, of tobacco use. For that reason, | am pleased to present to the Congress and to the American people this National Status Report on Smoking and Heaith. The information presented in this report is both startling and distressing, especially the new compilation of health and cost effects in each of our 50 States. For example: - In 1985, the average number of smoking-attributable deaths per State was 6,096, ranging from 271 in Alaska to 28,533 in California. - The average smoking-attributabie economic costs per State were $1.0 billion, ranging from $82 million in Alaska to $5.8 billion in California. — With the sum of State economic costs exceeding $52 billion, the economic impact of smoking can be put at some $221 per person each year. Thus cigarette smoking has an economic impact on every American, whether or not he or she smokes. This report also shows that smoking is a particularly important problem for young Americans -- nearly all smokers now start smoking regularly in their teenage years. in addition, cigarette smoking is increasingly becoming concentrated among Americans with lower incomes and less education. lam especially concerned that we make more progress in reaching young people, women, minorities, and blue-collar workers with accurate and compelling information about smoking and health. There is encouraging news in this report, as well. But we still have far to go in giving all Americans the information they need to make good health choices about smoking. it is my hope that the information in this report will be of help in that important cause. Louis W. Sullivan, M.D. Secretary PREFACE During the past several years, Our progress toward a smoke-free society has continued. Per capita cigarette consumption (18 years of age and older) decreased from 3,370 in 1985 to a preliminary estimate of 2,850 in 1989. Total cigarette consumption fell from 594.0 billion cigarettes in 1985 to 524.6 billion in 1989, despite growth in the size of the population. Data from the 1986 Adult Use of Tobacco Survey (reported here in detail) and the 1987 National Health Interview Survey (reported in other publications of the Public Health Service) show that the prevalence of cigarette smoking among adults is now under 30 percent, an important milestone. Nevertheless, smoking remains the chief preventable cause of death in our society. More than 1,000 Americans die each day from diseases caused by smoking. The decline in smoking has been substantially slower among women than among men. Smoking rates are higher among minorities, blue- collar workers, and less educated persons than in the overall population. This report provides valuable State-specific information on the health and economic impact of smoking, legislative measures to contro! smoking, and smoking cessation and prevention programs. It is readily apparent that many States have made much more progress than others in reducing smoking and smoking-related disease. | am pleased that Utah, my home State, has the lowest adult smoking prevalence among all 50 States -- 15 percent. However, an estimated 742 smoking-attributable deaths still occurred in Utah in 1985, and other States experienced smoking-attributable mortality rates three to four times as high as the rate in Utah. Clearly more needs to be done in all 50 States to prevent the needless death and disability, and pain and suffering, caused by the use of tobacco. Later this year, the Public Health Service will publish National health promotion and disease prevention objectives for the year 2000. These objectives have been developed in collaboration with State and focal government agencies and the private sector. Tobacco is one of the 21 priority areas for which specific objectives will be defined. The information in this report will serve as a benchmark against which States can measure their progress toward achieving ambitious goals related to smoking and smoking control. James ©. Mason, M.D., Dr.P.H. Assistant Secretary for Health TABLE OF CONTENTS Table of Contents .............. cece cece cece ee eect een ee nee ee ecenn ee eegeeeeerenreeannecences Introduction Executive SUMMALY .............. cece cece eect eee e tenet e sees se eeesnnar nn ereeecenes Acknowledgment ............. 20200 cc cece e ee eee tenet e eee neee eee eseeetenegreesess ress Special Sections 1986 Adult Use of Tobacco Survey ....0.. 0.0... eee e cece eee eee ene eee eee e er eene re ees Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs State-Specific Estimates, 1985 ...... 2.0.0.2... cece eee eee eee neers Activities of the Interagency Committee on Smoking and Health ... 2.2.2.0... cece een eee tenet ener tenn neerees Legislation Federal ...... oo. ccc ccc cc cnccccccceececceceeseteeeneteesecee ren ccssesseeeeceeenrereenenneess National, State and Local Programs National Programs ......... 20... 0c. cece eee ence eee tee ece tena eee eneeeneeeneeererenesss State and Local Programs ..............0 222.2 eee ceeeeee eet en eee e cen e nena eeeeeerees Smoking and Health Advocacy Groups ...........-....---2s-ece essere creer ener eee eter es ce eeceeeeeeeeeeeeees 7 ve ceeeeeee reese eeeed 37 INTRODUCTION a ——_—_ ss... EXECUTIVE SUMMARY Introduction Since the 1964 publication of the first Surgeon General's report linking cigarette smoking to illness and disease, efforts on the part of government and private organizations to reduce the prevalence of tobacco use and to educate the population onthe harmiul effects of tobacco, have increased dramatical- ly. Programs to educate the population on the harmful effects of tobacco and to help current smokers quit are evident at every level of government and in virtually every geographic area of the United States. Smoking cessation and prevention programs are offeredona Nationwide basis by the major voluntary health organizations. Private hospitals and organizations conduct cessation and education programs in a wide variety of locations. State and local governments have adopted legislation to control the sale of tobacco products and to limit their use to certain specific locations. The Federal Government has banned smoking on all domestic flights scheduled for two hours or less. Smoking and health advocacy groups have been formed to address the need for clean indoor air. Hotels and motels frequently offer nonsmoking rooms for their patrons, and one airline has implemented a total smoking ban on all its flights in the continental United States. The numbers and types of programs have grown with the publication of each new Surgeon General's report. Most of the early programs focused on the individual smoker. Follow- ing the release of the 1985 Surgeon General's Report on Cancer and Chronic Lung Disease in the Workplace and the 1986 Surgeon General’s Report on the Health Consequences of Involuntary (Passive) Smoking, many new programs were established emphasizing nonsmokers’ rights; the obligation of employers and operators of public places to provide smoke- free working and public assembly areas was also em- phasized. With the issuance in mid-1988 of the Surgeon General's report on tobacco use as an addiction, it is expected that many additional programs will come into existence, orthe focus of existing programs will change to meet new areas of concern. in recognition of the magnitude of the health impact of tobacco use and the ever increasing number of related programs, the Congress passed Public Law (P.L.) 98-474, the Comprehen- sive Smoking Education Act of 1984. Section 3(c) of this law requires that the Secretary of Health and Human Services report to the Congress biennially on the status of smoking programs in the Nation. This is the second report in a series. It covers the calendar years 1986 and 1987. These reports are intended to be used as directories by Members of Congress as well as by individuals at all levels. The contents of this report reflect the growth of smoking-re- lated programs and legislation. In the first report, ap- proximately 800 State and local programs were listed. This report identifies over 1,500 programs. At the time the 1986 Report was issued, 60 bills related to smoking and health had been introduced at the Federal level. This report contains information on nearly 100 Federal bills that have been intro- duced or adopted. At the State level, approximately 400 laws that influence smoking or tobacco sale and use were in effect in 1986. As of December 1987, the number of State laws had grown to nearly 600. This report also contains a summary of the activities of the Interagency Committee on Smoking and Health, listings of smoking and health advocacy groups, a section on focal ordinances in the twenty largest cities in the United States, a summary of the results of the 1986 Adult Use of Tobacco Survey, and a summary of a study conducted by the Centers for Disease Control on smoking-attrioutable mortality, years of potential life lost and economic costs in the 50 States. Report Highlights Results of the 1986 Survey of Adult Use of Tobacco. The fifth Adult Use of Tobacco Survey was conducted by the Office on Smoking and Health in 1986, 11 years after the previous one, which was conducted in 1975. Adult Use of Tobacco Surveys are unique in seeking information on knowledge, attitudes and behaviors of representative samples of the population relating to tobacco. Some key findings from this survey include the following: + 26.5 percent of the U.S. adult population are cigarette - smokers. * Thirty percent of the population use some form of tobac- co. Use of tobacco other than cigarettes is a male phenomenon and 9 percent of men currently smoke a cigar or pipe and 5 percent currently use smokeless tobacco. There has been a downward trend in the age at which smokers start to smoke regularly. Nearly all smokers now start smoking regularly in their teenage years. Cigarette smoking and use of tobacco vary with education and income. Those with higher education and who report higher incomes are less likely to smoke or use tobacco. There is no difference between these groups in the proportion of people who have ever been smokers, People of higher socioeconomic status are more likely to have quit smoking. There are different patterns of smoking among the dif- ferent subgroups of the population. Blacks tend to smoke fewer cigarettes a day than do whites, but use brands that are higher in tar content and are mentholated. Successtul quitters in 1986 were much more likely to report success on the first or second quit attempt than successful quitters in 1975. Even with the decrease in the proportion of smokers in the population, there has been little change in the proportion of smokers who have tried to quit between 1975 and 1986. Both of these figures suggest that the downward trend in smoking prevalence will continue for at least the short term. These findings suggest that the antismoking efforts in the private and public sectors are meeting with some success and that, if such efforts are continued, there will be a further reduction in smoking prevalence in the community. Dissemi- nation of these findings and other in-depth analyses of the 1986 survey are expected to lead to a more effective targeting of antismoking campaigns. These, in turn, should lead to a more rapid reduction in the prevalence of smoking in the community. Smoking-Attributable Mortality, Years of Potential Life Lost, and Economic Costs The adverse health impact of smoking and associated economic costs have long been accepted as enormous. This study attempted to quantify, on a State-by-State basis, the number of deaths, years of potential life lost, and the costs attributable to smoking for 1985. This study is not a cost- benefit analysis, but rather an attempt to quantify both the disease and economic impact of smoking for each State. Costs associated with smoking-related death and illness may be immediate or deferred. There are costs to the individual and to society in general. Indirect costs of smoking are the value of lost productivity, output, or manpower resources that cannot be used because of illness. In 1985, the average number of smoking-attributable deaths per State was 6,099 (ranging from 271 in Alaska to 28,533 in California). The rate of smoking-attributable deaths per 400,000 persons ranged from 45.3 in Utah to 175.9 in Ken- tucky (the average State rate was 129.1). The average number of smoking-attributable years of potential life lost (YPLL) to life expectancy per State was 70,621 (rang- ing from 4,335 in North Dakota to 335,319 in New York). The rate of smoking-attributable YPLL per 100,000 persons ranged from 643 in North Dakota to 2,167 in Kentucky (the average State rate was 1,489 ). The average smoking-attributable economic costs per State were $1.0 billion (ranging from $82 million in Alaska to $5.8 billion in California). On a per capita basis, these costs ranged from $54 per person in Puerto Rico to $284 in Rhode Island (the average State per capita cost was $205). Based on these State-specific estimates, the National totals are as follows. In 1985, more than 316,000 deaths* and an additional 3.7 million years of potential life lost (YPLL) to life ean expectancy were attributable to tobacco use. The total economic impact for all 50 States was over $52 billion: $23.7 billion in direct morbidity costs, $10.2 billion in indirect mor- bidity costs, and $18.4 billion in indirect mortality costs. On a per capita basis, the economic impact was $221 per person for the United States as a whole. A more recent national estimate of smoking-attributable mortality, based on updated relative risk estimates from the American Cancer Society's Cancer Prevention Study H, is 390,000 deaths in 1985. The derivation of this new estimate is explained in detailin the 1989 Surgeon General’s Report. Smoking causes more premature deaths than cocaine, heroine, alcohol, fire, automobile accidents, homicide, and suicide combined. The vast health and economic impact of smoking and tobacco use reinforces the need to sustain smoking cessation and prevention of smoking as a high- priority public health effort at the National level as well as within each State. Interagency Committee The Interagency Committee on Smoking and Health was established as part of the Comprehensive Smoking Education Act of 1984 (P.L. 98-474). The Committee, chaired by the Surgeon General of the U.S. Public Health Service, Dr. C. Everett Koop, is comprised of 25 members; 20 Federal mem- bers and 5 non-Federal scientists and physicians representing private entities. Since the inaugural meeting on October 1, 1985, the Committee has met five times. Topics of the meet- ings include: the impact of advertising and promotion of tobacco products; free cigarette sampling and other related marketing techniques; smoking and its impact on minority populations; implementation of the new smoking regulations promulgated by the General Services Administration; and the international aspects of tobacco and health. Legislation in an effort to simplify and standardize existing information on Federal and State legislation pertaining to smoking and health, this report examines the Federal laws and the laws of all 50 States and the District of Columbia through calendar year 1987. Nearly 600 State laws pertaining to smoking and health have been identified. This total does not include all laws pertaining to the taxation of cigarettes or tobacco products, but includes those laws that mandate that tax revenues be earmarked for special health-related programs or research. The smoking-related laws vary widely in their scope and intent, but for purposes of evaluation and comparability, they have been categorized as follows: limitations on smoking in public places; regulation on sale and use of tobacco products by minors; schools and school health education; regulations of advertising practices; commerce, taxation; and health and safety regulations. Each of the 50 States and the District of Columbia regulate the sale and/or use of tobacco in some fashion. In addition, * The State estimates that provide the basis for this National total were derived using relative risk estimates for smoking-related diseases from studies conducted in the 1950's and 1960's. Since those State calcula tions were made, more current relative risk estimates have become available. These estimates were used in the 1989 Surgeon General's Report on Reducing the Health Consequences of Smoking: 25 Years of Progress to yield an estimate of 390,000 smoking-attributable deaths in the United States in 1985. information was compiled from the largest 20 cities in the United States to provide a sampling of local regulations on smoking and tobacco sale and use. The local ordinances are grouped into five categories: smoking in public places; smok- ing regulations in the workplace; public safety regulations; municipal tobacco taxation; and regulation of cigarette sales to minors. All 20 cities have local ordinances pertaining to smoking in public places; nine in the workplace; 14 regarding public safety; tive enforcing local taxation; and eight regulating the sale to minors. Findings of State legislation include: + 43 States and the District of Columbia have lagislation restricting smoking in public places. * 20 States and the District of Columbia, a total of 21 jurisdictions, restrict smoking in Government and/or private workplace settings. + All States tax cigarettes. State taxes range from a low of 2¢ (North Carolina) to a high of 38¢ (Minnesota) per pack of cigarettes. » Five states prohibit the sale or use of clove cigarettes. * 19 States require elementary and secondary schools to include instruction on the hazards of tobacco use. - + 44 States and the District of Columbia restrict sales or distribution of tobacco products to minors. The age at which an individual can purchase tobacco products range from a high of 19 years of age toa low of 16 years of age; 14 States allow minors under age 18 to purchase tobacco products. Six States have no law pertaining to the sale or distribution of tobacco to a minor. National, State and Local Programs. The smoking and health movement in this country has been acollaborative effort involving virtually every facet of the health community. The National voluntary health organizations, their State and local affiliates, State and local health departments, the Federal Government, and numerous other agencies have played a crucial role in this effort. This section attempts to give the reader an overview of the activities of these various organizations with a special review of more than 1,500 com- munity level programs. The programs described include cessation clinics, prevention efforts aimed at children and adolescents, school programs, community and patient education programs, mass media campaigns, and individual self-help and counseling programs. Also included are summaries of smoking education and infor- mation programs of various agencies of the Federal Government, particularly those within the U.S. Public Health Service. ACKNOWLEDGMENTS This report was prepared by the U.S. Department of Health and Human Services under the general editorship of the Office on Smoking and Health, Center for Health Promotion and Education, Centers for Disease Control. Research and production support was provided by HCR, a management consulting firm in Washington, D.C. Managing Editor of the Report was John L. Bagrosky, Associate Director of the Office on Smoking and Health. Managing Director was Ronald M. Davis, M.D., Director of the Office on Smoking and Health. The editors acknowledge with gratitude all the Federal agencies, State, county and loca} health departments, National voluntary organizations and their State ‘and local affiliates, smoking and health advocacy groups, and the numerous individuals who cooperated in the production of this Report. 11 SPECIAL SECTIONS ee ____] 1986 ADULT USE OF TOBACCO SURVEY Introduction Since 1964, periodic Adult Use of Tobacco Surveys have been conducted to determine usage rates as well as descriptive information on smoking patterns of representative samples of the United States population. Information gathered included history of individual use of any tobacco product as well as attitudes on smoking-related issues. Previous Adult Use of Tobacco Surveys were conducted in 1964, 1966, 1970, and 1975. The most recent survey was conducted in 1986. Since the earlier surveys, Federal and private agencies have exerted considerable effort to educate smokers. This effort has included a number of Surgeon General's reports dealing with the health consequences of smoking. Since the landmark reports of 1964 and 1979, which were comprehen- sive reports on smoking-related diseases, specific reports have been prepared on the evidence linking smoking to can- cer, cardiovascular disease, and chronic obstructive lung disease. The 1986 Adult Use of Tobacco Survey was an opportunity to assess the impact of these reports and the public reaction to them by measuring attitudes towards smoking and the smoking behavior of the population. In recent years, there have been major advances in protecting the rights of the nonsmoker in work settings and in public places. Many of these changes followed the publication of the Surgeon General's 1986 report on involuntary smoking. More recently, the Surgeon General’s 1988 report on nicotine ad- diction received broad media coverage and should further alter how people perceive the use of tobacco. Public reaction to these reports in the form of the enactment of nonsmoking legislation, for example, can be measured by the series of Adult Use of Tobacco Surveys. The 1986 survey offers a good baseline for comparison since information was collected prior to the release of the last two Surgeon General's reports. Further, the impact of the reports can be measured in part by comparing the data from the 1986 survey with data from the surveys conducted in 1964, 1966, and 1975. Trend data on smoking prevalence are also available from the National Health Interview Survey (NHIS), an in-person survey conducted by the National Center for Health Statistics every 2 to 3 years during the past quarter century. These data were presented in detail in the 1989 Surgeon General's report, Reducing the Health Consequences of Smoking: 25 Years of Progress. It should be noted that the prevalence estimates derived from telephone surveys, including the 1970, 1975, and 1986 Adult Use of Tobacco Surveys, are generally two or three percentage points below those derived from in-person sur- veys, for reasons explained in the 1989 Surgeon General's report. The NHIS data are considered to be the data of highest quality (large sample size, high response rate), although the Adult Use of Tobacco Surveys offer much more comprehensive information related to tobacco use. 15 Survey Description In 1986, a telephone survey of smoking history, attitudes and beliefs was conducted. In this survey, 13,031 members of the civilian, non-institutionalized population of the United States were contacted. A two-stage sampling procedure was used within a computer-assisted telephone interview format. The first stage involved selecting a random sample of telephone exchanges within the United States. The sampling procedure was balanced for the number of telephones within the ex- change. Clusters of between 10 and 15 households within each exchange were contacted using random digit dialing; up to 27 callbacks were made. Households were enumerated and smoking status of members ascertained. A total of 36,405 households were contacted for a response rate of 85.5 percent. In the second stage, a further stratified random sampling procedure was undertaken to provide an approximately equal proportion of respondents in each smoking category (current, former, never). The stratification variable was the number of smokers in the household. Up to 10 callbacks were made to interview the selected respondents for a response rate of 86.9 percent. The overall response rate from the two procedures was 74.3 percent, representing the product of the response rate of each. Quality control procedures in the survey involved 26 hours of survey-specific training and practice for interviewers and silent monitoring of ten percent of all interviews by supervisory staff. Data obtained were weighted to reflect the United States population in two stages. First, a base weight was calculated that was the product of weighting for cluster (completed screeners within cluster), household (telephone numbers within household) and person (to account for selection based on smoking status). Second, post-stratification weighting was done for region, education, race, sex, and age. Cigarette Smoking Status and Quit Ratios Table 1 presents the data on cigarette smoking status from the 1986 Adult Use of Tobacco Survey. All percentages in this table are weighted to the total population as indicated above. To obtain population numbers for any subgroup from this table, the population estimate for the subgroup is multi- plied by the proportion of the group that smokes. The quit ratio (Pierce et al., 1986) is the statistic which indicates the propor- tion of ever smokers who have become former smokers. It is derived by dividing the number of former smokers in the population by the number who have ever smoked at least one hundred cigarettes in their lives. According to this survey, 26.5 percent of Americans of 17 years of age and older smoke cigarettes. Those who have never had a cigarette constitute 48.9 percent and those who have been smokers but have quit constitute 24.6 percent. Of those who have ever smoked, 48.1 percent are now former smokers (quit ratio). Among the male adult population, 29.5 percent are current smokers, 40.0 percent are never smokers and 30.4 percent are former smokers; the quit ratio is 50.8 percent. Among the female adult population, 23.8 percent are current smokers, 56.9 percent never smoked and 19.3 percent are former smokers; the quit ratio is 44.8 percent. There is an increase from 18.9 percent to 32.8 percent in smoking prevalence with increases in age from the 17 to 19 age group up to the 35 to 44 year olds. Prevalence declines to 13.9 percent for those 65 years of age and older. The quit ratio increases directly with age, from 22.3 percent for the 17 to 19 year olds to 70.4 percent for the 65 years of age and older group. The proportion of the white population currently smoking is 26.4 percent; the proportion of the black population currently smoking is 28.4 percent. Among whites who have ever smoked, 49.3 percent have stopped and among blacks who have ever smoked, 38.8 percent have stopped. The Western region has the lowest smoking prevalence, 24.5 percent, and the highest quit ratio, 51.7 percent. The Southeast region has the highest smoking prevalence, 28.2 percent, and shares the lowest quit ratio, 45.9 percent, with the Midwest. Among the different marital status groups, the divorced or separated group has the highest smoking prevalence, 38.2 percent. The widowed group, however, has the highest quit ratio, 58.9 percent. Smoking prevalence declines with increasing number of years of education. For those with 11 or fewer years of education, the prevalence is 31.4 percent; the proportion of smokers among those who have 16 years or more of education is 16.3 percent. The quit ratio increases from 44.1 percent for the less educated group to 63.5 percent for the more educated group. The same pattern is observed for income. Smoking prevalence falls from 28.9 percent for those with a household income of $10,000 or less, to 21.8 percent for those with a household income of more than $40,000. The quit ratio in- creases with each income category, from 41.5 percent to 58.8 percent. The smoking prevalence is 30.0 percent for those who fall below the poverty level and 27.3 percent for those who are above the poverty level; the quit ratio is 39.1 percent and 48.5 percent, respectively. Total Tobacco Use Status Cigarettes are the major type, but not the only type of tobacco, used by the population. People also smoke cigars and pipes and use chewing tobacco and snuff. Accordingly, it is important to review total tobacco use in the population. Table 2 presents the dataon tobacco use, including quit ratios, by sociodemographic variables. Among the adult male 16 population, 37.9 percent are current users of some form of tobacco, 35.1 percent are former users, and 27.0 percent have never been users; the quit ratio is 48.1 percent. Among the adult female population, 24.4 percent are current users of some form of tobacco, 20.9 percent are former users, and 54.7 percent have never been users, the quit ratio is 46.1 percent. A comparison of Table 1 and Table 2 shows that the use of tobacco other than cigarettes is predominantly a male phenomenon. There is a continual increase in prevalence of tobacco use as age increases, from 22.2 percent in the 17 to 19 years of age group, to 36.4 percent in the 35 to 44 years of age group. The prevalence decreases significantly to 19.5 percent for those 65 years of age and older. The quit ratio increases with age, from 35.3 percent for those 17 to 19 years old to 63.9 percent for those 65 years of age and older. The survey shows that the prevalence of tobacco use decreases with increasing years of education. tt ranges from 37.1 percent for those with 11 or fewer years of education, to 21.3 percent for those who have completed college and have 16 years or more of education. The quit ratio increases from 41.3 percentforthose with some high school education to 61.4 percent for those with a college degree. Among the marital status groups, those in the divorced or separated category have the highest overall tobacco use at 41.6 percent. The widowed category has the highest quit ratio of 54.1 percent. In the household income category, those with an annual income of between $20,000 and $29,999 have the highest tobacco use prevalence at 35.4 percent. Those with an annual income of $40,000 or more have the highest quit ratio at 57.2 percent. Tobacco Use: Cigar/Pipe and Smokeless Status As shown in Table 3, currently 4.3 percent of the United States adult population smoke cigars or pipes and 2.7 percent use smokeless tobacco. As indicated earlier, use of these types of tobacco occurs mainly in males, 8.7 percent of whom smoke cigars or pipes and 5.2 percent of whom use smokeless tobacco. Usage of cigars and pipes increases with age, up to 6.7 percent in the 45 to 54 years of age group and starts declining thereafter. Female usage is less than one percent. The opposite phenomenon is observed among the current users of smokeless tobacco. Smokeless tobacco use declines with age, up to the 45 to 54 year olds. Aimost the same proportion of whites and blacks, 2.8 percent and 2.3 percent, respectively, use smokeless tobacco. Currently, 4.4 percent of whites and 3.7 percent of blacks are smoking cigars or pipes. There is no marked variation among regions for cigar and pipe use. The Southeast, however, has a higher prevalence of smokeless tobacco use, 4.2 percent, followed by the West with 2.3 percent. The populations with 11 or fewer years of education and with 16 or more years of education have the highest prevalence of cigar and pipe smoking, 4.9 percent and 5.3 percent, respec- tively. The use of smokeless tobacco, however, declines from 4.5 percent to 1.6 percent as education increases. There is a pattern of increasing prevalence of cigar and pipe use from 3.1 percent to 5.5 percent as household income increases. The opposite is true for the use of smokeless tobacco: 4.1 percent for those with household incomes of less than $10,000; 2.1 percent for those with household incomes of $40,000 or more. Of those above the poverty level, 4.7 percent smoke cigars or pipes and of those below the poverty level, 3.0 percent smoke cigars or pipes. For smokeless tobacco, the figures are reversed: 2.5 percent for those above the poverty level and 4.3 percent for those below the poverty level. Tobacco Use: Status of Different Combinations Table 4 shows the different combinations of tobacco use. The proportion of the United States adult population that currently smokes cigarettes, but does not use other forms of tobacco, is 24.3 percent, while another 2.3 percent also use other forms of tobacco. Former cigarette smokers who do not use any other form of tobacco represent 22.6 percent. Another 1.9 percent of the United States population are former cigarette smokers who currently use either smokeless tobacco (0.9 percent) or cigars or pipes (1.0 percent). The proportion of the population that has never smoked cigarettes nor used any other tobacco is 46.5 percent. Another 1.1 percent, although they have never smoked cigarettes, currently use smokeless tobacco and 1.3 percent smoke cigars or pipes. Changes in Smoking and Tobacco Use Since 1975 Tables 5 and 6 present the cigarette smoking and tobacco use data from the 1975 Adult Use of Tobacco Survey. Comparison of the data from the 1975 survey with data from the 1986 survey shows that more adult males smoked in 1975, 40.5 percent, than in 1986, 29.5 percent. Smoking prevalence for adult females was also higher in 1975 at 31.4 percent compared to 23.8 percent in 1986. Smoking prevalence increased with age, peaking in the 35 to 44 years of age group, after which it decreased. In 1975, smoking prevalence increased from 38.2 percent in 21 to 24 year olds to 43.6 percent in 35 to 44 year olds, then decreased to 17.4 percent for those 65 years of age and older. Asimilar pattern existed in the 1986 data; however, the whole curve was lower. In 1986, smoking prevalence increased from 18.9 percent in the 17 to 19 year olds (a younger age group than surveyed in 1975), peaked at 32.8 percent in the 35to 44 years 17 of age group, then decreased to 13.9 percent for those 65 years of age and older. The quit ratio increases continually according to both the 1975 and the 1986 surveys, although it is at a higher overall level in 1986. In 1975, the quit ratio increased from 28.1 percent in the youngest age group to 57.9 percent in the oldest age group. The pattern is similar in 1986. The quit ratio increased from 22.3 percent in the youngest age group to 70.4 percent in the oldest age group. Within the education category, smoking prevalence in 1986 decreased as education level increased. Those with 11 or fewer years of education had a smoking prevalence of 31.4 percent while those with 16 or more years of education had a smoking prevalence of 16.3 percent. In 1975, however, the smoking prevalence increased from 35.2 percent for those with some high school education to 40.2 percent forthose with a high school education and decreased for those with a college education. Overall, smoking prevalence has decreased considerably from 1975 to 1986 for those with 16 or more years of education from 27.6 percent in 1975 to 16.3 percent in 1986. The quit ratio by education is totally different for each year surveyed. In 1986, it continued to increase from 44.1 percent for those with 11 or fewer years of education to 63.5 percent for those with 16 or more years. In 1975, however, the quit ratio was 38.6 percent for those with less than 12 years of education. It then increased for those with some college, 41.1 percent, to a high of 51.2 percent for those with a college degree. Describing Smoking Patterns The health consequences of smoking are related to the de- gree of exposure that a person has to tobacco smoke (Sur- geon General's reports 1964-1986). The mostcommonly used index of exposure is the number of cigarettes smoked per day. However, the accuracy of this index as a measure of exposure has been questioned. Biochemical studies have found that the correlation between the number of cigarettes smoked per day and the biochemical markers of use, cotinine, thiocyanate, and carbon monoxide, is not high. A related index of exposure is the “strength” of the cigarette smoked. Three categories of this exposure variable, selected to give approximately equal distributions of the population, are reported in Table 7. The Federal Trade Commission has established a standard procedure for measuring the relative strengths of different cigarettes by assessing the amount of tar and nicotine that each delivers when smoked by a machine ina standard manner. The level of tar and the level of nicotine delivered by different cigarettes according to the standard measurement method are highly correlated and it is sufficient to report only one. Three categories of cigarette tar level, also selected to provide reasonably equal distributions, are reported in this Table. The Table also provides information on the percentage of each group that smokes menthol cigarettes. Menthol, which has some local anesthetic properties, may enable a smoker to have a stronger inhalation technique and, therefore, to obtain a larger dose of tobacco smoke con- stituents per cigarette. The proportion of current smokers who smoke 15 or fewer cigarettes per day (“light" smokers) is 35 percent. An equal proportion, 34.9 percent, smoke 16 to 24 cigarettes per day and 30.1 percent smoke 25 or more cigarettes per day ("heavy smokers”). The proportion of those smoking 15 or fewer cigarettes among male current smokers is 29.8 percent and among femaies it is 40.7 percent. There are 36.2 percent male and 23.4 percent female current smokers who are heavy smokers, smoking 25 or more cigarettes per day. Among 17 to 19 year olds, more smokers, 53.8 percent, tend to smoke 15 cigarettes or fewer per day. This proportion of light smokers decreases with increasing age up to the 55 to 64 years of age group at 29.8 percent. in the oldest age category, those 65 years of age and older, the proportion of light smokers was 42.1 percent. However, this change may be a result of differential mortality in heavier smokers rather than a change in cigarette smoking pattern. The proportion of heavy smokers increases with age, from 12.1 percent of the 17 to 19 year olds, to 38.5 percent of the 45 to 54 year olds. Then it falls to 21.3 percent for those 65 years of age and older. Among white smokers 31.2 percent are light smokers and 33.1 percent are heavy smokers. Among blacks, however, the majority, 61.3 percent, are light smokers and 11 .4 percent are heavy smokers. The region with the highest proportion of light smokers, 39.1 percent, and the lowest proportion of heavy smokers, 28.8 percent, is the Western region. The Midwest has the lowest proportion of light smokers, 31.7 percent, and the highest proportion of heavy smokers, 33.3 percent. The difference in the number of cigarettes smoked per day by education level is only minor. Of those with 16 years or more of education, 39.1 percent smoked 15 or fewer cigarettes per day and of those with 11 or fewer years of education, 33.5 percent smoked 15 or fewer cigarettes per day. Only 28.1 percent of the more educated and 30.0 percent of the less educated smoked 25 or more cigarettes per day. The majority of smokers, 58.8 percent, smoke cigarettes with a tar level of more than 15 mg/per cigarette. This is true for both males, 65.2 percent, and females, 51.7 percent, and for each age group. Among white smokers, 31.8 percent smoke “low-tar” cigarettes, with a tar level of less than or equal to 10 mg/per cigarette, and 55.9 percent smoke "high-tar” cigarettes with more than 15 mg/per cigarette. However, among black smokers, 14.5 percent smoke low-tar cigarettes, and the majority, 78.0 percent, smoke cigarettes with a high-tar yield. The Midwest region has the highest proportion of smokers of high-tar cigarettes, 64.3 percent, and the Northeast has the lowest proportion, 50.6 percent. High-tar cigarettes are smoked by 50.4 percent of the more educated smokers and 64.8 percent of the less educated smokers. Overall, 29.2 percent of current smokers, 24.9 percent of males and 34.0 percent of females, use menthol cigarettes. Noticeably, 75.5 percent of black smokers use menthol cigarettes, compared to 23.1 percent of whites. The Southeast region has the highest proportion, 31.2 percent, of menthol 18 cigarette users while the West has the lowest proportion, 24.5 percent. Of smokers who fall below the poverty level, 38.6 percent smoke menthol cigarettes, a higher percentage than the 27.7 percent above the poverty level who smoke menthol cigarettes. In general, the proportion that smokes menthol cigarettes in any particular subpopulation will reflect the distribution of blacks in that population. The Smoking Patterns of Former Smokers Smoking patterns, i.e., the amount and type of tobacco use of former smokers, are only important if they are different from those of current smokers. If, for example, heavy smokers predominated among current smokers and light smokers predominated among former smokers, there would be con- cern that there might be a large group of “hard-core” smokers resistant to change. Therefore, the smoking prevalence might start to level off. Table 8 presents data for those who have quit in the last 5 years. In this group of former smokers, 38.2 percent smoked 15 or fewer cigarettes per day, 29.6 percent smoked 16 to 24 cigarettes per day, and 32.2 percent smoked 25 or more cigarettes per day. Among these former smokers, 31.2 per- cent of males and 46.6 percent of females were light smokers, but 39.2 percent of males and 23.7 percent of females were heavy smokers. The proportion that used to be heavy smokers increased in each age group to 30.8 percent of 25 to 44 year olds and 45.1 percent of the 45 to 64 year olds, but it was lower, 27.8 percent, among those 65 years of age and older. Among white smokers, 36.1 percent used to be light smokers and 34.2 percent used to be heavy smokers. Among black smokers, these proportions were 57.0 percent and 12.1 percent, respectively. Among former smokers, 42.1 percent of those with 16 or more years of education used to smoke 15 or fewer cigarettes as opposed to 36.0 percent of those with 11 or fewer years of education. Of the more educated former smokers, 25.5 per- cent used to be heavy smokers, and 35.2 percent of the less educated former smokers were heavy smokers. Overall, 57.6 percent of former smokers used to smoke high-tar cigarettes, 60.5 percent of males and 54.1 percent of females. For all groups, the proportion of former smokers who used to smoke high-tar cigarettes is higher than the proportion who used to smoke cigarettes with lower tar content. Low-tar cigarettes, less than or equal to 10 mg, were used by 33.4 percent of white former smokers and 15.5 percent of black former smokers. Also, 55.3 percent of white former smokers used to smoke high-tar cigarettes compared to 77.2 percent of black former smokers. Menthol cigarettes were used by 30.3 percent of former smokers, 23.6 percent of males and 38.3 percent of females. Again, menthol usage is mainly ablack phenomenon with 72.4 percent of black former smokers who used to smoke menthol cigarettes compared to 25.9 percent of white former smokers. The overall conclusion is that there are not substantial dif- ferences between former smokers and current smokers in their pattern of smoking. This lack of difference suggests that the patterns of smoking examined here (daily cigarette con- sumption, tar yield, mentholation) might not be associated with smokers’ ability to quit. Attempts to Quit Smoking Among Current Smokers Knowledge of changes in current smoking status is not ex- clusive in predicting what is likely to happen over the next several years with respect to smoking prevalence. Also relevant is the proportion of smokers who have made quit attempts. Table 9 presents these data for different subgroups of the population. More than one-third, 35.5 percent, of current smokers have never tried to quit; 36.7 percent of male and 34.2 percent of female smokers. Another 37.3 percent of all smokers made one to two attempts, 18.9 percent made three to five attempts, and 8.3 percent attempted to quit six or more times. By age, 47.2 percent of the youngest age group, 17 to 19 year olds, have never tried to stop, 32.2 percent of the 35 to 44 year age group and 37.0 percent of the 65 years of age and older group have never tried to stop. The proportion of those who did not try to quit is similar for whites and blacks, 35.6 percent and 34.3 percent, respectively. Of those who have not completed high school, 37.1 percent have never made an attempt to quit, while of those with a college degree or more, 32.5 percent have not tried to quit. As shown in Table 10, among current smokers in 1975, 37.6 percent had never attempted to quit; 35.4 percent of males and 40.4 percent of females. Another 37 percent of all smokers made one to two attempts, 18.1 percent made three to five attempts, and 7.3 percent made six or more attempts to quit. In the 21 to 24 years of age group in 1975, 37.8 percent had never attempted to quit, a contrast to 42.5 percent of the 20 to 24 years of age group in 1986. Among the older groups, however, more people made no attempt to quit in 1975, 40.4 percent for the 55 to 64 years of age group and 44.9 percent for the 65 years of age and older group. In 1986, those figures had dropped to 35.8 percent and 37.0 percent, respectively. In 1975, among those who had not completed high school, 36.4 percent had never tried to stop, while among those with a college degree or more, 33.3 percent had made no attempt to quit. In the different marital status categories, the widowed had the highest proportion of those who had never tried to quit, 48.7 percent. This proportion does not vary substantially for the different income groups, from 38.1 percent among those earning less than $10,000 to 36.1 percent among those with an income of $20,000 or more. Comparing the 1975 data to the 1986 data on the number of attempts to quit, there are very few differences of any mag- nitude among any subgroups of the population. There are two possible interpretations of this lack of change. Either the process of changing smoking patterns is consistent over time or the way in which quit attempts are recalled does not truly 19 reflect quitting behavior. Given the consistent pattern of decrease in smoking prevalence over time, the first interpretation seems likely. Quit Attempts of Former Smokers The number of former smokers who succeed on either the first or the second quit attempt is a measure of the success rate of quit attempts in the community. These data are presented for 1986 in Table 11. The majority of former smokers, 70.2 percent, have made one to two attempts before quitting, 21.2 percent tried three to five times, and 8.6 percent tried six or more times. The same pattern holds true for male former smokers, 68.9 percent of whom tried one to two times, and female former smokers, 72.2 percent of whom made one to two attempts. White former smokers who made one to two attempts were 70.3 percent, and black former smokers, 68.6 percent. Table 12 shows that in 1975, the majority of former smokers, 59.0 percent, made one to two attempts before quitting, 24.8 percent tried three to five times and 16.2 percent tried six or more times. The same pattern holds for males, 56.9 percent of whom tried one to two times, and females, 62.9 percent of whom tried one to two times. The major difference between 1975 and 1986 is that a greater proportion of former smokers indicated that they were suc- cessful on their first or second attempt to quit in 1986 (70.2 percent) than in 1975 (59.0 percent). Age of Initiation of Smoking Age of initiation of smoking is another important variable predicting what will happen to smoking prevalence. Initiation of smoking by adolescents is influenced by social mores. Table 13 shows that almost haif of current smokers, 46.7 percent, started when they were younger than 18 years of age. By the age of 20, 78.3 percent had initiated smoking. Among males currently smoking, 51.7 percent started before 18 years of age and 83.9 percent started before their 21st birthday. Among female current smokers, however, these figures are 41.0 percent and 72.0 percent, respectively, indicating that females have traditionally started smoking at older ages. Among the 25 to 44 years of age group, 20.2 percent started smoking regularly after the age of 20 years, among the 45 to 64 years of age group, 29.2 percent had done so, and among those 65 years of age and older, the proportion is 44.3 percent. Thus, the age of initiation of smoking has remained an adoles- cent phenomenon and has decreased over time. Among white smokers, 49.1 percent started before 18 years of age, 79.9 percent before 21 years of age. However, among blacks, 31.0 percent had started before they reached the age of 18 years and 68.2 percent before the age of 21 years. Thus, black smokers tend to start smoking at older ages than white smokers. People with 16 years or more of education tend to start later in life compared to those with less education; 28.1 percent had started before the age of 18 years, 69.1 percent before the age of 21 years and 30.9 percent after the age of 20 years. For those with 11 or fewer years ot education, these propor- tions are 59.3 percent, 83.3 percent and 16.7 percent, respec- tively. Age of initiation among former smokers is important if it is different from that of current smokers. Age of initiation might predict the strength of addiction and the difficulty in quitting. Again, this might indicate that current smokers may have more difficulty quitting than former smokers. Table 14 shows that among former smokers, 41.3 percent started smoking before 18 years of age and 76.1 percent before 21 years of age. Among male former smokers, 46.0 percent initiated smoking before 18 years of age and 81.2 percent had done so before 21 years of age. However, the respective figures for famale former smokers are 34.6 percent and 68.8 percent. Only 18.8 percent of male former smokers started smoking regularly after the age of 20 years, while 31.2 percent of the female former smokers did so. The proportion of former smokers that started after they were 20 years of age differs within the different age groups, 16.1 percent of the 25 to 44 years of age group, 26.1 percent of the 45 to 64 years of age group and 41.2 percent of those 65 years of age and older. In summary, slightly higher proportions of current 20 smokers began to smoke before the age of 18 years compared to former smokers. This pattern is in accord with the hypothesis that the lower the age of initiation, the greater is the difficulty of quitting. Among former white smokers, 42.0 percent started before the age of 18 years and 76.9 percent before the age of 21 years. Among black former smokers, however, 34.9 percent started smoking regularly before 18 years of age and 68.7 percent had started before 21 years of age. Among those with 11 or fewer years of education, 26.7 percent started smoking after the age of 20 years. The proportion for those who have 16 years or more of education is 24.0 percent. Further Information This summary of the 1986 Adult Use of Tobacco Survey provides only some of the basic information relating to smok- ing behavior. More detailed information on the survey, includ- ing detailed analyses of smoking behavior in subgroups defined by more than one variable, and an outline of how people in the major sociodemographic categories responded to each question, will be available from the Office on Smoking and Health before the end of 1988. Further, afully documented public access computer tape will also be available before the end of 1988. Table 1 Cigarette Smoking Status and Quit Ratios by Total (Age 17+ years) SEX Male Female AGE (1st grouping) 17-19 20-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 17 18-24 25-44 45-64 65+ RACE White Black Other REGION Midwest Northeast Southeast West MARITAL STATUS Married/Cohabitating Widowed Divorced/Separated Never Married Unknown EDUCATION 11 or Fewer Years 12 Years 13-15 Years 16+ Years HOUSEHOLD INCOME $10,000 or Less $10,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000+ Unknown EMPLOYMENT Administrator/Manager Professional/Technical Sales/Clerical Craftsman Operative Laborer/Service Never in Labor Force Occupation Not Reported POVERTY LEVEL*** Above Below Unknown * Smoking status totals to 100%. 26.5 29.5 23.8 18.9 25.0 31.4 32.8 29.3 26.0 13.9 15.9 24.1 32.0 27.7 13.9 26.4 28.4 24.5 26.6 - 25.5 28.2 24.5 26.9 18.0 38.2 23.4 33.5 31.4 28.9 24.4 16.3 28.9 28.7 31.4 28.0 21.8 21.4 22.6 17.1 25.7 34.8 32.6 30.2 20.9 28.4 27.3 30.0 21.4 Current Former 24.6 30.4 19.3 5.4 10.2 19.8 26.0 31.6 36.0 33.2 3.6 9.4 22.5 33.8 33.2 25.7 18.0 19.1 22.6 26.8 23.9 26.2 28.5 25.8 23.9 11.8 37.1 24.8 24.0 22.2 28.4 20.5 23.0 22.8 24.9 31.2 23.1 33.0 26.3 23.4 32.6 24.0 20.8 9.2 24.4 25.7 19.3 23.1 Soclo Demographic Variables 1986 Smoking status (%) Never 48.9 40.0 56.9 75.7 64.7 48.8 41.2 39.1 38.0 52.8 80.5 66.6 45.4 38.5 52.8 48.0 53.6 56.4 50.8 47.7 47.9 49.3 446 56.3 37.9 64.8 29.4 43.8 47.2 53.4 55.2 50.6 48.3 45.8 47.1 47.0 55.5 44.4 56.6 50.9 32.6 43.3 49.0 69.9 47.2 47.0 50.7 55.5 Quit ratio** 0.481 0.508 0.448 0.223 0.290 0.387 0.442 0.519 0.580 0.704 0.186 0.280 0.413 0.550 0.704 0.493 0.388 0.439 0.459 0.513 0.459 0.517 0.515 0.589 0.384 0.335 0.526 0.441 0.454 0.476 0.635 0.415 0.445 0.420 0.470 0.588 0.519 0.593 0.605 0.476 0.483 0.424 0.408 0.307 0.463 0.485 0.391 0.519 Est. pop. Sample (mil.) 176.5 83.9 92.6 10.7 20.0 41.2 32.2 22.6 22.3 27.4 4.4 26.4 73.4 44.9 27.4 151.4 19.4 5.7 43.7 37.1 61.9 33.8 113.8 12.4 14.9 35.1 0.4 46.3 66.9 32.8 30.5 17.9 31.4 37.7 22.5 36.0 31.1 16.0 27.5 43.3 22.7 18.8 28.7 11.9 75 128.4 17.0 31.1 size 13,031 6,377 6,654 560 1,086 3,010 2,792 1,825 1,791 1,967 193 1,453 5,802 3,616 1,967 11,563 1,096 372 3,236 2,968 4,301 2,526 8,364 1,011 1,446 2,179 31 2,431 4,872 3,118 2,610 1,220 2,204 2,853 1,735 2,947 2,072 1,438 2,240 3,290 1,725 1,286 1,873 597 582 9,913 1,046 2,072 ** The Quit ratio is the number of former smokers divided by the number of people who have ever smoked. *** Poverty Level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 21 Table 2 Tobacco Use: Status and Quit Ratlos by Socio Demographic Variables 1986 Tobacco use status (% Quit Est.pop. Sample Current Former Never ratio” — (mil.) size Total (Age 17+ years) 30.8 27.7 415 0.473 1765 13,031 SEX Male 37.9 35.1 27.0 0.481 83.9 6,377 Female 24.4 20.9 54.7 0.461 92.6 6,654 AGE (1st grouping) 17-19 22.2 12.1 65.7 0.353 10.7 560 20-24 28.1 16.8 55.2 0.374 20.0 1,086 25-34 34.8 24.0 41.2 0.408 41.2 3,010 35-44 36.4 29.1 34.5 0.445 32.2 2,792 45-54 35.1 32.1 32.8 0.477 22.6 1,825 55-64 31.8 36.9 31.3 0.537 22.3 1,791 65+ 19.5 34.4 46.2 0.639 27.4 1,967 AGE (2nd grouping) 17 19.1 10.8 70.2 0,360 4.4 193 18-24 27.2 15.9 57.0 0.369 26.4 1,453 25-44 35.5 26.2 38.3 0.425 73.4 5,802 45-64 33.5 34.5 32.0 0.507 44.9 3,616 65+ 19.5 34.4 46.2 0.639 27.4 1,967 RACE White 30.8 28.6 40.55 0.482 151.4 11,563 Black 32.3 21.5 46.2 0.399 19.4 1,096 Other 26.2 22.8 50.9 0.465 5.7 372 REGION Midwest 30.6 26.3 43.1 0.462 43.7 3,236 Northeast 29.6 28.7 41.7 0.492 37.1 2,968 Southeast 33.2 26.9 39.9 0.448 61.9 4,301 West 28.2 29.7 42.1 0.513 33.8 2,526 MARITAL STATUS Married/Cohabitating 31.5 30.9 37.6 0.496 «113.8 8,364 Widowed 22.1 26.1 518 0.541 12.4 1,011 Divorced/Separated 416 269 31.5 0.993 14.9 1,446 Never Married 27.2 17.9 54.9 0.397 35.1 2,179 Unknown 38.0 32.6 29.4 0.461 0.4 31 EDUCATION 11 or Fewer Years 37.1 26.1 36.7 0.413 46.3 2,431 12 Years 32.3 26.2 41.5 0.448 66.9 4,872 13-15 Years 27.8 26.9 45.3 0.492 32.8 3,118 16+ Years 21.3 33.9 44.8 0.614 30.5 2,610 HOUSEHOLD INCOME $10,000 or Less 33.3 23.6 43.2 0.415 17.9 1,220 $10,000-$19,999 32.9 24.8 42.2 0.430 31.4 2,204 $20,000-$29,999 35.4 25.9 38.7 0.423 37.7 2,853 $30,000-$39,999 32.0 27.9 40.1 0.466 22.5 1,735 $40,000+ 26.8 35.9 37.2 0.572 36.0 2,947 Unknown 25.6 25.2 49.2 0.497 31.1 2,072 EMPLOYMENT Administrator/Manager 28.0 37.6 34.4 0.574 16.0 1,438 Professional/Technical 20.7 30.7 48.6 0.597 275 2,240 Sales/Clerical 27.4 25.4 47.1 0.481 43.3 3,290 Craftsman 42.9 33.9 23.2 0.441 22.7 1,725 Operative 39.4 26.8 33.8 0.404 18.8 1,286 Laborer/Service 34.3 23.2 42.5 0.404 28.7 1,873 Never in Labor Force 23.3 165 60.2 0415 11.9 597 Occupation Not Reported 34.2 26.2 39.5 0.434 75 582 POVERTY LEVEL**” Above 31.6 28.9 39.6 0.477 128.4 9,913 Below 34.8 23.1 42.2 0.999 17.0 1,046 Unknown 25.6 25.2 49.2 0.497 31.1 2,072 * Tobacco use status totals to 100%. ** The Quit ratio is the number of former smokers divided by the number of people who have ever smoked. *** Poverty Level Is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 22 Table 3 Tobacco Use: Cigar/Pipe and Smokeless Tobacco Use Status by Socio Demographic Variables 1986 Cigar/pipe smoking Smokeless tobacco use Status (%) status (%) Est. pop. Sample Current Former Never Total Current Former Never Total (mil.) size Total (Age 17+ years) 43 22.2 73.5 100 2.7 3.9 93.4 100 «176.5 13,031 SEX Male 8.7 41.8 49.6 100 5.2 7.4 87.4 100 83.9 6,377 Female 0.3 45 95.2 100 0.5 0.8 98.7 100 92.6 6,654 AGE (ist grouping) 17-19 1.5 13.6 85.0 100 41 6.1 89.8 100 10.7 560 20-24 2.0 166 81.4 100 2.9 5.0 92.1 100 20.0 1,086 25-34 4.0 19.1 76.9 100 2.4 3.3 94.3 100 41.2 3,010 35-44 5.0 26.2 68.8 100 2.2 29 94.9 100 32.2 2,792 45-54 6.7 25.2 68.1 100 2.5 3.9 93.6 100 22.6 1,825 55-64 5.1 27.9 67.0 100 3.1 41 92.8 100 22.3 1,791 65+ 3.9 22.6 73.5 100 3.0 4.2 92.8 100 27.4 1,967 AGE (2nd grouping) 17 0.8 13.0 86.2 100 4.0 4.0 92.0 100 4.4 193 18-24 2.0 16.0 82.0 100 3.2 5.6 91.1 100 26.4 1,453 25-44 4.4 22.2 73.3 100 2.3 3.1 94.5 100 73.4 5,802 45-64 5.9 26.5 67.6 100 2.8 4.0 93.2 100 44.9 3,616 65+ 3.9 22.6 73.5 100 3.0 4.2 92.8 100 27.4 1,967 RACE White 4.4 23.4 72.2 100 2.8 3.9 93.3 100 9=151.4 11,563 Black 3.7 13.9 82.4 100 2.3 3.9 93.7 100 19.4 1,096 Other 3.5 19.4 77. 100 1.8 3.7 94.5 100 5.7 372 REGION Midwest 48 22.6 72.6 100 2.1 3.5 94.4 100 43.7 3,236 Northeast 46 19.6 75.7 100 1.4 2.0 96.5 100 37.1 2,968 Southeast 3.8 23.2 73.0 100 4.2 5.0 90.8 100 61.9 4,301 West 4.1 22.7 73.2 100 2.3 4.4 93.2 100 33.8 2,526 MARITAL STATUS Married/Cohabitating 48 25.3 69.9 100 2.7 4.0 93.3 100 «113.8 8,364 Widowed 1.8 8.9 89.2 100 3.2 2.4 94.4 100 12.4 1,011 Divorced/Separated 5.6 20.1 74.3 100 2.2 4.3 93.5 100 14.9 1,446 Never Married 2.8 17.7 79.4 100 2.8 4.0 93.2 100 35.1 2,179 Unknown 2.4 27.5 60.1 100 1.4 1.4 87.2 100 0.4 31 EDUCATION 11 or Fewer Years 49 22.8 72.3 100 45 5.8 89.7 100 46.3 2,431 12 Years 3.6 20.0 76.5 100 2.4 3.7 93.8 100 66.9 4,872 13-15 Years 3.9 22.5 73.6 100 1.9 3.7 94.5 100 32.8 3,118 16+ Years 5.3 26.0 68.7 100 1.6 1.7 96.7 100 30.5 2,610 HOUSEHOLD INCOME Less than $10,000 3.1 16.8 80.1 100 44 5.4 90.5 100 17.9 1,220 $10,000-$19,999 4.0 21.2 74.9 100 3.0 4.7 92.3 100 31.4 2,204 $20,000-$29,999 4.3 23.1 72.6 100 2.6 41 93.3 100 37.7 2,853 $30,000-$39,999 5.0 24.2 70.8 100 2.6 4.0 93.4 100 22.5 1,735 $40,000+ 5.5 28.1 66.4 100 2.1 3.0 94.9 100 36.0 2,947 Unknown 3.3 174 79.6 100 2.7 3.0 94.3 100 31.1 2,072 EMPLOYMENT Administrator/Manager 6.0 30.0 63.9 100 1.6 2.2 96.2 100 16.0 1,438 Professional/Technical 3.5 21.3 75.2 100 1.1 1.8 97.1 | 100 27.5 2,240 Sales/Clerical 2.2 13.9 83.8 100 0.7 2.0 97.3 100 43.3 3,290 Craftsman 8.2 41.0 50.7 100 6.4 93 84.2 100 22.7 1,725 Operative 6.5 27.8 65.7 100 46 5.6 89.8 100 18.8 1,286 Laborer/Service 3.5 17.7 78.7 100 3.4 4.3 92.3 100 28.7 1,873 Never in Labor Force 1.6 10.1 88.3 100 2.5 4.0 93.5 100 11.9 597 Occupation Not Reported 4.4 22.2 73.4 100 48 4.1 91.1 100 7.5 582 POVERTY LEVEL* Above 4.7 23.9 71.4 100 2.5 3.8 93.7 100 128.4 9,913 Below 3.0 18.6 78.3 100 43 6.2 89.5 100 17.0 1,046 Unknown 3.3 17.1 79.6 100 2.7 3.0 94.3 100 31.1 2,072 * Poverty level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 23 Total (Age 17+ years) SEX Male Female AGE (1st grouping) 17-19 20-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 17 18-24 25-44 45-64 65+ RACE White Black Other REGION Midwest Northeast Southeast West MARITAL STATUS Married/Cohabitating Widowed Divorced/Separated Never Married Unknown EDUCATION 11 or Fewer Years 12 Years 13-15 Years 16+ Years HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20 ,000-$29,999 $30,000-$39,999 $40,000+ Unknown EMPLOYMENT Administrator/Manager Professional/Technical Sales/Clerical Craftsman Operative Laborer/Service Never in Labor Force Occupation Not Reported POVERTY LEVEL’ Above Below Unknown * Poverty level is based on the definition provided by the U.S. Bureau of the Census. Tobacco Use: Status of Different Combinations by Tabie 4 Socio Demographic Variables 1986 Tobacco use status (%) Current Cigarettes Former Cigarettes No other Plusother No other Only Only tobacco tobacco tobacco smokeless cigars/pipe 24.3 2.3 22.6 0.9 1.0 24.9 46 26.4 1.9 2.2 23.7 0.1 19.3 0.1 0.0 17.2 1.7 5.3 0.2 . 23.4 1.6 9.8 0.3 0.1 28.8 26 18.5 0.7 0.7 29.6 3.2 23.9 1.0 1.2 26.6 2.7 28.0 1.6 2.1 23.8 2.2 33.2 1.3 1.4 12.8 11 30.6 1.3 1.3 14.9 0.9 3.6 . . 22.3 1.7 8.9 0.3 0.1 29.2 2.8 20.8 0.8 0.9 25.2 2.5 30.6 1.4 1.8 12.8 11 30.6 1.3 1.3 24.1 2.3 23.5 1.0 1.1 26.4 19 16.9 0.7 0.5 216 29 18.5 0.3 0.3 24.2 2.4 20.7 0.6 1.2 23.8 1.7 24.8 0.4 1.6 25.6 2.6 21.5 1.6 0.8 22.3 2.2 24.9 0.6 0.7 24.4 2.5 26.1 1.2 1.2 17.2 0.8 24.2 0.4 1.1 34.6 3.6 22.2 0.4 1.3 21.9 1.5 11.0 0.4 0.4 25.7 78 32.6 46 283 3.1 22.2 1.6 1.0 26.7 2.2 22.2 0.9 0.8 22.4 2.0 20.8 0.5 0.9 14.8 15 26.1 0.5 1.8 26.3 25 19.0 1.0 0.5 26.4 2.3 20.6 1.6 0.9 29.0 2.4 21.0 1.0 0.8 25.1 3.0 22.5 1.0 1.4 19.8 2.1 29.2 0.6 1.4 19.8 1.6 21.3 0.6 1.1 20.7 1.9 30.9 06 1.5 16.3 0.8 24.6 0.4 1.3 24,7 1.0 22.4 0.3 0.7 29.3 5.6 28.3 28 1.5 28.9 3.7 21.6 1.6 0.8 27.8 2.5 18.7 1.0 11 19.7 1.2 8.7 0.3 0.3 25.5 2.9 22.3 0.6 1.5 24.9 2.4 23.6 1.0 1.1 27.7 2.3 17.7 1.2 4 19.8 1.6 21.3 0.6 1.1 24 No other tobacco 46.5 35.8 56.3 72.5 62.2 46.7 39.8 36.9 35.0 49.9 77.3 63.9 43.7 35.9 49.9 45.6 50.8 55.3 48.6 45.6 45.4 47.0 42.5 53.6 36.2 61.8 29.4 40.6 45.4 51.4 52.6 47.7 46.5 43.6 45.5 44.0 53.1 41.2 54.7 50.2 28.8 39.0 47.0 68.0 43.5 44.8 47.6 53.1 Never Cigarettes Only Only smokeless _cigars/pipe 1.1 1.3 1.8 2.5 0.4 0.2 25 0.7 1.7 0.8 1.0 1.0 0.2 1.2 0.3 19 1.4 1.6 1.4 1.5 3.2 . 1.8 0.9 0.7 1.1 0.9 18 1.4 1.5 11 1.3 1.5 1.4 . 1.1 0.8 1.3 0.7 1.5 1.4 1.4 1.2 1.2 0.8 1.4 2.7 . 0.6 14 1.6 1.4 1.9 1.3 0.8 0.9 0.8 1.2 0.7 1.9 2.3 0.6 0.8 1.0 0.9 1.3 0.5 1.4 0.8 2.2 1.5 1.0 0.8 2.4 0.4 15 0.2 0.5 1.9 1.9 1.8 2.6 1.5 0.5 1.5 0.3 2.4 1.4 0.8 1.4 2.5 0.6 1.5 1.0 See text for exact procedures. Table 5 Cigarette Smoking Status and Quit Ratios by Socio Demographic Variables Total (Age 21+ years) SEX Male Female AGE (1st grouping) 21-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 21-24 25-44 45-64 65+ MARITAL STATUS Married Widowed Divorced/Separated Never Married Unknown EDUCATION Some high school High school graduate Some college College graduate Unknewn HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000+ Unknown EMPLOYMENT Proftessional/Technical Administrator/Manager Sales/Clerical Craftsman Operatives Laborer/Service Not in Labor Force Occupation Not Reported 1975 Smoking status (%) Current Former Never Total 35.8 24.0 40.3 100 40.5 32.1 27.5 100 31.4 16.4 52.2 100 38.2 14.9 46.9 100 41.5 21.8 36.7 100 43.6 23.4 33.0 100 38.5 27.6 33.9 100 31.8 29.8 38.4 100 17.4 24.0 58.6 100 38.2 14.9 46.9 100 42.4 22.5 35.1 100 35.5 28.6 35.9 100 17.4 24.0 58.6 100 35.4 26.3 38.3 100 24.0 15.8 60.2 100 54.8 17.7 27.5 100 36.5 16.9 46.7 100 27.4 31.0 41.7 100 35.2 22.1 42.7 100 40.2 22.1 37.6 100 36.3 25.3 38.3 100 27.6 29.0 43.4 100 25.1 24.3 50.6 100 34.8 19.3 45.9 100 38.2 26.4 35.3 100 36.9 30.7 32.4 100 29.6 19.5 50.9 100 28.3 20.6 51.2 100 32.6 19.2 48.2 100 32.7 20.6 46.7 100 34.9 14.3 50.8 100 36.0 14.9 49.1 100 36.4 15.6 48.0 100 28.9 15.5 §5.6 100 37.8 27.9 34.3 100 25 Quit ratio 0.401 0.442 0.343 0.281 0.345 0.349 0.418 0.483 0.579 0.281 0.347 0.446 0.579 0.426 0.397 0.244 0.316 0.530 0.386 0.355 0.411 0.512 0.492 0.356 0.409 0.454 0.398 0.421 0.370 0.386 0.291 0.293 0.300 0.350 0.425 Sample size 10,682 4,949 5,733 1,144 2,757 2,050 1,891 1,434 1,406 1,144 4,807 3,325 1,406 7,387 1,075 1,029 1,170 ai 2,828 3,742 2,173 1,863 76 3,685 3,919 1,778 1,300 652 696 336 699 380 257 461 7,201 Table 6 Tobacco Use: Status and Quit Ratios by Socio Demographic Variables 1975 Tobacco use status (%) Current Former Never Total Total (Age 21+ years) 42.9 22.9 34.2 100 SEX Male 53.7 29.2 17.1 400 Female 32.8 17.1 50.1 100 AGE (1st grouping) 21-24 42.1 16.9 414 100 25-34 46.9 21.4 31.7 100 35-44 49.1 22.3 28.6 100 . 45-54 46.9 25.0 28.1 100 55-64 40.2 26.9 33.0 100 65+ 28.3 23.8 47.8 100 AGE (2nd grouping) 21-24 42.1 16.9 41.1 400 25-44 47.9 218 30.4 100 45-64 43.9 25.8 30.3 100 65+ 28.3 23.8 47.8 100 MARITAL STATUS Married 42.9 24.6 32.5 100 Widowed 31.0 16.14 52.9 4100 Divorced/Separated 59.3 17.7 23.0 100 Never Married 42.0 19.1 39.0 100 Unknown 27.4 31.0 41.7 100 EDUCATION Some high school 43.8 20.9 35.3 100 High school graduate 46.0 20.5 33.5 100 Some college 41.9 25.9 32.2 100 College graduate 36.6 278 35.6 100 Unknown 37.7 20.4 42.0 100 HOUSEHOLD INCOME Less than $10,000 41.6 18.9 39.5 100 $10,000-$19,999 453 25.0 29.6 100 $20,000+ 45.8 279 26.3 100 Unknown 35.1 20.3 44.6 100 EMPLOYMENT Professional/Technical 30.0 22.0 48.0 100 Administrator/Manager 34.0 19.8 46.1 100 Sales/Clerical 33.5 20.7 45.8 100 Craftsman 35.7 15.2 49.1 100 Operatives 38.9 17.1 44.0 100 Laborer/Service 37.0 16.4 46.6 100 Not in Labor Force 30.8 16.3 52.9 100 Occupation Not Reported 48.2 25.7 26.1 100 26 Quit ratio 0.348 0.352 0.343 0.286 0.313 0.312 0.348 0.401 0.457 0.286 0.313 0.370 0.457 0.364 0.341 0.230 0.312 0.530 0.323 0.308 0.382 0.432 0.351 0.312 0.355 0.379 0.366 0.423 0.368 0.382 0.299 0.306 0.307 0.347 0.347 Sample size 10,682 4,949 5,733 1,144 2,757 2,050 1,891 1,434 1,406 1,144 4,807 3,325 1,406 7,387 1,075 1,029 1,170 a1 2,828 3,742 2,173 1,863 76 3,685 3,919 1,778 1,300 652 696 336 699 380 257 461 7,201 Table 7 Cigarette Exposure Levels: Amount Smoked, Tar Levels and Percent Menthol Among Current Smokers by Soclo Demographic Variables 1986 Cigarettes per day Tar level, mg/cig % who 15 or 25 or use less 16-24 more Total <=10 310-15 >15 Total menthol Total (17-65+) 35.0 34.9 30.1 100 29.6 11.6 58.8 100 «29.2 SEX Male 29.8 34.0 36.2 100 26.8 8.0 65.2 100 24.9 Female 40.7 35.9 23.4 100 32.7 156 51.7 100 34.0 AGE (1st grouping) 17-19 §3.8 34.1 12.1 100 31.7 2.7 65.6 100 29.3 20-24 41.0 40.0 19.0 100 30.4 49 64.8 100 24.1 25-34 39.2 32.8 28.0 100 32.2 5.6 62.1 100 36.9 35-44 28.8 35.3 35.9 100 30.6 12.7 56.7 100 «31.3 45-54 26.9 34.6 38.5 100 26.3 19.2 545 100 23.0 55-64 29.8 33.8 36.4 100 26.2 16.2 57.5 100 24.4 65+ 42.1 36.7 21.3 100 26.3 22.6 51.1 100, 21.1 AGE (2nd grouping) 17 51.7 42.8 5.5 100 38.9 4.0 57.1 100 29.0 18-24 43.8 37.9 18.3 100 29.9 43 658 100 =25.2 25-44 34.5 33.9 31.5 100 31.5 8.8 59.7 100 «34.4 45-64 28.3 34.2 37.5 100 26,3 17.8 55.9 100 = 23.7 65+ 42.1 36.7 21.3 100 26.3 22.6 51.1 100, 21.1 RACE White 31.2 35.7 33.1 100 31.8 12.3 §5.9 100 23.1 Black 61.3 27.3 41.4 100 14.5 76 78.0 100 755 Other 40.5 40.6 18.8 100 26.2 5.3 68.5 100 24.9 REGION Midwest 31.7 35.0 33.3 100 25.3 10.4 64.3 100 = 330.5 Northeast 34.9 35.3 29.8 100 36.8 12.6 50.6 100 279 Southeast 35.3 35.9 28.8 100 28.0 12.7 59.3 100 =. 31.2 West 39.1 32.0 28.8 100 31.0 96 59.4 100 24.5 MARITAL STATUS Married/Cohabitating 32.7 34.6 32.7 100 29.6 12.4 58.0 100 27.3 Widowed 40.3 37.0 22.7 100 30.3 19.1 50.7 100 28.9 Divorced/Separated 30.2 37.2 32.6 100 26.9 13.8 59.3 100 »=- 332.3 Never Married 45.3 33.8 20.9 100 31.6 5.0 63.4 100 34.1 Unknown §3.8 22.4 23.8 100 19.5 80.5 100 =34.7 EDUCATION 11 or Fewer Years 33.5 36.5 30.0 100 23.5 11.6 64.8 100 27.6 12 Years 34.4 33.7 31.9 100 29.4 11.9 58.7 100 29.7 13-15 Years 36.4 36.1 27.4 100 36.8 9.7 53.5 100 §=320 16+ Years 39.1 32.8 28.1 100 36.4 13.2 50.4 100 27.1 HOUSEHOLD INCOME Less than $10,000 40.5 33.8 25.7 100 22.1 11.0 66.9 100 =: 336.8 $10,000-$19,999 34.8 34.2 31.0 100 27.5 12.9 59.5 100 26.7 $20,000-$29,999 34.0 36.5 29.6 100 31.5 11.4 57.1 100 28.3 $30,000-$39,999 35,3 34.4 30.3 100 30.7 9.7 59.6 100 +296 $40,000+ 29.3 34.1 36.6 100 34.6 11.9 53.4 100 27.7 Unknown 39.3 35.2 25.5 100 27.9 11.9 60.2 100 29.6 EMPLOYMENT Administrator/Manager 32.3 36.3 31.4 100 31.2 15.1 53.7 100 26.4 Professional/Technical 34.6 34.7 30.7 100 41.6 13.0 453 100 29.7 Sales/Clerical 38.2 34.4 27.3 100 32.7 14.4 52.9 100 »=33.0 Craftsman 27.8 33.6 38.6 100 24.0 10.3 65.7 100 «23.5 Operative 32.3 34.0 33.7 100 24.3 9.0 66.7 100 26.0 Laborer/Service 37.0 34.6 28.4 100 28.9 93 61.8 100 30.0 Never in Labor Force 43.6 36.7 19.6 100 25.1 10.7 64.3 100 = 35.7 Occupation Not Reported 40.1 41.4 18.5 100 27.9 10.1 62.0 100 32.9 POVERTY LEVEL’ Above 33.3 35.2 31.6 100 31.1 11.7 57.2 100 27.7 Below 41.4 32.4 26.2 100 21.9 10.1 68.0 100 38.6 Unknown 39.3 35.2 25.5 100 27.9 11.9 60.2 100 29.6 * Poverty ievel is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 27 Table 8 Cigarette Exposure Levels: Amount Smoked, Tar Levels and Percent Menthol Among Former Smokers* by Socio Demographic Variables 1986 Cigarettes per day Tar level, mg/cig 15 25 orless 16-24 ormore Total <=10 >1 0-15 >15 Total Total (Age 17+ years) 38.2 29.6 32.2 100 31.5 109 576 100 SEX Male 31.2 29.6 39.2 100 29.4 10.1 60.5 100 Female 46.6 29.7 23.7 100 34.0 11.9 54.1 100 AGE (1st grouping) 17-19 80.6 7.4 12.0 400 25.3 45 70.2 100 20-24 58.3 25.2 16.5 100 42.1 1.9 56.0 100 25-34 40.5 32.0 275 100 38.2 45 57.3 100 35-44 34.9 29.8 35.4 100 25.0 10.8 64.2 100 45-54 27.0 27.0 46.0 100 32.9 16.3 50.8 100 55-64 24.8 31.0 44.2 100 23.7 19.3 57.0 100 65+ 36.3 35.9 27.8 100 26.4 21.1 52.5 100 AGE (2nd grouping) 17 96.6 3.4 . 100 7.3 . 92.7 100 18-24 61.5 22.0 16.5 100 40.1 2.8 57.1 100 25-44 38.2 31.1 30.8 100 32.8 7A 60.1 100 45-64 25.8 29.1 45.1 100 28.0 17.9 54.1 100 65+ 36.3 35.9 27.8 100 26.4 21.1 52.5 100 RACE White 36.1 29.7 34.2 100 33.4 11.3 55.3 100 Black 57.0 30.9 12.1 100 15.5 7.4 77.2 100 Other 41.5 23.4 35.1 100 25.2 11.6 63.2 100 REGION Midwest 37.4 32.6 30.0 100 26.6 11.3 62.1 100 Northeast 34.3 31.3 34.4 100 42.1 11.5 46.4 100 Southeast 37.4 29.0 33.6 100 28.5 10.3 61.2 100 West 45.0 25.4 29.6 100 30.3 10.8 58.9 100 MARITAL STATUS Married/Cohabitating 33.8 30.6 35.6 100 31.4 11.8 56.8 100 Widowed 47.0 28.1 24.9" 100 25.6 19.7 54.7 100 Divorced/Separated 37.4 30.7 31.9 100 21.6 10.6 67.8 100 Never Married 54.4 24.8 20.7 100 39.0 48 56.3 100 Unknown . 63.5 36.5 100 12.7 . 87.3 100 EDUCATION 11 or Fewer Years 36.0 28.8 35.2 100 20.8 12.4 66.8 100 12 Years 36.5 29.8 33.7 100 33.4 10.8 55.8 100 13-15 Years 40.8 27.7 31.5 100 33.5 11.4 55.1 100 16+ Years 42.1 32.4 25.5 100 39.2 8.7 52.1 100 HOUSEHOLD INCOME Less than $10,000 45.6 29.6 24.9 100 20.8 12.4 66.9 100 $10,000-$19,999 33.7 33.3 33.0 100 33.0 10.4 56.5 100 $20,000-$29,999 39.9 28.2 32.0 100 31.7 6.1 62.2 100 $30,000-$39,999 34.6 30.7 34.7 100 34.2 10.2 556 100 $40,000+ 39.6 28.1 32.2 100 36.9 12.9 50.2 100 Unknown 37.3 29.5 33.2 100 23.7 148 61.5 400 EMPLOYMENT Administrator/Manager 30.5 33.1 36.4 100 37.3 11.3 51.4 100 Professional/Technical 43.4 275 29.1 100 36.4 96 540 100 Sales/Clerical 46.9 29.6 23.4 100 36.4 10.7 52.9 100 Craftsman 25.8 27.3 46.9 100 25.4 14.3 60.3 100 Operative 28.6 38.5 32.9 100 24.4 9.6 66.0 100 Laborer/Service 39.8 28.2 32.0 100 26.3 12.0 618 100 Never in Labor Force 50.3 20.1 29.7 100 22.0 9.3 68.7 100 Occupation Not Reported 36.7 27.4 35.9 100 30.7 58 63.5 100 POVERTY LEVEL”* Above 37.7 29.9 32.4 100 34.2 10.0 55.8 100 Below 45.2 27.0 27.7 100 19.7 12.3 679 100 Unknown 37.3 29.5 33.2 100 23.7 146 61.5 100 * Former smokers who had quit within the last five years. % who use menthol 30.3 23.6 38.3 34.4 31.6 34.0 35.6 26.5 21.7 23.9 35.8 32.0 34.7 23.9 23.9 25.9 72.4 28.0 39.5 25.5 27.2 30.2 29.7 28.8 39.5 28.6 23.8 31.3 29.5 29.7 31.2 39.5 27.2 33.9 34.6 25.8 27.7 28.2 33.6 33.3 16.9 32.3 33.4 32.9 32.0 30.0 39.0 27.7 ** Poverty level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 28 Table 9 Quitting: Total Number of Attempts of Current Smokers by Socio Demographic Variables 1986 Attempts to quit smoking (% of current smokers) Est. pop. Sample 0 1-2 3-5 6+ Total = (mil.) size Total (Age 17+ years) 35.5 37.3 18.9 8.3 100 46.7 4,686 SEX Male 36.7 36.9 17.1 9.4 100 24.7 2,341 Female 34.2 37.8 20.9 7.0 100 22.0 2,345 AGE (1st grouping) 17-19 47.2 31.1 18.6 3.1 100 2.0 168 20-24 42.5 42.3 11.6 3.5 100 5.0 419 25-34 33.8 40.2 19.2 6.8 100 12.9 1,276 35-44 32.2 39.6 20.0 8.2 100 10.6 1,154 45-54 34.1 35.3 215 9.2 100 6.6 687 55-64 35.8 32.5 20.0 11.7 100 5.8 575 65+ 37.0 28.9 18.8 15.4 100 3.8 407 AGE (2nd grouping) 17 60.8 20.6 17.2 1.4 100 0.7 49 18-24 42.0 41.2 13.2 3.6 100 6.3 538 25-44 33.1 39.9 19.5 7.5 100 23.5 2,430 45-64 34.9 34.0 20.8 10.4 100 12.4 1,262 65+ 37.0 28.9 18.8 15.4 100 3.8 407 RACE White 35.6 37.9 18.8 7.7 100 39.8 4,112 Black 34.3 32.9 199 12.8 100 5.5 438 Other 37.7 39.0 17.3 5.9 100 1.4 136 REGION . Midwest 35.3 38.8 17.2 8.7 100 11.6 1,197 Northeast 32.1 37.2 20.9 9.8 100 9.4 1,056 Southeast 37.2 36.7. 18.3 7.8 100 17.4 1,582 West 36.1 36.8 20.3 6.7 100 8.2 851 MARITAL STATUS Married/Cohabitating 33.6 38.8 19.4 8.2 100 30.5 2,853 Widowed 34.7 293 22.7 13.3 100 2.2 294 Divorced/Separated 35.3 38.1 17.2 9.5 100 5.7 730 Never Married 43.4 33.2 17.4 6.1 100 8.2 794 Unknown 12.3 55.6 18.3 13.8 100 0.1 15 EDUCATION 11 or Fewer Years 37.1 33.5 20.2 9.2 100 14.5 946 12 Years 35.2 38.6 18.8 7.4 100 19.3 1,955 13-15 Years 35.1 39.3 17.7 7.9 100 8.0 1,140 16+ Years 32.5 40.8 17.4 9.4 100 5.0 645 HOUSEHOLD INCOME Less than $10,000 33.6 36.6 20.0 9.8 100 5.2 490 $10,000-$19,999 35.3 37.4 19.7 7.6 100 9.0 889 $20,000-$29,999 37.1 37.7 16.2 9.0 100 11.8 1,170 $30,000-$39,999 29.5 39.1 24.9 6.5 100 6.3 642 $40,000+ 34.4 39.2 17.2 9.2 100 7.9 874 Unknown 41.2 33.4 18.2 7.2 100 6.6 621 EMPLOYMENT Administrator/Manager 29.7 42.7 18.7 8.9 100 3.6 459 Professional/Technical 36.0 38.4 16.4 9.3 100 4.7 579 Sales/Clerical 35.7 37.0 20.9 6.4 100 11.1 1,197 Craftsman 35.6 35.4 19.1 9.9 100 7.9 726 Operative 33.1 38.3 19.5 9.2 100 6.1 533 Laborer/Service 37.0 37.0 17.0 8.9 100 8.6 791 Never in Labor Force 42.3 36.1 17.1 4.5 100 2.5 186 Occupation Not Reported 35.6 34.7 218 7.8 100 2.1 215 POVERTY LEVEL* Above 34.5 38.2 18.9 8.4 100 35.0 3,627 Below 35.0 36.4 19.8 8.9 100 5.1 438 Unknown 41.2 33.4 18.2 7.2 100 6.6 621 * Poverty level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 29 Quitting: Total Number Table 10 by Soclo Demographic Variables Total (Age 21+ years) SEX Male Female AGE (1st grouping) 21-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 21-24 25-44 45-64 65+ MARITAL STATUS Married Widowed Divorced/Separated Never Married Unknown EDUCATION Some high school High school graduate Some college College graduate Unknown HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000+ Unknown EMPLOYMENT Professional Technical Administrator/Manager Sales/Clerical Craftsman Operatives Laborer/Service Not in Labor Force Occupation Not Reported 0 37.6 35.4 40.4 37.8 35.3 34.6 39.5 40.4 44.9 37.8 35.0 39.9 44.9 36.0 48.7 39.3 42.3 40.6 36.4 40.4 36.9 33.3 32.5 38.1 36.0 36.1 45.5 34.8 39.5 45.1 37.9 41.0 39.2 39.2 36.9 1975 Attempts to quit smoking (% of current smokers) 1-2 3-5 6+ 37.0 18.1 7.3 39.2 17.8 7.7 34.3 18.4 6.9 41.0 16.4 48 39.7 18.7 6.4 39.5 17.6 8.3 33.7 18.3 8.4 30.8 19.9 8.9 33.5 15.8 5.8 41.0 16.4 4.8 39.6 18.2 7.2 32.6 18.9 8.6 33.5 15.8 5.8 37.6 18.5 7.9 32.0 14.1 5.3 36.8 17.8 6.1 35.5 17.1 5.1 43.4 16.0 35.9 19.4 8.3 36.1 17.2 6.3 38.8 15.9 8.3 39.1 21.3 6.4 35.7 10.3 21.5 35.8 17.9 8.3 39.1 18.4 6.6 37.8 18.9 7.2 31.2 16.0 7.3 44.2 15.2 5.8 37.1 18.7 47 36.7 12.6 5.6 34.6 20.0 75 32.0 20.9 6.2 32.1 21,7 7A 35.8 15.2 9.8 37.3 18.2 76 30 of Attempts of Current Smokers Total 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 Sample size 4,262 2,139 2,123 497 1,249 976 788 504 248 497 2,225 1,292 248 2,951 272 572 463 1,130 1,680 879 558 15 1,452 1,661 723 426 210 274 130 303 168 108 165 2,904 Table 11 Quitting: Total Number of Attempts of Former Smokers by Soclo Demographic Variables 1986 Attempts to quit smoking (% of former smokers) Est. pop. Sample 0 1-2 3-5 6+ Total = (mil.) size Total (Age 17+ years) . 70.2 21.2 8.6 100 43.5 4,614 SEX Male . 68.9 21.6 9.5 100 25.6 2,606 Female . 72.2 20.5 7.2 100 17.9 2,008 AGE (1st grouping) 17-19 : 88.0 9.4 2.6 100 0.6 42 20-24 . 73.4 216 5.0 100 2.0 180 25-34 . 73.4 20.3 6.3 100 8.2 867 35-44 . 68.8 22.4 8.8 100 8.4 983 45-54 . 628 254 118 100 7.4 731 55-64 : 68.4 20.8 10.8 100 8.0 831 65+ . 74.3 18.4 7.3 100 9.1 980 AGE (2nd grouping) 17 100.0 . . 100 0.2 11 18-24 . 75.1 20.1 48 100 2.5 21 25-44 . 714 21.3 7.6 100 16.6 1,850 45-64 . . 65.8 23,0 11.2 100 15.2 1,562 65+ . 74.3 184 7.3 100 9.1 980 RACE White . . 703 21.1 8.6 100 38.9 4,228 Black . 68.6 22.8 8.7 100 3.5 282 Other 5 72.4 19.5 8.1 100 1.1 104 REGION . Midwest . 71.1 215 7.5 100 9.9 1,090 Northeast : 68.5 23.2 8.3 100 9.9 1,110 Southeast . 70.6 19.6 9.8 100 =: 14.8 1,478 West . 70.7 21.2 8.2 100 8.9 936 MARITAL STATUS Married/Cohabitating . 70.0 21.1 8.9 100 32.4 3,265 Widowed : 72.8 19.7 7.5 100 3.2 424 Divorced/Separated . 68.3 22.4 9.3 100 3.6 475 Never Married . 715 22.4 6.1 100 41 438 Unknown . 69.9 7.3 22.7 100 0.1 12 EDUCATION 11 or Fewer Years ; 73.0 19.2 7.9 100 «11.5 857 12 Years ; 71.2 20.4 8.4 100 16.0 1,574 13-15 Years . 68.1 23.4 8.5 100 7.3 1,058 16+ Years . 66.8 23.2 10.1 100 8.7 1,125 HOUSEHOLD INCOME Less than $10,000 . 70.7 22.2 7.1 100 3.7 374 $10,000-$19,999 : 71.0 220 7.0 100 7.2 712 $20,000-$29,999 . 72.1 18.4 9.5 100 8.6 922 $30,000-$39,999 . 67.3 24.4 8.4 100 5.6 608 $40,000+ . 68.9 226 85 100 -11.2 1,264 Unknown . 71.5 183 10.3 100 7.2 734 EMPLOYMENT Administrator/Manager : 64.0 25.8 10.1 100 5.3 635 Professional/Technical . 67.0 23.2 9.9 100 7.2 906 Sales/Clerical . 73.2 19.7 7.1 100 10.1 1,094 Craftsman . 70.4 21.1 8.5 100 7.4 690 Operative , 678 214 10.8 100 4.5 437 Laborer/Service . 74.7 19.2 6.2 100 6.0 540 Never in Labor Force . 76.3 17.2 6.5 100 1.4 109 Occupation Not Reported , 72.2 16.7 11.1 100 1.8 203 POVERTY LEVEL* Above : 70.0 21.7 8.3 100 833.0 3,593 Below . 69.6 22.1 8.3 100 3.3 287 Unknown . 71.5 18.3 10.3 100 7.2 734 Poverty level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 31 Table 12 Quitting: Total Number of Attempts of Former Smokers by Soclo Demographic Variables Total (Age 21+ years) SEX Male Female AGE (1st grouping) 21-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 21-24 25-44 45-64 65+ MARITAL STATUS Married Widowed Divorced/Separated Never Married Unknown EDUCATION Some high school High school graduate Some college College graduate Unknown HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000+. Unknown EMPLOYMENT Professional/Technical Administrator/Manager Sales/Clerical Craftsman Operatives Laborer/Service Not in Labor Force Occupation Not Reported 1975 Attempts to quit smoking (% of former smokers) 0 1-2 3-5 6+ 59.0 24.8 16.2 56.9 25.5 17.6 62.9 23.7 13.5 55.8 32.0 12.2 63.7 24.4 118 60.2 23.5 16.3 §3.1 29.0 18.0 56.3 23.3 20.4 64.1 19.9 16.0 55.8 32.0 12.2 62.1 240 13.9 54.6 26.4 19.1 64.1 19.9 16.0 58.0 25.0 17.0 66.4 210 126 58.4 26.0 15.6 64.9 25.1 10.0 79.1 20.9 . 57.2 24.8 18.0 57.8 23.7 186 62.7 25.2 12.1 58.6 268 14.7 83.1 12.5 4.4 57.7 24.4 17.9 58.3 26.2 15.5 59,7 235 168 63.5 23.4 13.1 66.6 20.4 13.0 70.6 178 116 48.6 36.7 14.7 59.2 28.0 128 64.0 20.7 15.2 §46 32.39 13.2 60.0 22.3 17.7 57.8 25.1 17.1 32 Total 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 Sample size 2,687 1,632 1,055 185 651 495 567 446 343 185 1,146 1,013 343 2,112 171 181 217 645 872 579 572 ' 19 736 1,103 578 270 159 150 79 122 67 47 84 1,979 Table 13 Age of Initiation of Smoking: Current Smokers by Socio Demographic Variables 1986 Age when started smoking regularly (% of current smokers) <16 16-17 18-20 921+ Total (Age 17+ years) 20.8 25.9 31.6 21.7 SEX Male 23.5 28.2 32.2 16.2 Female 17.7 23.3 31.0 28.0 AGE (1st grouping) 17-19 43.4 43.0 13.6 . 20-24 28.2 36.9 31.6 3.2 25-34 23,5 29.2 31.5 15.8 35-44 16.3 24.6 33.6 25.5 45-54 16.2 17.4 39.3 27.1 55-64 15.8 21.5 31.0 31.7 65+ 17.1 15.2 23.5 443 AGE (2nd grouping) 17 54.8 45.2 . . 18-24 30.2 38.0 29.3 2.5 25-44 20.3 27.1 32.4 20.2 45-64 16.0 19.3 35.4 29.2 65+ 17.1 15.2 23.5 44.3 RACE White 21.9 27.2 30.8 20.2 Black 115 . 19.5 37.2 31.8 Other 25.6 14.4 33.9 26.1 REGION Midwest 21.5 25.0 31.7 21.8 Northeast 20.1 26.2 34.3 19.4 Southeast 20.0 25.5 31.9 22.7 West 22.1 27.6 28.0 22.3 MARITAL STATUS Married/Cohabitating 19.4 25.0 33.3 22.3 Widowed 13.0 16.2 25.8 45.1 Divorced/Separated 21.7 24.8 27.5 26.0 Never Married 26.9 32.3 30.2 10.6 Unknown 41.9 30.4 166 11.1 EDUCATION 11 or Fewer Years 30.0 29.3 24.0 16.7 12 Years 18.4 27.1 32.5 22.0 13-15 Years 15.0 23.0 37.5 24.5 16+ Years 12.5 15.6 41.0 30.9 HOUSEHOLD INCOME Less than $10,000 21.8 27.6 25.1 25.6 $10,000-$19,999 24.6 23.1 32.8 19.4 $20,000-$29,999 19.7 26.6 32.6 21.1 $30,000-$39,999 18.8 27.9 33.6 19.7 $40,000+ 16.6 24.9 35.3 23.2 Unknown 23.5 26.2 27.1 23.3 EMPLOYMENT Administrator/Manager 15.9 22.5 34.1 27.5 Professional/Technical 12.8 19.8 40.0 27.5 Sales/Clerical 18.0 24.0 33.5 24.5 Craftsman 27.2 27.8 28.9 16.1 Operative 21.5 30.9 28.9 18.7 Laborer/Service 19.8 26.8 30.4 23.0 Never in Labor Force 31.3 30.2 254 13.2 Occupation Not Reported 26.6 24.3 29.6 19.6 POVERTY LEVEL’ Above 20.0 25.5 33.2 21.3 Below 22.5 27.9 266 23.0 Unknown 23.5 26.2 27.1 23.3 Est. pop. Sample (mil.) 45.8 24.3 215 2.0 5.0 12.7 10.4 6.5 5.7 3.6 0.7 6.3 23.1 12.2 3.6 39.0 5.4 1.4 11.5 9.3 16.9 8.2 29.9 2.2 o_o ANOR oom oOonwuw UuUuDHdh Amon wnou 10.9 size 4,615 2,312 2,303 166 416 1,259 1,141 680 563 390 47 535 2,400 1,243 390 4,052 431 132 1,182 1,037 1,549 847 2,807 289 720 784 15 927 1,935 1,127 626 486 881 1,153 640 858 597 456 563 1,176 718 529 781 186 206 3,585 433 597 * Poverty level is based on the definition provided by the U.S. Bureau of the Census. See text for exact procedures. 33 Former Smokers by Socio Demographic Variables 1986 Total (Age 17+ years) SEX Male Female AGE (1st grouping) 17-19 20-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 17 18-24 25-44 45-64 65+ RACE White Black Other REGION Midwest Northeast Southeast West MARITAL STATUS Married/Cohabitating Widowed Divorced/Separated Never Married Unknown EDUCATION 11 or Fewer Years 12 Years 13-15 Years 16+ Years HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000-$29,999 $30,000-$39,998 $40,000+ Unknown EMPLOYMENT Administrator/Manager Professional/Technical Sales/Clerical Craftsman Operative Laborer/Service Never in Labor Force Occupation Not Reported POVERTY LEVEL‘ Above Below Unknown text for exact procedures. Table 14 Age of Initiation of Smoking: Age when started smoking regularly (% of former smokers) <16 17.2 20.5 12.5 446 27.1 23.2 18.0 15.1 14.9 11.0 35.0 30.3 20.5 15.0 11.0 17.9 10.5 16.7 14.7 16.3 18.1 19,7 17.1 7.9 20.2 22.8 13.6 21.1 18.4 16.1 114 15.7 20.5 19.1 17.3 14.9 16.2 12.9 13.1 13,7 20.7 25.8 19.4 23.4 19.9 17.6 15.3 16.2 16-17 24.1 25.5 22.1 51.2 41.2 30.3 25.9 24.5 19.5 15.0 65.0 419 28.0 21.8 15.0 24.1 24.4 22.9 26.0 25.1 23.7 21.6 24.6 14.9 21.2 29.7 35.0 25.9 24.7 24.3 20.6 18.5 22.2 27.9 27.2 24.4 21.3 24.8 19.8 22.8 26.2 23.1 24.5 37.7 31.0 24.9 22.0 21.3 34 18-20 34.8 35.2 34.2 4.2 30.2 34.0 36.6 36.1 37.9 32.7 26.6 35.3 37.1 32.7 34.9 33.8 33.3 34.1 37.6 33.4 34.9 ” 96.1 27.9 31.9 31.9 31.1 26.2 34.0 38.5 443 26.8 29.4 31.7 36.7 40.8 37.0 37.2 39.0 36.8 34.7 32.6 28.4 28.7 30.3 35.1 27.1 37.0 21+ 23.8 18.8 31.2 1.4 12.4 19.6 24.4 27.7 41.2 1. 16. 26. 41. N= — fh 23.1 31.3 27.1 25.2 21.1 24.8 23.8 22.2 49.3 26.8 15.6 20.4 26.7 23.0 21.1 24.0 39.0 27.9 21.3 18.9 19.9 25.4 25.1 28.1 26.8 18.4 18.5 27.8 10.1 18.8 22.4 35.5 25.4 Est. pop. Sample (mil.) 40.9 24.3 16.6 0.5 2.0 77 8.0 6.8 7.7 8.3 0.1 2.3 15.7 14.5 8.3 size 4,352 2,487 1,865 38 173 818 934 695 733 901 10 201 1,752 1,488 901 3,993 260 99 1,028 1,043 1,387 894 3,117 378 445 400 12 796 1,507 994 1,055 342 674 879 577 1,198 682 596 855 1,027 666 410 508 103 187 3,405 265 682 * Poverty level is based on the definition provided by the U.S. Bureau of the Census. See Age of Initiation of Smoking: Table 15 Current Smokers by Socio Demographic Varlables Total (Age 21+ years) SEX Male Female AGE (1st grouping) 21-24 25-34 35-44 45-54 55-64 654+ AGE (2nd grouping) 21-24 25-44 45-64 65+ MARITAL STATUS Married Widowed Divorced/Separated Never Married Unknown EDUCATION Some high school High school graduate Some college College graduate Unknown HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000+ Unknown EMPLOYMENT Professional/Technical Administrator/Manager Sales/Clerical Craftsman Operatives Laborer/Service Not in Labor Force Occupation Not Reported 1975 Age when started smoking regularly (% of current smokers) <16 21.9 28.8 13.6 27.0 25.3 18.9 18.1 20.3 24.1 27.0 22.4 19.0 24.1 22.2 13.0 24.4 21.6 76.2 33.1 20.0 15.8 13.7 25.6 24.6 22.0 16.2 23.4 9.9 12.5 18.8 15.0 23.6 16.7 11.7 25.5 35 16-17 20.8 22.6 18.5 28.7 23.1 20.3 19.8 17.4 10.7 28.7 21.8 18.8 10.7 20.6 13.7 21.9 24.9 7.9 20.9 21.6 20.9 18.0 16.5 19.7 21.7 22.5 17.8 18.8 18.9 20.8 24.5 15.3 27.1 16.8 21.1 18-20 32.7 31.9 33.8 36.8 36.0 35.0 31.2 29.0 19.7 36.8 35.5 30.3 19.7 33.5 26.2 28.1 35.6 15.9 24.7 33.6 39.0 37.5 32.0 29.5 34.7 35.9 29.8 35.9 35.5 33.5 35.9 34.5 32.7 32.0 31.8 21+ 24.6 16.6 34.1 7.4 15.7 25.9 30.9 33.4 45.5 7.4 20.3 31.9 45.5 23.8 47.1 25.6 17.9 21.3 24.9 24.3 30.8 25.9 26.1 21.7 25.4 29.0 35.4 33.1 26.8 24.6 26.5 23.5 39.5 21.7 Sample size 4,339 2,176 2,163 499 1,262 990 805 517 266 499 2,252 1,322 266 2,997 287 580 470 5 1,155 1,704 887 571 22 1,479 1,680 734 446 2i1 278 131 304 170 110 167 2,968 Table 16 Age of Initiation of Smoking: Former Smokers by Socio Demographic Variables 1 Total (Age 21+ years) SEX Male Female AGE (1st grouping) 21-24 25-34 35-44 45-54 55-64 65+ AGE (2nd grouping) 21-24 25-44 45-64 65+ MARITAL STATUS Married Widowed Divorced/Separated Never Married Unknown EDUCATION Some high school High school graduate Some college College graduate Unknown HOUSEHOLD INCOME Less than $10,000 $10,000-$19,999 $20,000+ Unknown EMPLOYMENT Professional/Technical Administrator/Manager Sales/Clerical Craftsman Operatives Laborer/Service Not in Labor Force Occupation Nat Reported 975 Age when started smoking regularly (% of former smokers) <16 16-17 18-20 21+ 21.3 21.5 34.4 228 25.8 22.6 33.2 18.3 13.0 19.5 36.5 31.0 26.5 31.2 37.0 5.3 23.2 25.6 40.5 10.7 24.7 22.2 33.0 20.0 17.1 23.9 36.3. 22.7 21.5 15.3 30.0 933.2 18.2 15.4 29.3 37.0 26.5 31.2 37.0 5.3 23.9 24.1 37.1 15.0 19.1 19.9 33.4 275 18.2 15.4 29.3 37.0 21.3 22.0 35.0 216 15.2 14.0 26.5 44.2 21.7 22.9 29.6 25.8 24.8 20.5 36.4 18.2 43.6 13.2 17.8 25.3 27.8 21.6 26.6 24.0 24.3 21.0 33.9 20.8 18.8 24.6 36.7 19.9 10.8 19.5 42.7 27.0 35.1 13.1 23.0 28.9 23.5 20.1 30.3 26.1 21.9 22.7 36.0 19.4 16.5 21.5 38.3 23.7 23.8 20.7 29.9 255 12.6 22.9 45.8 188 14.4 21.5 38.7 25.4 9.5 18.6 53.3 18.6 16.5 25.3 30.4 27.9 32.5 24.4 23.6 196 13.5 25.1 43.1 18.3 5.2 13.9 29.7. 51.2 0390215 33.1 215 36 Sample size 2,686 1,632 1,054 185 651 495 567 445 343 185 1,146 1,012 343 2,112 171 180 217 6 644 872 579 572 19 735 1,103 578 270 159 150 79 122 67 47 84 1,978 SMOKING-ATTRIBUTABLE MORTALITY, YEARS OF POTENTIAL LIFE LOST, AND ECONOMIC COSTS STATE-SPECIFIC ESTIMATES, 1985 INTRODUCTION Cigarette smoking has been identified as the chief avoidable cause of death in the United States (USDHHS, 1982). Meas- urements of the impact of smoking, using calculations of smoking-attributable mortality and economic costs, have recently appeared in several medical journal articles (Rice et al., 1986; Ravenholt, 1985; CDC, 1987b) as well as in an Office of Technology Assessment Staff Memorandum (OTA, 1985). These estimates of disease impact vary according to methods and data sources used in the calculations. Nonethe- less, reported numbers of smoking-attributable deaths are enormous, ranging from a low of 270,000 in 1980 (Rice et al., 1986) to a high of 485,000 in 1983 (Ravenholt, 1985). In 1987, the Office on Smoking and Health (OSH) of the Centers for Disease Control (CDC) estimated that 320,515 deaths were attributable to smoking in the United States in 1984 (CDC, 1987b}. This was approximately 15.7 percent of the totai number of deaths in the United States in that year. Sub- sequently, the 1989 report of the Surgeon General estimated that 390,000 deaths were caused yearly by smoking. This estimate was based on updated relative risks from the American Cancer Society's Cancer Prevention Study II (USDHHS, 1989). In addition to mortality, years of potential life lost (YPLL) are used to measure disease impact. Rice estimated 3.9 million YPLL were lost due to smoking in 1980. The CDC estimate was 949,924 years lost before age 65 and 3.6 million if YPLL were calculated to life expectancy. To better understand the economic impact of smoking, smok- ing-attributable direct and indirect costs have been calculated. Economic calculations of smoking-attributable disease impact range from $53.7 billion in 1984 (Rice et al., 1986) to $65 billion in 1985 (OTA, 1985). Economic costs generated by diseases associated with smoking include direct health-care costs (hospitalization, physician fees, medications, nursing home costs, and other professional fees), indirect morbidity losses (lost income due to disability, transportation costs, homecare services, etc.), and indirect mortality losses (lost productivity from persons who die prematurely from smoking-attributable diseases). This report will present State-specific calculations for smok- ing-attributable mortality, years of potential life lost, and economic costs in the United States. These calculations were performed using a software program (SAMMEC) developed by the Minnesota Department of Health (MDH) and provided to States through the CDC (Shultz, 1986). 37 BACKGROUND In 1984, the MDH’s Technical Advisory Committee on Non- smoking and Health produced The Minnesota Plan for Non- smoking and Health (MDH, 1984). The background research for this document included calculations of smoking- attributable disease impact specific for Minnesota. Analysts at the MDH designed a computer program using well-known software (Lotus 1-2-3) (Lotus, 1984), which produced the calculations, tables, and graphs used in the Plan as well as in numerous presentations to the public and to the State legis- lature. The calculations were subsequently incorporated into a menu-driven software package, SAMMEC: Smoking- Attributable Mortality, Morbidity, and Economic Costs (Shultz, 1988), which facilitates similar analyses for any given popula- tion if the appropriate raw data are available. In Minnesota, smoking-attributable disease impact estimates effectively portrayed the magnitude of the smoking and health issue to the public and were used in support of nonsmoking legislation in Minnesota. These data and a strong coalition of public health, medical, educational, and other disciplines succeeded in bringing about important nonsmoking legislation. This legis- lation funds statewide smoking intervention curricula, promotes nonsmoking through a public education campaign, establishes a grants program for community-based programs, expands enforcement of the Minnesota Clean Indoor Air Act, provides evaluation of all programs, and raises the State excise tax on cigarettes (Shultz et al., 1986). METHODS FOR CALCULATING SMOKING-ATTRIBUTABLE DISEASE IMPACT Smoking-Attributable Mortality and Years of Potential Life Lost The theoretical bases for the calculations used in SAMMEC are found in a 1986 paper by Rice (Rice et al., 1986). The method used by Rice involves calculating smoking-at- tributable fractions (SAFs) of total mortality due to 21 diseases known to be caused by or associated with smoking in aduits. This calculation has three components: the relative risks (RR) (defined as the mortality rate among exposed persons divided by the mortality rate among unexposed persons) of smoking- related disease in current and former smokers, the prevalence of smoking among men and women 20 years of age and older, and the crude mortality data for the population under study. For these calculations, the RR estimates used are weighted averages derived from four longitudinal studies of smoking- related illness (Hammond, 1966; Doll and Peto, 1976; Cederlof et al., 1977; Doll et al., 1980). It should be noted that these RR estimates are now outdated, because the lon- gitudinal studies from which calculations were made involved persons who began smoking in the period between 1900 and 1950. The pattern of smoking among men inthe United States was well established by the end of that period, but women did not begin smoking in large numbers until the 1950s and 1960s (Warner and Murt, 1982). As the removal of social barriers began to permit gender equality in this behavior, gender equality in smoking-related diseases, especially lung cancer, is now beginning to occur (American Cancer Society, 1986). Therefore, the RRs reported in the earlier studies underes- timate the disease impact of smoking today, especially among women. There is a substantial lag period between smoking and the development of smoking-attributable mortality in a given population. In men, peak mortality due to smoking has occurred; in women, the peak mortality due to smoking has not yet occurred. Additional longitudinal observations will be necessary to update RRs for both genders as smoking be- havior changes in the United States. RRs reported in the 1989 report of the Surgeon General changed substantially from those summarized by Rice. The disease categories, their International Classification of Diseases (ICD-9) codes, and relative risk estimates used in SAMMEC are shown in Table 1. In addition to SAFs of deaths among adults aged 20 years and older, SAFs for four pediatric causes of death are calculated by SAMMEC. For the four pediatric diagnoses, the mortality attributed to maternal smok- ing during pregnancy for children aged <4 years were deter- mined using RRs from Mcintosh (McIntosh, 1984) and current smoking prevalence among women 20-64 years of age as a proxy for the percentage of pregnant women who smoke. The disease-specific SAFs are calculated by using the ap- propriate RRs and the prevalence of current and former smoking in the population with the following equation: {PotP1(RR1)}+p2(RR2)}-1 SAF = Tperpr(RRi}ep2(ARe}] Po = percentage of never smokers, p1 = percentage of current smokers, p2 = percentage of former smokers, RR; = relative risk for current smokers (relative to never smokers), and RR2 = relative risk for former smokers (relative to never smokers) (Walter, 1976). This formula is derived from the standard attributable risk (AR) formula (Lilienfeld and Lilienfeld, 1980): AR = p(RR-1){p(RA-1}+1). In addition to the number of deaths attributable to smoking, years of potential life lost (YPLL) are also calculated by SAMMEC. This measurement quantifies premature death due to smoking-caused disease in the population under study (CDC, 1986). For each smoking-related diagnosis, deaths (by gender and five-year age group) are multiplied by the number of years of remaining life, calculated from the midpoint of the five-year age category at death and ending at the cutoff point chosen (i.e., age 65 or life expectancy). The YPLL are then summed and mukiplied by the SAF for that diagnosis, age category, and gender. YPLL may be measured to any age cutoff point. Usually, YPLL are measured to age 65 (the generally recognized age for retirement) or to life expectancy, which varies according to the population in question (by race, sex, region, etc.). The smoking-attributable mortality and YPLL rates for the population under study may be calculated using census data and a numerical constant (for example, the number of deaths per 100,000 persons). These rates permit comparisons between populations if the characteristics of the populations are otherwise similar. The rates presented below are not age-adjusted. Smoking-Attributable Economic Costs A detailed discussion of the health economics of cigarette smoking is beyond the scope of this report. However, much has been written in the last two decades about the health care costs and indirect losses due to smoking-attributable disease (Luce and Schweitzer, 1978; Shultz, 1985; OTA, 1985; Rice, Hodgson et al., 1986; Warner, 1987; Schelling, 1987). Smok- ing is a dynamic, time-dependent process. Costs associated with illness and injury due to smoking may be immediate or deferred; there are both costs to the individual and costs to society in general. These latter costs may be direct, such as publicly funded health care and cigarette-caused fire losses, or indirect such as lost income and lost tax revenue due to _ premature death. The calculations of State-specific economic costs performed by SAMMEC closely follow on Rice, et al. (1986). Three components of this prevalence-based estimate are reported: direct health-care costs, indirect morbidity los- ses, and indirect mortality losses. Direct Heaith-Care Costs Due to Smoking SAMMEC calculates the following direct costs of medical care (personal health expenditures) to treat diseases related to smoking: hospitalization, physician services, sevices of other health practitioners, nursing home care, and drugs. Fire damage and burn care would be included if data were available. These calculations are based on SAFs of personal health care expenditures estimated for the population under study. The SAFs were generated using the ratio of medical care utilization by ever smokers compared to utilization by never smokers. This ratio was developed based on self-reported data from the 1983 National Health Interview Survey. The utilization ratio was limited to illnesses in the major categories of smoking-re- lated diseases (neoplastic, circulatory, and respiratory dis- eases). The formula used to calculate the SAF is from Walter (Walter, 1976). Indirect Costs Due to Smoking Indirect costs of smoking are the value of lost productivity, output, or forgone manpower resources when smoking-re- lated illness and death cause lost time from work and from other productive activities. Not included are intangible costs such as pain and suffering, which are recognized by the legal system as worthy of recompense. The cost or value to society of all deaths attributed tc smoking is the product of the number of deaths attributed to smoking and the expected values of an individual's future earnings, with sex and age taken into ac- count. To convert this stream of costs into present worth, these costs are discounted (in the case of SAMMEC, at 6 percent). To obtain indirect morbidity costs (that is, the costs associated with lost work, disability, and illness due to nonfatal smoking- related conditions), SAMMEC simply calculates the proportion of total costs which are indirect costs based on Rice's National calculations. This function assumes that the proportion of total smoking-attributable costs which are indirect morbidity costs is the same for both the population under consideration and for the United States as a whole. Population-specific direct health-care costs and indirect mortality costs are calculated based on data entered into SAMMEC for the population under study. Using these two sets of data, the indirect morbidity costs are derived. Other Cost Factors Tobacco products (primarily cigarettes) caused 248,100 fires in the United States in 1985. These fires were responsible for 1,703 civilian deaths and 3,997 civilian injuries. Fire losses in the United States totaled $422 million in direct property damage in 1985 (CPSC, 1987) and millions more in direct medical costs for expensive burn care and for indirect mor- bidity and mortality losses due to premature death and dis- ability. These measurements of disease impact are not included in SAMMEC, but some States have caiculated these data separately (Colorado Department of Health, 1986; Was- silak and Smith, in press; Personal Communication, G. Istre, Oklahoma Department of Heatth, June 10, 1988). Data Used in 1985 SAMMEC Calculations Mortality Numbers of deaths by sex and five-year age category for each of the diagnoses listed in Table 1. were obtained from each State’s department of vital statistics for 1985, with the excep- tion of Puerto Rico (1983). Some States had incomplete data for the diagnosis of cardiac arrest (ICD-9 code 427.5); for these States, the smoking-attributable mortality (SAM) will be underestimated. YPLL was calculated to both age 65 (years of productive life lost) and to life expectancy as estimated for the United States for both sexes and all races in 1980. Mortality and YPLL rates per 100,000 persons were calculated using totals for each category and the 1985 population of each State (U.S. Bureau of the Census, 1987). The YPLL rate to 65 years of age was calculated for the population less than 65 years of age in each State. Smoking Prevalence For most jurisdictions, the prevalence of current and former smokers for each State was obtained using questions in- cluded in the 1985 Current Population Survey of the United States. This survey collected information from 114,342 civilian, noninstitutionalized persons, aged 16 years and older. Approximately 55 percent of the total sample consists of self-respondents, while the remainder were proxy respon- dents (Marcus and Crane, 1986). For this study, the prevalence of smoking was calculated for men and women, aged 20 years and older, by State. These prevalence es- timates were further divided into two age groups for use in SAMMEC: 20-64 years of age and 65 years of age and older. This stratification was necessary to adjust SAFs for the much 39 lower prevalence of smoking among persons 65 years of age and older; many of these older persons have quit smoking, and many smokers have died prematurely as a result of smoking. The prevalence rates for Puerto Rico were estimated using data from several different sources (Dietz, in press). The prevalence estimates used for each State are weighted ac- cording to Bureau of Census procedures by age, race, sex, and Hispanic/non-Hispanic categories. The final estimates are shown in Table 2. The estimates for Minnesota were from the Behavioral Risk Factor Surveillance System (Unpublished data, Minnesota Department of Health, 1986). Personal Health Care Expenditures Personal health care expenditure data were obtained from Health Care Financing Administration publications (Levit, 1985; Lazenby, 1986). First, State specific personal health care expenditures by cost center were identified for 1982. Cost centers included in SAMMEC are physician services, hospitalization, drugs and medical sundries, nursing home care, and other professional services. Not included are dental care, eyeglasses and appliances, and other personal health care. These expenditures were adjusted to 1985 levels by multiplying 1985 National Cost Center figures by an index for each cost center in each State. These indices were obtained by dividing the 1982 State-specific cost center figure by the 1982 National cost center figure. The 1982 index for each State’s cost center was then multiplied by the 1985 National per capita figure for each cost center to obtain a 1985 State- specific per capita figure for each cost center. These figures were then multiplied by the State population (U.S. Bureau of the Census, 1986) to obtain a total figure for each cost center in each State for 1985. This calculation is summarized as follows: 1982 1985 State cost National cost 1985 State-specific center figure X centerfigure X State = cost center 1982 1985 population _ figure National cost U.S. population center figure Economic data for Puerto Rico were obtained directly from the Division of Analysis and Cost-Accounting from the Puerto Rico Department of Health (Dietz, in press). Data for the District of Columbia were obtained using 1985 total per capita health care costs for Maryland, Virginia, and the District of Columbia, using the same technique as in individual States, multiplied by the population of the District of Columbia (Rivo et al., 1989). SAMMEC does not account for costs of program administra- tion, research, and construction of medical facilities that are generated by tobacco abuse. RESULTS The smoking-attributable mortality by State is shown in Table 43. More than 316,000 deaths were caused by smoking in 1985 in the United States. ” The average number of deaths per State was 6,099 (ranging from 271 in Alaska to 28,533 in California). The overall U.S. smoking-attributable mortality rate is 133.6 per 100,000, and the average State smoking-attributable mor- tality rate per 100,000 persons is 129.1 (ranging from 45.3 in Utah to 175.9 in Kentucky). States above the average were found predominantly east of the Rocky Mountains. Of all smoking-attributable deaths in the United States, 67 percent were men, 32 percent were women, and 1 percent were children less than 5 years of age. Smoking-attributable YPLL before 65 years of age are shown in Table 4. Approximately 940,000 YPLL before 65 years of age occurred due to the smoking-attributable deaths in 1985. The average number of YPLL before 65 years of age per State was 18,140 (ranging from 1,828 in Wyoming to 79,491 in California). The overall rate for the United States was 397.9 years per 100,000 persons less than age 65 years; the average State YPLL rate was 391.1 per 1 00,000 (ranging from 205.8 in Utah to 678.3 in the District of Columbia). Table 5. shows the YPLL if measured to life expectancy for all races in the United States. Using this cutoff point, more than 3.6 million YPLL resulted from smoking-attributable deaths in 1985. The average State YPLL to life expectancy was 70,621 (ranging from 4,335 in North Dakota to 335,319 in New York). The overall U. S. rate is 1,549.3 per 100,000, and the average State YPLL rate is 1,488.8 (ranging from 643.2 in North Dakota to 2,167.3 in Kentucky). The smoking-attributable economic costs foreach State are shown in Table 6. The total societal economic impact of smoking in the U.S. for all SO States was over $52 billion. This sum represents $23.7 billion (45.2 percent) in direct morbidity costs, $10.2 billion (19.6 percent) in indirect morbidity costs, and $18.5 billion (35.2 percent) in indirect mortality costs (adult and pediatric). The average State economic impact was $1.007 billion (ranging from $82.3 million in Alaska to $5.812 billion in California). On a per capita basis, the economic impact was $221 forthe United States as a whole; the average State per capita impact was $205 (ranging from $54 per capita in Puerto Rico to $284 per capita in Rhode Island). DISCUSSION These data on the impact of smoking in each State confirm the results of previous National studies: smoking causes large numbers of deaths and avery large dollar costto society. The sums of the State figures are similar to the National figures mentioned in the Introduction to this section. In addition, the data suggest that because smoking prevalence is highest in ID the eastern and southern United States, smoking-attributable disease impact is highest in these areas. State estimates such as these serve to alert policy makers and the general public to the specific impact that smoking has in their respective States. SAMMEC software helps translate epidemiologic constructs and surveillance data into usable and understandable results. Many States have already pub- lished articles in newsletters, epidemiology bulletins, and State medical journals that cite SAMMEC calculations. Such disease impact estimates serve as an instrument of risk be- havior change and health policy intervention at the State level (Shultz, 1988). In addition, several foreign Nations have used the SAMMEC software in assessing the impact of smoking on their populations. Political, conceptual, and ethical issues in the use of these estimates have been discussed elsewhere (Shultz, 1988; Warner, 1987; Schelling, 1987). it must be emphasized that the figures produced by SAMMEC are estimates that vary according to the components of the calculations. For instance, each of the relative risks which contribute to the weighted average relative risks used in SAMMEC has a confidence interval. Therefore, the at- tributable fractions will vary according to these confidence intervals. In addition, there are confidence intervals around the prevalence rates used in SAMMEC, which are not reflected in the estimates of attributable fractions. Despite the limitations of the methodology, SAMMEC is a valid and easy-to-use tool for estimating the overall state-specific disease impact of smoking. The estimates for mortality, YPLL, and economic impact produced by SAMMEC are conservative. Because the relative risk estimates were developed in the 1960s, the risks for women (and possibly for men) are likely to be underestimates of the risks in the 1980s. Additional data (published in 1989) from a large, longitudinal study by the American Cancer Society confirms this prediction. In addition, 1985 prevalence estimates were used although 1985 mortality resulted from higher smoking rates 10 to 40 years ago. Had the earlier prevalence figures been used in these calculations, smoking attributable estimates would have been higher. Therefore, the figures reported here are conservative estimates of mortality and YPLL due to smoking. In these calculations, mortality is a unit of measurement, and therefore each of these deaths does not represent a named, individual person. Mortality in this context is a way of quantify- s, the smoking-caused illness suf- economic data provide another way of quantifying the effect that this particular f economic activity in our society. They do not describe a net cost effect nor do they indicate the potential savings if tobacco use were eliminated in the United ing, on a population basi fered by individuals. In the same context, the behavior has on the stream o States. * The State estimates that provide the basis for this National total were derived using relative risk estimates for smoking-related diseases from studies conducted in the 1950's and 1960's. Since those State calcu available. These estimates were used in the 1989 Surgeon General’ of Progress to yield an estimate of 390,000 smoking-attributal lations were made, more current relative risk estimates have become s Report on Reducing the Health Consequences of Smoking: 25 Years ble deaths in the United States in 1985. 40 Persons who die prematurely may actually provide a slight savings to society in terms of social security outlays, Medicare expenses, and nursing home care (Warner 1987). In fact, most persons who die of smoking-related diseases do so after 65 years of age. Although smokers have a higher risk of illness at any given age, nonsmokers will live longer and therefore incur medical bills through chronic illness well into old age. Warner (1987) has pointed out that the shift in life expectancy resulting from a tobacco-free society would create an enormous economic burden on social security and retire- ment systems. This burden could be partially offset by the contributions that persons beyond retirement age bring to our society in terms of employment, investments, taxes paid, voluntarism, and general wisdom. There are also economic “benefits” of the tobacco industry to society in terms of jobs, excise taxes, cultural promotion, etc. These are estimated by the Tobacco Institute to be as much as $45 billion (Chase Econometrics, 1985). However, these “benefits” do not compensate for either the tangible or the intangible emotional and personal consequences of smoking- attributable disease. In addition, money spent on tobacco would almost certainly be spent on other consumer goods if tobacco consumption were eliminated. Thus, the economic “loss” brought about by the loss of tobacco revenues and ancillary business revenues would be negligible (Warner, 1987). Health professionals do not depend on economic arguments to preserve life and to prevent disease. Smoking causes more premature deaths than do all the following together: cocaine, heroin, alcohol, fire, automobile accidents, homicide, and suicide (Warner, 1987). The results presented here permit comparisons of the impact of smoking to the impact of other health risks ideftified by States, thus encouraging the appropriate assignment of scarce public health resources. Even as smoking prevalence declines in this country (CDC, 1987a), smoking-attributable illness will continue to cause an enormous disease burden well into the twentieth century (Brown and Kessler, 1987). Thus, efforts to prevent and treat tobacco use in each of the States must continue to be a high-priority public health effort. REFERENCES 1. American Cancer Society. 1986 Cancer facts and figures. New York, American Cancer Society, 1986. 2. Brown, C.C., Kessier, L.G. Projections of lung cancer mortality in the U.S.: 1985-2025. Journal of the National Cancer Institute, 80(1), 1988. 3. Cederlof, R., Friberg L., Lundman, T. The interactions . of smoking, environment, and heredity and their implica- tions for disease etiology: A report of epidemiological studies on the Swedish twin registries. Acta Medica Scandinavica 612(suppi):7-128, 1977. 4. Centers for Disease Control. Progress in chronic dis- ease prevention: Cigarette smoking in the U.S., 1986. 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Report prepared for the Colorado State Board of Health Association. Denver, Colorado, July 1986. 41 9. Consumer Product Safety Commission. Toward a less fire-prone cigarette. Final report of the technical study group on cigarette and little cigar fire safety. Report prepared under the Cigarette Safety Act of 1984. Washington, D.C., October 1987. Cooper, B.S., Rice, D.P. The economic cost of illness revisited. Social Security Bulletin 39(2):21-36, 1976. Dietz, V.J., Novotny, T.E., Rigau-Perez, J.G., Shultz, J.M. Smoking-attributable mortality, years of potential life lost, and direct health care cost for Puerto Rico, 1983. In press, PAHO Bulletin. Doll, R., Peto, R. Mortality in relation to smoking: 20 years’ observations on male British doctors. British Medical Journal 2:1525-36, 1976. Doll, R., Gray, R., Hafner, B., Peto, R. Mortality in relation to smoking: 22 years’ observations on female British doctors. 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TABLE 1 RELATIVE RISKS OF SMOKING-ASSOCIATED DISEASES BY GENDER AND SMOKING STATUS* Relative Risk Male Female ICD-9CM Current Former Current Former Code Diagnoses Smoker Smoker Smoker Smoker Infectious Diseases 010-102 Tuberculosis 2.56 1.95 1.00 1.00 Neoplasms 140-149 Lip, oral cavity 6.62 2.28 3.25 1.74 150 Esophagus 4.80 1.65 4.90 1.87 181 Stomach 1.49 1.17 2.30 1.00 157 Pancreas 2.00 1.37 1.48 1.26 161 Larynx 7.33 8.84 3.25 1.74 162 Lung : 10.02 4.47 3.67 1.29 180 Cervix uteri NA NA 3.00 1.40 188 Urinary biadder 2.30 1.60 1.89 1.94 189 Kidney 1.47 1.63 1.50 1.02 Cardiovascular Diseases 401-405 Hypertension 1.39 1.21 1.43 1.40 410-414 {HD (ages 65) 1.88 1.38 1.67 117 410-414 IHD (ages 65) 1.49 1.20 1.28 1.27 427.5 Cardiac arrest 3.00 1.00 3.00 1.00 430-438 Stroke 1.32 1.00 1.45 1.28 440 Atherosclerosis 1.83 4.14 1.94 2.40 441 Aortic aneurysm 4.46 2.95 3.19 3.01 Respiratory Diseases 480-487 Pneumonia/infiuenza 1.79 1.00 1.29 1.17 491-492 Bronchitis/emphysema 10.13 10.97 7.40 4.89 496 Airways obstruction 10.13 10.97 7.40 4.89 Digestive Diseases §31-534 Ulcers 2.88 2.12 3.21 2.46 Pediatric Conditions 7 Short gestation/fow birth weight 1.76 769 Respiratory distress syndrome 1.76 770 Respiratory conditions of newborn 1.76 798.0 Sudden infant death syndrome 1.50 "Source: Rice et ail., 1986 NA = Not Applicable TABLE 2 PREVALENCE (%) OF SMOKING BY STATE, AGE, AND SEX, UNITED STATES, 1985° Age Groups (Years) 20-64 65+ 20+ State Maies Females Males Femaies Males Females Alabama 42.7 25.5 15.8 12.2 38.8 23.0 Alaska 44.2 29.8 30.1 15.8 43.4 28.9 Arizona 36.4 275 23.4 13.8 34.7 25.3 Arkansas 41.8 30.7 15.2 49 37.4 25.2 Califomia 31.4 24.4 15.3 12.4 29.4 22.4 Colorado 31.8 29.3 23.5 12.8 30.9 27.2 Connecticut 32.5 30.7 22.6 16.7 31.1 28.0 Delaware 37.6 32.0 22.5 14.3 35.5 29.1 District of Columbia 36.4 32.4 22.6 13.6 346 28.8 Florida 38.6 31.2 20.7 13.9 34.9 27.1 Georgia 413 29.0 25.8 13.6 39.5 26.4 Hawait 34.2 27.2 13.1 11.3 30.5 24.3 Idaho 29.1 23.3 13.7 13.7 26.4 21.4 Illinois 33.9 29.3 19.4 10.9 31.9 26.1 Indiana 39.4 33.4 17.0 12.8 36.5 29.8 lowa 35.3 25.3 21.2 14.6 32.8 23.0 Kansas 37.6 30.2 19.8 9.0 35.0 25.8 Kentucky 39.3 36.9 29.7 16.0 38.1 33.7 Louisiana 36.5 26.1 29.2 12.2 35.6 23.8 Maine 34.9 32.1 16.0 13.1 31.5 27.6 Maryland 33.8 30.5 19.4 16.0 31.7 28.2 Massachusetts 30.0 30.4 20.2 16.0 28.6 27.6 Michigan 37.3 37.2 20.0 15.9 35.0 33.6 Minnesota 37.3 31.7 14.0 11.6 33.7 27.5 Mississippi 39.0 27.2 30.6 10.9 38.0 24.1 Missouri 33.5 26.6 18.2 14.4 31.2 24.2 Montana 27.5 28.5 18.3 12.7 26.1 25.8 Nebraska 28.3 26.9 17.8 6.7 26.5 22.2 Nevada 40.5 37.6 22.8 15.6 38.6 35.3 New Hampshire 38.0 29.0 21.1 15.1 35.7 26.4 New Jersey 33.2 27.1 19.9 15.1 31.1 24.7 New Mexico 34.8 25.9 21.8 16.3 32.9 24.1 New York 34.3 29.3 16.5 10.7 31.8 25.9 North Carolina 42.4 27.4 26.1 10.4 40.2 24.3 North Dakota 30.7 28.0 16.5 7.9 28.6 24.6 Ohio 37.6 33.9 18.1 12.0 34.9 29.8 Oklahoma 38.5 31.8 21.2 23.9 36.2 30.2 Oregon 29.8 29.4 11.0 17.9 26.9 27.5 Pennsyivania 35.4 28.8 15.6 13.9 32.0 25.6 Puerto Rico 41.8 14.9 32.9 46 41.5 13.5 Rhode Isiand 39.0 37.8 19.5 11.0 36.3 32.5 South Carolina 35.2 24.3 29.5 7.6 34.4 21.3 South Dakota 33.6 29.7 16.9 10.7 30.5 26.4 Tennessee 40.3 29.5 17.4 78 37.1 25.2 Texas 37.6 28.8 25.1 12.5 36.2 26.2 Utah 20.4 12.2 10.5 27 19.2 10.7 Vermont 34.2 32.1 20.3 18.2 32.0 29.4 Virginia 37.7 31.4 38.2 13.9 37.8 28.8 Washington 33.6 29.7 12.1 14.6 29.9 26.9 West Virginia 41.8 3.1 22.9 10.1 38.4 28.7 Wisconsin 28.6 28.1 22.2 10.4 27.6 24.7 Wyoming 33.5 36.1 20.6 10.5 32.1 32.0 *Source: Current Population Survey, 1985, U.S. Bureau of the Census, except for Puerto Rico (Center for Health Promotion and Education, 1987) and Minnesota (Behavioral Risk Factor Surveillance System, 1986). 44 TABLE 3 SMOKING-ATTRIBUTABLE MORTALITY BY STATE UNITED STATES, 1985 State Men Women = Pediatric Total Rate* Alabama 3,672 1,457 45 5,174 129.5 Alaska 187 74 10 271 54.3 Arizona 2,688 4,125 31 3,844 122.6 Arkansas 2,771 1,046 28 3,845 163.7 California 18,524 9,773 236 28,533 109.5 Colorado 1,971 1,002 32 3,005 94.2 Connecticut 2,711 1,528 3 4,269 135.0 Delaware 573 261 15 849 137.6 District of Cotumbia 579 319 13 914 147.6 Florida 12,517 5,544 125 18,186 161.3 Georgia 5,342 2.117 80 7,539 127.7 Hawaii 549 205 12 766 77.0 Idaho 695 258 6 959 96.1 Hlinois 10,530 §,138 178 15,846 137.8 Indiana 5,356 2,525 64 7,945 144.6 iowa 2,816 1,183 18 4,017 139.5 Kansas 2,179 953 21 3,183 130.2 Kentucky 4,454 1,989 54 6,497 176.9 Louisiana 3,909 1,618 44 5,571 125.1 Maine 1,262 573 26 1,861 161.0 Maryland 3,478 1,727 61 5,266 121.3 Massachusetts §,315 3,154 46 8,515 146.6 Michigan 8,152 4,163 138 12,453 137.3 Minnesota 3,372 1,624 43 5,039 120.3 Mississippi 2,447 753 33 3,233 124.7 Missouri 5,147 2,440 51 7,638 152.2 Montana 690 349 8 1,047 127.4 Nebraska 1,621 597 13 2,231 140.1 Nevada 963 496 45 1,474 158.5 New Hampshire 921 469 8 1,398 140.6 New Jersey 6,822 3,287 71 10,180 134.9 New Mexico B42 355 20 1,217 64.9 New York 17,191 9,429 260 26,880 181.6 North Carolina 5,884 2,345 68 8,297 134.9 North Dakota 554 200 6 760 144.5 Ohio 10,618 5,156 107 15,881 148.0 Oklahoma 3,223 1,468 40 4,731 144.1 Oregon 2,441 1,268 28 3,737 139.1 Pennsyivania 12,100 5,747 114 17,961 151.6 Puerto Rico’ * 1,791 628 51 2,470 75.4 Rhode Isiand 998 570 3 1,571 163.6 South Carolina 2,980 962 37 3,979 121.4 South Dakota 684 270 9 963 137.2 Tennessee 4,756 1,729 52 6,537 137.8 Texas 11,602 5,095 131 16,828 103.6 Utah 470 255 17 742 45.3 Vermont 489 246 5 740 138.3 Virginia 5,046 2,163 75 7,284 131.5 Washington 3,672 1,858 63 5,593 126.6 West Virginia 2,298 1,012 15 3,325 W717 Wisconsin 3,954 1,642 40 5,636 118.1 Wyoming 329 158 10 497 98.4 TOTAL 214,135 100,303 2,706 317,144 133.6 Highest State 18,524 9,773 260 28,533 175.9 Lowest State 187 74 3 271 45.3 AVERAGE 4,118 1,929 52 6,099 129.1 *per 100,000 persons **based on 19893 data. 45 TABLE 4 SMOKING-ATTRIBUTABLE YEARS OF POTENTIAL LIFE LO UNITED STATES, 1985 ST TO AGE 65 BY STATE, State Men Women Pediatric Total Rate’ Alabama 12,968 3,283 2,880 19,131 545.2 Alaska 1,134 229 668 2,031 421.4 Arizona 6,000 1,828 1,998 9,826 358.1 Arkansas 7,403 2,157 1,797 11,357 565.0 Califomia 48,090 16,157 15,244 79,491 341.3 Colorado §,011 1,622 2,095 8,728 300.6 Connecticut 6,984 2,420 1,962 11,366 413.6 Delaware 1,599 589 975 3,163 577.2 District of Cotumbia 2,532 799 854 4,185 678.3 Florida 27,911 9,090 8,029 45,030 485.7 Georgia 18,472 §,281 §,159 28,912 544.5 Hawaii 1,775 407 805 2,987 333.4 Idaho 1,485 400 367 2,252 253.3 lilinois 28,603 9,564 11,498 49,665 490.3 Indiana 14,328 4,637 4,098 23,063 475.7 lowa 5,472 1,781 1,172 8,425 341.4 Kansas 4,869 1,507 1,386 7,762 370.1 Kentucky 12,817 4,451 3,514 20,782 639.4 Louisiana 11,839 3,752 2,830 18,421 459.3 Maine 2,606 909 1,689 5,207 519.1 Maryland 10,072 3,656 3,948 17,676 455.2 Massachusetts 13,022 4,677 2,954 20,653 410.8 Michigan 21,576 8,509 8,889 38,974 483.9 Minnesota 7,329 2,215 2,760 12,304 335.4 Mississippi 7,268 1,903 2,114 11,285 494.3 Missouri 12,003 4,106 3,301 19,410 448.2 Montana 1,656 587 525 2,768 382.3 Nebraska 2,816 911 868 4,595 333.9 Nevada 2,785 1,085 999 4,869 582.4 New Hampshire 2,282 750 517 3,549 404.7 New Jersey 20,165 5,969 4,589 30,723 466.4 New Mexico 1,952 686 1,318 3,956 305.7 New York 45,010 16,371 16,795 78,176 505.1 North Carolina 18,203 12,158 4,411 34,772 639.2 North Dakota 2,289 688 405 3/382 577.1 Ohio 28,240 14,050 6,888 49,178 521.2 Oklahoma 8,408 2,599 2,579 13,586 472.2 Oregon 4,960 1,877 1,781 8,618 369.2 Pennsytvania 30,023 9,262 7,373 46,658 459.6 Puerto Rico’ * 2,816 1,083 3,290 7,189 219.4 Rhode Island 2,495 776 223 3,494 425.6 South Carolina 9,864 2,534 2,417 14,815 504.8 South Dakota 1,328 343 574 2,245 371.7 Tennessee 14,825 4,301 3,334 22,460 §39.0 Texas 35,911 12,656 8,440 57,007 387.8 Utah 1,996 306 1,069 3,371 205.8 Vermont 1,190 416 301 1,907 404.0 Virginia 15,165 4,713 4,815 24,693 498.5 Washington 8,252 2,910 4,077 15,239 396.4 West Virginia 5,716 1,841 974 8,531 508.4 Wisconsin 8,397 2,625 2,561 13,583 326.7 Wyoming 915 277 636 1,628 394.0 TOTAL 571,222 197,703 174,745 943,278 397.9 Highest State 48,090 16,371 16,795 79,491 678.3 Lowest State 915 229 223 1,828 205.8 AVERAGE 10,985 3,802 3,361 18,140 391.1 “per 100,000 persons less than 65 years of age **based on 1983 data. 46 TABLE 5 SMOKING-ATTRIBUTABLE YEARS OF POTENTIAL LIFE LOST TO LIFE EXPECTANCY BY STATE, UNITED STATES, 1985 State Men Women Pediatric Total Rate* Alabama 33,205 8,506 3,245 44,956 1,125.0 Alaska 2,891 1,120 751 4,762 954.3 Arizona 28,511 13,687 2,244 44,442 1,417.2 Arkansas 30,467 12,763 2,035 45,265 1,927.0 California 201,519 112,287 17,609 331,415 1,272.0 Colorado 21,324 11,331 2,373 35,028 1,098.4 Connecticut 29,237 17,016 2,217 48,470 1,532.9 Delaware 6,587 3,357 1,112 11,056 1,791.9 District of Columbia 7,731 4,019 986 12,736 2,064.2 Florida 130,118 65,384 9,091 204,593 1,814.4 Georgia 64,981 26,104 5,858 96,943 1,642.3 Hawai: 6,504 5,130 920 12,554 1,261.7 Idaho 7,133 2,978 416 10,527 1,054.8 Ilinois 119,349 61,066 13,020 193,435 1,682.6 Indiana 59,785 29,608 4,619 94,012 1,711.5 lowa 27,299 12,408 1,330 41,037 1,424.9 Kansas 22,253 10,415 1,561 34,229 1,413.3 Kentucky 50,770 25,210 4,059 80,039 2,167.3 Louisiana 46,894 21,250 3,217 71,361 1,602.2 Maine 12,836 6,268 1,927 21,031 1,819.3 Maryland 23,629 10,382 4,480 38,491 886.5 Massachusetts 54,566 32,506 3,350 90,422 1,556.3 Michigan 89,875 50,660 10,056 150,591 1,659.8 Minnesota 33,913 16,448 3,115 53,476 1,276.9 Mississippi 28,188 10,060 2,386 40,634 1,567.1 Missouri 52,389 25,287 3,742 81,418 1,622.8 Montana 7,321 4,080 596 11,997 1,459.5 Nebraska 14,801 6,229 986 22,016 1,382.9 Nevada 11,272 6,725 1,128 19,125 2,056.5 New Hampshire 9,818 §,223 $79 15,620 1,571.4 New Jersey 53,870 16,807 §,211 75,888 1,005.7 New Mexico 8,691 4,069 1,485 14,245 994.1 New York 198,238 117,683 19,398 335,319 1,890.6 North Carolina 70,452 37,347 5,006 112,805 1,834.5 North Dakota 3,076 B46 413 4,335 643.2 Ohio 117,635 61,753 7,820 187,208 1,744.7 Oklahoma 34,963 17,127 2,909 54,999 1,675.8 Oregon 25,630 14,161 2,012 41,803 1,556.3 Pennsylvania 132,230 66,579 8,516 207,325 1,749.4 Puerto Rico** 12,854 6,895 3,880 23,629 721.1 Rhode Isiand 10,778 6,226 250 17,254 1,797.3 South Carolina 36,037 13,205 2,745 51,987 1,585.9 South Dakota 6,707 2,778 648 10,133 1,443.4 Tennessee 55,891 22,532 3,851 82,274 1,734.6 Texas 134,393 64,804 9,749 208,946 1,286.4 Utah 7,522 3,586 1,235 12,343 753.5 Vermont 5,268 2,830 340 8,438 1,577.2 Virginia 59,228 27,446 5,441 92,115 1,662.7 Washington 38,792 21,723 4,618 65,133 1,497.7 West Virginia 25,039 12,434 1,100 38,573 1,992.4 Wisconsin 38,950 17,982 2,884 59,816 1,253.0 Wyoming 3,547 1,788 721 6,056 1,199.2 TOTAL 2,314,957 1,158,108 199,240 3,672,305 1,549.3 Highest State 201,509 117,683 19,398 335,319 2,167.3 Lowest State 2,891 846 250 4,335 643.2 AVERAGE 44,518 22,271 3,832 70,621 1,488.8 “per 100,000 persons. **based on 1983 data. 47 TABLE 6 SMOKING-ATTRIBUTABLE ECONOMIC COSTS BY STATE, UNITED STATES, 1985 IN MILLIONS OF DOLLARS Direct Indirect indirect Pediatric Indirect Per Capita State Morbidity Morbidity Mortality Mortality Total Cost* Alabama 349.6 174.4 367.5 10.1 901.6 226 Alaska 34.7 16.4 28.8 2.4 82.3 165 Arizona 294.9 109.8 195.6 7.1 607.5 194 Arkansas 196.0 101.1 222.7 6.3 526.1 224 California 2,932.4 1,059.8 1,766.7 53.2 §,812.1 223 Colorado 329.3 109.8 157.3 7.3 603.8 189 Connecticut 348.7 123.6 222.2 6.9 701.4 222 Delaware 69.5 27.5 51.3 3.4 151.7 246 District of Columbia 19.0 26.0 82.0 3.0 130.0 211 Florida 835.2 407.4 790.1 28.1 2,060.7 183 Georgia 537.9 257.7 534.4 18.0 1,347.9 228 Hawaii 88.1 32.1 50.5 2.8 173.5 174 Idaho 68.6 25.6 46.8 1.3 142.2 143 Minois 1,325.7 514.8 934.6 40.2 2,815.4 245 Indiana 563.9 448.1 231.4 14.4 1,257.9 229 lowa 192.7 45.6 177.3 4.1 419.6 146 Kansas 159.4 70.3 136.4 49 370.9 153 Kentucky 327.0 170.0 397.5 12.3 906.9 246 Louisiana 263.8 138.4 302.9 8.8 713.9 160 Maine 124.7 57.0 128.4 6.0 316.1 273 Maryland 446.6 185.3 360.9 13.8 1,006.5 232 Massachusetts 847.5 288.4 462.0 21.2 1,619.1 279 Michigan 1,103.9 275.8 699.6 31.2 2,110.4 233 Minnesota 483.1 154.3 230.0 9.7 877.0 209 Mississippi 210.2 98.8 210.1 74 526.6 203 Missouri 594.7 232.0 434.6 11.5 1,272.9 254 Montana 39.9 20.6 46.3 1.8 108.7 132 Nebraska 156.4 56.3 91.8 3.0 307.6 193 Nevada 121.1 47.6 91.4 3.5 263.6 283 New Hampshire 95.0 40.4 81.6 1.8 218.9 220 New Jersey 701.7 301.1 604.2 16.3 1,623.4 215 New Mexico 719 33.1 62.4 46 172.0 120 New York 1,865.1 907.3 1,780.9 58.5 4,611.8 260 North Carolina 491.6 267.5 606.6 15.4 1,981.1 225 North Dakota 93.7 36.6 29.8 1.0 461.1 239 Ohio 1,246.2 481.7 885.5 24.0 2,637.4 246 Oklahoma 339.6 259.3 135.5 9.1 743.5 227 Oregon 151.6 83.5 192.3 6.3 433.7 161 Pennsylvania 1,403.7 542.4 954.6 25,7 2,926.3 247 Puerto Rico** 38.8 33.0 95.2 11.5 178.5 54 Rhode island 133.0 48.7 90.0 1.0 272.5 284 South Carolina 227.9 124.3 282.0 8.4 642.5 196 South Dakota 60.7 24.2 42.0 2.0 129.0 184 Tennessee 284.4 352.6 157.2 11.7 806.0 170 Texas 1,618.9 617.0 1,079.2 29.4 3,344.5 206 Utah 43.2 27.0 18.1 3.8 92.1 56 Vermont 52.0 19.8 38.5 V1 114.2 208 Virginia 534.4 236.0 455.7 16.9 1,243.0 224 Washington 428.7 153.0 281.2 14.3 877.1 202 West Virginia 199.1 93.2 206.2 3.4 501.9 259 Wisconsin 469.5 266.7 266.7 9.0 1,011.8 212 Wyoming 38.9 15.1 27.3 4.6 85.8 170 TOTAL 23,653.9 10,237.9 17,823.8 623.3 52,338.9 221 Highest State 2,932.4 1,059.8 1,780.9 58.5 §,812.1 284 Lowest State 19.0 16.1 18.1 0.8 82.3 54 AVERAGE 454.9 196.9 342.8 12.0 1,006.5 205 “in dollars, based on 1985 resident population estimates, U.S. **based on 1983 data. 48 Bureau of the Census. ACTIVITIES OF THE INTERAGENCY COMMITTEE ON SMOKING AND HEALTH INTERAGENCY COMMITTEE ON SMOKING AND HEALTH The Interagency Committee on Smoking and Health was established as part of the Comprehensive Smoking Education Act of 1984 (P.L. 98-474). This Committee advises the Secretary of Health and Human Services in a wide range of issues pertaining to smoking and health. Specifically, the Committee is charged with the coordination of research and education programs and maintenance of a liaison with ap- propriate Federal and non-Federal agencies relating to smok- ing and health. The Committee is chaired by the Surgeon General, Dr. C. Everett Koop, and comprises five non-Federal members who are scientists and physicians representing private entities involved in informing the public about the health effects of smoking and representatives from the Federal agencies listed below. The Executive Secretary of the Committee is John L. Bagrosky, Associate Director of the Office on Smoking and Health. Federal Agencies Department of Agriculture Department of Defense Department of Education Department of Justice Department of Labor Environmental Protection Agency Federal Trade Commission General Services Administration Veterans Administration U.S. Public Health Service Centers for Disease Control Office of the Director Office on Smoking and Health, Center for Chronic Disease Prevention and Health Promotion Office of the Assistant Secretary for Health Office of Disease Prevention and Health Promotion Office of Minority Health National Institutes of Health National Cancer Institute National Heart, Lung and Blood Institute National Institute of Child Health and Human Development Health Resources and Services Administration Indian Health Service Alcohol, Drug Abuse, and Mental Health Administration National institute on Drug Abuse The Interagency Committee on Smoking and Health held its inaugural meeting on October 1, 1985. The meeting was an orientation session for the Committee members. Dr. Koop opened the meeting with an overview of the Committee’s mandate and its responsibilities. Dr. John Holbrook, Univer- sity of Utah School of Medicine, presented the medical and historical perspectives of the smoking issue; Mr. Matthew Myers, Coalition on Smoking and Health, gave a history of the Comprehensive Smoking Education Act of 1984; and Mr. Donald Shopland, Office on Smoking and Health, spoke on 51 smoking prevalence. The Committee voted that in future meetings it would examine in depth a single topic within the smoking issue. The February 12, 1986 meeting was devoted to a review of the impact of advertising and promotion of tobacco products. Presentations included opening remarks by the chairperson, Dr. Koop; an overview of the promotion of tobacco products by Dr. Kenneth E. Warner, University of Michigan; Dr. Virginia Ernster, University of California, spoke on tobacco advertising over the years; Dr. Elizabeth Whelan, American Council on Science and Health, examined the coverage of the health hazards of smoking in magazines; and Dr. Paul Magnus, National Heart Foundation of Australia, spoke on cigarette advertising and its influence on the media’s coverage of the issue. Dr. Ruth Roemer, University of California in Los An- geles, although unable to attend, submitted her paper on national legislative strategies to control cigarette advertising, promotion, and marketing. The Committee met on June 4, 1986 to review the issue of free cigarette sampling and other related marketing techni- ques. After opening remarks by Dr. Koop, Dr. Edward Popper, Northeastern University, gave an overview of cigarette sam- pling and couponing; Mr. Donald Garner, Southern Illinois University School of Law, reviewed the legal and public policy aspects of tobacco sampling; Dr. Richard Daynard, North- eastern University and Mr. John Kirkwood, Chicago Lung Association, examined two community efforts to ban tobacco sampling. At the conclusion of the meeting, Dr. Koop, in his role as physician, Surgeon General, and Chairperson of the Committee, called on local organizations concerned with health and particularly the health of children to initiate immediate steps to control cigarette sampling in their communities. Smoking and its impact on minority populations was the topic of discussion at the meeting on March 31, 1987. Dr. Alfred Marcus, Jonsson Comprehensive Cancer Center at the University of California in Los Angeles, spoke on the prevalence of smoking among minorities; Dr. Claudia Baquet, National Cancer Institute, presented statistical information on the incidence of smoking-related diseases in minorities; Dr. Emilio Carillo, Harvard School of Public Health, discussed effective interventions in minority communities; and Dr. Alan Blum, Baylor College of Medicine, explained various market- ing and advertising campaigns and techniques targeted toward minority populations. At the conclusion of the meeting, Dr. Koop called for support of minority leadership in efforts to counteract the forces that are encouraging the uptake of smoking by minority youth and the continuation of smoking by minority adults. The General Services Administration printed its new smoking regulations in the Federal Register on December 8, 1986. The implementation of these regulations by Federal agencies was the topic of the October 15, 1987 meeting. Terence C. Golden, Administrator of the General Services Administration, dis- cussed the new regulations, their development and implemen- tation; Dr. Barbara Hulka, University of North Carolina in Chapel Hill, presented the health effects of exposure to en- vironmental tobacco smoke; and Mr. John Pinney, John F. Kennedy School of Government at Harvard University and former Director of the Office on Smoking and Health, spoke on worksite smoking policies. Following the speakers’ presentations, various Federal agency representatives sum- marized the policies within their individual departments and the enforcement of such policies. The meeting held on February 18, 1988, entitled Tobacco and Health Internationally, discussed the health effects of tobacco use internationally and activities of transnational tobacco com- panies to expand Third World markets for tobacco products. Dr. Judith Longstaff Mackay, Hong Kong Council on Smoking - and Health, discussed U.S. tobacco activities in Asia; Dr. Gregory Connolly, representing the American Public Health Association, presented information on the activities of transna- tional tobacco conglomerates; Dr. Ted T.L. Chen, National Department of Health in Taiwan and University of Mas- sachusetts in Amherst, spoke on tobacco use and promotion in Taiwan; Mr. James Swomley, American Lung Association and International Union Against Tuberculosis and Lung Dis- ease, discussed the positions of these organizations on inter- national tobacco use and tobacco trade policies; and Mr. Michael Pertschuk, the Advocacy Institute, discussed health policy implications of international tobacco trade. Dr. Koop called on government agencies and private organizations to increase their activities on tobacco and health internationally. He added that health warnings should be required on all packages of cigarettes that are exported, in the language of the receiving country, and that countries should work together more effectively to coordinate an aggressive worldwide cam- paign to curb the use of tobacco. The following abstracts summarize papers submitted or com- ments made to the Interagency Committee at each of the respective meetings. October 1, 1985: Inaugural Meeting Comments by: Koop, C. Everett, M.D. Surgeon General, U.S. Public Health Service and Deputy Assistant Secretary for Health, Washington, D.C. An estimated 340,000 Americans die prematurely each year because they smoke. Allowing for population growth, cigarette composition, and smoking patterns, as many as 10 million Americans may have died prematurely over the past 20 years because they smoked cigarettes. The Interagency Committee on Smoking and Health should resolve to reduce those premature deaths to zero. The Com- mittee remains committed to reducing the proportion of adults who smoke to below 25 percent by the year 1990. Increased awareness of smoking hazards through public information and education programs, including physician and public health officials support, is the only way to achieve this goal. 52 Shopland, Donald R., and Brown, Clarice, Office on Smoking and Health, Rockville, Maryland. “Changes in Cigarette Smoking Prevalence In the U.S., . 1955-1983.” A significant decline in the percentage of current smokers among the male population occurred from 1964 to the most recent survey date, 1983, from an estimated 52.9 percent in 1964 to 35.2 percent in 1983. There has also been an - increase in the percent of males who quit smoking and in the percent of males who never smoked on a regular basis. There has been less of a change in the adult female popula- tion. Findings indicate that although there was an increase in the percent of former smokers among adult females between 1965 and 1970, there was a less significant change between 1970 and 1983 in either the percent of former smokers or - persons who had ever smoked. Patterns of smoking prevalence among adults reflect the changes in initiation and adoption of cigarette smoking among teenagers. The prevalence of cigarette smoking among high _ school seniors declined to its lowest point in 1984, the most recent survey date, with only 18.7 percent of all seniors surveyed indicating that they were daily smokers. Since 1977, there has also been a higher prevalence rate among teenage girls as compared to teenage boys. Comments by: Myers, Matthew, Coalition on Smoking Or Health, Washington, D.C. “History of the Comprehensive Smoking Education Act” The Comprehensive Smoking Education Act was first intro- duced in the fall of 1981; it became law in 1985. Public Law 98-474 is the most important smoking legislation enacted in the last 15 years. The Act has three primary provisions: 1) all cigarette advertisements and packages are te rotate the four new specific informative health warnings; 2) cigarette com- panies are to disclose to the Secretary of Health and Human Services (HHS) a complete list of all ingredients added to tobacco during the manufacture of cigarettes; and 3) the Secretary of HHS is to develop and implement a program to inform the public of the health hazards of smoking. This latter provision should include the coordination of all research and educational programs and activities related to smoking and health, and the creation and maintainance of a liaison between Federal agencies, State and local governments and the private sector. Factors prompting the effort to legislate this bill included: 1) the Federal Trade Commission report that the current health warning was no longer effective; 2) the Surgeon Generai began a new series of reports on the Health Consequences of Smoking; 3) data from the Office on Smoking and Health and other Federal agencies showed that increasing trends in smoking were related to advertising and educational efforts; and 4} the major voluntary organizations created legislative and lobbying offices in Washington, D.C. Comments by: Holbrook, John H., University of Utah, Salt Lake City, Utah. “Historical and Medical Perspectives on Smoking.” In the 1930s and 1940s reports began linking smoking with cancer, heart disease, and adverse effects on the unborn child. In the 1950s, isolated cases were associating smoking with excess morbidity and mortality primarily due to cancer, lung cancer, emphysema, bronchitis, and coronary heart dis- ease. The first Surgeon General’s report in 1964 directly stated that smoking was causatively associated with lung cancer and bronchitis. Subsequent reports further detailed the health effects associated with smoking. The types of evidence cited in the reports include: epidemiologic, experimental, clinical, and pathologic evidence. Factors effecting the level of addic- tion and the adverse health effects depend upon: dose, genetic makeup, environmenta! exposures, and underlying medical disorders of each individual smoker. Major biomedi- cal effects of smoking include: atherosclerosis (cardiovas- cular problems), cancer, chronic obstructive lung disease (emphysema and bronchitis), and the effects on the unborn fetus during pregnancy (low-birthweight). February 12, 1986: Advertising and Promotion of Tobacco Products Warner, Kenneth E., Department of Health Planning and Administration, School of Public Health, University of Michigan, Ann Arbor, Michigan. “Promotion of Tobacco Products: An Overview of the Issues.” Cigarettes are the Nation’s most heavily advertised consumer product. in 1984, the industry devoted over $2 billion to promoting the product, more than $8 for every man, woman, and child (smokers and nonsmokers). In 1980, cigarette ads accounted for just under 15 percent of product advertising in newspapers, 10 percent in magazines, and almost a third of all outdoor advertising. Over one half of all revenues from newspaper supplements represented cigarette advertising and nearly one in every two billboards carried an advertise- ment for cigarettes. Increasingly, the tobacco companies are relying on sponsorship of sports and cultural events, free or subsidized distribution of product samples, and “social issue” advertising campaigns to promote the image of their product. Massive cigarette advertising reduces media coverage of the health effects of smoking, which in turn, contributes to a greater prevalence of smoking and smoking-related disease. The problem of cigarette promotion can be addressed several different ways: imposing a complete ban on all promotion of tobacco products; eliminating the seductive imagery of cigarette advertising; reducing misleading advertising by re- quiring the tobacco industry to disclose that there is no con- troversy on the hazards of smoking; and mounting boycotts of publications that accept cigarette advertising, cancelling sub- scriptions to those that do and informing them as to the reason. 53 Ernster, Virginia L., Department of Epidemiology and International Health, School of Medicine, Univer- sity of California, San Francisco, California. “Tobacco Advertising Over the Years: Types, Themes, Voluntary Codes and Related Legislation.” Over the last half century there has been an increase in cigarette advertising and promotions targeted toward women; the emergence of a number of cigarette brands designed exclusively for females is one indication of the targeting of women as cigarette consumers. Approximately $2 billion is currently being spent by the tobacco industry to advertise and promote cigarettes in the U.S. In addition, smokeless tobacco advertising and promotions are onthe rise. Underwriting sporting events has been a major form of promoting smokeless tobacco. Advertisements have suggested that smokeless tobacco is an acceptable alterna- tive to cigarette smoking. Until 1960, attempts to regulate cigarette advertising were concerned primarily with the false health benefits claimed for specific brands. Since 1960, the concern has been with ensuring that the scientific facts about cigarettes be included in advertisements. More needs to be learned about audiences targeted for tobac- co advertising, promotional efforts, and the effects of advertis- ing on usage patterns by various groups. Continued monitoring of advertisements for themes and validity of claims is necessary for the ongoing formulation of public policy on tobacco advertising. Whelan, Elizabeth M., and White, Lawrence, American Council on Science and Health, New York, New York. “How Well Do American Magazines Cover the Health Hazards of Smoking?” In January 1986, the American Council on Science and Health commissioned a study of magazine coverage of health hazards of smoking. A select group of 20 mass circulation magazines were surveyed. The study tabulated all articles published in the last five years on selected health hazards and health promotion topics, then determined how many of those mentioned smoking. The study ranked how highly smoking was emphasized as a risk factor in selected articles dealing with specific diseases. The tabulations were then associated with acceptance of cigarette advertising by each publication. From the survey, several conclusions were made. Magazines that accept cigarette ads are less likely to report on hazards of smoking. Researchers hypothesize that this is less the result of direct tobacco industry pressure than of self-censor- ship, based on editors’ fear of iosing advertising revenues. Banning cigarette advertising may result in better coverage of the health hazards of smoking; however, the tobacco industry is firmly ensconced in the American economy; inasmuch as two major tobacco companies own two large food con- glomerates. I may be that the government must therefore assume more responsibility in educating the public on the health hazards of smoking. Such campaigns could easily and fairly be financed by an increase in the cigarette excise tax. Magnus, Paul, The National Heart Foundation of Australia, Canberra City, Australia. “Aspects of the Tobacco-Media Story and Cigarette Advertising.” Early U.S. media coverage of the cigarette smoking and health issues was limited. Most women’s magazines still shun the smoking and health story, due to the powerful influence of the activities and advertising of the tobacco industry. There has been significant undercoverage of the smoking issue from the first major scientific discoveries in the late 1930s and early 1950s, dueto the cigarette manufacturers’ economic influence on advertising revenues. There is little evidence that massive cigarette advertising revenue may have influenced newspaper coverage of smok- ing and health issues. However, for women’s magazines the evidence is convincing, and supported by accounts from health writers. Women’s magazines seem to censor them- selves on the issue, free from direct intervention from the tobacco industry. A primary function of the print media is to inform the public. With over 40 years’ growing scientific evidence available on smoking and health, the cumulative evidence filtering through the media has inevitably been large. But it has been so attenuated and small compared with what should have been, that the American public remains demonstrably underin- formed. Cigarette advertising revenue impedes free speech and the dissemination of health information and thus con- tributes to smoking rates and subsequent unnecessary deaths. Roemer, Ruth, School of Public Health, University of California, Los Angeles, California. “National Legislative Strategies to Control Cigarette Advertising, Promotion, and Marketing.” Banning cigarette advertising and promotion, increasing the tax and price of cigarettes, and strengthening smoking educa- tion are the three most important legislative strategies the United States can adopt to control smoking. Worldwide legislative activities are described; evaluating these strategies is, however, difficuk because of the many factors involved in tobacco use. Various countries have adopted total bans, strong partial bans, and moderate or minor bans on cigarette advertising. The United States, having already adopted a minor ban, may choose between total or strong partial bans: a total ban is recommended, as convey- ing a stronger message and as more enforceable. First amendment considerations may, however, require adoption of a partial ban. Many countries have found tax and price increases effective, and academic work shows that price elasticity affects the 54 demand for cigarettes. Tax increases are objected to on the grounds that they are regressive; however, the advantages of having to give up smoking, particularly for the young, who are often only temporarily poor, outweigh any unfair financial losses. Either the Federal excise tax or State taxes might be raised: raising the Federal tax would be more effective, en- forceable, and revenue-neutral. Researchers have demonstrated that anti-smoking education is a necessary companion to anti-smoking legislation: further funding of anti- smoking education programs should be legislated. An adver- tising ban will also aid education programs by releasing the media from self-imposed censorship on smoking that is motivated by fear of losing advertising revenue. An important publication is now in preparation that will en- courage members of Congress to take the measures recom- mended here. It will show deaths, days of hospitalization, and medical care costs associated with the smoking diseases in each state. June 4, 1986: Free Cigarette Sampling Daynard, Richard A., President of Group Against Smoking Pollution (GASP) of Massachusetts, and Professor at Northeastern University School of Law, Boston, Massachusetts. “Case Study of Successful Community Efforts to Ban Cigarette Sampling.” Whether cigarette sampling is done directly (e.g. handouts), or indirectly (e.g. print media or couponing and mail distribu- tion), tobacco companies use carefully planned strategies and target specific populations. Often, samples fall into the hands of underage youth and are viewed by many as a public nuisance. Successful efforts to ban the distribution of free cigarette samples are described and recommendations are made to encourage additional bans. Suggestions considered crucial to a successful ban on sampling include identifying one group to lead the legislative efforts and rallying community and political support. This should be complemented with a credible legal resource that can provide on-the-spot legal expertise. Comments by: Kirkwood, John L., Executive Director of the Chicago Lung Association, Chicago, Illinois. Tobacco promotions and advertisements encourage youth to begin smoking, contrary to the industry’s claim that the focus of their advertising is to encourage smokers to switch brands. Therefore, the Committee is urged to support a ban on all tobacco promotions and advertisements. If this is not feasibie, restrictions should be enforced on advertising directed toward youth. All role models should be removed from advertise- ments and 25 percent of media fees should be donated to counter-advertising groups. In addition, distribution of free cigarette samples and sponsorship of events should be banned. Popper, Edward T., College of Business Admini- stration, Northeastern University, Boston, Massachusetts. “Sampling and Couponing Promotional Activity in the Domestic Cigarette Market.” Since 1963, advertising expenditures for tobacco products have remained relatively flat while promotional expenditures amounted to 52.1 percent of tobacco advertising budgets in 1983. This shitt is a direct result of restrictions imposed to eliminate the tobacco industry’s use of broadcast advertising and the limited market response to print media. Tobacco companies currently rely on sampling and couponing to stimu- late new usage of their products. To more accurately reflect these changes in advertising and promotional expenditures, the Federal Trade Commission data collection system should be modified. Also, more research should be conducted to study the effect of promotional strategies on the consumer. Garner, Donald W., Southern Illinois University School of Law, Carbondale, Illinois. “Tobacco Sampling, Public Polley and the Law.” Product liability laws that hold sellers of dangerous products liable for civil damages have never been enforced against cigarette manufacturers. The tobacco industry would have the public believe that tobacco promotions and advertising are protected under the First Amendment's freedom of speech clause, the Cigarette Labeling and Advertising Act, and the Smokeless Tobacco Education Act. This, however, is not the case. States possess the constitutional authority to protect the public from the tobacco industry and the negative effects of smoking. Even if cigarette and snuff advertising and sam- pling were accorded “commercial speech” protection, com- plete or limited prohibition is well within the constitutional power of the state. From 1970 to 1983, the cigarette com- panies increased their sampling expenditures from $12 million to $126 million; a 10-fold increase. Future anti-sampling legislation should be shaped by two sampling realities: 1) the state has an obligation to protect children as well as adults and 2) limited sampling is almost impossible to enforce when a law permits sampling to adults. March 31, 1987: Smoking and Minority Populations Comments by: Blum, Alan, Department of Family Medicine, Baylor College of Medicine, Houston, Texas. “Trends in Marketing and Cigarette Advertising Towards Black and Hispanic Populations.” Although overall cigarette consumption has declined (about one percent per year since 1980) America still has one of the highest smoking rates in the world. An increasing percentage of smokers is in the minority populations. Trends in advertising and marketing have been shifting towards minority popula- tions; tailoring marketing strategies towards Spanish- speak- ing consumers while incorporating the idiosyncrasies of both the language and country in brand awareness. 55 There is a saturation of black-oriented publications and billboards with cigarette advertising campaigns. Between 25- 40 percentof all eight sheet advertising in predominantly black areas is for cigarettes. There is a shift; however, focusing on sampling, couponing and the sponsorship of sports and enter- tainment events (i.e., concerts, dance companies, and soccer tournaments). Although necessary, counter-advertising campaigns are dif- ficult to develop, especially with the fear of losing tobacco industry revenue. There has been a lack of involvement from ethnic civil organizations (i.e., NAACP, National Urban League), to support government and voluntary health agency efforts to prevent and end smoking, primarily due to large amounts of tobacco industry contributions. Carrillo, Emilio J., American Institutes for Research, Harvard School of Public Health, Cambridge, Mas- sachusetts. “A Rationale for Effective Smoking Prevention and Ces- sation Interventions In Minority Communities.” In order to be successful, smoking prevention and cessation activities aimed at minority communities must consider the characteristics of those communities. Although U.S. minority communities are heterogeneous, they have common ele- ments, which when identified, assist in the development of targeted smoking prevention and cessation activities. Some basic commonalities among minority populations are as follows. Socio-economic: Minority communities generally have lower median incomes, lower educational levels and reside in more urban and inner city locations that expose these groups to greater environmental hazards than the general non-minority population. Social-cultural: Minority com- munities generally place a strong emphasis on both the nuclear and extended family, and have a shared sense of kinship and close community ties (socio-economic conditions have resulted in geographical clustering of minority com- munities); possess key central reference points: churches, community agencies, barbershops, laundromats, and the general store; place importance on local community advo- cates, such as unpaid and unaffiliated community leaders; and maintain linguistic and cultural affinities. Socio-demographic: Minority populations are young in age and have a higher birthrate ratio than their non-minority counterparts. Recommended strategies for intervention are: encouraging group work in smoking cessation efforts; stressing the benefits to the community and family in better health habits; stressing the short-term disadvantages of smoking; providing short- term products of group efforts; and use of appropriate vehicles to carry the anti-smoking message. An accurate analysis of the targeted audience is paramount i.e., identifying the level ot development, level of literacy, prevalent language, key community activities, and popular media types. The specific characteristics and culture of adolescents in each community should be addressed, as well as the life changes they are undergoing such as, migration and transition from school to work. Smoking and pregnancy risks must be strongly associated. Marcus, Alfred C., and Crane, Lori A., Jonsson Comprehensive Cancer Center, University of California, Los Angeles, California. “Current Estimates of Adult Cigarette Race/Ethnicity.” Smoking by An analysis of data obtained from the 1985 National Health Interview Survey (NHIS) indicates the overall smoking rate among blacks is noticeably higher than it is for whites and Hispanics, with whites ranking second and Hispanics third. Although black males continue to smoke at a higher rate, which is estimated at nearly 40 percent, Hispanic males are smoking at virtually the same rate as white males. Among females, blacks are again ranked first, with whites ranked a close second, and Hispanics third. There is a decline in cigarette smoking by white, black, and Hispanic males. Although females also showed a decline in smoking during the same period (1978-1985), the absolute decline was typically about half that of males. Whites are much more likely to be heavy smokers than black and Hispanic smokers. There is also a recent decline in the percentage of white and black females who have never smoked. Much more could be done to encourage physicians to perform brief behavioral counseling with their smoking patients. Pre- vious research has shown that physician advice to quit smok- ing can increase the quit rate from five percent per year to a quit rate approaching 10 percent. The U.S. Public Health Service as a whole, and especially the Office on Smoking and Health and the Office of the U.S. Surgeon General, might also intensify their efforts to promote physician-based smoking cessation programs as public health policy in the United States. Baquet, Claudia R., Minority Field Program, Special Populations Studies Program, Division of Cancer Prevention and Control, National Cancer institute, Bethesda, Maryland. “The Association of Tobacco to Cancer and Other Health Conditions in Minority Populations.” More than 80 percent of the excess mortality observed among blacks and other minority populations is attributed to six causes of death: cancer, cardiovascular diseases and stroke, chemical dependency, diabetes, homicide and accidents, and infant mortality. For blacks (males and females) excess deaths from these major causes accounted for approximately 47 percent of the total annual deaths among those age 45 years or younger during 1979 through 1981, and for almost 43 percent of the deaths among those age 70 years or younger. Cigarette smoking has been identified as a major cause for cancer (30 percent of all cancer deaths), coronary heart disease, peripheral vascular diseases, and low birthweight/in- fant mortality. In addition, the risk of certain cancers is greatly increased when tobacco use is combined with other ex- posures, such as asbestos in the workplace or excessive alcohol consumption. The adverse heaith effects of involun- tary smoking on nonsmokers has also been documented. 56 It is apparent that tobacco use (cigarettes and smokele: contributes significantly to the excess incidence, morbid and mortality experienced by U.S. minority groups. In additi to a distinct cancer experience, minorities also have oth tobacco-related conditions at rates that differ from the gene: population, i.e., cardiovascular and respiratory diseases, k birthweight and infant mortality. Findings from an analysis of (NHIS) data suggest th Hispanic rates for tobacco-related disease may increase intl future and that special attention to cessation and preventic efforts aimed at this group is needed. Tobe successful, effor to reduce and prevent tobacco-related morbidity and mortali in minority communities must be based on representative ar accurate population-specific data, as well as cultural relevant interventions. October 15, 1987: GSA Regulations Hulka, Barbara S., Department of Epidemiology) University of North Carolina, Chapel Hill, Nort Carolina. ‘ “Health Effects of Exposure to Environmental Tobace: Smoke.” The predominant source of environmental tobacco smok: (ETS) is sidestream smoke (SS) emitted from the smoldering end of cigarettes. While SS is known to contain toxie anc carcinogenic compounds, SS is diluted and its physiocochemical characteristics are altered in the formatior of ETS. The most consistent findings on adverse health effects of ETS are on the respiratory tracts of young children. There is a dose-response relationship between risk of respiratory problems and number of smokers in the home and/or number of cigarettes smoked. Studies from many countries indicate that the risk of lung cancer to nonsmoking spouses of smokers is approximately 30 percent greater than the risk for nonsmoking spouses of nonsmokers. A positive association between number of cigarettes smoked per day and the relative risk has been reported. The question as to whether chronic exposure to ETS enhan- ces the risk of morbidity or mortality from cardiovascular diseases has yet to receive adequate study, Comments by: Golden, Terence C., Administrator, General Ser- vices Administration, Washington, D.C. The General Services Administration’s (GSA) regulations for smoking in Federal office buildings were developed in the interest of the health and safety of the Federal worker. in addition, the regulations were developed with the full coopera- tion and support of the entire Federal community, so therefore, they were not regulations of the GSA, but for the GSA. The regulations were part of the goals and objectives of the GSA for improving the quality of the working environment of the Federal employee; air quality was the beginning. Various problems came into play; however, as the buildings were old, and heating, air-conditioning, ventilation, and overall air cir- culation were poor. The response to the regulations has been positive as the regulations take into consideration the needs of the non- smokers to a smokefree environment and the needs of the smokers to have space available for smoking cigarettes. Comments by: Pinney, John M., Executive Director, Institute for the Study of Smoking Behavior and Policy, John F. Ken- nedy School of Government, Harvard University, Cambridge, Massachusetts. Over the past ten years the U.S. has made great progress in establishing an awareness of the issues of cigarette smoking, especially in Federal office buildings. The medical and scien- tific evidence supporting the fact that cigarette smoking has adverse effects on a person's health has been paramount in swaying the public and providing a vehicle of awareness for the health effects associated with cigarette smoking. This awareness also comes from a variety of issues: 1) findings that environmental tobacco smoke is a cause of disease in healthy nonsmokers, 2) nonsmokers’ vocalization of the prob- lem, and 3) the fact that the issue of smoking in the workplace is a health and safety issue and not one of a person's personal rights. The public’s response to the information on smoking has been dramatic; more states and communities are passing ordinan- ces restricting smoking in public places and are establishing worksite smoking policies. The efforts of the General Services Administration and the Department of Defense have assisted in bringing about a greater awareness of the smoking and health issue and have changed public attitudes toward cigarette smoking. February 18, 1988: Tobacco and Heath Intemationally Comments by: Mackay, Judith L., Executive Director, Hong Kong Council on Smoking and Health, Hong Kong. In Asia, the American and British tobacco companies are promoting tobacco in ways long banned in the United States. Political pressure is being brought to bear on Asian govern- ments to allow the promotion of American tobacco products. The threat of trade sanctions has now become a pattern in Asia. American tobacco is being sold in Asia by different standards than those that apply to its sale in the U.S., i.e., without any health warnings on the packets. In addition, the tar content of cigarettes sold in Asian countries is higher than in the United States. A recommendation of the Sixth World Conference on Smoking and Health in November 1987 was that, as a 57 minimum, no promotion should be allowed in developing countries that is illegal in the country of origin. While tobacco markets are decreasing in Western countries, transnational tobacco companies are turning East; smoking is increasing in developing countries at a rate of two percent per annum. The World Health Organization (WHO) report predicts that smoking-related diseases will appear in develop- ing countries before communicable diseases and malnutrition have been controlled, and thus the gap between rich and poor countries will widen further. China is the biggest producer and the biggest consumer of tobacco in the world. The large international companies are setting up joint ventures with the Chinese. They have also started sponsorship of athletic and sporting events in China. In 1987, the Hong Kong government became the first Asian government, and only the second worldwide, to ban the im- portation, manufacture, and sale of smokeless tobacco. In an effort to eliminate the ban, the U.S. tobacco firms mobilized various U.S. government and industry representatives. The Hong Kong government's official reply was that this was an internal heaith matter; therefore, importation from any country was banned and the local manufacture would become illegal. Governments in developing countries are vulnerable on the tobacco issue, particuiarly when they become doubly bound to foreign interests. Comments by: Connolly, Gregory N., Representing the American Public Health Association, Washington, D.C. “Transnational Tobacco Trade.” The United States has had great success relative to the decline in the prevalence of smoking. However, this success translates to marketing tobacco to young people in developing nations. There are seven transnational tobacco companies, of which four are based in the U.S. Excluding state monop- olies and companies in Socialist nations, they produce ap- proximately 80 percent of the world’s cigarettes. There has been a 73 percent increase since 1968 in smoking prevalence throughout the world. The World Health Organization (WHO) estimates that last year, one billion persons throughout the world smoked five trillion cigarettes, and 2 1/2 million smok- ing-attributable deaths occurred. Since the early 1970s, sharp increases in smoking rates, followed in turn by increases in smoking-attributable death and disease, occurred in Brazil and other Latin American countries. The multinationals now see the state-owned mo- nopolies in the Far East as significant barriers to their penetra- tion of Asia. When the multinationals penetrate, they transform how tobacco is presented, how it’s advertised, and how it’s promoted. The result is the creation of new demand, particularly among females who are targeted. In mid-1985, high trade deficits with Japan gave new leverage to cigarette companies to merge their interest with the U.S. Trade Office to reduce the U.S. trade imbalance in the Far East. The Office of the U.S. Trade Representative initiated a trade investigation against Japan for failure to allow free access to the cigarette market by the multinational companies. Japan still allows cigarette advertising on television. In April 1987, there were over 2,000 Western style advertisements on television, and it ranked number two of all TV advertising. Although the female smoking rate is low in Japan, there has been heavy advertising for products like Virginia Slims and the Japan Tobacco, Inc. brand called Misty, an upscale French cigarette. They are promoting this product to the nonsmoking female; for the adolescent market, there is a new brand called the Dean cigarette, modeled after the American adolescent hero, James Dean. It could be argued that the sale of tobacco in the Far East will aid the tobacco farmer in the U.S. Historically, when the multinationals went into Latin America and Africa, and greatly expanded tobacco production in Brazil, Zimbabwe, and Malawi, the U.S. tobacco farmer lost dominance in the world market. By 1980, 20 percent of the tobacco in American cigarettes was being re-exported to the U.S. from efforts by the multinationals. Comments by: Chen, Ted T.L., National Department of Health, Taiwan, University of Massachusetts, Amherst, Massachusetts. “U.S. Tobacco Trade with Talwan.” Several factors have contributed to the current state of American tobacco trade to Taiwan: the decline of the U.S. smoking population, the high trade deficit, a large smoking population in Taiwan, the monopoly of tobacco sale by the national government in Taiwan, and Section 301 of the 1974 Congressional Trade Act. The sale of tobacco in Taiwan is pushed hard by the U.S. government. In 1985, the U.S. Trade Representative negotiated with the Taiwan government for tobacco trade with Section 301 of the Congressional Trade Act. In January 1987, American tobacco agents began the sale of American tobac- cos in Taiwan. Cigarette smoking is an adult male dominant behavior in Taiwan. The data show that the cigarette smoking rate in Taiwan is very high among men, over 50 percent, but very low among women, below 7 percent. The smoking rate among youth has been low, especially among teenage girls. Some of the primary strategies that the foreign tobacco agents have used to sell tobacco in Taiwan is to target the sale of tobacco to youth and women. Youth smoking is prohibited at home and at school, and is relatively low. Women smoking is not con- doned anywhere, and is very rare. This virtue of cultural practice unfortunately has been looked upon by American tobacco agents as an opportunity for exploitation. According to Tung’s 1987 study, teenage smoking in Taiwan may be on the rise. Over 80 percent of the youth smoking cigarettes indicated a preference for smoking foreign 58 cigarettes. Moreover, the director of the National Bureau of Tobacco and Wine Monopoly indicated that the volume of foreign tobacco imports to Taiwan between January 1 to October 31, 1987, is about 22 times more than the total import of the year 1986. The case of marketing of American tobacco in Taiwan has both domestic and international significance and implication. The case study shows that American cigarette companies, with the help of the U.S. government, have found anew frontier in Taiwan. Comments by: Swomley, James W., International Union Against Tuberculosis and Lung Disease, New York, New York. “The Activities of the World Health Organization Regard- ing Transnational Tobacco Trade.” There is a growing awareness worldwide about the tobacco problem. Not only is the tobacco industry killing Americans at home, more than 300,000 each year, but it is killing 2.5 million people worldwide each year. The United States tobacco industry is sharing with the tobacco industry in England, and ~ the tobacco industry in the rest of the world in the rising mortality total worldwide. The International Union Against Tuberculosis and Lung Disease heid a regional meeting in the Sudan where 60 percent of the tobacco is imported. Resources in the Sudan, whether its own agricultural effort or hard currency, are going - for tobacco. The government is indicating an interest in doing — something about the problem. Aresolution, passed by the Board of Directors of the American Lung Association, addresses the worldwide issue: “Whereas smoking causes an estimated 2.5 million deaths each year worldwide, and whereas the use of tobacco products is in- creasing in Third World countries, and whereas U.S. govern- ment is using trade policy, including trade sanctions, to actively encourage the export of American tobacco products; now therefore, be it resolved that the American Lung Associa- tion calls upon the U.S. government to accept its international responsibility to protect and promote health throughout the world by applying the Surgeon General's goal of a smoke-free society to its international activity. Be it further resolved that import restrictive measures and/or higher tariffs developed by our trading partners, not be considered actionable under U.S. trade laws, nor be criticized as protectionistic measures. Fur- thermore, be it resolved that trade in tobacco products no jonger be considered as an item for trade negotiations.” Comments by: Pertschuk, Michael, American Cancer Society- National Board of Directors, Advocacy Institute, Washington, D.C. “U.S.-Based Transnational Tobacco Trade and Advertis- ing: The Implications of International Health Policy.” The U.S. government’s involvement in the export of advertising practices that would violate U.S. laws designed to protect American youth should be examined. The aggressive pursuit of Third World tobacco cultivation by the transnational companies themselves has harmed American tobacco farmers far more than protectionist policies. The health of U.S. citizens is directly affected by the tobacco industry’s Third World strategies. It is becoming increasingly 59 evident that, desperate over the shrinking domestic markets, the tobacco companies have adopted the very same Strategies for promoting smoking among women, minorities, the impoverished, and the undereducated in the United States, as they have in the countries of Asia, Europe, and in Latin America. LEGISLATION LEGISLATIVE SUMMARY During the 1930s and 1940s scientific reports began to as- sociate smoking with cancer, heart disease, and other ad- verse health effects. This evidence continued to mount during the 1950s, On June 1, 1961, the presidents of the American Cancer Society, the American Public Health Association, the American Heart Association, and the National Tuberculosis Association sent a letter to President Kennedy urging the formation of a Presidential commission to study the implica- tions of the tobacco problem. Under the leadership of Surgeon General Luther L. Terry, an advisory committee was formed to assess the available knowledge and make appropriate recommendations. On January 11, 1964, the United States Public Health Service released the first Surgeon General's report on Smoking and Health. The Report concluded that cigarette smoking was causally related to lung cancer; was the most important cause of chronic bronchitis and increases the risk of dying from chronic bronchitis and emphysema; and that it was prudent to assume that cigarette smoking caused coronary disease. The’ Report concluded that cigarette smoking is a health hazard of sufficient importance to warrant appropriate remedial action. During the 1970s and 1980s subsequent Surgeon General's reports established the scientific evidence that cigarette smok- ing is the single largest cause of preventable morbidity and mortality in the United States. In 1986, the Public Health Service produced a Surgeon General's Report which established the link between “passive smoking” and disease in healthy nonsmokers. In response to the growing awareness of the health hazards associated with cigarette smoking and the acknowledgement of the rights of nonsmokers to a smoke-free environment, an upsurge in tobacco-related legislation has occurred at the National, State and local level. As of December 1987, nearly 100 congressional bills address- ing smoking-or tobacco-related issues had been introduced during the 98th, 99th, and 100th sessions of Congress. Al- though the 100th Congress continues through 1988, for pur- poses of this report only those bills introduced through December 31, 1987 are mentioned. A number of bills refer- ence smoking-and tobacco-related issues on a secondary level, or in some instances merely by inference; therefore, review of the subject indexes for legislation introduced would not necessarily reveal all of this legislation. Additionally, com- panion bills introduced in both the House and Senate, which are identical, may only be reported in indexes under one bill number. For these reasons, tallies of bills introduced may differ significantly from one another depending upon the depth of the index search conducted. The following discussion will focus on those bills that clearly deal with smoking issues, although instances where smoking or tobacco sale or use is implied are noted. In addition to the Federal legislation, a comprehensive search of State statute books and legislative tracking services 63 indicate that nearly 600 State laws pertaining to smoking and the sale or use of tobacco products are currently in effect. This total does not necessarily include each law pertaining to the taxation of cigarettes or tobacco products, but rather laws that deal with smoking in public places, distribution to minors, schools and health education, commerce, and public health and safety regulations. Federal Legislation At the Federal level, during the 98th, 99th, and 100th sessions of Congress, nearly 100 bills addressing smoking, tobacco use or both had been introduced as of December 1987. Four health-related bills passed during this time. This report will briefly describe the bills tracked by subject areas related to the smoking and health issue. Although other laws passed may be tobacco related, for the purposes of this report, the four laws passed reflect health related (smoking) implications. These bills are categorized into seven topic areas: Limitations on Smoking in Public Places; Regulation of Sale to and Use of Tobacco Products by Minors; Schools and School Health Education; Regulation of Advertising Practices; Commerce; Taxation; and Health and Safety Regulations as they pertain to smoking and tobacco use. Some bills vary in scope and intent, and are grouped in more than one category. (See Table 1. following the Federal legislative narrative.) Limitations on Smoking In Public Places Five bills introduced in the House of Representatives during the 98th session of Congress applied primarily to smoking on board passenger-carrying aircraft and other forms of transpor- tation subject to interstate commerce regulations. During the 99th session, three bills were introduced pertaining to smoking limitations: H.R. 133 would amend the Federal Aviation Act of 1958 to prohibit smoking in more than one designated area of a passenger-carrying aircraft; S. 1440 and S. 1937 would restrict smoking to designated areas in all U.S. Government buildings and impose a civil penalty for anyone who disregards this restriction. Inthe 100th Congress, H.R. 1008 cited as the “Nonsmoking Health Protection Act of 1987,” would restrict smoking to designated areas in all buildings and sections of buildings occupied by the U.S. Government. Five bills were introduced in the 100th Congress to amend the Federal Aviation Act of 1958 to prohibit smoking on domestic commercial aircraft flights: H.R. 1078, H.R. 3377 “Aircraft Cabin Air Quality Protection Act of 1987,” H.R. 432 “Airline Anti-Smoking Act,” H.R. 3018, which specifies flights of two hours or less, and H.R. 2040, which includes both domestic and international flights. H.J.R. 395, Public Law 202, was passed in December 1987 to prohibit smoking on certain domestic flights. Senate dill S. 51, cited as the “Prohibition of Smoking in Public Conveyances Act of 1987,” would make it unlawtul for any person to smoke in any regularly scheduled public conveyance traveling within the U.S. and to smoke ina waiting area in a terminal for a public conveyance unless ina designated smoking area. A $500 fine would be imposed for violation. Regulation of Sale to and Use of Tobacco Products by Minors in the 100th session of Congress, H.R. 3294 would amend the Federal Food, Drug, and Cosmetic Act to regulate the sale and distribution of tobacco products. Cited as the “Comprehen- sive Tobacco Health and Safety Act of 1987,” this act would make it unlawful to sel! tobacco products to any person under the age of 18 years (or older if a state statute so declares) or to distribute free samples, misbranded or adulterated products. Cited as the “Adolescent Tobacco Education and Prevention Act," H.R. 3658 would use grant funds provided under the Drug Free Schools and Communities Act of 1986 to provide education relating to the use of tobacco products and would make it unlawful to sell a tobacco product to any person under the age of 18 years, or older as established by a State statute. In regards to vending machines, it would be unlawtul to sell or cause to be sold a tobacco product in a vending machine without a posted sign stating, “The Sale of Cigarettes to Minors is Strictly Prohibited.” Schools and School Health Education Of the six bills introduced between the 98th and 99th sessions of Congress, two became law. S. 1574 was passed into Public Law 99-252 in February 1986. This law, cited as the “Com- prehensive Smokeless Tobacco Health Education Act of 1986,” directs the Secretary of Health and Human Services to develop educational programs, materials and public service announcements on the health hazards associated with smokeless tobacco and make these items available to States, local governments and school systems. These programs are to be developed by the Secretary of Health and Human Services in consultation with the Secretary of Education, medical and public health entities, consumer groups and other appropriate contacts. After developing these programs, the Secretary is required to submit an annual report to the Con- gress concerning the smokeless tobacco activities under- taken. In addition, this law makes it unlawtul to manufacture, package or import for sale or distribution, or advertise any smokeless tobacco product uniess the product bears one of three warning statements in a conspicuous location on the product. H.R. 2370, cited as the "Nurse Education Amendments of 1985,” became Public Law 99-92 in August 1985. This law amended the Public Health Service Act by directing the Secretary of Health and Human Services to make grants and contracts available for specified demonstration projects and for the education and training of nurses in the subject of smoking and health. Two additional clauses contained in the text of this bill state that: * Amanufacturer or importer of cigarettes may apply to the Federal Trade Commission for a description of the label rotation process or any other requirement of the clause; and 64 * Sect. 13 Section 3(c) of the Comprehensive Smoking Education Act is amended by striking out “1985" and inserting in lieu thereof “1986.” Regulation of Advertising Practices Nineteen bills were introduced that pertain to the advertising of tobacco roducts: three were introduced during the 98th session, eight during the 99th session, and eight during the 100th session of Congress. The content of these bills varies from labeling, packaging, and advertising on specific media to- deductions for advertising costs. Of the bills introduced, two became law. Companion bills H.R. 3979 and S. 772, introduced in the 98th session of Congress, were passed into Public Law 98-474, Known as the Comprehensive Smoking Education Act, this law amends the Public Health Service Act to establish an Interagency Committee on Smoking and Health to coordinate Federal and private research and education activities regard- ing the health hazards of smoking, and amends the Federal. Cigarette Labeling and Advertising Act to change the label requirements for cigarettes. Two bills (H.R. 2950 and H.R. 3510) were introduced during the 99th session and incorporated into S. 1574, which became Public Law 99-252 in February 1986. These three bills specifi- cally addressed the labeling of smokeless tobacco: H.R. 2950 cited as the "Comprehensive Smokeless Tobacco Education Act” would require specific warnings on all smokeless tobacco products and advertisements, H.R. 3510 cited as the “Com-- prehensive Smokeless Tobacco Health Risk Education Act,” proposed to establish a Federal initiative to require warning labels on smokeless tobacco products and advertisements, - and S. 1574 (now Public Law 99-252) makes it unlawful to manufacture, package or import for sale or distribution within the U.S. any smokeless tobacco product unless the product bears one of three health warning labels. Public Law 99-252 - is cited as the “Comprehensive Smokeless Tobacco Health Education Act of 1986.” One bill in the 98th Congress (H.R. 5043), and three bills in - the 99th Congress (H.R. 760, H.R. 2835, S. 1116) would amend the Federal Cigarette Labeling and Advertising Act to prohibit the advertising of any tobacco product on any medium of electronic communication and make technical changes in - the rotation of warning labels, respectively. H.R. 2835 con- tained a technical amendment for Section 3(c) of the Com- - prehensive Smoking Education Act to strike out “1985” and insert “1986.” H.R. 760 cited as the “Health in Advertising Act,” would amend Section 6 of the Act to make it unlawful to advertise cigarettes, little cigars, and any other tobacco product on any medium of electronic communication subject to the jurisdiction of the Federal Communications Commis- sion. During the years of 1967-1971, broadcasters provided free air time to private and government organizations for anti-smoking public service announcements that educated the public about the dangers of cigarette smoking. H.Res. 286 was introduced in the 100th session of Congress to suggest that the Federal ~ Government strongly encourage both print and electronic media to voluntarily print or air public service messages describing the deadly effects of cigarette smoking. H.J.Res. 271 authorizes and directs the President to call upon radio and television broadcasters to educate the public, in cooperation with public health organizations, about the dangers of cigarette smoking. H.R. 1272, cited as the “Health Protection Act of 1987,” would amend the Federal Cigarette Labeling and Advertising Act and the Comprehensive Smokeless Tobacco Health Education Act of 1986 in regards to the advertising of tobacco products by striking out clauses that reflect or state, ”. .and advertis- ments....” Cited as the “Health Protection Act of 1987,” H.R. 1532 would ban and declare all consumer sales promotion of tobacco products unlawtul. Two companion bills from the 99th Congress (H.R. 3950 and S. 1950) and four bills from the 100th Cangress disallow any deductions for advertising expenses for tobacco products. H.R. 3950, from the 99th Congress, and S. 446, H.R. 3503, H.R. 1563, H.R. 2606 all include the clause that disallowed deductions for other promotional expenses with respect to sales of tobacco and tobacco products. Commerce Five bills were introduced in the 100th session of Congress, six bills during the 99th session, and one in the 98th session pertaining to the purchase, sale, distribution, or importation of cigarettes and tobacco products. . In the 99th session, S. 1418 would amend the Agricultural Act of 1938, and the Agricultural Act of 1949 to improve the Tobacco Price Support Program and determine market quotas for flue-cured and burley tobacco. In the 100th Congress, H.R. 1218 would require the Secretary of Agriculture to estab- lish an advisory committee to study the economic impact of prohibiting the lease and transfer of flue-cured tobacco acreage allotments and quotas for the 1987 and subsequent crops of flue-cured tobacco. H.R. 3629 was introduced in the 99th session of Congress to make appropriations for the Department of Defense for military functions and for other purposes. In Section 8101 of this bill it is clearly stated that none of the funds appropriated by this Act shall be available in connection with the operation of commissary stores, exchanges, and ship stores that do not sell cigarettes and tobacco products at a price equivalent to the lowest average prevailing retail price. The Conference Report by the House of Representatives stated that the con- ferees agreed to delete the Senate provision that would in- crease the price of tobacco products sold on military installations yet direct the Assistant Secretary of Defense for Health Affairs to submit a report on his recommendations concerning the health issues surrounding tobacco products and the military. This report would include how cigarette prices effect the consumption patterns, the health of military personnel and the economic cost to the military and society. The Defense Department is to report on the economic impact of increasing the price of tobacco products in commissaries and exchanges and of including State and local taxes in the price of tobacco products. The Department is also required to inform the Committees of the status of an internal Defense Department proposal to discontinue the sale of cigarettes in commissaries. 65 Introduced in the 100th Congress, S. 868 would require the Secretary of Agriculture and the Secretary of Commerce to conduct a joint study of commodities and products that may be produced and marketed in conjunction with the production of tobacco. S. 471 would amend title 10 of the United States Code to revise the method for pricing tobacco products for sale in commissaries, exchanges, and ships’ stores. H.R. 259 was introduced in the 99th session of Congress to amend the Federal Aviation Act of 1958 to prohibit air carriers from dispensing alcoholic beverages and tobacco products without charge to passengers. Five bills addressed restrictions on importing tobacco; one in the 98th session, three in the 99th session, and one in the 100th session of Congress. S. 67 and H.R. 1022, both intro- duced in the 99th session, would amend the Agricultural Adjustment Act of 1938 to prohibit the importation of tobacco that has been grown or processed using pesticides and other chemicals whose use has been prohibited in this country for health reasons; H.R. 6418 introduced in the 98th session, addressed the same issue. H.R. 1137 would impose restric- tions on the quantity of foreign unmanufactured tobacco that may be imported into the United States. In the 100th Con- gress, S. 969 would impose quotas on certain products of the Republic of Korea until the Republic of Korea fully opens its markets to cigarettes produced in the United States. Taxation Over 43 bills applicable to the taxation of cigarettes and smokeless tobacco were introduced in the House and Senate during the 99th and 100th sessions of Congress. Seventeen bills attempted to amend the Internal Revenue Code of 1954 to increase the Federal excise tax on cigarettes. Some of these bills would distribute increased tax revenues to the general fund, the Federal Hospital Insurance Trust Fund under the Social Security Act, and to research on tobacco- related diseases; others would fund the Medicare and Medicaid programs and attempt to reduce the Federal deficit. The Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA), which amended Section 5701 of the Internal Revenue Code, increased the Federal excise tax on cigarettes from 8 to 16 cents per pack of 20 cigarettes. Although several bills were passed into law extending the period of expiration for the tax increase, Public Law 99-272, passed in December 1985, instituted the 16¢ -per-pack tax rate increase. During the 100th Congress, five bills were introduced to increase the tax rate on cigarettes: four of the bills (H.R. 2104, H.R. 493, H.R. 260 and S. 447) would increase the tax rate to 32 cents per pack; H.R. 1233 would increase the rate to 40 cents per pack. S. 447 would also increase the tax rate on snuff and chewing tobacco to 8 cents per pack. During the 99th session of Congress, three bills were intro- duced pertaining solely to smokeless tobacco: H.R. 3064 would impose an excise tax on smokeless tobacco products with tax revenues allocated to the Medicaid program; H.R. 3078, broader in scope, would establish a Federal program to assist states in implementing programs on the dangers of smokeless tobacco and imposes an excise tax of 32 cents on all smokeless tobacco products. Proceeds from this tax would be used to establish a trust fund for cancer research and educational programs on smokeless tobacco and would disallow a deduction for expenses incurred in advertising smokeless tobacco. Senate bill 1782 would impose a $1.25 excise tax per pound on snuff and 40 cents per pound on chewing tobacco. Four bills introduced in the 100th Congress would amend the Internal Revenue Code of 1986 to disallow deductions for advertising and promotional expenses for tobacco products: H.R. 2607, H.R. 1563, H.R. 3503 and S. 446. H.R. 581 would amend the Internal Revenue Code of 1986 to allow individuals and corporations to treat qualified no-net cost tobacco expenditures as a deductable expense. Health and Safety Regulations In the 98th Congress, two bills (H.R. 3979 and S. 772) were introduced to establish an Interagency Committee on Smok- ing and Heath to coordinate smoking-related activities Nation- ally. These bills, which were previously discussed, were passed into Public Law 98-474. One bill introduced in the 99th session entitled “Medicare Part B Premiums Nonsmoking Discounts” would provide a dis- count for nonsmokers participating in the Medicare program. In the 100th Congress, H.R. 3440 cited as “Fire Safe Cigarette Act of 1987" and S. 1763 “An Act to Reduce Fires Caused by Cigarettes” would direct the Secretary of Health and Human Services to issue a fire safety standard for cigarettes to reduce the risk of ignition presented by cigarettes. H.R. 2376 is an act to amend the Consumer Product Safety Act by removing the section exempting tobacco and tobacco products from the consumer Product Safety Commission's jurisdiction. Summary The following is a list of the Congressional bills passed into Federal law during the 98th and 99th Congress pertaining to smoking and the use of tobacco products. Although the 100th Congress continues through 1988, H.J.R. 395 was passed into law during the 100th Congress in December 1987. * Comprehensive Smoking Education Act, Public Law 98-474, 98th Congress, October 1984. One of several health warning labels is required to be displayed on all packages of cigarettes manufactured, sold or distributed, and on all advertisements of cigarettes within the United States, excluding outdoor billboards. Location and for- mat of these labels are specified. The Federal Cigarette Labeling and Advertising Act is amended. In addition, each cigarette manufacturer, packager or importer shall submit annually to the Secretary of Health and Human Services a confidential list of cigarette additives (in- gredients), either directly or by a designated entity, which does not name either the manufacturer of the additives or the brand of cigarettes using the additives. Based on this information, the Secretary may submit to Congress a report summarizing on-going and proposed research on the health effects of cigarette additives, and in particular, discuss any ingredient the Secretary judges to pose health risks to cigarette smokers or to be of public interest. Finally, an Interagency Committee on Smoking and Health is established to increase the availability of 66 information on the health consequences of smoking. Federal and private research and education activities regarding the health hazards of smoking will be coor- dinated through this effort. Nurse Education Amendments of 1985, Public Law 99-92, 99th Congress, August 1985. The Secretary of Health and Human Services is directed to make grants and contracts available for specified demonstration projects and for the education and training of nurses in the subject of smoking and health. This law amends the Public Health Service Act. The Consolidated Omnibus Budget Reconelilation Act (COBRA), Public Law 99-272, 99th Congress, April 1986, and the laws amending the Tax Equity and Fiscal Responsbllity Act of 1982 (TEFRA): The Emer- gency Extension Act of 1985, Public Law 99-1 07, 99th Congress, September 1985, and Public Laws 99-1 81, 99-189 & 99-201, 99th Congress, December 1985. The Federal excise tax on cigarettes is increased from 8 to 16 cents per pack of cigarettes. This increase is based according to weight per thousand, which is calculated to an amount per package. Comprehensive Smokeless Tobacco and Health Education Act of 1986, Public Law 99-252,99th Con- gress, February 1986. The Secretary of Health and Human Services, through the Office on Smoking and Health and in consultation with the Secretary of Educa- tion, medical and public heath entities, consumer groups and other appropriate entities, is directed to develop educational programs, materials and public service an- nouncements on the health hazards associated with smokeless tobacco. These items will be made available to States, local governments, and school systems. In addition, through the Surgeon General of the United States, the Secretary of Health and Human Services will submit a biennial report to Congress concerning the smokless tobacco activities undertaken and recommend- ing legislation and administrative action. The law also requires that all packages of smokeless tobacco manufactured, sold, and distributed within the United States must display one of several health risk warning labels. Location and format of the display of these labels are specified. Smokeless tobacco companies are re- qured to provide the Secretary of Health and Human Services with a confidential list of smokeless tobacco additives and the nicotine contet of smokeless tobacco brands. Prohibition Against Smoking on Scheduled Flights and Tampering with Smoke Alarm Devices, Public Law 100-202, 100th Congress, December 1987. It is unlawful to smoke in the passenger cabin or lavatory on any flight scheduled for less than a two-hour duration. The Secretary of Transportation isdirected to promuigate regulations to carry out this provision. Twenty-eight months after enactment of this law, this provision will expire. Indirectly, this law led to a ban on smoking on commuter rail lines serving New York City. The law theatened to withhold Federal funds to the New York - Metropolitan Transportation Authority unless smoking was banned on the Long Island Railroad. Legislation Introduced During the 98th-100th Sessions of Congress with Regard to Smoking and Health TABLE 1. |. Limitations on Smoking House - 98th - Senate in Public Places -H. H.R. 4395 H.R. 4955 H.R. 5507 H.R. 6217 House - 99th - Senate AR. 733 S$. 1446 S. 1937 House - 100th - Senate H.R. 432 S.R. 154 H.R. 1008 H.R. 1078 H.R. 2040 H.R. 3018 H.R. 3377 ll. Regulation of Sale to House - 100th - Senate and Use of Tobacco Products by Minors lil. Schools and School House - 98th - Senate Health Education HRD 4851 House - 99th - Senate “RA. wR. 4 H.R. 3510° H.R. 2950° H.R. 3769°** House - 100th - Senate HR. 3658" IV. Regulation of House - 98th - Senate Advertising Practices HR. 5043 H.R. 3979*° S. 772** House - 99th - Senate HR. 3510° HA. 760 S. 1116 H.R. 2835 S. 1574°° House - 100th - Senate H.R. 1272 Ss. 446° H.R. 1532 H.R. 1563° H.R. 2606" H.R. 3503° H.Res. 286 HJ.R. 271 * Categorized under more than one topic in text. ** Passed into law V. Commerce Vi. Taxation Vil. Health and Safety Regulations House - 98th - Senate AR. 6418 House - 99th - Senate HR 259 8. 67 H.R. 1022 S. 1418 H.R. 1137 H.R. 3629 House - 100th - Senate HR. 1218 Ss. 471 .R. 3294 S. 868 S. 969 House - 99th - Senate H-R. 1653 H.R. 1324 $. 820 H.R 951 H.R. 2981 S. 874 H.R 844 H.R. 3451 S. 1205 H.R, 236 H.R. 3452°* S. 1712 H.R. 1200 H.R. 3722 S. 1732 H.R. 1561 H.R. 3918°* S. 1633 H.R. 1594 H.R. 3981** S. 1782 H.R. 3788 H.R. 3992 H.R. 1826 H.R. 3993 H.R. 2600 H.R. 3994 H.R. 3039 H.R. 3996 H.R. 1421 H.R. 4006°* H.R. 2548 H.R. 1826 House - 100th - Senate ; 260 . 446 H.R 493 S. 447 H.R. 581 H.R, 1233 H.R. 2104 H.R. 1563°* H.R. 2606° H.R. 3503* House - 98th - Senate House - 99th - Senate 5. House - 100th - Senate HR. 2376 5. 1763 H.R. 3440 67 State Legisiation Within the past two years, due to increasing evidence of the health hazards associated with environmental tobacco smoke, State legislatures have been focusing on limiting smoking in public places, specifically in the workplace. Inform- ing the general public about the health hazards of cigarette smoking and tobacco use has also been a major focus of State and local legislative efforts. All 50 States and the District of Columbia have enacted legislation pertaining to the sale or use of tobacco products. The laws vary from State to State and range from restrictions on smoking in public places to the distribution of the sales tax on tobacco products. For purposes of analysis, the major smoking and tobacco laws have been categorized by content in the following subject areas: Limitations on Smoking in Public Places; Regulation of Sale to and Use of Tobacco Products by Minors; Schools and School Health Education; Regulation of Advertising Practices; Commerce; Taxation; and Health and Safety Regulations. Limitations on Smoking In Public Places In recognition of the public health hazards of secondhand smoke, the majority of States and the District of Columbia have enacted legislation to protect the rights of nonsmokers. Various enclosed or indoor areas frequented by or accessible to the general public are required to implement strict regula- tions to prohibit smoking in certain areas and are required to post signs designating smoking and nonsmoking areas. As noted in Figure 1., the restrictions vary in degree from State to State. The most comprehensive legislation of this nature has been adopted by the States of Alaska, Connecticut, Florida, Maine, Minnesota, Montana, Nebraska, New Jersey, Utah, and Washington. These States, classified as having extensive restrictions on smoking (See Figure 1.), prohibit or restrict smoking to designated areas in vehicles of public transporta- tion, health care facilities, offices of health care practitioners, passenger elevators, cultural and recreational facilities, educational facilities, retail stores, restaurants, government buildings, public meetings, offices, and private workplaces. Moderate restrictions are less extensive in that they do not regulate or restrict smoking in private workplaces. Basic restrictions include States regulating smoking in four or more areas, and States classitied as nominal restrict smoking in one to three areas. While Georgia’s criminal code specifically prohibits smoking on public transportation and in elevators only, it also prohibits smoking in any public area where a no-smoking sign is posted. Mississippi restricts smoking on public transit, South Carolina prohibits smoking on school buses, and Louisiana prohibits smoking in the arena of the Superdome. These States, along with Arkansas, Delaware, Kentucky, Vermont, and West Virginia, are designated as having nominal regulations in Figure 1. Seven States do not have any current laws that would restrict or regulate smoking in public places. (See Table 1.) 68 TABLE 1. STATES THAT DO NOT IMPOSE ANY LIMITS ON SMOKING IN PUBLIC PLACES Alabama Tennessee lilinois Virginia Missouri Wyoming North Carolina Smoking is most commonly prohibited or restricted in public transportation vehicles, health care offices and facilities, and elevators. Thirty-seven jurisdictions regulate smoking on public conveyances and in hospitals, nursing homes and other health care facilities, and 30 jurisdictions regulate smoking in passenger elevators. Alaska, California, Florida, Hawaii, Maryland, New Jersey, Utah, and Washington specifically prohibit smoking in transportation terminals. Many States have also taken steps to curtail or prohibit smok- ing in indoor cultural and recreational facilities such as libraries, museums, theaters, galleries, arenas, and auditoriums. Waen smoking is permitted, it is confined to an area that the proprietor, or person in control of the facility, has designated and posted as a smoking area. Smoking in school buildings and on school grounds is regu- lated by 32 States. These regulations restrict smoking for students, school personnel, and others with access to the educational facilities. Less than half of the States prohibit smoking in the public areas of supermarkets, grocery stores, or other retail stores, or require restaurants to establish non- smoking sections for their customers. In the past two years, seven States passed legislation requiring restaurant owners to dedicate a portion of their establishment for nonsmoking patrons and to post signs indicating the area designated for smokers. Colorado does not restrict smoking in restaurants or taverns, but does encourage establishments to seat non- smokers away from smokers. In addition, public places that sell or serve food are required to post signs at or inside their entrances indicating whether separate seating provisions have been made for nonsmokers. Inthe State of Washington, no public place (other than a bar, tavern, bowling alley, tobac- co shop, or restaurant) may be designated as a smoking area in its entirety. Twenty-nine States restrict smoking in public buildings owned, leased, or operated by governmental entities, and 23 States prohibit or restrict smoking in public meetings. The States of Alaska, Florida, Kansas, Maine, Massachusetts, Oregon, and South Dakota also prohibit smoking in jury deliberation rooms. Many States are encouraging employers to establish worksite smoking policies to protect the rights of the nonsmokers and STATE LAWS REGULATING SMOKING FIGURE 1. NEW HAMPSHIRE LKEKRMRPR OV VERMONT WASHINGTON RXR KKK XORKY) Xs _ 5 PKK ; a NS yy Y MON {IANA NORTH DAKOTA@ MINNESOTA AXP AFI \\ OO TEPC v0, = 00000. 06564 SETT Kx ae PR ROOOOK XS * ARO K KOEI RK KK KAN OANA s LOL K KKM ET AY ND f OKIE iE HODE ISLA O00 OREGON KXXQOOKOIIC ne : ; PY CKIKK) PO nn occ cciunnenete ; XXX é N mC XK KK RRO CI RX IDAHO CXYYY , > ORY? SOKO p ORE AYYYXXY YMICHIGAN Bo ONNECTICUT x QOOOOKKXMKKN ERIK CK Ke SKK “ POO OOOO OO OOK KK ICCC MING fF RY iru) F POO 0,98 ELK wyoO $ KY hide a Sees : et NEW JERSEY KXXKX RN NEBRASKA HI aT ey «(DELAWARE OOOO o MARYLAND KW: RTT ee XRG RICKY \) BC Me: ROOK KOT 0.¢. RK: XY Xx RRR KKK Yi COLORADO Qe ee Cit PO pala 3 0006066006. SS AROLINA RR RE ; x CAROL ALIFORNIA X) ¢ KCAL AO SV SOUTH BAS é : AROLINA IC : RANE , - ~ AS Rr 20 (X \) SS OVE: m PRON 4 \ OOO 0.60.00 006000b08 ON ALABAMA \ SS 4.6.6.6.6.6.666660.6¢ SN RRS RIARAR SR SN c’ : \ ALY | | Extensive EXO Moderate Basic QQAYY Nominal a No Restrictions HAWAII. to provide for a smoke-free workplace. Twenty-one jurisdic- tions, which include the District of Columbia, have legislation governing smoking in offices and other workplaces. In some States this legislation applies only to workplaces controlled by the State or other governmental entity, while in others the legislation applies to both public and private employers. (See Table 2.) TABLE 2. STATES RESTRICTING SMOKING IN OFFICES AND OTHER WORKPLACES Alaska New Hampshire California New Jersey Connecticut New Mexico Florida North Dakota Indiana Ohio Maine Oregon Michigan Utah Minnesota Vermont * Montana Washington Nebraska Wisconsin “Effective 7/1/88 California requires that State departments employing more than 50 workers adopt a written policy recognizing the rights of nonsmokers to a smoke-free environment in meetings and at individual work stations. New Mexico requires State agen- cies and political subdivisions that employ more than 15 individuals to establish and implement written smoking policies and to provide a smoke-free environment to employees who request one. Washington prohibits smoking in office reception areas and waiting rooms of any buildings owned or leased by the State, counties, cities, or other municipalities. Ohio prohibits smoking in all State office build- ings, except in designated areas. New Hampshire and Oregon impose the same restrictions in allgovernmentoffices. Alaska prohibits smoking in all places of employment, public or private, where a no-smoking sign is posted. Florida, Min- nesota, Montana, Nebraska, North Dakota, Utah, and Wiscon- sin restrict smoking to designated areas in offices and other public places serving as workplaces. in addition, Florida requires that, upon request, employers provide employees with workspaces that are not within a designated smoking area. The statutes of Connecticut and New Jersey mandate that employers of more than 50 people establish and post written rules regarding smoking and nonsmoking within their busi- ness facilities. Maine requires that employers of one or more persons establish written policies concerning smoking and nonsmoking by employees and that they prohibit smoking, except in designated areas. Colorado does not directly regu- late smoking in the workplace. However, it encourages those in charge of offices and commercial establishments to designate nonsmoking areas physically separated from the working environments where other employees smoke. 70 Several States also impose restrictions on smoking in workplaces not usually frequented by the general public. Minnesota, Nebraska, and Utah have directed their State health departments to establish rules to prohibit or restrict smoking in factories, warehouses, and similar places of work where the inadequacy of ventilation or the close proximity of workers causes smoke pollution detrimental to the health and comfort of nonsmoking employees. Nevada prohibits smoking in any mill or other building in which ano-smoking sign is conspicuously posted over each principal entrance. Similarly, West Virginia prohibits smoking in any factory, mercantile establishment, mill, or workshop where a no-smoking sign is conspicuously placed over and near each principal entrance. in Pennsylvania and Kentucky, prison officials have the dis- cretion to either grant or withhold permission to smoke inorder to control inmate behavior. Pennsylvania law provides that prisoners may be allowed to smoke as a reward for good conduct, but states that prisoners may not be deprived of the right to smoke for longer than two weeks. In Kentucky, prison wardens are authorized to permit or prohibit smoking by inmates whenever they believe such regulation will enhance or improve the discipline of the inmates. Not only do the States differ dramatically in regulating areas where smoking is restricted, but they also impose different forms of punishment for violations. In most cases, violations are punishable by a small fine. Fines of $25 or less are imposed in Connecticut, Delaware, Kansas, Pennsylvania, and Vermont. Kentucky and West Virginia impose the lowest fines: $1 to $5 for smoking on school grounds or in school buildings; Hawaii has the highest with fines up to $500 for initial violations of smoking in public places. Arkansas, California, Georgia, Idaho, lowa, Massachusetts, Montana, Nevada, New York, North Dakota, Oklahoma, and Oregon impose fines of up to $100 for violating laws restricting smok- ing. Higher fines, from $100 to $300, are imposed by Alaska, Maryland, New Jersey, Rhode Island, and the District of Columbia for failing to comply with the restrictions on smoking in public places. Rhode Island increased the penalty from $20 to $250 for each offense. injunctive relief may be granted for violating smoking restric- tions in Alaska, Minnesota, Nebraska, New Hampshire, and Wisconsin. Idaho, Michigan, Massachusetts, New Jersey, and New York can imprison offenders for violation of the smoking laws. A number of States do not specify the penalty in the prohibiting statutes, but instead characterize the viola- tion as either a misdemeanor or petty offense. These States include Arizona, Florida, Mississippi, Ohio, South Dakota, Texas, Utah, and Washington. Regulation of Sale to and Use of Tobacco Products by Minors The sale or distribution of cigarettes or tobacco products to minors is regulated by 45 jurisdictions, including the District of Columbia. (See Figure 2.) Missouri does not impose restric- tions at the State level, but permits cities, towns, and municipalities to enact ordinances prohibiting the sale to or use of cigarettes by minors. Six States do not regulate the gale or distribution of tobacco products to minors. (See Table 3.) TABLE 3. STATES WITHOUT RESTRICTIONS ON SALE TO OR USE OF TOBACCO PRODUCTS BY MINORS Kentucky New Mexico Louisiana Wisconsin Montana Wyoming In the past two years, seven States specifically added smoke- less tobacco in the laws pertaining to the sale and or use of tobacco products to minors. Kansas prohibits only the sale of cigarettes to minors. The other State statutes have much broader prohibitive language and randomly outlaw the sale or furnishing, or both, of cigars, cigarettes, snuff, chewing tobac- co, smokeless tobacco, smoking material, and tobacco in any form to minors. Twenty-one States also prohibit the sale or furnishing of cigarette wrapping papers and other smoking paraphernalia to minors. The majority of States prohibiting the sale of cigarettes or other tobacco products to minors define a minor as anyone under the age of 18 years. In the past two years, seven States passed legislation pertaining to the age of minors. Colorado, Georgia, New Hampshire, and Virginia all passed legislation establishing the age of minority as it pertains to tobacco products. Three States increased the age to 18 years: Hawaii, Indiana, and Massachusetts. Hawaii increased the age from 15 to 18 years of age. Nine jurisdictions define a minor as anyone under the age of 16 years, and five define a minor as 17 years of age or younger. Alabama and Utah prohibit such sales to anyone under the age of 19 years. (See Table 4.) TABLE 4. AGES OF MINORS PERTAINING TO THE SALE OF TOBACCO PRODUCTS ACCORDING TO STATE Alabama 19 Montana . Alaska 16 Nebraska 18 Arizona 18 Nevada 18 Arkansas 18 New Hampshire 18 Califonia 18 New Jersey 16 Colorado 18 New Mexico . Connecticut 16 New York 18 Delaware 17 North Carolina 17 District of Columbia 16 North Dakota 18 Florida 18 Ohio 18 Georgia 17 Oklahoma 18 Hawaii 18 Oregon 18 Idaho 418 Pennsylvania 16 Minois 18 Rhode Island 16 Indiana 18 South Carolina 18 lowa 18 South Dakota 18 Kansas 18 Tennessee 18 Kentucky . Texas 16 Louisiana . Utah 19 Maine 18 Vermont 17 Maryland 16 Virginia 16 Massachusetts 18 Washington 18 Michigan 18 West Virginia 18 Minnesota 18 Wisconsin . Mississippi 18 Wyoming . Missouri 18 *Age of minors is not specified for cigarette or tobacco use. 71 The penalties for violation of the laws relating to selling or furnishing tobacco products to minors vary from State to State. In 14 States, such offenses are punishable only by a fine. In the remaining jurisdictions, such offenses are punishable by fine, imprisonment, or both. The heaviest penalties are im- posed by Kansas: anyone convicted of the offense of selling cigarettes to a person under 18 years of age in Kansas is subject to a fine of not more than $1000 or imprisonment for not more than one year, or both. In addition to prohibiting the sale or furnishing of cigarettes or other tobacco products to minors, 13 States prohibit the use or possession, or both, of such products by minors. Minors found guilty of using or possessing tobacco are punishable by afine in Idaho, Illinois, Rhode Island, and West Virginia, and by a fine or imprisonment, or both in Kansas, Michigan, and Tennessee. Louisiana does not specifically prohibit the use of tobacco by minors, but does authorize public school prin- cipals to suspend any student who uses tobacco in school buildings, on school property, or in schoo! buses. In the remaining six States, the use of tobacco by a minor is clas- sified as either amisdemeanor or petty offense with no specific penalty described in the statute. Neither lowa nor Oklahoma make possession of cigarettes by a minor a punishable offense. However, any minor under 18 years of age who has cigarettes or cigarette papers in his possession and who refuses to give information at the request of any peace officer, juvenile court officer, truant officer, or teacher as to where the articles were obtained, is guilty of a misdemeanor. Florida does not make possession of cigaret- tes or cigarette materials by a minor a punishable offense. Nonetheless, minors who have or have had cigarettes in their possession may be summoned by sheriffs, deputies, and police officers and compelled to testify in court as to where and from whom they obtained such articles. Minors charged with violation of the law prohibiting smoking or possession of cigarettes or other tobacco products in Nebraska and West Virginia may obtain immunity from prosecution or punishment upon disclosure of the identity of the person or firm from whom they obtained the cigarettes or tobacco products. Twelve States require dealers, distributors, or vendors of cigarettes or other tobacco products to post notice at the point of sale that the sale to or purchase of such products by minors is prohibited by law. Idaho, Maine, and Utah go further by forbidding any person to maintain a tobacco vending machine accessible to minors. Violation of this restriction is a mis- demeanor. Colorado has passed legislation to specifically include “smokeless tobacco” as a product prohibited for dis- tribution to minors through vending machines. New Hampshire imposes a $25 fine for the sale of tobacco products to minors through a vending machine. Utah and Michigan also make liable any persons who permit minors to smoke on their property. {In Utah, it is a mis- demeanor for the proprietor of any place of business to know- ingly permit minors to use tobacco on his or her premises. In Michigan, anyone who knowingly harbors or grants a minor the privilege of gathering on his or her property for the purpose of indulging in the use of cigarettes is subject to punishment by fine or imprisonment. STATES ACCORDING TO AGE OF MINORS FIGURE 2. NEW HAMPSHIRE WASHINGTON MINNESOTA NORTH DAKOTA MONTANA MASSACHUSETTS WISCONSIN MICHIGAN SOUTH DAKOTA WYOMING NEW JERSEY DELAWARE MARYLAND NEBRASKA NEVADA ILLINOIS D.C. COLORADO KANSAS KENTUCKY NORTH CAROLINA od CALIFORNIA TENNESSEE SOUTH OKLAHOMA cA INA ARKANSAS ARIZONA NEW MEXICO LOUISIANA oe AGE OF MINORS ty HAWAII SS None 16 17 18 iV it 19 Schools and School Health Education Concern for the health and welfare of their residents has prompted 19 States to require elementary and secondary schools to include instruction on the dangers associated with tobacco use as part of their health education programs. Alabama, Connecticut, and Oklahoma have directed their departments of education to establish and implement in-ser- vice training programs to educate teachers, school ad- ministrators, and other school personnel about the effects of nicotine or tobacco use. These programs also provide instruc- tion on the methods and materials necessary for effective instruction in prevention of drug abuse. All educational institutions in Minnesota that provide teacher training must offer programs in the personal use, misuse of, and dependency on tobacco. Students must take and pass the program. Connecticut law dictates that universities that train teachers must provide instruction on the effects of nicotine and tobacco use on health, character, citizenship, and personality development and the best methods for instructing students on these topics. Connecticut will not grant a certifi- cate to teach or supervise in any public school to any person who has not passed an examination on the effects of nicotine and tobacco use. California and Florida have no specific statutory provisions for mandatory instruction on the effects of tobacco use in elemen- tary and secondary schools. Both States, however, require that upon adoption of instructional materials for use in the schools, schoo! boards shall include only instructional materials that portray accurately the physical effects of tobac- co use. Florida’s Cancer Control and Research Act provides that proven causes of cancer, including smoking, should be publicized and made the subject of educational programs for the prevention of cancer. These programs are to be made available to all citizens of the State. In Arkansas, California, Connecticut, lowa, Louisiana, Mas- sachusetts, New Jersey, and Texas, legislatures have taken ahard line on the use of tobacco products by students in public schools. In lowa, the school board may suspend or expel any student who violates the rule prohibiting the use of tobacco. In California and Louisiana, school principals are authorized to suspend any student who uses tobacco in school buildings, on school grounds, or in school buses. Violations by juveniles in New Jersey are within the jurisdiction of the municipal court. Arkansas law prohibits smoking in public schools unless in a designated area and only then by nonstudents over the age of 18 years. Connecticut and Massachusetts prohibit smoking onschool grounds during school hours. Students in Texas are prohibited from smoking at any school related or sanctioned activity on or off school property. Regulation of Advertising Practices In addition to the above-noted restrictions on smoking and tobacco use, there are a number of statutory provisions that are unique to individual States. For example, Minnesota forbids persons running for public office from distributing cigarettes to voters. Utah prohibits cigarette advertising on billboards, streetcars, buses, or any other displays, but does permit cigarette dealers to post signs in front of their 73 businesses indicating that they are cigarette dealers. Califor- nia prohibits any firm manufacturing smokeless tobacco in the State to underwrite or sponsor any professional or amateur sporting event in the State. Violation is a misdemeanor punishable by a fine of up to $500. Delaware and Utah passed legislation requiring containers of smokeless tobacco to carry warning labels. Illinois and West Virginia passed legislation requiring outdoor billboards adver- tising smokeless tobacco to carry health warnings of the product. North Carolina amended their promotion statutes as they pertain to flue-cured tobacco. Commerce Several States impose restrictions on the manufacturing of tobacco products in the home. These laws ensure com- pliance with the labor standards and regulations adopted for the industry and protect the health and welfare of industrial homeworkers. To safeguard the health and morals of minors, seven States prohibit the employment of minors to manufac- ture, pack, or sell tobacco products. Texas passed legislation to prohibit neighborhood con- venience stores from selling cigarette papers without the additional purchase of loose tobacco. In recognition of the serious health hazards posed by the smoking of clove cigarettes, four States including Maryland, Nevada, New Mexico, and Utah prohibit the sale of these cigarettes. Violation of these provisions constitutes a mis- demeancr. Florida prohibits the sale, use, possession, gift, or other disposition of cigarettes or other products designed for smoking made in whole or in part from cloves, clove oil, or any derivative of those substances. (See Table 5.) TABLE 5. — STATES PROHIBITING SALE OR USE OF CLOVE CIGARETTES Florida New Mexico Maryland Utah Nevada Michigan and Massachusetts explicitly prohibit the sale of adulterated cigarettes. Massachusetts also makes it a crime to sell exploding cigars or cigarettes. While not criminally prohibiting the sale of adulterated cigarettes, New York provides litigants with a model civil complaint form to be filed against the seller of adulterated cigarettes. The retail price of a package of 20 cigarettes (as of November 1, 1986), including Federal and State excise taxes and State sales taxes (but not municipal taxes), ranged from a low of 90.5 cents in Kentucky to a high of $1.34 in Washington. (The Tobacco Institute, The Tobacco Tax Burden: Historical Compilation, 1986, vol. 21.) Several jurisdictions regulate tobacco use by persons com- mitted to State institutions. In Minnesota, it is illegal to furnish cigarettes to prison inmates without permission from the Com- missioner of Corrections. West Virginia prohibits giving or selling tobacco products to State mental hospital patients and to girls committed to “industrial homes” without permission of the superintendent. It is a misdemeanor in New Jersey to sell tobacco to reformatory inmates. Conversely, South Carolina donates confiscated cigarettes (where the dealer failed to pay taxes) to mental patients in State facilities. Taxation All States tax cigarettes, and all States, with the exception of West Virginia, require that persons obtain licenses before engaging in the business of distributing, retailing, wholesaling or manufacturing cigarettes, and other tobacco products. In most cases, the licensing provisions are mechanisms by which the States can police the collection of cigarette taxes. North Carolina has the lowest tax rate per pack of cigarettes and Minnesota the highest, 2 cents and 38 cents, respectively. (See Figure 3.) Nineteen States raised their cigarette taxes between 1985 and 1987. Even with these increases at the State level and the temporary increase from 8 cents to 16 cents per pack imposed at the Federal level, taxes amounted to only 29.9 percent of the average retail price for all States in i986. In 1965, the combined Federal and State taxes con- stituted 51.4 percent of the average retail price. (The Tobacco Institute, The Tax Burden on Tobacco: Historical Compilation, 1986 pp. 64-96.) From 1954 to 1976, the combined Federal and State taxes accounted for more than 40 percent of the retail price of cigarettes. Since that time, the combined tax as a percentage of retail price has remained below 40 percent. The ratio was lowest in 1982 when the combined Federal and State taxes were only 26.8 percent of the average retail price of cigarettes (ibid. pp. 92). (See Table 6.) Alaska, Idaho, Kentucky, Louisiana, Nebraska, and New Jer- sey channel a portion of their cigarette tax revenues into health-and cancer-related programs. Kentucky credits one- half cent of its per-pack tax revenues to the University of Kentucky Tobacco and Health Research Institute to finance tobacco research programs and projects on the health hazards created by tobacco use. Although Louisiana has no laws or pending legisiation to control smoking in public places (except prohibiting smoking in the arena of the Superdome}, it does devote $1 million annually from its cigarette tax revenues to the Cancer and Lung Trust Fund. The fund is used solely to finance cancer research, research on cardiopulmonary diseases, and clinical investigation and training in the field of cancer and cardiopul- monary diseases. New Jersey also deposits $1 million of its annual cigarette tax revenues into the New Jersey State Commission on Cancer Research. Nebraska sets aside 1 cent per pack of the special privilege tax assessed against distributors and wholesalers of cigaret- tes to fund the Nebraska Cancer Research Fund. Monies from the fund are earmarked exclusively for grants and con- tracts for research of cancer and smoking diseases. Eligibility to apply for and receive the grants and contracts is limited to the University of Nebraska and other post-secondary institutions having colleges of medicine in Nebraska. Cigarette tax revenues are also apprapriated to fund Idaho's Cancer Control Account. These funds are spent cn contract- ing for and obtaining services that will promote cancer control for the citizens of Idaho through research, education, screen- ing, and treatment. Finally, Alaska allocates tax revenues in 74 TABLE 6. FROM JULY 1, 1950 STATE CIGARETTE TAX RATE CHANGES THROUGH DECEMBER 1, 1987 Rate Rate Year (in cents) (in cents) first July 1, December 31, State enacted 1950 1987 Alabama 1927 3.0 16.5 Alaska 1949 3.0 16.0 Arizona 1933 2.0 15.0 Arkansas 1925 4.0 21.0 California 1959 0.0 10.0 Colorado 1964 0.0 20.0 Connecticut 1935 3.0 26.0 Delaware 1949 2.0 14.0 District of Columbia 1949 1.0 17.0 Florida 1943 5.0 24.0 Georgia 1923 5.0 12.0 Hawaii 1939 2.9 30.0 Idaho 1945 3.0 18.0 Illinois 1941 3.0 20.0 Indiana 1947 3.0 15.5 lowa 1921 2.0 26.0 Kansas 1927 3.0 24.0 Kentucky 1936 2.0 3.0 Louisiana 1926 8.0 16.0 Maine 1941 4.0 28.0 Maryland 1958 0.0 13.0 Massachussetts 1939 5.0 26.0 Michigan 1947 3.0 21.0 Minnesota 1947 4.0 38.0 Mississippi 1930 4.0 18.0 Missouri 1955 0.0 13.0 Montana 1947 2.0 16.0 Nebraska 1947 3.0 27.0 Nevada 1947 3.0 20.0 New Hampshire 1939 2.5 17.0 New Jersey 1948 3.0 27.0 New Mexico 1943 4.0 15.0 New York 1939 3.0 21.0 North Carolina 1969 0.0 2.0 North Dakota 1925 5.0 27.0 Ohio 1931 2.0 18.0 Oklahoma 1933 5.0 23.0 Oregon 1966 0.0 27.0 Pennsylvania 1935 4.0 18.0 Rhode Island 1939 3.0 25.0 South Carolina 1923 5.0 7.0 South Dakota 1923 3.0 23.0 Tennessee 1925 3.0 13.0 Texas 1931 4.0 26.0 Utah 1923 2.0 23.0 Vermont 1937 4.0 17.0 Virginia 1960 0.0 2.5 Washington 1935 4.0 31.0 West Virginia 1947 1.0 17.0 Wisconsin 1939 3.0 30.0 1951 0.0 8.0 Wyoming STATES CIGARETTE EXCISE TAX RATES FIGURE 3. NEW HAMPSHIRE |: MANE SZ WASHINGTON VERMONT MONTANA MINNESOT MASSACHUSETTS WISCONSIN 3s LZ HAWAIt TAX RATE (by cents) VA 1 fA 7 to 24 EZ 25 to 30 GEE over 30 the amount of 5.5 mills per cigarette to fund health care, health research, and health promotion and education programs. Health and Safety Regulations In an effort to protect the public from negligent activity that could result in fires, explosions, or the contamination of food, several States have enacted legislation relating to smoking and the discarding of smoking materials under potentially unsafe and unsanitary conditions. The most common legis- lation of this nature prohibits the discarding of cigarettes or other smoking materials in or near forest areas. Sixteen States outlaw such activity. New Jersey, Oregon, and Virginia have compensatory provisions that make any person who negligently causes a forest fire liable for the costs of confining, extinguishing, or suppressing the fire. A smaller number of jurisdictions also seek to control behavior that may cause a fire on public or private property by prohibiting persons from discarding lighted cigarettes, cigars, matches, or other materials from moving vehicles. Seventeen States outlaw smoking in the vicinity of flammable materials such as fireworks, explosives, and petroleum products. Restrictions on smoking in or near the surface structure of mines and upon taking smoking materials, such as matches, pipes, cigars, or cigarettes, into underground mines are imposed by 14 States. Colorado, Illinois, Kentucky, and New Mexico permit the person in charge of an under- ground mine to search anyone entering the mine to prevent 76 him or her from taking, carrying, or using any smoking materials therein. Only nine States prohibit persons from indiscriminately dis- posing cigarettes or other smoking materials on public or private property. These laws are designed to control potential fire hazards and litter. Five jurisdictions seek to protect the public's health and wel- fare by banning smoking in food storage or preparation areas. California outlaws smoking in ice storage areas, while Ok- lahoma prohibits tobacco use in rooms where dairy products are unpacked. Idaho, indiana, and Virginia regulate smoking in food factories and processing, production, and storage areas. California, Illinois, and Massachusetts have organized and selected special committees or commissions to study and report on the health findings and social effects pertaining to smoking and health programs and environmental pollutants. Ohio and Texas legislatures have stressed their support for a Smokefree Young America by the Year 2000. The following is a list of the State laws pertaining to smoking and the use of tobacco and tobacco products according to category. STATE LEGISLATION Alabama * The Comprehensive Health Education Act institutes a health education program, which expressly includes tobacco. Reference Date 1978. ALA. CODE Section 16- 40-7 (Supp. 1984). Regulation of Sale to and Use of Tobacco Products by Minors + Furnishing cigarettes, cigarette tobacco or cigarette paper, or any substitute there of, to minors is prohibited. On conviction, violators are fined not less than $10 or more than $50, and may be imprisoned in county jail or sentenced to hard labor for not more than 30 days. Reference Date 1896. ALA. CODE Section 13A-12-3 (1975). Commerce * Retailers and wholesalers of tobacco products must ob- tain a privilege license. Reference Date 1935. ALA. CODE Sections 40-12-72 and 40-12-73 (1977). * A minor is defined as a person under 19 years of age. Taxation Reference Date 1975. ALA. CODE Section 26-1-1 (1977). * The tax rate per pack is 16.5¢ and was last changed in 1984. The Tobacco Institute, The Tax Burden on Tobac- Schools and School Health Education co: Historical Compilation, 1986, vol. 21, p. 9. * The Drug Abuse Education Act mandates the creation of A portion of the cigarette tax revenue is reallocated for a comprehensive drug abuse education program for stu- dents in grades one to twelve. Tobacco is expressly included. Nonpublic schools must also comply with this Act. The Act provides for the implementation of in-service education programs for teachers, administrators, and other personnel. Reference Date 1969. ALA. CODE Sec- tions 16-41-1 to 16-41-10 (1975). Alaska Limitations on Smoking in Public Places ¢ Smoking is declared a nuisance and a public health hazard. Smoking is prohibited in the following areas: public transportation; elevators; any place operated by the state, including an office, library, museum, theater, concert hall, convention hall, gymnasium, swimming pool, or other place of entertainment or recreation; public and private schools and pre-school or day care facilities; courtroom or jury rooms; places under control of the state while a public meeting is in progress; health care facilities and waiting rooms; food service establishments with seating capacity of at least 50 persons; grocery stores and places of employment where the employer posts a sign prohibiting smoking. Smoking is permitted in smok- ing sections designated by the person in charge of the indoor place or vehicle, cabs where the driver and all 77 the retirement of additional bonds of the State Industrial Development Authority. Reference Date 1904. ALA. CODE Section 40-25-23 (Supp. 1987). passengers consent, and on stage as part of a theatrical production. The person in charge of the indoor place or vehicle must display a “Smoking Prohibited by Law — Maximum Fine $50” sign, which includes the international symbol for no smoking. Where a smoking section has been designated, signs must specify where smoking is allowed and prohibited. A person who smokes in a prohibited area is subject to a civil fine between $10 and $50. A person who is required to and fails to post smoking and nonsmoking signs is subject to a civil fine between $20 and $300. Injunctive relief may also be obtained for repeated violations. Ref- erence Date 1975. ALASKA STAT. Sections 18.35.300 to 18.35.360 (Supp. 1984). Regulation of Sale to and Use of Tobacco Products by Minors * The sale or giving of cigarettes, cigars, or tobacco to one under 16 is prohibited and constitutes a “violation.” Viola- tions are punishable by fine or imprisonment or both. Reference Date 1978. ALASKA STAT. Section 11.76.100; ALASKA STAT. Sections 12.55.015, 12.55.035 (1983). Schools and School Health Education ° Effective October 1, 1985, the health promotion and education programs funded by the 5 mill excise tax on cigarettes are to include promoting the implementation of school health education programs for all grades to en- hance wellness, good nutrition, and physical and mental fitness and to encourage the avoidance of unnecessary health risks, including smoking and the use of alcohol and other drugs. ALASKA STAT. Section 43.50.190 (1985). Commerce * No person may sell, purchase, possess, or acquire cigarettes as a manufacturer, distributor, vending machine operator, or buyer without a license. ALASKA STAT. Section 43.50.010 (1983). Taxation * The tax rate per pack is 16¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * Effective October 1, 1985, the excise tax of 5 mills on each cigarette imported or acquired in the state is to be used principally to fund health care, health research, and health promotion and education programs. Reference Date 1961. ALASKA STAT. Section 43.50. 190(a) (Supp. 1987). Health and Safety Regulations * Throwing a lighted cigarette or other burning material on forest land during fire season is a misdemeanor punish- able by a $25 to $500 fine or by imprisonment of from 10 days to six months or both. Operators of sawmills and public conveyances must post copies of the statutory provisions. Conveyances operated on forest land must have suitable disposal receptacles for burning materials. Reference Date 1961. ALASKA STAT. Sections 41.15.070, 41.15.080, & 41.15.140 (1983). Arizona Limitations on Smoking in Public Places ¢ Smoking is recognized as a nuisance and a danger to public health, and is prohibited in elevators, public recrea- tional facilities, buses, health care institutions, public wait- ing rooms in health professionals’ offices, and in school buildings. Smoking is, however, permitted in designated areas. Violation of this section is a petty offense. Refer- ence Date 1973. ARIZ. REV. STAT. ANN. Section 36- 601.01 (Supp. 1984-1985). It is required for state buildings to post rules designating smoking and nonsmoking areas within buildings and to prohibit smoking in meeting rooms, classrooms, restrooms, waiting areas, and half the area of cafeterias and lounges. It also makes it illegal to smoke in buses, museums, stores, elevators, hospitals, libraries, courtrooms, and 50-seat restaurants. Reference Date 1986, ARIZ. REV. STAT. ANN. Section 36-601.02 (West Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * The sale or furnishing of cigars, cigarettes or cigarette papers, and smoking or chewing tobacco to minors is prohibited. Minors are prohibited from possessing or 78 accepting cigars, cigarettes or cigarette papers, and smoking or chewing tobacco. Violation of this section constitutes a petty offense. Reference Date 1901. ARIZ. REV. STAT. ANN. Section 13-3622 (1978). A minor is defined as a person under 18 years of age. Reference Date 1972. ARIZ. REV. STAT. ANN. Section 8-201 (1974). Schools and School Health Education * Schools are required to educate students about the harm- ful effects of tobacco use. Reference Date 1981. ARIZ. REV. STAT. ANN. Section 15-712 (1984). Commerce * Every person selling tobacco, cigarettes, or cigars must obtain a license from the Department of Revenue. Refer- ence Date 1973. ARIZ. REV. STAT. ANN. Section 42- 1203 (1980). Taxation * The tax rate per pack is 15¢ and was last changed in 4984. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Arkansas Limitations on Smoking In Public Places * Smoking is prohibited in doctors’ or dentists’ waiting rooms, in hospital corridors, nurses’ stations, in hospital rooms other than private patient rooms, in day care centers licensed by the Human Services Department, and on school buses. Smoking is permitted in designated smoking areas. This Act expressly excludes hotels, motels, and restaurants. Violation of this provision con- stitutes a misdemeanor punishable by a $10 to $100 fine. Reference Date 1977. ARK. STAT. ANN. Sections 82- 3701 to 82-3703 (Supp. 1983); ARK. STAT. ANN. Section 83-925 (Supp. 1985). All state agencies are required to take into consideration both nonsmokers and smokers when establishing and implementing a smoking policy for the general office space of each state agency. Reference Date 1987. ARK. CODE OF 1987 ANN. Section 25-1-102 (Supp. 1987). Smoking is prohibited in day care centers licensed by the Division of Social Services, Human Services Department. Reference Date 1985. ARK. CODE OF 1987 ANN. Sec- tion 20-78-217 (1987). Commerce * The Health Department is provided with more regulatory control over quality of tobacco products; penalities for possession of untaxed tobacco products are increased. Reference Date 1977. ARK. CODE OF 1987 ANN. Sec- tions 26-57-202, 26-57-207, 26-57-216, 26-17-218, 26- 57-248 & 26-57-254 (1987). Taxation * The tax rate per pack is 21¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. The enactment of the Tobacco Products Tax Act recog- nizes that “the smoking of cigarettes is detrimental to the health of the smoker.” The legislative intent and purpose of the Act is “to provide for the close supervision and control of the licensing of persons to sell cigarettes in order to assure that cigarettes are fresh and not con- taminated....” Reference Date 1977. ARK. STAT. ANN. Sections 26-57-202, 26-57-216, 26-57-218 & 26-57-254. Smokeless tobacco, snuff, and smoking tobacco are defined as tobacco products and are taxable under 16 Regulation of Sale to and Use of Tobacco Products by percent of the Arkansas Tobacco Products Tax. Refer- Minors * Any adult, other than the parent or guardian, is prohibited from contributing to the delinquency of a minor by furnish- ing tobacco in any form or cigarette papers to anyone under 18 years of age. Violation of this prohibition is a class A misdemeanor. Reference Dates 1975 and 1929. ARK. STAT. ANN. Sections 41-2406 & 41-2465 (1977). Schools and School Health Education * Smoking in public schools is prohibited unless in a desig- nated smoking area provided for non-students over the age of 18 years. Violation is a misdemeanor punishable by a fine of $10 to $100. Reference Date 1987. ARK. CODE OF 1987 ANN. Section 6-21-609 (Supp. 1987). ence Date 1983. ARK. CODE OF 1987 ANN. Sections 26-57-203 & 26-57-208 (Supp. 1987). Every person under the Arkansas Tobacco Products Tax Act is required to pay the excise tax on tobacco products and every wholesaler selling cigarette papers shall pay an excise tax of 25¢ per package of 32 sheets. Reference Date 1983. ARK. CODE OF 1987 ANN. Section 26-57- 801 (Supp. 1987). In cities separated by the state line, the cigarette tax rate imposed is the same as the adjoining city across the Arkansas state line. Reference Date 1983. ARK. CODE OF 1987 ANN. Section 26-57-208 (1987). California Limitations on Smoking in Public Places * A nonsmoking area of not less than 50 percent of pas- senger seats is required on trains, airplanes, and street railroad cars departing from the state. Signs must be posted designating nonsmoking areas. A violation of this section, however, is not a crime. Reference Date 1971. CAL. PUB. UTIL. CODE Section 561 (West Supp. 1985). 79 * Bus drivers are prohibited from smoking on buses in which “young people” ride. Reference Date 1982. CAL. VEH. CODE Section 12523 (West Supp. 1985). * School district officials are required to designate smoking areas for teachers and other school employees who ara prohibited from smoking on school grounds, except in these designated areas. Effective until January 1, 1989. Reference Date 1982. CAL. EDUC. CODE Sections 35176.5 & 35176.6 (West Supp. 1985). Each state department must adopt a policy recognizing the right of nonsmokers to a “smoke-free environment” in formal and informal meetings and in work stations. Ref- erence Date 1982. CAL. GOV'T. CODE Section 19262 (West Supp. 1985). Smoking is prohibited in patient care areas and waiting rooms of clinics, except in designated smoking areas. Smoking is prohibited in patient rooms unless all persons assigned to the room consent. Signs designating smok- ing and nonsmoking areas must be posted except in patient rooms. Smoking in prohibited areas is an infrac- tion punishable by a fine up to $100, Skilled nursing and intermediate care facilities are excluded. Reference Date 1980, CAL. HEALTH & SAFETY CODE Sections 1234, 1235(b), 1286 & 1290 (West Supp. 1985). Smoking is prohibited on public transportation and is punishable by fines up to $50 or 20 hours of community service. Reference Date 1981. CAL. PENAL CODE Sec- tion 640 (West Supp. 1985). The California Indoor Clean Air Act provides that non- smokers are entitled to a smoke-free area in public build- ings during public meetings. Smoking is prohibited during performances in publicly owned buildings, except in the lobby. No such prohibition applies to indoor sporting events. Nonsmoking areas must be provided in res- taurants where capacity is 50 or more if the restaurant is in a publicly owned building. The legislative intent is not to preempt local regulation of smoking. In fact, the statute states that “a local governing body may ban completely the smoking of tobacco.” Smoking is prohibited in retail food production and marketing establishments, except in designated areas. Reference Date 1976. CAL. HEALTH & SAFETY CODE Sections 25940 to 25947 (West 1984). The regulation of smoking in public places is necessary to protect the health, safety, welfare, comfort, and en- vironment of nonsmokers; therefore, smoking of tobacco or any plant product in any vehicle of the public transit system is a misdemeanor. Reference Date 1987. CAL. HEALTH & SAFETY CODE Sections 25948 to 25949.8 (West Supp. 1988). A city or county is permitted to enforce its ordinance regulating the smoking of tobacco in a private residence that is licensed as a child day care facility during hours of operation with respect to those areas of the facility where children are present. Reference Date 1986. CAL. HEALTH & SAFETY CODE Section 1596.795 (West Supp. 1988). Regulation of Sale to and Use of Tobacco Products by Minors + Furnishing tobacco, cigarettes, cigarette papers, of any other preparation of tobacco, or any other smoking instru- ment or paraphernalia to one under 18 years of age is prohibited. Violation of this prohibition constitutes a mis- demeanor. Tobacco dealers and sellers must post a copy of this Act. Failure to post a copy of the Act is punishable 80 by a $10 fine for the first violation, and $50 or up to 30 days in jail for subsequent violations. Reference Date 1891. CAL. PENAL CODE Section 308 (West Supp. 1985). Schools and School Health Education * This section authorizes the selection of instructional materials on the effects of smoking, along with other environmental and health topics. When adapting instruc- tional materials for use in the schools, governing boards shall include only instructional materials that accurately portray the effects on the human system of the use of tobacco. Referdnce Date 1976. CAL. EDUC. CODE Sec- tion 308 (West Supp. 1985). A community college student may be suspended for persistently smoking in prohibited areas. Reference Date 1983. CAL. EDUC. CODE Sections 76030 to 76034 (West Supp. 1985). Apupil may be suspended or recommended for expulsion if the superintendent or principal of the school determines that the pupil has, among others, possessed or used tobacco. This law also repeals the authority of the govern- ing beard of any school district maintaining a high school to adopt rules and regulations permitting the smoking and possession of tobacco on the campus of a high school or while under the authority of the school principal. Refer- ence Date 1983. CAL. EDUC. CODE Section 48901 (West Supp. 1988). Regulation of Advertising Practices * Any person, firm, or corporation engaged in the manutac- . ture or sale of smokeless tobacco products within the state that sponsors or underwrites any professional or amateur sporting event is guilty of a misdemeanor punishable by a fine of $500. Reference Date 1986. CAL. BUS. & PROF. CODE Section 17537.3 (West Supp. 1987). Commerce * Tobacco may not be manufactured at home. Reference Date 1939. CAL. LAB. CODE Section 2651 (West Supp. 1985). * Acigarette distributor must obtain a state license for each place of business at which he or she engages in the business of distributing cigarettes. CAL. REV. & T. CODE Section 30140 (West 1979). * Not more than two percent of the discounts granted to distributors of cigarettes by manufacturers of cigarettes for cash payments may be used to reduce costs. Refer- ence Date 1985. CAL. BUS. & PROF. CODE Section 17026.5 (West Supp. 1987). Taxation ° The tax rate per pack is 10¢ and was last changed in 1967. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol 21. p. 9. * Sales of cigarettes by the original importer to the licensed distributor are exempt from the taxes imposed by the Cigarette Tax Law if they are manufactured outside the United States. Reference Date 1959. CAL. REV. & T. CODE Section 30105 (West Supp. 1988). Health and Safety Regulations * Smoking is prohibited in or around a vehicle carrying explosives. Violation is punishable as a misdemeanor by a fine up to $1,000, six months imprisonment, or both. Reference Date 1959. CAL. VEH. CODE Sections 31614 & 31618 (West Supp. 1985). Smoking is prohibited within a hazardous fire area. Smok- ing is prohibited in national forests, except at times and places designated by U.S. Secretary of Agriculture regulations. Reference Date 1965. CAL. PUB. RES. CODE Sections 4255 & 4331 (West 1984). Smoking is prohibited in ice-storage rooms as a sanitation requirement. A violation is punishable by a fine between $50 and $1,000, six months imprisonment, or both. Ref- erence Date 1953. CAL. HEALTH & SAFETY CODE Sections 4004 & 4009 (West 1979 & Supp. 1985). One who carelessly or negligently throws or places a lighted cigarette on something that may cause a fire is guity of a misdemeanor. Reference Date 1939. CAL. HEALTH & SAFETY CODE Sections 13001 (West 1984). Discarding a lighted or nonlighted cigarette upon any highway, sidewalk, or upon any public or private property is prohibited. Violation is punishable by a mandatery fine of $20 to $40 for the first conviction, $50 to $1,000 for the second conviction, and $100 to $1,000 for subsequent convictions. A second conviction may result in requiring the offender to pick up litter for not less than four hours; the third conviction authorizes not less than eight hours of such work. Reference Date 1939. CAL. HEALTH & SAFETY CODE Section 13002 (West 1984). Restaurant employees are prohibited from smoking where food is prepared or utensils are cleaned or stored. Employers must post "No Smoking” signs in working areas. No penalty is provided under this section. Refer- ence Date 1961. CAL. HEALTH & SAFETY CODE Sec- tion 27605 (West Supp. 1985). A proclamation pursuant to Section 4423.1 shall not be issued preventing smoking on public or private land, unless smoking is specifically banned by proclamation or county ordinance. Smoking is permitted within areas where all flammable vegetation has been cleared to mineral soil, in established public campgrounds, and in motor vehicles. Reference Date 1976. CAL. PUB. RES. CODE Section 4423.4 (West 1984). People in vehicles and pedestrians are prohibited from throwing lighted or unlighted tobacco products onto roads and adjoining areas. Reference Date 1959. CAL. VEH. CODE Section 23111 (West 1971). The State Department of Health Services is requested to appoint a scientific advisory board to conduct a scientific study of the causal relationship of lung injuries, fatal and otherwise, and health problems associated with the smoking of clove cigarettes. Uncodified. Reference Date 1987. Colorado Limitations on Smoking In Public Places * Smoking is declared to be a “matter of public concern,” and is prohibited in the following public places: elevators, hospitals, public buildings, recreational facilities, public transportation vehicles, and schools, except in desig- nated smoking areas. While restaurants, taverns, and commercial establishments are not covered by the statute, the legislature expressly encourages owners of such establishments to designate nonsmoking areas. Those in charge of public places must post notices desig- nating smoking and nonsmoking areas. Private busi- nesses are urged to designate nonsmoking work areas. Statutory provisions may also be adopted as local regula- tions. Reference Date 1977. COLO. REV. STAT. Sec- tions 25-14-101 to 25-14-105 (1982). Regulation of Sale to and Use of Tobacco Products by Minors ¢ Any person who knowingly furnishes any cigarettes or tobacco products toe any person under the age of 18 years 81 shall be fined $25. In addition, any person who sells or offers to sell any smokeless tobacco products by use of a vending machine shall be punished by afine. Reference Date 1987. COLO. REV. STAT. Section 18-13-121 (Supp. 1988). Commerce * It is unlawful for any wholesaler to sell or offer cigarettes for sale without first obtaining a license. Reference Date 1964. COLO. REV. STAT. Section 39-28-102 (1974). Taxation * The tax rate per pack is 20¢ and was last changed in 1986. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. ¢ The time at which the cigarette tax is payable and the penalties imposed for late payment are clarified. Refer- ence Date 1964. COLO. REV. STAT. Section 39-28-105 (Supp. 1988). * Penalties are imposed for failure to file cigarette and tobacco products tax returns when they are due. Refer- ence Date 1986. COLO. REV. STAT. Sections 39-28- 108, 39-28.5-106 & 39-28.5-110 (Supp. 1987). Health and Safety Regulations * Taking cigarettes into a mine is prohibited. Mine operators may search miners if they believe cigarettes are being taken into the mine. Violation of these provisions is a misdemeanor. COLO. REV. STAT. Sections 34-29-103 & 34-29-104 (1984). Connecticut Limitations on Smoking In Public Places * Smoking is prohibited in government-controlled build- ings, while a governmental meeting or public school or college class is in session, public reception or waiting rooms and healthcare facilities, except in posted smoking areas. Notice is to be posted at institution entrances. Patients may request no-smoking rooms. Except in designated areas, smoking is also prohibited in res- taurants with seating capacity for more than 75, except where private social functions are being held, and in passenger elevators where no-smoking notices are posted. Smoking is prohibited in any area of a retail food store open to the general public. Violation of these provisions constitutes an infraction. Restaurants in violation shall have three demerit point items deducted from their rating score under the commis- sioner of health services regulations. Reference Date 1974. CONN. GEN. STAT. ANN. Section 1-21b (West Supp. 1988). Smoking is prohibited in buses, railroad cars, and school buses, unless a special compartment of such vehicle is designated as a smoking area. The maximum fine for violation of this section is $25. This is an infraction that eliminates the necessity of court appearance. Reference Date 1949. CONN. GEN. STAT. ANN. Section 53-198 (1985). Employers of more than 50 people must establish and post written rules regarding smoking in the place of busi- ness. Such rules must designate smoking and nonsmok- ing areas. Reference Date 1987. CONN. GEN. STAT. ANN. Section 31-40q (West Supp. 1988). Schools and School Health Education * The effects of cigarette smoking are to be taught to public school students. Teacher training institutions must pro- vide instruction to teachers about the best methods to educate students concerning the health effects of cigaret- tas. The State Board of Education and the Board of © Governors, in consultation with the Commissioner of Mental Health and the State Alcohol and Drug Abuse Commission, must develop health education programs for elementary and secondary schools and for the training of teachers, administrators, and guidance personnel with reference to the effects of nicotine or tobacco. Reference Date 1977. CONN. GEN. STAT. ANN. Section 10-19 (West Supp. 1985). Prospective teachers must pass an examination on the effects of cigarette smoking before being issued a certifi- - cate to teach in the public schools. Reference Date 1977. CONN. GEN. STAT. ANN. Section 10-145a (West Supp. 1985). Commerce * Every person engaging in the business of selling cigaret- tes in the State of Connecticut as a dealer must secure a license from the Commissioner of Revenue Services. Reference Date 1949. CONN. GEN. STAT. ANN. Section 12-287 (1983). * The Commissioner of Revenue Services may refuse or - revoke a license under certain conditions for distributors under the motor fuels tax, cigarette tax, and alcoholic beverages tax. Reference Date 1984. CONN. GEN. Regulation of Sale to and Use of Tobacco Products by STAT. ANN. Sections 12-286, 12-436 & 12-456 (West - Minors Supp. 1988). « Furnishing tobacco in any form to a person under 16 years of age is prohibited. Violation of this provision is punishable by a fine up to $25 for the first offense, and from $25 to $100 for subsequent offenses. Reference Date 1902. CONN. GEN. STAT. ANN. Section 53-344 (West 1958). Taxation * The tax rate per pack is 26¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. 82 Delaware Limitations on Smoking in Public Places * Smoking on public trolleys and buses is punishable by a fine between $5 and $25. Reference Date 1960. DEL. CODE ANN. Title 11, Section 1326 (1979). Regulation of Sale to and Use of Tobacco Products by Minors ¢ The Family Court has exclusive original criminal jurisdic- tion over matters that include the furnishing of tobacco to a child. Furnishing tobacco in any form to one under 17 years of age, except when furnished by the minor’s parent or guardian, is prohibited. Reference Date 1953. DEL. CODE ANN. Title 10, Section 922(14) (1974) and Title 11, Section 1106 (1979). Regulation of Advertising Practices * Smokeless tobacco products shall not be sold without a product warning label as required by Federal law. Refer- ence Date 1953. DEL. CODE ANN. Title 30, Sections 5301 & 5321 (Supp. 1986). Commerce ¢ No person shall engage in or conduct the business of manufacturing, purchasing, selling, consigning, or dis- tributing tobacco products in the State of Delaware without having first obtained a license. Reference Date 1953. DEL. CODE ANN. Title 30, Section 5307 (1974). Taxation * The tax rate per pack is 14¢ and was last changed in 1971. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. « A tax is imposed on the sale or use of tobacco products other than cigarettes, including smokeless tobacco and cigars at a rate of 15 percent of the wholesale price. Reference Date 1953. DEL. CODE ANN. Title 30, Section 5305 (Supp. 1987). * The definition of “wholesale price’ is clarified to aid in the enforcement of the tobacco products tax. Reference Date 1953. DEL. CODE ANN. Title 30, Sections 5301 & 5305 (Supp. 1986). District of Columbia Limitations on Smoking in Public Places * Inhaling tobacco smoke is declared to be a health hazard, and smoking is prohibited in elevators, selling areas of retail stores (except tobacco shops), public assembly, and hearing rooms owned by the government, schools, public transportation, and health care facilities. “No- smoking” signs are required to be posted. Violations of no-smoking provisions are punishable by a $10 to $50 fine for the first offense, and $50 to $100 for subsequent offenses. Failure to post signs or mutilation of signs is punishable by a $300 fine. On-site inspection and injunc- tive relief are also available enforcement options. Refer- ence Date 1979. D.C. CODE ANN. Sections 6-911 to 6-917 (1981). Smoking is prohibited on public passenger vehicles seat- ing 12 or more. Carriers may refuse to transport violators. Violation is also punishable by a fine of $10 to $50 for the first offense, and by a fine of $50 to $100, up to 10 days imprisonment for subsequent violations, or both. Refer- ence Date 1975. D.C. CODE ANN. Sections 44-223 (b)(1), 44-225 & 44-226 (1981 & Supp. 1985). 83 Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigars, cigarettes, or tobacco in any form to a person under 16 years of age is prohibited. Violators are fined between $2 and $10, or imprisoned for between 5 and 20 days. Reference Date 1891. D.C. CODE ANN. Section 22-1120 (1981). Commerce * No person shall manufacture for sale, keep for sale, sell or offer to sell cigarettes, or display cigarettes for sale in vending machines without first having obtained a license. Reference Date 1949. D.C. CODE ANN. Section 47-2403 (1981). Taxation * The tax rate per pack is 17¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. Florida Limitations on Smoking In Public Places Florida’s Clean Indoor Air Act prohibits smoking in public places or at public meetings except in designated smok- ing areas. This prohibition does not apply in cases in which an entire room or hall is used for a private social function and seating arrangements are under the control of the sponsor of the function and not of the proprietor or person in charge of the room or hall. Public place means the following indoor areas used by the general public: government buildings; restaurants that seat more than 50 persons, except restaurants that designate smoking areas according to customer demand; retail stores, except a retail store where the primary business is the sale of tobacco products; public means of mass transportation and their associated terminals; elevators; hospitals; nursing homes; educational facilities; libraries; courtrooms; jury waiting and delibera- tion rooms; grocery stores; public school buses, museums; theaters; auditoriums; arenas; recreational facilities; and places of employment. Public meeting means all meetings open to the public including meetings of homeowner, condominium or renter or tenant associations unless such meetings are held in a private residence. Reference Date 1986. FLA. STAT. ANN. Section 386.201 (Supp. 1986). Possession of lighted tobacco products on an elevator is prohibited, and constitutes a second degree mis- demeanor. Reference Date 1983. FLA. STAT. ANN. Sec- tion 823.12 (West Supp. 1985). Elevator certificates of operation must contain a prescribed no-smoking provision. Reference Date 1974. FLA. STAT. ANN. Section 399.07(d)(3) (West Supp. 1985). Regulation of Sale to and Use of Tobacco Products by Minors Furnishing cigarettes, cigarette wrappers, or any other tobacco product to minors or compelling them to smoke is prohibited. Violation is punishable as a second degree misdemeanor. Law enforcement officials may compel a minor to testify as to where he or she obtained cigarettes. Reference Date 1985. FLA. STAT. ANN. Sections 859.06 & 859.07 (Supp. 1986). One who furnishes cigarettes to a minor is subject to a fine up to $500 or imprisonment up to 60 days or both. Reference Date 1971. FLA. STAT. ANN. Sections 775.082(4)(b) & 775.083(1)(e) (West 1976 & Supp. 1985). A minor is defined as a person under 18 years of age. Reference Date 1973. FLA. STAT. ANN. Section 743.07 (West Supp. 1985). 84 Schools and School Health Education * The State Instructional Materials Council's duties include evaluation and recommendation of materials for schools about the effects of smoking. When recommending in- structional materials for use in the schools, each council shall include only instructional materials that accurately portray the effects of the use of tobacco on the human system. To be repealed October 1, 1991. Reference Date 1981. FLA. STAT. ANN. Section 233.09(4)(b) (West Supp. 1985). This section authorizes cancer research, recognizes that smoking is a cause of cancer and encourages programs to educate people on the prevention of cancer. Reference Date 1979. FLA. STAT. ANN. Section 381.371(2)(c) (West Supp. 1985). Commerce * No person shall engage in the business of selling or dealing in tobacco products as a distributor in any place of business in Florida without first having received a license to engage in such business. FLA. STAT. ANN. Section 210.35 (West FLA. Session Law Service, Ch, 85-141, 1985). No person shall sell, use, possess, give away, or other- wise dispose of cigarettes, made in whole or in part from, or containing cloves, clove oil, eugenol, or any derivative thereof. FLA. STAT. ANN. Section 859.09 (West FLA. Session Law Service, Ch. 85-151, 1985). The uniform standards for sales, pricing, advertising of, and calculation of cost of cigarettes are defined and penalties for violations are prescribed. Uncodified. West FLA. Session Law Service, Ch. 87-353 (1987). An advisory council shall advise the department on the condition of the tobacco crop. The composition and - method of appointment of members of the advisory coun- cil are defined; exemptions to tobacco producers and handlers are listed. Reference Date 1970. FLA. STAT. ANN. Sections 573.858 to 573.878 (Supp. 1988). Taxation * The tax rate per pack is 24¢ and was last changed in 1986. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. » The rate of tax imposed on cigarettes is increased in an - amount equal to the scheduled reduction in the rate ofthe Federal cigarette tax. Reference Date 1982. FLA. STAT. ANN. Sections 210.02, 210.11 & 210.20 (Supp. 1986). ¢ Taxes are imposed on certain tobacco products; license fees and surety bonds are defined. Reference Date 1985. FLA. STAT. ANN Sections 210.25 to 210.75 (Supp. - 1986). + The cigarette tax rate is revised to eliminate a credit against the tax. It deletes authorization for credit for taxes paid on cigarettes shipped to another state or that are unsalable or have been destroyed. It also revises the distribution of tax proceeds. Reference Date 1982. FLA. STAT. ANN. Sections 210.02, 216.05, 210.20 & 210.55 (Supp. 1986). Health and Safety Regulations * Discarding cigarettes (defined as litter) is prohibited on public roadways, in state waters or on private property without the consent of the owner. Violation constitutes a second degree misdemeanor, and the court may impose additional penalties of picking up litter or other commen- surate labor. Reference Date 1975. FLA. STAT. ANN. Section 403.413 (West Supp. 1985). Discarding lighted smoking materials from a vehicle is prohibited. Willful violation is a third degree felony, and careless violation is a second degree misdemeanor. Penalties may be imposed against both individuals and businesses. Reference Dates 1935 and 1972. FLA. STAT. ANN. Sections 590.10 & 590.14 (West 1962 & Supp. 1985). Georgia Limitations on Smoking in Public Places * As part of the criminal code, smoking is prohibited in public elevators, public transportation, and any other public area designated by a no-smoking sign. This sec- tion is punishable by a fine between $10 and $100. Reference Date 1975. GA. CODE ANN. Section 26-9910 (1983). : Regulation of Sale to and Use of Tobacco Products by Minors * The sale or furnishing of cigarettes or tobacco-related objects to any minor under the age of 17 years is prohibited. The purchase or procurement of such for any minor is also prohibited. Reference Date 1987. GA. CODE ANN. Sections 16-12-170 to 16-12-173 (Supp. 1987). Schools and Schoo! Health Education * A prescribed health education course of study in the schools may include cigarette abuse instruction. The State Superintendent of Schools is responsible for the preparation or approval of a manual detailing the course of study. Reference Date 1971. GA. CODE ANN. Section 32-1901 (Supp. 1984). Commerce * No person shall engage in the business of manufacturing, purchasing, selling, consigning, vending, dealing in, or distributing cigars or cigarettes without a license. Refer- ence Date 1955. GA. CODE ANN. Section 48-11-2 (Supp. 1987). * The U.S. Congress is urged to enact legislation that permits tobacco growers to purchase poundage allot- ments from flue-cured owners in their tobacco belt. Un- codified. Reference Date 1987. Taxation * The tax rate per pack is 12¢ and was last changed in 1971. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The rate of taxation on cigars is changed from 15 to 13 percent of the wholesale price. Reference Date 1955. GA. CODE ANN. Section 48-11-2 (Supp. 1987). Health and Safety Regulations © Itis unlawful to start a fire by discarding a lighted cigarette. Violation is punishable as a misdemeanor. Reference Date 1971. GA. CODE ANN. Sections 26-9926a & 26- 9927a (1983). Hawaii Limitations on Smoking In Public Places * Smoking is prohibited in state operated enclosed meeting rooms, elevators, enclosed arenas, and enclosed com- munity centers. Maximum penalty is $100. Other enfor- cement provision includes ejection from the no-smoking area of anyone issued a citation or summons who con- 85 tinues to smoke. Reference Date 1976. HAWAII REV. STAT. Sections 321-201 to 321-206 (1976 & Supp. 1984). * Smoking is prohibited in certain public places, including, but not limited to, certain areas of public and private health care facilities, restaurants, theaters, museums, libraries, galleries, state- or county-owned buildings, and other areas open to the public. Reference Date 1987. HAWAII REV. STAT. Sections 328K-6 & 328K-125 (Supp. 1987). * Each employer who operates an office or offices in the state is required to adopt, implement, and maintain a written smoking policy in the workplace. Reference Date 1987. HAWAII REV. STAT. Sections 328K-11 to 328K-16 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing tobacco in any shape or form to a person under 15 years of age is prohibited and is punishable by a fine up to $100. Tobacco dealers forfeit their license after a second offense. Reference Date 1890. HAWAII REV. STAT. Sections 445-212 & 445-213 (1976). * The age at which a person may purchase tobacco products is increased from 15 years to 18 years of age. Reference Date 1890. HAWAII REV. STAT. Sections 445-212, 445-212.5 & 445-213 (Supp. 1987). Commerce * It is unlawful for any wholesaler or dealer to sell or use tobacco products in Hawaii without having first received a license issued by the Department of Taxation. Refer- ence Date 1939. HAWAI REV. STAT. Section 245-2 (1976). Taxation * The tax rate per pack is 30¢ as the rate is 40 percent of the wholesale price. This was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. Idaho Limitations on Smoking In Public Places * Smoking is prohibited in public places and at public meetings except in designated smoking areas. Public place is defined as any enclosed indoor area used by the public including, but not limited to, restaurants with a seating capacity of 30 or more, retail stores, grocery stores, end stores that sell food primarily for off-site consumption, public conveyances, educational facilities, hospitals, nursing homes, auditoriums, arenas, and meet- ing rooms. Smoking is also prohibited in elevators. Viola- tion is punishable by a fine not to exceed $50. Reference Date 1985. IDAHO CODE Sections 39-5501 to 39-5509 (1985). Smoking is prohibited in public buildings controlled by governmental agencies while public meetings are in progress, except in designated smoking areas. Violation is punishable by a fine between $5 and $10. No-smoking signs are to be displayed. Reference Date 1975. IDAHO CODE Sections 18-5904 to 18-5906 (Supp. 1985). Smoking is not allowed in restaurants, except in restrooms or by members of the public in the dining rooms. Notices forbidding tobacco use, except as provided, are to be posted. Violation is punishable by a fine between $10 and $100, six months imprisonment, or both. Reference Date 1925. IDAHO CODE Sections 39- 1612 & 39-1613 (1977). Smoking of tobacco or other products in or upon any bus, except a charter, is prohibited and punishable by a fine. Reference Date 1987. IDAHO CODE Section 39-5510 (Supp. 1987). 86 Regulation of Sale to and Use of Tobacco Products by Minors - A person under 18 years of age who possesses cigars, cigarettes, or tobacco in any form, or cigarette papers, or a person who furnished cigars, cigarettes, or tobacco in any form, or cigarette papers to anyone under 18 years, is guilty of a misdemeanor. The person furnishing tobacco is fined from $50 to $100 for the first offense, and $300 or up to six months in jail for the second offense. Refer- ence Date 1981. IDAHO CODE Section 18-1502A (Supp. 1985). Making tobacco vending machines accessible to minors under 18 years, or otherwise making tobacco available to minors is punishable as a misdemeanor. Also, any person violating this provision is deemed guilty of keeping and maintaining a nuisance; abatement and injuncture relief may be obtained. Reference Date 1972. IDAHO CODE Sections 18-1503 & 18-1504 (1977). Schools and School Health Education * Public school education should include instruction on the effects of smoking. The State Board of Education is responsible for preparation of study guides and materials. Reference Date 1963. IDAHO CODE Section 33-1605 (1981). Commerce * Retailers, wholesalers, and vending machine operators - who purchase, sell, offer for sale, distribute, or store cigarettes must receive a license or permit from the state tax commission. Reference Date 1974. IDAHO CODE Sections 63-2501 to 63-2503 (Supp. 1987). Taxation * The tax rate per pack is 18¢ and was last changed in 1987. The Tobacco Institute, "Cigarette Tax Data,” 1987. * The rate of the cigarette tax is increased by 89/200 of 1¢ for each cigarette. The distribution of the cigarette tax revenues is provided. Reference Date 1974. IDAHO CODE Sections 63-2506, 63-2520 & 63-2522 (Supp. 1987). * Part of the revenue collected by the cigarette tax goes to a Cancer Control Account created by Section 57-1702. Reference Date 1974. IDAHO CODE Section 63- 2520(b)(4) (Supp. 1985). * The Cancer Control Account is to promote cancer control through research, screening, and treatment. Reference Date 1979. IDAHO CODE Section 57.1702 (Supp. 1985). Health and Safety Regulations * Smoking is prohibited in food products factories. Violation is punishable by fines between $25 and $500, six months imprisonment, or both. Reference Date 1921. IDAHO CODE Sections 37-2006 & 37-2008 (1977). * Discarding lighted cigarettes from a vehicle or in an area where a fire may be caused is prohibited. Violation is a misdemeanor. Reference Date 1972. IDAHO CODE Sec- tion 18-7005 (1977). « Discarding lighted tobacco in a forest or range land during the closed season is prohibited. Violation is a petty mis- demeanor. Reference Date 1972. IDAHO CODE Section 38-117 (1977). Ilinois Regulation of Sale to and Use of Tobacco Products by Minors ¢ The purpose of the Tobacco Accessories and Smoking Herbs Control Act is to control sale and possession of tobacco and illegal drugs because of their potential health hazard. Furnishing a person under 18 years of age with “tobacco accessories” or "smoking herbs” is prohibited. A warning to minors must be posted where tobacco acces- sories and smoking herbs are sold. Violation is aclass C misdemeanor. Minors use of a false identification to obtain prohibited items is also a violation. Reference Date 1982. ILL. REV. STAT. Ch. 23, Paragraphs 2358-1 to 2358-5 (1983). Persons under 18 years of age are prohibited from buying cigars, cigarettes, or tobacco in any form unless upon the written order of the minor’s parent or guardian. Furnishing cigars, cigarettes, or tobacco in any form to one under 18 years is prohibited unless upon the written order of the minor's parent or guardian or unless sold in the presence of such parent or guardian. One who violates this section is subject to a fine up to $50 for the first offense and up to $100 for subsequent offenses. Reference Date 1887. ILL. REV. STAT. Ch. 23, Paragraphs 2357 & 2358 (West Supp. 1987). The Smokeless Tobacco Limitation Act prohibits the dis- tribution of sample cigarettes or smokeless tobacco to persons under the age of 18 years. Reference Date 1887. ILL. REV. STAT. Ch. 23, Paragraphs 2358-1 to 2358-5 (West Supp. 1987). 87 Schools and School Health Education * The health education program in schools is to include instruction about tobacco use. Reference Date 1971. ILL. REV. STAT. Ch. 122, Paragraph 863 (1983). Regulation of Advertising Practices ¢ Outdoor billboard advertisements for smokeless tobacco are required to bear one of three health warning state- ments. Reference Date 1987. ILL. REV. STAT. Ch. 23, Paragraphs 2358-1 & 2358-2 (West Supp. 1987). Commerce * Distributors of cigarettes in the State of Illinois must be licansed. ILL. REV. STAT. Ch. 120, Section 453.4 (1970). Taxation * The tax rate per pack is 20¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p.9. Health and Safety Regulations * Smoking is prohibited in gassy and underground mines, and in or near any magazine. Reference Date 1953. ILL. REV. STAT. Ch. 96-1/2, Paragraphs 1302, 2003, 2105, 2107, & 3115 (1983). * Various organizations are requested to report on the findings and evaluations of the smoking programs within the State of Illinois. Uncodified. Reference Date 1987. * Smoking is prohibited in stores that sell fireworks and in fireworks factories. ILL. REV. STAT. Ch. 127-1/2, Para- graphs 109 & 113 (1983). Indiana Limitations on Smoking In Publie Places ¢ Indiana's Clean Indoor Air Act prohibits smoking in public places or at public meetings, except in designated smok- ing areas. Violation is a Class C infraction. Reference Date 1987. IND. CODE ANN. Sections 13-1-13-1 to 13-1-13-9 (1987). Regulation of Sale to and Use of Tobacco Products by Minors * The sale of tobacco to one under 16 years of age is prohibited. Knowledge of the violation is a Class C infrac- tion, and it is no defense that the minor did not smoke the tobacco. Reference Date 1980. IND. CODE ANN. Sec- tion 35-46-1-10 (West Supp. 1985-1986). * Persons in control of vending machines are required to post signs stating that those under 16 years of age are forbidden to buy cigarettes. Failure to post notice is a Class C infraction. Reference Date 1983. IND. CODE ANN. Section 35-46-1-11 (West Supp. 1985-1986). * The sale and delivery of tobacco to persons under 18 years of age is prohibited. Violation is a Class C infraction. Tobacco vending machines must post notice of the prohibition. Reference Date 1987. IND. CODE ANN. Sec- tions 34-4-38-1 to 34-4-38-3 (West Supp. 1987). Schools and School Health Education * Governing bodies and county superintendents shall in- clude instruction in the nature and effects of tobacco to students in grades four to eight. The State Board of Education must include a separate course on the effects of enumerated drugs, including tobacco, for high school students. Willful refusal to provide the instruction is grounds for dismissal. Reference Date 1975. IND. CODE ANN. Section 20-10.1-4-9 (West 1984). Commerce * Employment of one under 17 years of age to manufacture or pack tobacco is prohibited unless an exemption is granted. In an action for damages for personal injuries by one under 17 years of age based on his or her tobacco related employment, strict liability is applicable. Reckless violation is a Class C misdemeanor. Reference Date 1973. IND. CODE ANN. Sections 20-8.1-4-24, 20-8.1-4- 28 & 20-8.1-4-31 (West 1984). Cigarette distributors must obtain registration certificates - from the Department of State Revenue. Reference Date 1947. IND. CODE ANN. Section 6-7-1-16 (1984). Taxation * The tax rate per pack is 15.5¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. « A tax is imposed on the distribution of tobacco products other than cigarettes at the rate of 25 percent of the - wholesale price. Reference Date 1987. IND. CODE ANN. Sections 6-7-2-2 to 6-7-2-4 (West Supp. 1987). Health and Safety Regulations * Tobacco use is prohibited where food is processed or stored. Reference Date 1949. IND. CODE ANN. Section 16-1-22-21 (West 1984}. Smoking is prohibited in or near a vehicle carrying ex- plosives and in explosives plants except in designated - areas. Violation is a Class C misdemeanor unless the state fire marshal has demanded compliance in writing; violation is then a Class A misdemeanor. Reference Date 1969. IND. CODE ANN. Sections 22-11-13-16, 22-11-13- 20, & 22-11-13-28 (West 1981). lowa Limitations on Smoking in Public Places * Smoking is prohibited in indoor theaters, libraries, art museums, concert halls, auditoriums, or similar facilities that are open to the public (except in designated smoking areas and food consumption areas), elevators, nonsmok- ing areas of public transportation, health care facilities and patient rooms (except in designated smoking sec- tions), and in nonsmoking areas of public buildings. Signs must be posted designating nonsmoking areas. A violator of this Act must pay a civil fine of $50 for each violation. Reference Date 1939. IOWA CODE ANN. Sections 98.1 to 98A.6 & 805.8 (West Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors « Furnishing cigarettes or cigarette papers or tobacco in any form, including the sale or gift of smokeless tobacco, to a person under 18 years of age is prohibited, unless there is a written authorization from the minor's parent or guardian. A first violation is a “simple“ misdemeanor and subsequent violation is a “serious” misdemeanor. Refer- ence Date 1939. IOWA CODE ANN. Sections 98.2, 98.4 & 98.5 (West Supp. 1988). Minors under 18 years of age possessing cigarettes or cigarette papers anywhere except at home are required to tell where the cigarettes were obtained. Refusal to comply is a misdemeanor. Reference Date 1909. IOWA CODE ANN. Sections 98.4 and 98.5 (West 1984). Schools and School Health Education * In order for a district to be on an approved list, the effects of tobacco must be taught in both the elementary and secondary schools. The State Board of Public Instruction is responsible for enforcement. Reference Date 1975. IOWA CODE ANN. Section 257.25 (West Supp. 1985). * Astudent may be suspended or expelled for tobacco use at school. Reference Date 1965. IOWA CODE ANN, Section 279.9 (West Supp. 1985). * Area vocational schools and community colleges are not required to prohibit tobacco use. Reference Date 1965. IOWA CODE ANN. Section 280A.23(3) (West Supp. 1985). Taxation * The tax rate per pack is 26¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * Tobacco tax assessment periods, penalties and appeal periods, and filing of sales and services tax refund claims are defined. Reference Date 1967. IOWA CODE ANN. Section 98.45 (West Supp. 1988). ¢ The rate of the cigarette and little cigar and tobacco products taxes are specified. Reference Date 1971. JOWA CODE ANN. Section 135C.23 (West Supp. 1987). Health and Safety Regulations * The authority to prevent, abate, and contro! air pollution is delegated. Reference Date 1972. Section 455.B145 (West Supp. 1987). Kansas Limitations on Smoking In Public Places * Smoking is prohibited where no-smoking signs are posted in public meeting rooms, elevators, indoor theaters, libraries, art museums, concert halls, health care facility waiting rooms, and public buses. Violation is punishable by a fine up to $25. Reference Date 1975. KAN. STAT. ANN. Section 21-4008 (1981). Smoking is prohibited in public places including, but not limited to, restaurants, retail stores, educational facilities, courtrooms, and state, county, or municipal buildings. The use of tobacco products in health care institutions or any place where health care services are provided to the public is also prohibited. Repeals 21-4008. Reference Date 1987. KAN. STAT. ANN. Sections 21-4009 to 21- 4014 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * This taxation act provides that selling cigarettes to a person under 18 years of age is prohibited. It is also a 89 violation for one under 18 years of age to buy cigarettes. Maximum penalty for a violation is a fine up to $1,000 or up to one year imprisonment or both. Distribution of sample cigarettes to minors under 18 years of age is punishable by a fine of $500 to $2,500 or up to one year in prison or both. Reference Date 1933. KAN. STAT. ANN. Sections 79-3321 and 79-3322 (1984). Commerce * Each person engaged in the business of selling cigarettes in the State of Kansas must secure a license from the division of taxation. Reference Date 1933. KAN. STAT. ANN. Section 79-3304 to 79-3306 (Supp. 1987). Taxation * The tax rate per pack is 24¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Kentucky Limitations on Smoking In Public Places ¢ Smoking is prohibited on school grounds, except by adult employees in designated smoking rooms. This exception, however, applies only to counties in which there is a first or second class city or urban county government. Viola- tion is punishable by a fine between $1 and $5. Reference Date 1972. KY. REV. STAT. Section 438.050 (1985). Regulation of Sale to and Use of Tobacco Products by Minors * The law prohibiting cigarette smoking by minors under 18 years of age was repealed effective January 1, 1975. Reference Date 1974. KY. REV. STAT. Sections 438.020 to 438.040 (1985). Commerce * No person other than a manufacturer shall acquire cigarettes in Kentucky on which the state cigarette tax has not been paid, nor act as a wholesaler, vending machine operator, subjobber, transporter, or unclassified acquirer of such cigarettes without first obtaining a license from the Department of Revenue. Reference Date 1982. KY. REV. STAT. Section 138.195 (1983). * The Kentucky Tobacco Task Force has been reauthorized to help resolve the problems facing the tobacco program. Uncodified. House Res. 20 (1986). Taxation * The tax rate per pack is 3¢ and was last changed in 1970. The Tobacco Institute, The Tax Burden on Tobacco: Historical Compilation, 1986, vol. 21, p. 9. * These provisions create a Tobacco Research Trust Fund. Funding is provided by levying a tax on cigarettes, to be combined with available Federal funding. Funds ap- propriated for the Research Trust Fund go to the Univer- sity of Kentucky Tobacco and Health Research Institute and are to be applied exclusively to projects and programs “directed toward improvements in the tobacco industry, and more specifically toward proving or disprov- ing questions of health hazards to tobacco users...” Section 248.520(5). A Tobacco Research Board, com- prised of 14 members, is to authorize and review the research projects, and is to make yearly reports. Refer- ence Date 1978. KY. REV. STAT. Sections 248.510 to 248.570 (Supp. 1984). Health and Safety Regulations * Disposing of lighted tobacco products is prohibited in or near forests. Smoking in forests during an emergency period of fire danger is prohibited. Reference Date 1964. KY. REV. STAT. Section 149.370 (1980). * Taking cigarettes into a mine is prohibited. The mine operator is to make frequent searches to prevent carrying __ in or using such articles as cigarettes. Reference Date 1952. KY. REV. STAT. Section 352.1 70(3) (1983). Louisiana Limitations on Smoking in Public Places * Smoking is allowed in all areas of the Louisiana Super- dome except in the arena. Violators shall be advised of the prohibition by Superdome personnel. Reference Date 1987. LA. REV. STAT. ANN. Section 40:1299.131 (West Supp. 1988). Schools and School Health Education * A student may be suspended for smoking on school property or buses. Reference Date 1922. LA. REV. STAT. ANN. Section 17:416(A)(1)(a)(vi) (West Supp. 1985). Commerce * Every person who sells at wholesale or by vending machine, who is about to engage in the business of receiving unstamped or non-tax paid cigarettes, cigars, and smoking tobacco or who is engaged in the business of receiving stamped cigarettes at wholesale must obtain 90 a permit from the collector of revenue. Reference Date 1974. LA. REV. STAT. ANN. Section 47:844 & 47:846 (West Supp. 1988). * Wholesale dealers may present manufacturer's affidavits on returned damaged merchandise at the time of pur- chase of tobacco stamps as payment for the stamps. Reference Date 1970. LA. REV. STAT. ANN. Section 47:843 (West Supp. 19988). * Provisions regarding ownership of vehicles involved in the transportation of tobacco products and the prescribed taxation procedures are defined. Reference Date 1985. LA. REV. STAT. ANN. Section 47:863 (West Supp. 1988). « The minimum amount of bond that tobacco dealers are required to furnish is increased from $1,000 to $10,000. Reference Date 1974. LA. REV. STAT. ANN. Section 47:848 (West Supp. 1988). Taxation * The tax rate per pack is 16¢ and was last changed in 1984. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * One million dollars annually from the tax levied on cigaret- tes goes to the Cancer and Lung Trust Fund. Reference Date 1980. LA. REV. STAT. ANN. Section 47:869 (West Supp. 1985). Health and Safety Regulations * Discarding a cigarette that causes a fire on another's land constitutes criminal negligence, Penalty for violation is a fine up to $300 or imprisonment for up to 30 days or both. Reference Date 1944, LA. REV. STAT. ANN. Section 14:204(3) (West 1974). This section establishes the Cancer and Lung Trust Fund, which is funded by the $1,000,000 in revenue derived from the cigarette tax. The monies in the fund are used solely for-“cancer research and research on cardio-pul- monary disease and clinical investigation and training in the field of cancer and cardio-pulmonary diseases.” The fund is administered by the Department of Health and Human Resources. Reference Date 1980. LA. REV. STAT. ANN. Section 40:1299.88 (West Supp. 1985). Maine Limitations on Smoking in Public Places * Smoking is prohibited in any public area of any publicly owned building and at indoor public meetings where no-smoking signs are posted, except where all members present consent. No penalty is provided. Reference Date 1981. ME. REV. STAT. ANN. Title 22, Section 1578-A (West Supp. 1987). * Smoking is prohibited in nursing homes, except in desig- nated smoking areas. Reference Date 1983. ME. REV. STAT. ANN. Title 22, Section 1825 (Supp. 1984). * Smoking is prohibited in jury rooms, unless all members consent. No penalty is provided. Reference Date 1983. ME. REV. STAT. ANN. Title 22, Section 1580 (Supp. 1984), * Smoking is prohibited in all sections of retail stores whose total area open to the public exceeds 4,000 square feet. No-smoking signs are required to be posted. Violation is punishable by a fine of not more than $50. ME. REV. STAT. ANN. Title 22, Sections 269-A & 1681 to 1684 (1987). + Every employer must establish, or may negotiate through the collective bargaining process, a written policy con- cerning smoking and nonsmoking by employees. In order to protect the employer and employees from the detrimental effects of smoking by others, the policy shall prohibit smoking except in designated areas. Failure to establish, post or supervise the implementation of a policy is a civil violation punishable by a fine of not more than $100. ME. REV. STAT. ANN. Title 22, Section 580-A (1985). * As a fire prevention measure, smoking is prohibited in mills, public buses, factories, machine shops, shipyards, 91 covered bridges, stables "or other buildings” where a no-smoking sign is posted. One who smokes in a prohibited area is fined $5, and one who destroys a no-smoking sign is fined $10. Reference Date 1954. ME. REV. STAT. ANN. Title 25, Section 2433 (1974). Restaurants are required to establish no-smoking areas and to post a sign indicating the smoking policy. ME. REV. STAT. ANN. Title 22, Section 1579-A (West Supp. 1987). The “Workplace Smoking Act of 1985” requires employers to establish, post, and enforce a written policy concerning smoking and nonsmoking by employees in that portion of the facility for which they are responsible. ME. REV. STAT. ANN. Title 22, Section 1580-A (West Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors « Furnishing cigarettes or tobacco to one under 18 years of age is prohibited. A violator of this section is fined be- tween $20 and $50 for each violation. Reference Date 1983. ME. REV. STAT. ANN. Title 22, Section 1579 (Supp. 1984). * The sale of cigarettes in vanding machines not super- vised by an adult is prohibited, except when located in areas where minors are not allowed by law. ME. REV. STAT. ANN. Title 22, Section 1628 (West Supp. 1987). Commerce * Each person engaging in the business of selling cigaret- tes in Maine must secure a license from the Tax Asses- sor. Reference Date 1954. ME. REV. STAT. ANN. Title 36, Section 4362 (1978). Taxation The tax rate per pack is 28¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Certain changes have been made in the Maine tax law. All cigarettes sold are subject to a scheduled increase. Reference Date 1975. ME. REV. STAT. ANN. Title 36, Sections 111 to 5255-B (West Supp. 1987). This law relates to the taxation of tobacco products. Reference Date 1969. ME. REV. STAT. ANN. Title 36, Section 5224-A (West Supp. 1987). Health and Safety Regulations * Discarding a lighted cigarette from a moving vehicle oron forest, brush, grass or other lands is prohibited. Violations are punishable by a fine from $10 to $50. Reference Date 1979. ME. REV. STAT. ANN. Title 12, Sections 9324(3) and 9701 (1981). * Discarding burning cigarettes and cigars from railroad equipment is prohibited. No penalty is provided. Refer- ence Date 1954. ME. REV. STAT. ANN. Title 12, Section 9406 (1981). Maryland Limitations on Smoking In Public Places Directors of hospitals, nursing homes, health clinics, and physicians’ offices are required to establish and imple- ment a plan to protect the health of nonsmoking patients by regulating smoking on the premises. No penalty is provided. Reference Date 1957. MD. HEALTH ANDENV. CODE ANN. Section 11-205 (1982). Smoking or carrying lighted tobacco products is prohibited in a public mass transit bus, railcar, or transit station. Maximum penalty is $250 for each offense. Ref- erence Date 1957. MD. TRANSP. CODE ANN. Section 7-705 (Supp. 1984). Smoking is prohibited in any intrastate motor bus carrier. Maximum fine is $25. Reference Date 1975. MD. ANN. CODE Article 78, Section 35A (1980). Smoking is prohibited on public elevators. No-smoking signs must be posted. Maximum fine is $25. Reference Date 1975. MD. ANN. CODE Article 89, Section 64 (1979). The Washington County Commissioners are authorized to enact ordinances regulating smoking in county offices and county office buildings. Reference Date 1987. MD. ANN. CODE Article 25, Section 236B (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors One who is in the business of manufacturing or selling cigars, cigarettes, smoking or smokeless tobacco products is prohibited from selling cigarettes to one under 16 years of age, unless the individual is an agent of his employer or has prior written consent of his parents. It is also unlawful for any person who is not a dealer to purchase cigars, cigarettes, smoking or smokeless tobacco for an individual. A violator of this section is fined between $10 and $100 for each offense, or imprisoned 92 between five and 30 days if the fine is not paid. Reference Date 1888. MD. ANN. CODE Article 27, Sections 404 & 405 (1985). » Adealer, vendor, or other person may not sell, barter, or give any smokeless tobacco products to an individual under 16 years of age; subject to penalties. Reference Date 1951. MD. ANN. CODE Article 27, Sections 404 & 405 (1988). Commerce .» A license is required to manufacture cigars or cigarettes. A residence may not be used to manufacture cigarettes or cigars except by the immediate family members. Viola- tion of these provisions brings a fine between $5 and $100, or imprisonment between 10 days and one year or both. Reference Dates 1884 and 1904. MD. ANN. CODE _ Article 27, Sections 327, 330 & 333 (1982). The position of Inspector of Tobacco has been repealed from the Maryland Department of Agriculture and certain provisions for the State Tobacco Warehouse. Reference Date 1957. MD. ANN. CODE AGRIC. Article Sections 7-101, 7-301, 7-326R, 7-402, 7-404 & 7-413R (Supp. 1987). Daily reports from leaf tobacco sellers are required after each sales day during the auction season. Reference Date 1957. MD. ANN. CODE AGRIC. Article Sections 7-403 & 7-411 (Supp. 1987). The bond requirement for persons who weigh leaf tobac- co for a commission selling agency has been repealed. Reference Date 1957. MD. ANN. CODE AGRIC. Article Section 7-209 (Supp. 1987). The sale or offer for sale of clove cigarettes in the state is prohibited. Violation is a misdemeanor subject to a $500 fine. Reference Date 1986, MD. ANN. CODE Article - 27, Section 40A (1988). * The State Tobacco Authority is authorized to impose a penalty on an auction warehouse that oversells its daily quota. Reference Date 1957. MD. ANN. CODE AGRIC. Article Section 7-207 (Supp. 1987). Taxation * The tax rate per pack is 13¢ and was last changed in 1980. The Tobacco Institute, The Tax Burden on Tobac- co. Historical Compilation, 1986, vol. 21, p. 9. * The most recent population figures are required to be used in the computation of tobacco tax revenue distribu- tion. Reference Date 1958. MD. ANN. CODE Article 81, Section 460 (Supp. 1987). * The Maryland Acquired immune Deficiency Syndrome (AIDS) Research and Information Fund supported with, in addition, the taxes on cigarettes to conduct or finance research has been repealed. MD. ANN. CODE Health- General Section 18-333 (1987). ¢ This law imposes a specified tax of 6 1/2 mills per cigarette on sample cigarette packages and alters, after modification in the Federal tax, the applicablity of the supplemental state tax on cigarettes. Reference Date 1958. MD. ANN. CODE Article 81, Section 432, 433 & 460 (Supp. 1987). Health and Safety Regulations * Smoking is prohibited in mines. Reference Date 1957, MD. NAT. RES. CODE ANN. Section 7-404(e) (1983). * Smoking is prohibited in fireworks plants, unless in a designated smoking area. Reference Date 1955. MD. ANN. CODE Article 38A, Section 23 (1982). Massachusetts Limitations on Smoking in Public Places * Smoking is prohibited in public elevators, supermarkets, and Massachusetts Bay Transportation Authority mass transit vehicles. Smoking is restricted to designated areas in museums, libraries, health care facilities, and mass transit conveyances. The person in control of these facilities must post no-smoking notices. Reference Date 1947. MASS. GEN. LAWS ANN. Chapter 272, Section 43A (West Supp. 1985). A separate provision prohibiting smoking in public con- veyances and transportation facilities provides for a fine up to $50 or up to 10 days in jail, or both for violation. Reference Date 1947. MASS. GEN. LAWS ANN. Chapter 272, Section 43 (West 1970). The fine for violation of smoking in public conveyances is increased from $50 to $100. Reference Date 1947. MASS. GEN. LAWS ANN. Chapter 272, Section 43A (West Supp. 1987). Smoking is prohibited in buildings used for stabling hor- ses. Maximum penalty is a $200 fine, one month im- prisonment, or both. After an order of compliance is issued, noncompliance is punished by a fine of up to $10 per day. Reference Date 1924, MASS. GEN. LAWS ANN. Chapter 272, Sections 86C, 86E, & 86F (West 1970). This law protects the public health by prohibiting smoking in jury rooms. Reference Date 1986. MASS. GEN. LAWS ANN. Chapter 234, Section 34C (West Supp. 1987). 93 Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigarettes, chewing tobacco, snuff, or tobacco in any of its forms to one under 18 years of age is prohibited, unless by a parent or guardian. This is punish- able by a fine of not less than $100 for the first offense, not less than $200 for second offense, and not less than $300 for third or subsequent offense. Vending machines must have a notice posted prohibiting minors’ use. One who violates this section is punishable by a fine up to $50. Reference Date 1985. MASS. GEN. LAWS ANN. Chapter 270, Section 6 (West Supp. 1987). Schools and School Health Education * Schools are required to provide education about the effects of tobacco. Reference Date 1974. MASS. GEN. LAWS ANN. Chapter 71, Section 1 (West 1982). * The use of tobacco in public schools during normal school hours is prohibited. Reference Date 1987. MASS GEN. LAWS ANN. Chapter 71, Section 2A (West Supp. 1988). Commerce * It is unlawtul to employ one under 16 years of age to manufacture or pack tobacco. Reference Date 1887. MASS. GEN. LAWS ANN. Chapter 149, Section 61(21) (West 1982). * Manufacturing tobacco in one’s home constitutes unlaw- ful industrial homework. Reference Date 1937. MASS. GEN. LAWS ANN. Chapter 149, Section 144 (West 1982). imprisonment up to 30 days. Reference Date 1930. MASS. GEN. LAWS ANN. Chapter 148, Section 54 (West * No parson shall sell cigarettes or act as a manufacturer, 1985). wholesaler, vending machine operator, unclassified ac- quirer, transporter, or retailer of cigarettes in Mas- sachusetts unless licensed to do so. Reference Date 1945, MASS. GEN. LAWS ANN. Chapter 64C, Section 2 (1978). « Whoever sells exploding cigars or cigarettes is subject to a fine up to $100. Reference Date 1967. MASS. GEN. LAWS ANN. Chapter 148, Section 52A (West Supp. 1985). Taxation « One who sells adulturated smoking products is subject to a fine between $200 and $500, or imprisonment up to six months. Reference Date 1958. MASS. GEN. LAWS ANN. Chapter 94, Section 307 (West 1984). * The tax rate per pack is 26¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The membership of the Special Commission to inves- tigate, study, and report on the health effects of indoor air pollution has been increased. MASS. Resolve of 1987. Ch. 2 (1987). Health and Safety Regulations ° Discarding lighted cigarettes and cigars from vehicles on aroad near forest lands or open fields, or upon forest land Michigan Regulation of Sale to and Use of Tobacco Products by Minors Limitations on Smoking In Public Places * Smoking on a school bus within one hour of pupils’ use is prohibited. Maximum penalty is a fine up to $100, or - of the bus is prohibited. Reference Date 1981. MICH. COMP. LAWS ANN. Section 257.316a (Supp. 1985). Smoking is prohibited in retail food establishments, ex- cept in designated areas. No-smoking signs must be posted at entrances. Maximum penalty is a $100 fine. Reference Date 1968. MICH. COMP. LAWS ANN. Sec- tion 289.707a (1984). Food service establishments with a seating capacity of 50 or more people are required to post notices and designate areas for nonsmokers. The area is not to exceed 50 percent of the establishment. Reference Date 1978. MICH. COMP. LAWS ANN. Section 333.12905 (West Supp. 1987). Nursing homes must adopt a policy regulating smoking to provide patients with no-smoking rooms, designated smoking areas, and prohibit tobacco sales except as provided for by owners. Notices must be posted for smoking and nonsmoking areas. Reference Date 1978. MICH. COMP. LAWS ANN. Sections 333.21333 and 333.21733 (1980). Smoking is prohibited in all passenger elevators and violation is punishable by a fine of $50 or 90 days im- prisonment. Signs must be posted in elevators containing the prohibition and penalty. Reference Date 1967. MICH. COMP. LAWS ANN. Section 408.820 (1985). Smoking is prohibited in public places and at meetings of public bodies, except in designated smoking areas. Ref- erence Date 1978. MICH. COMP. LAWS. ANN. Sections 333.12601 to 333.12617 (West Supp. 1987). * Furnishing cigarettes to one under 18 years of age is punishable by a fine up to $50 or up to 30 days imprison- ment for each offense. A person under 18 years of age who smokes cigarettes in public is subject to a fine up to $10 or imprisonment up to five days. One who allows a person under 18 years of age to enter upon his land to smoke cigarettes is subject to a fine up to $50 or imprison- ment up to 30 days. However, a parent or guardian is not in violation of this section if the smoking is done on the parent's property. Reference Date 1972. MICH. COMP. LAWS ANN. Section 722.643 to 722.651 (Supp. 1985). Furnishing any form of tobacco to one under 17 years, unless upon parent's or guardian’s written order, is punishable by a fine of from $5 to $50 or by imprisonment of from 10 to 30 days or both. Reference Date 1889. MICH. COMP. LAWS ANN. Sections 722.651 and 722.652 (1968). Schools and School Health Education * School instruction about the effects of tobacco is re- quired. Reference Date 1976. MICH. COMP. LAWS ANN. Section 380.1170 (Supp. 1985). ¢ The Critical Health Problems Education Act requires an educational program that includes the topic of tobacco. Reference Date 1948. MICH. COMP. LAWS ANN. Sec- tion 388.382(a) (1976). Commerce ¢ No person shail sell, purchase, possess, or acquire cigarettes, or act as a manufacturer, wholesaler, vending machine operator, unclassified acquirer, or transporter of cigarettes in Michigan unless licensed to do so by the revenue division of the Department of the Treasury. Ref- erence Date 1949. MICH. COMP. LAWS ANN. Section 7.411(3) (1984). Taxation * The tax rate per pack is 21¢ and was last changed in 1982. The Tobacco Institute, Tax Burden on Tobacco: Historical Compilation, 1986 vol. 21, p. 9. * The tax imposed for each cigarette sold in the state is increased from 10.5 to 12.5 mills. Reference Date 1979. MICH. COMP. LAWS ANN. Section 205.507, 205.507(a), and 205.520 (West Supp. 1988). Health and Safety Regulations * Selling adulterated cigarettes constitutes a mis- demeanor. Reference Date 1931. MICH. COMP. LAWS ANN. Section 750.27 (1968). Minnesota Limitations on Smoking In Public Places * The Minnesota Clean Indoor Air Act (enacted “to protect the public health, comfort and environment...” ) prohibits smoking in public places and meetings, except in desig- nated smoking areas. Public place means any enclosed indoor area used by the general public or serving as a place of work, including, but not limited to, restaurants, retail stores, offices and other commercial establishments, public conveyances, educational facilities, hospitals, health care facilities, day care centers, nursing homes, auditoriums, arenas, and meeting rooms, but excluding private, enclosed offices occupied exclusively by smokers even though such office may be visited by nonsmokers. Proprietors of public places are responsible for posting appropriate signs and for arranging nonsmoking seating areas. Factories, warehouses, and similar places of work not usually frequented by the general public are not included except where the public health commissioner determines that smoke pollution exists that is detrimental to nonsmoking employees. No public place other than a bar may be designated as a smoking area in its entirety. tf abar is designated as a smoking area in its entirety, this designation must be posted conspicuously on all entran- ces normally used by the public. Violation constitutes a petty misdemeanor. Affected individuals and state offi- cials may institute injunction actions against repeated violators. Reference Date 1975. MINN. STAT. ANN. Sec- tions 144.411 to 144.417 (West Supp. 1988). It is a trespass, punishable as a misdemeanor, to inten- tionally smoke where no-smoking signs are posted or when the operator of a common carrier requests no smoking. Reference Date 1971. MINN. STAT. ANN. Sec- tion 609.605(1) (West Supp. 1985). Regulation of Sale to and Use of Tobacco Products by Minors * One having control of a cigarette vending machine is required to post a sign which states that persons under 18 years of age are forbidden to buy cigarettes. Violation 95 constitutes a misdemeanor. Reference Date 1961. MINN. STAT. ANN. Section 325E.07 (West 1981). * Furnishing tobacco, cigarette papers, or pipes for smok- ing to one under 18 years of age constitutes a mis- demeanor. Using tobacco, cigarette papers, or pipes for smoking by one under 18 years of age constitutes a petty misdemeanor. Local ordinances may provide more strin- gent regulation. Reference Date 1981. MINN. STAT. ANN. Section 609.685 (West Supp. 1985). Schools and School Health Education * Teacher education institutions must provide, and each prospective teacher must satisfactorily complete, courses in the misuse of and dependency upon tobacco. Reference Date 1959. MINN. STAT. ANN. Section 126.05 (West 1979). Commerce « No person shall engage in the business of selling, manufacturing, or transporting cigarettes in the State of Minnesota without first having received a license from the State Commissioner of Taxation. Reference Date 1947. MINN. STAT. ANN. Sections 297.01 & 297.04 (West 1972). ¢ The distribution of tobacco product samples is prohibited except in tobacco stores. Reference Date 1975. MINN. STAT. ANN. Sections 144.412 & 144.414 (West Supp. 1988). * No person shall distribute smokeless tobacco products, including snuff and chewing tobacco, except in tobacco stores. Reference Date 1986. MINN. STAT. ANN. Sec- tion 325F.76 to 325F.78 (West Supp. 1988). Taxation * The tax rate per pack is 38¢ and was last changed in 1987. The Tobacco institute, “Cigarette Tax Data,” 1987. * The Omnibus Tax Law increases the cigarette and liquor taxes. Reference Date 1987. Minnesota Tax & Spending Law Ch. 268 (1987). Health and Safety Regulations * State fire officials may post no-smoking signs in areas “wherever they deem public safety requires.” No penalty is provided for violation. Reference Date 1965. MINN. STAT. ANN. Section 299F.38 (West 1972). * Discarding a lighted cigarette or cigar on forest land and failing to extinguish it immediately constitutes a mis- demeanor punishable by a fine of between $25 and $100, or by imprisonment of between 10 and 90 days. Refer- ence Date 1929. MINN. STAT. ANN. Section 88.19 (West 1977). * When it is determined that a forest fire hazard exists, the commissioner may prohibit smoking by written order, except in homes and enclosed vehicles. Rewards of up to $25 may be given for information leading to conviction of violation. Reference Date 1978. MINN. STAT. ANN. Sections 88.22 & 88.76 (West Supp. 1985). One who negligently sets fire to a hotel or its furnishings by smoking is guilty of a misdemeanor. Notices must be posted in every sleeping room to advise occupants of this provision. Reference Date 1982. MINN. STAT. ANN. Section 327.74 (West Supp. 1985). Intentionally smoking near explosives or inflammable materials constitutes a misdemeanor. If a risk of death or serious bodily hatm is knowingly created, the penalty may be a fine up to $10,000 or up to five years imprisonment, or both. Reference Date 1971. MINN. STAT. ANN. Sec- tion 609.60(1) (West Supp. 1985). Mississipp. Limitations on Smoking In Public Places ° Once a bus driver requests a passenger to stop smoking a cigar or pipe on a public bus, and the passenger continues to smoke, he may be ejected from the bus. The violator is also guilty of a misdemeanor. Reference Date 1942. MISS. CODE ANN. Section 97-35-1 (1973). Regulation of Sale to and Use of Tobacco Products by Minors ¢ Furnishing cigars, cigarettes, smoking tobacco, or snuff to one under 18 years of age without prior written consent of the minor’s parent or guardian is prohibited. Violation is punishable by a fine between $20 and $100, imprison- ment for from one week to three months, or both. Refer- ence Date 1892. MISS. CODE ANN. Section 97-5-25 (1973). The judge shall charge the grand jury concerning enfor- cement of the statute relating to furnishing tobacco to minors. Reference Date 1978. MISS. CODE ANN. Sec- tion 13-5-47(2) (Supp. 1984). Commerce + Every distributor, wholesaler, retailer, distributing agent, vendor, and every other person engaged in the sale or 96 use of tobacco upon which a tax is required to be paid, must receive a permit from the State Tax Commission allowing him to engage in such business. Reference Date 1942. MISS. CODE ANN. Section 27-69-5 (1972). ~ Nonresident tobacco dealers must be licensed to ship tobacco products into Mississippi. Reference Date 1942. MISS, CODE ANN. Section 27-69-7 (Supp. 1987). « This law reduces or eliminates the credit allowed to dealers for affixing tobacco stamps. MISS. CODE ANN. Chapter 500. Taxation * The tax rate per pack is 18¢ and was last changed in 4985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Health and Safety Regulations * Discarding cigarettes or cigars on a public road or on another's private property constitutes a misdemeanor in addition to civil liability for damages. Violators may be ordered to pick up litter along the roadways or punished by a fine up to $500 or both. Reference Date 1973. MISS. CODE ANN. Section 97-15-29 (Supp. 1984). Missouri Regulation of Sale to and Use of Tobacco Products by Commerce Minors * Every cigarette wholesaler must obtain a license from the * Any municipality may prohibit furnishing cigarettes or director of the Missouri Department of Revenue. MO. cigarette wrappers to minors within its corporate limits, ANN. STAT. Section 149.035 (Vernon 1976). and may provide punishment or fines. Reference Date 1895. MO. ANN. STAT. Section 71.740 (Vernon 1952). Taxation . ina i : * The tax rate per pack is 13¢ and was last changed in Nncoee ofthe a pede taaboale ith Dapardent hase 1982. The Tobacco Institute, The Tax Burden on Tobac- . ee : co: Historical Compilation, 1986, vol. 21, p. 9. provisions. (No general definition of minor was located). Reference Date 1982. MO. ANN. STAT. Section 208.040 * A tax is imposed on the sale of cigarettes equal to a (Vernon Supp. 1985). portion of the federal excise tax. Reference Date 1985. MO. ANN. STAT. Section 149.082 (Vernon’s Supp. 1988). Montana Limitations on Smoking in Public Places Commerce * The Montana Clean Indoor Air Act of 1979 restricts smok- * Every wholesaler, subjobber, retailer, or cigarette vendor ing to designated areas of any enclosed public area or shall obtain a license from the Montana Department of vehicle. Enclosed work places for more than one Soon te leniiseen 1969. MONT. CODE ANN. employee are also included. The Act’s purpose is to ection 16-11-120 ( ). en norsmokers, nearn ang reserve areas for * A7-day credit limit is set on sales or delivery of cigarettes Smokers. Areas Inciuded are elevators, restaurants, or other tobacco products from a wholesaler to a retailer. stores, offices, trains, buses, educational or health Reference Date 1937. MONT. CODE ANN. Section 53- facilities, indoor recreational facilities, museums, gal- 3-204 (1985). Repealed in 1985. Section 28, Ch. 670 in leries, libraries, and public meeting rooms. Restrooms, 1985. taverns and bars that do not serve meals, and rooms or vehicles with a capacity of six or less are exempted from Taxation the Act. A person required to designate smoking or non- . . : . : The cigarette excise tax is increased to 24¢ per package. The amexing 5 Da : who falls oes Coe tne “s to $25. tax on cigarettes sold in packages of more than 20 cigarettes eference Date 1979. ' . Sections is based on a per cigarette basis. Reference Date 1947. 50-40-101 to 50-40-109 (1983). MONT. CODE ANN. Sections 16-11-111, 16-11-119 & 17-5- 408 (1985). Health and Safety Regulations A designated nonsmoking area is required in each enclosed public place. Violation is punishable by a fine of + Discarding lighted cigarettes or cigars near a forest is not more than $1 00. Reference Date 1985. MONT. prohibited. Violation is a misdemeanor. Reference Date CODE ANN. Sections 50-40-104 & 50-40-2014 (1985). 1939. MONT. CODE ANN. Section 76-13-124 (1983). 97 Nebraska Limitations on Smoking In Public Places + The Nebraska Clean Indoor Air Act was enacted for the purpose of protecting “public health, comfort, and en- vironment by prohibiting smoking in public places and at public meetings, except in designated smoking areas.” Coverage includes any enclosed indoor area used by the public or that serves as a workplace including, but not limited to, restaurants, retail stores, offices and other commercial establishments, public conveyances, educa- tional facilities, hospitals, nursing homes, auditoriums, arenas, and meeting rooms. Private offices used only by employees who smoke, an entire room or hall used fora private function and controlled by the function's sponsor and bars or restaurants with serving areas of less than 1,200 square feet, however, are exempted. With respect to factories, warehouses, and similar places of work not usually frequented by the general public, the Department of Healthis required to establish rules to restrict or prohibit smoking in those places of work when the close proximity of workers or the inadequacy of ventilation causes smoke pollution detrimental to the health and comfort of non- smoking employees. Notices must be posted designating smoking and non- smoking areas. The health department has rulemaking power to implement the Act and may waive these provisions upon request. Violation of the Act is penalized as a class V misdemeanor or by injunction. Reference Date 1979. NEB. REV. STAT. Sections 71-5701 to 71- 5713 (1981). Regulation of Sale to and Use of Tobacco Products by Minors * Smoking cigars, cigarettes, or use of other tobacco in any form by one under 18 years of age constitutes a class V misdemeanor. However, ff the minor discloses who fur- nished the tobacco, the minor may avoid prosecution. Reference Date 1911. NEB. REV. STAT. Section 28- 1418 (1981). One who furnishes cigarettes, cigarette papers, or tobac- co in any form, to one under 18 years of age is guilty of a class IIl misdemeanor for each offense. Reference Date 1885. NEB. REV. STAT. Section 28-1419 (1981). A licensee who furnishes cigars, tobacco, cigarettes, or cigarette material to a minor is guilty of a class III mis- demeanor. An additional penalty can be revocation of licanse. Corporation officers, directors, or managers are subject to this section's penalty. Reference Date 1919. NEB. REV. STAT. Section 28-1425 (1981). 98 * A minor who misrepresents his age to buy tobacco products is guilty of a class V misdemeanor. Reference Date 1919. NEB. REV. STAT. Section 28-1427 (1981). Schools and School Health Education * Public schools are required to provide instruction in tobacco abuse as part of a drug abuse education pro- gram. Reference Date 1885. NEB. REV. STAT. Section. 79-1270 (Supp. 1984). Commerce * It is unlawful for any person, partnership, or corporation to sell, keep for sale, or give away in the course of trade, any cigars, tobacco, cigarettes, or cigarette materials without first obtaining a license. Reference Date 1919- NEB. REV. STAT. Section 28-1420 (1979). Taxation * The tax rate per pack is 27¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. * One cent of the cigarette tax is placed in the Nebraska Cancer Research Fund. Reference Date 1981. NEB. REV. STAT. Section 77-2602 (Supp. 1984). * The Tobacco Products Tax Act establishes that each first owner of tobacco products to be sold in the state be licensed. The cigarette tax is increased to 27¢ per pack- age of 20 cigarettes. Reference Date 1947. NEB. REV. STAT. Sections 59-1502, 77-2602, 77-2602.03, 77-2609, 77-2713.2, 77-4001 to 77-4025 (Supp. 1988). Health and Safety Regulations * The Game and Parks Commission may regulate smoking in state parks and recreation grounds. Violation con- stitutes a class V misdemeanor. Reference Date 1929 NEB. REV. STAT. Sections 81-805(2) and (9) (1981). Legislative appropriations to the Department of Health are to be distributed to Nebraska’s medical colleges anc post secondary educational institutions for cancer anc smoking disease research. The Department of Health shall establish program criteria, application procedures and other similar administrative procedures. Reference Date 1981. NEB. REV. STAT. Sections 81-637 to 81-64C (Supp. 1984). Nevada Limitations on Smoking In Public Places * To protect human health and safety, smoking is prohibited except in designated smoking areas in public elevators, libraries, museums, public buses, public meet- ings held in rooms located in public buildings including university lecture and concert halls, hallways, waiting rooms and cafeterias open to the public in state buildings, in public waiting rooms, lobbies and hallways of health care facilities and offices of health care professionals. Additionally, smoking is prohibited in buildings owned or operated by a public governmental agency and in hotels, motels or restaurants when designated by the owner. One who violates this section is subject to a fine between $10 and $100. Reference Date 1975. NEV. REV. STAT. Section 202.2491 (1988). « Smoking in a mill or other building where notices prohibit- ing smoking are posted constitutes a misdemeanor. Ref- erence Date 1911. NEV. REV. STAT. Section 475.050 (1979). Regulation of Sale to and Use of Tobacco Products by Minors ° Furnishing cigarettes, cigarette papers, or tobacco of any description to one under 18 years of age is prohibited without the written consent of the minor's parent or guar- dian. Superintendents of juvenile facilities may supply tobacco to minors 16 years or older who are confined to institutions, with parental permission. A violator of this section is subject to a fine up to $500. Subsequent violations by tobacco dealers can result in license forfei- ture. Reference Date 1911. NEV. REV. STAT. Section 202.010 (1979). Commerce * itis unlawful to employ one under 16 years of age to work in a tobacco warehouse or tobacco manufacturing plant. Reference Date 1919. NEV. REV. STAT. Section 609.190(1)(e) (1983). * A person shall not engage in business as a dealer of cigarettes in the State of Nevada unless he or she first secures a wholesaler’s or retailer's license from the state. Reference Date 1947. NEV. REV. STAT. Section 370.080 (1983). * itis a misdemeanor to sell or offer for sale a cigarette that contains cloves to the extent of 20 percent or more by weight. Reference Date 1985. NEV. REV. STAT. Section 202.2495 (1988). Taxation ° The tax rate per pack is 20¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. * The distribution of the proceeds from the cigarette tax are reallocated. Reference Date 1983. NEV. REV. STAT. Section 370.500 (1988). * The rate of tax on cigarettes is increased contingent upon the expiration of part of the federal tax. Reference Date 1977. NEV. REV. STAT. Sections 370.165 & 370.350 (1988). Health and Safety Regulations * The state forester firewarden may prohibit or restrict smoking in any place other than a vehicle or cleared land when there is a fire safety risk. Public announcements and posted signs will be used to notify prohibition or restrictions. Violation constitutes a misdemeanor. Refer- ence Date 1953. NEV. REV. STAT. Section 473.065 (1983). * Discarding lighted cigarettes or cigars from a moving vehicle, or in a place where a fire may start is prohibited. Violation is punishable as a misdemeanor. Reference Date 1929. NEV. REV. STAT. Section 475.030 (1979). New Hampshire Limitations on Smoking in Public Places * Smoking is restricted to designated smoking areas in enclosed places that are publicly owned or supported by tax revenues. Included are publicly owned, operated or supported transportation, common carrier waiting rooms, elevators, retail stores, entertainment facilities, educa- tional facilities, government offices, polling places, health care facilities, and public meetings. No-smoking signs are to be posted and are not to be removed or defaced. Willful refusal to obey restrictions is a violation and may be enjoined. To enforce such a violation, the attorney general may bring a civil action for appropriate relief. Reference Date 1981. N.H. REV. STAT. ANN. Sections 155.45 to 155.49 (Supp. 1983). * The Clean Indoor Air in Restaurants Act requires res- taurants that seat 50 persons or more to designate non- smoking areas. Reference Date 1987. N.H. REV. STAT. ANN. Sections 155:57 to 155:63 (Supp. 1987). » Smoking is prohibited in grocery food stores. The person in charge of the store is responsible for posting signs and enforcement. Reference Date 1986. N.H. REV. STAT. ANN. Sections 155:54 to 155:56 (Supp. 1986). + Employers are required to establish and to adopt smoking policies in the workplace. Reference Date 1986. N.H. REV. STAT. ANN. Sections 155:50 to 155:53 (Supp. 1986). Regulations of Sale to and Use of Tobacco Products by Minors + The sale and distribution of tobacco products to persons under 18 years of age is prohibited and punishable by a fine of $25 for the first offense. This includes tobacco products in vending machines. Reference Date 1939. N.H. REV. STAT. ANN. Sections 78:12-b & 78:12-c (Supp. 1986). Commerce * Each manufacturer, wholesaler, subjobber, vending machine operator, and retailer of tobacco products must secure a license from the tax commissioner. Reference Date 1939. N.H. REV. STAT. ANN. Section 78:2 (1971). * The commissioner shall refund the purchase price for stamps destroyed after affixing to outdated, damaged, or tobacco products that could not be sold. Reference Date 1939. N.H. REV. STAT. ANN. Section 78:10 (Supp. 1986). Taxation * The tax rate per pack is 17¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. » Hf the Federal excise tax on cigarettes is abolished, the rate of the New Hampshire cigarette tax shall be 25¢. Reference Date 1939. N.H. REV. STAT. ANN. Section 78:7 (Supp. 1986). Health and Safety Regulations « Discarding “flammable waste material” on, near, or ad- jacent to roadways where fire might start in woodlands is prohibited. When a fire hazard is proclaimed, smoking may be prohibited in or near woodlands. Failure to comply with these provisions constitutes a violation. Reference Dates 1909, 1949, and 1951. N.H. REV. STAT. ANN. SECTIONS 224.32 to 224.36 (Supp. 1983). New Jersey Limitations on Smoking in Public Places * One who smokes or carries lighted tobacco on public transportation or in a public place where municipal or- dinance or the person in control of the place prohibits smoking is guilty of a petty offense and is subject to a fine up to $200. Reference Date 1978. N.J. STAT. ANN. Section 2C:33-13 (Supp. 1987). Legislative findings and declarations with respect to smoking in public places recognize a conflict between smokers’ and nonsmokers’ rights. Tobacco smoke is stated to be, in addition to a health hazard to smokers, an annoyance and nuisance to most nonsmokers, as well as a substantial health hazard to some nonsmokers. Smoking on passenger elevators, other than in a single family dwelling, is prohibited, and signs must be posted to that effect. Smoking is also prohibited in health care facilities, except in designated areas. Smoking is permitted in private patient rooms or where all patients have consented, in waiting rooms where nonsmoking areas can be provided, in cafeterias seating 50 or more if an adequate nonsmok- ing section can be provided, and enclosed employee offices if permitted by the person in control of the facility. The state, its agencies, or political subdivisions may suggest guidelines for nonsmoking areas. Smoking and 100 no-smoking signs must be posted at entrances to health care facilities and in health care providers’ waiting rooms. Smoking is prohibited on school, college, university, and professional training school premises, except in desig- nated areas. Administrators of these institutions are to make and enforce regulations to implement the prohibi- tion. Designated smoking areas must be clearly marked by posted signs at public entrances. Nonsmoking areas must be established in indoor theaters, libraries, museums, concert halls, auditoriums, or other similar facilities, except sporting event facilities. Employers must establish written rules to govern smoking in the work place. The rules must contain a written policy. and procedures to protect the health, welfare, and comfort of employees from the detrimental effects of tobacco. smoke, which shall include designated nonsmoking. areas. Smoking is prohibited in enclosed retail food and market- ing stores. Violation of these restrictions on smoking areas is punishable by a fine up to $100. Health depart- ments are to notify the person in control of a building of violations and order compliance. Failure to comply is punishable by up to $25 for the first offense, up to $100 for the second offense, and up to $200 for each sub- sequent offense. Courts may also order immediate com- pliance. Court action is not available to an individual complainant. A joint committee composed of General Assembly com- mittee members is to monitor and evaluate the effective- ness of these provisions. The committee is also to receive a report from the Commissioner of Health within two years of the Act’s effective date to aid the committee in recom- mending administrative or legislative changes. This Act’s provision supersedes other laws, except where municipal ordinance prohibits smoking or where fire safety laws are in effect in areas where smoking is permitted under this Act. N.J. STAT. ANN. Sections 26:3D-1 to 26:3D-22 (West Supp. 1985). N.J. STAT. ANN. Sections 26:3D-23 to 26:3D-45 (West N.J. Session Law Service, Chs. 184, 186, 318 (1955)). The Port Authority may regulate smoking in air terminals, moored floating craft, and marine terminals where ap- propriate signs are posted. Viclation is punishable by a fine up to $50 for the first offense or up to 30 days imprisonment or both, by up to $100 or 60 days imprison- ment for a second offense or both, and by $50 to $200 or 60 days imprisonment for subsequent offenses or both. Reference Date 1953. N.J. STAT. ANN. Sections 32:1- 146.4 & 32:1-146.5 (West 1963). Smoking is prohibited where appropriate signs are posted in or near Hudson Tubes. Violations are punishable by a fine up to $50 or Up to 30 days imprisonment or both. Reference Date 1964. N.J. STAT. ANN. Sections 32:4- 146.8 & 32:1-146.9 (West Supp. 1985). New Jersey encourages restaurants to establish non- smoking areas. Every restaurant is required to post signs at every public entrance indicating whether or not it main- tains a nonsmoking section. N.J. STAT. ANN. Sections 26:3E7 to 26:3E13 (West N.J. Session Law Service, Ch. 185 (1985)). Smoking in places of employment, in certain restaurants, and in enclosed retail and food marketing stores is con- trolled. Reference Date 1985. N.J. STAT. ANN. Sections 26:3D-23 to 26:3D-45 and 26:3E-7 to 26:3E-13 (1987). Regulation of Sale to and Use of Tobacco Products by Minors * One who furnishes cigarettes, cigarette papers, or tobac- co in any form to a minor under 16 years of age is a disorderly person, and violation is punishable by a fine up to $100. Reference Date 1904. N.J. STAT. ANN. Section 2A:170-51 (West 1985). Schools and School Health Education * Violations by juveniles of the statute restricting smoking in educational institutions are within the jursidiction of the municipal court. Reference Date 1982. N.J. STAT. ANN. Section 2A:4A-23 (1987). Commerce * Manufacturing tobacco in one’s home is prohibited. Ref- erence Date 1941. N.J. STAT. ANN. Section 34:6- 136.3(4) (West 1965). 101 * Employing one under 18 years of age to prepare, sell, or serve tobacco products is prohibited. Reference Date 1968. N.J. STAT. ANN. Section 34:2-21.17 (West Supp. 1985). No person shall engage in or conduct the business of manufacturing, purchasing, selling, consigning, or dis- tributing cigarettes without having first obtained an ap- propriate license. Reference Date 1948. N.J. STAT. ANN. Section 54:40A-3 (West 1960). The revenue stamp discount for distributors is increased and the number of vending machines and premises al- lowable are also increased. Certain licensing thresholds and penalties under Unfair Cigarette Sales Tax Act of 1952 are defined. Reference Date 1948. NJ. STAT. ANN. Sections 54:40A-4, 54:40A-11.1,56:7-20 & 56:7-33 (1987). Taxation * The tax rate per pack is 27¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. Atter 1983, $1,000,000 of the cigarette surtax will be deposited annually in the Cancer Research Fund, to be appropriated toward funding of the New Jersey State Commission on Cancer Research. Reference Date 1982. N.J. STAT. ANN. Section 54:40A-37.1 (West Supp. 1985). ¢ A seven-member tobacco industry advisory council is established in the Cigarette Tax Bureau to report to the governor, director, and supervisor of the Bureau and to give advice and counsel the enforcement and administra- tion of the Cigarette Tax Act. Reference Date 1968. N.J. STAT. ANN. Section 54:40A-45 (West Supp. 1985). Health and Safety Regulations * Discarding lighted cigarettes or cigars in a forest is prohibited. Reference Date 1981. N.J. STAT. ANN. Sec- tion 13:9-44.7 (West Supp. 1985). * One who negligently or knowingly starts a fire by discard- ing a cigarette on forest land is liable for the costs incurred in putting out the fire. Reference Date 1981. N.J. STAT. ANN. Section 13:9-44.5 (West Supp. 1985). Smoking is prohibited near explosives. Reference Date 1971.N.J. STAT. ANN. Section 21:1-132(D) (West Supp. 1985). Violation of the no-smoking provision near explosives is punishable by fines of $25 to $500 for a first offense, $150 to $500 for a second offense, and $250 to $1,000 for subsequent offenses. Permits are also revocable for cause. Reference Date 1960. N.J. STAT. ANN. Section 21:1A-140 (West 1969). * Discarding an “object, article, or debris of any nature” (deemed to include lighted cigarettes and cigars) from vehicles is prohibited. Violation is punishable by a fine of from $100 to $500. Registered owners or drivers are presumed to be responsible for violations. Signs to this effect are to be posted on highways. Reference Dates 1921 and 1975. N.J. STAT. ANN. Sections 39:4-64 & 39:4-64.1 (West Supp. 1985). New Mexico Limitations on Smoking In Public Places * The New Mexico Clean Indoor Air Act makes it unlawful for any person to smoke in a public place or at a public meeting except in smoking- permitted areas. Public place means any enclosed indoor area used by the public. For places of employment, each employer shall adapt, imple- ment, and maintain a written smoking policy that shall prohibit, at a minimum, smoking in elevators and nurses aide stations or similar facilities for treatment of employees and shall provide for smoke-free work areas to accommodate employees who request such areas. Any person who commits an unlawful act under The Clean Indoor Air Act shall be fined not less than $10 nor more than $250 for each violation. Reference Date 1985. NM. STAT. ANN. Sections 24-16-1 to 24-16-11 (1987). Commerce + Each person engaged in the business of selling cigarettes in New Mexico must register with the state. Reference Date 1953. N.M. STAT. ANN. Section 7-12-9 (1983). * No person shall sell clove cigarettes in New Mexico. Violation is a petty misdemeanor. Reference Date 1985. N.M. STAT. ANN. Sections 57-2-14 & 57-2-15 (1987). Taxation ° The tax rate per pack is 15¢ and was last changed in 1986. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * A 25 percent tobacco products tax is imposed on all tobacco products. Reference Date 1953. N.M. STAT. ANN. Sections 7-12-1 to 7-12-10 (1987). * The law provides for an increase in the cigarette tax and imposes an inventory tax. Reference Date 1978. N.M. STAT. ANN. Sections 7-1-6.11, 7-12-3, 7-12-3.1, 7-12- 3.2 & 24-20-1 (1987). * The cigarette excise tax is increased to the rate of 1¢ for each cigarette sold in the state. Reference Date 1953. - N.M. STAT. ANN. Sections 7-1-6.11, 7-12-1 & 7-12-3 (1987). Health and Safety Regulations * Smoking or carrying smoking materials is prohibited in mines or in or near magazines and violation constitutes a misdemeanor. Mine operators are required to search employees at least once a week for such articles. Refer- ence Date 1933. N.M. STAT. ANN. Sections 69-13-2, 69-13-3, 69-19-5, 69-20-17 & 69-32-6 (Supp. 1983). New York Limitations on Smoking In Public Places * Smoking is prohibited in churches and schools used as voter registration places. Reference Date 1976. N.Y. ELEC. LAW Section 5-204(7) (Consol. 1977). Smoking is prohibited on public transportation vehicles, or in any indoor facility open to the public as a library, museum, or theatre, except by performers as part of the theatrical production. Violation is punishable by a fine between $10 and $100. Restrooms, separate lobbies, and other designated smoking areas are exempted. Ref- erence Date 1975. N.Y. PUB. HEALTH LAW Sections 1300-0 to 1399-q (Consol. Supp. 1984). (A complaint form is provided following the text of Section 1399-0 that may be filed against one who starts a fire in a building by smoking.) 102 » Smoking or possessing lighted cigarettes and cigars in or near New York Port Authority controlled air and marine terminals where no-smoking signs are posted is prohibited. Violation is punishable by a fine of up to $50 or up to 30 days imprisonment for a first offense or both, - $25 to $50 or up to 60 days imprisonment or both for a second offense, and $50 to $200 or 60 days imprison- ment or both for subsequent offenses. Reference Date 1953, N.Y. UNCONSOL. LAWS Ch. 170, Sections 1 & 2 (Consol. 1984). Smoking is restricted to designated areas in factories. No-smoking notices must be posted as directed by the tire commissioner. Reference Date 1921. N.Y. LAB. LAW Section 283 (Consol. 1983). Regulation of Sale to and Use of Tobacco Products by Minors * A person, business, or corporation in control of a place that sells tobacco products is required to post a sign that states that sale of cigars, cigarettes, chewing tobacco, powdered tobacco, or other tobacco products to one under 18 years of age is prohibited. A violation of this section is punishable by a fine up to $100 for the first offense and up to $250 for all subsequent violations. Reference Date 1965. N.Y. GEN. BUS. LAW Section 399-e (Consol. Supp. 1984). One who sells tobacco in any form to one under 18 years of age is guilty of aclass B misdemeancr. ltis no defense that a child was acting as an agent for another. Reference Date 1965. N.Y. PENAL LAW Section 260.20(5) (Consol. 1984). Commerce * No person shall be a cigarette wholesale dealer unless he has been granted and publicly displays in his place of business a license from the Department of Taxation and Finance. Reference Date 1939. N.Y. TAX LAW Section 480 (Consol. 1975). * Cigarette marketing standards to regulate and control the sale price of cigarettes within the state at wholesale and retail levels have been established and are defined. Ref- erence Date 1985. N.Y. TAX LAW Sections 483 to 487 (Consol. 1987), Taxation * The tax rate per pack is 21¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Health and Safety Regulations * Smoking is prohibited within 150 feet of ships, docks, warehouses, piers, wharfs, and other places where petroleum oil is stored or kept for export. Violation con- Stitutes a misdemeanor. Reference Dates 1909 and 1965. N.Y. GEN. BUS. LAW Sections 306 & 306-a (Con- sol. 1980). Following New York’s Uniform Commercial Code Section 2-314 (which makes the seller of unmerchantable goods civilly liable) a complaint form for the sale of adulterated cigarettes (e.g. adead mouse in the tobacco) is provided. N.Y. U.C.C. SECTION 2-314 (Consol. 1981) (Form No. 5). North Carolina Regulations of Sale to and Use of Tobacco Products by Minors * Selling cigarettes or cut tobacco to one under 17 years of age is prohibited and is punishable by a fine up to $500 and/or imprisonment for upto six months. Reference Date 1891. N.S. GEN. STAT. Section 14-313 (1981). Regulation of Advertising Practices * The promotion or sale and use of tobacco statutes is amended and clarified in regards to flue-cured tobacco farmers. Reference Date 1959. N.C. GEN. STAT. Sec- tions 106-568.20 to 106-568.36 (Supp. 1987). Commerce « No person shall engage in the business of a distributor of cigarettes without having obtained a license from the Secretary of State. Reference Date 1969. N.C. GEN. STAT. Section 105-113.11 (1979). Taxation * The tax rate per pack is 2¢ and was last changed in 1969. The Tobacco Institute, The Tax Burden on Tobacco: Historical Compilation, 1986, vol. 21, p. 9. * Income tax deductions are provided for marketing as- sessments on tobacco grown in North Carolina. Refer- ence Date 1967. N.C. GEN. STAT. Sections 105-130.5 & 105-147 (Supp. 1987). North Dakota Limitations on Smoking in Publle Places * Forthe purpose of separating smokers from nonsmokers, nonsmoking areas must be provided in all places of public assembly, and are to be designated by the person con- trolling the place of public assembly. Smoking areas may not exceed 50 percent of the total area. Places of public assembly include enclosed theatres, elevators, health care facilities, state owned buildings such as hospitals, state institutions, office buildings, libraries, public educa- tion buildings, and public transportation vehicles. Res- taurants and other food service establishments with seat- ing capacity for more than 50 people are also included. Maximum penalty for violation is $100. Reference Date 1977. N.D. CENT. CODE Sections 23-12-09 to 23-12-11 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors + Furnishing cigarettes, cigarette papers, cigars, snuff, or tobacco in any other form to a minor, and smoking or use by a minor of cigarettes, cigarette papers, cigars, snuff, or tobacco in any other form constitute class B mis- demeanors. Reference Date 1973. N.D. CENT. CODE Section 12.1-31-03 (1976). » A minor is defined as a person under 18 years of age. Reference Date 1877. N.D. CENT CODE Section 14-10- 01 (1981). Commerce * Each person engaged in the business of selling cigaret- tes, cigarette papers, snuff, cigars, or tobacco must secure a license from the attorney general. Reference Date 1941. N.D. CENT. CODE Section 57-36-02 (1983). ¢ The license fees for wholesalers and retailers of tobacco products is revised. Reference Date 1965. N.D. CENT. CODE Sections 43-31-14, 43-33-08, 43-33-11, 53-06. 1- 03, 57-36-02, 62.1-01-01 & 62.1-04-03 (Supp. 1987). * Cigarette distributors and wholesalers may not sell un- used stamps. The stamps may be returned for 95 percent - of their face value. Reference Date 1941. N.D. CENT. - CODE Sections 57-36-07, 57-36-12 & 57-36-25 (Supp. 1987). _ Taxation * The tax rate per pack is 27¢ and was last changed in 1987. The Tobacco institute, “Cigarette Tax Data,” 1987. * An additional tax of 6 1/2 mills on each cigarette is levied. Reference Date 1965. N.D. CENT. CODE Section 57-36- 32 (Supp. 1987). * The excise tax on cigars, snuff, and other tobacco- products is increased from 11 to 25 percent of the wholesale purchase price. Reference Date 1963. N.D. CENT. CODE Sections 57-36-25 to 57-36-28 (Supp. 1987). Ohio Limitations on Smoking in Public Places « Smoking is prohibited on public transportation vehicles where no smoking areas are clearly posted. Violation constitutes a minor misdemeanor. Reference Date 1984. OHIO REV. CODE ANN. Sections 2917.41(2) & (3)(E) (Page Supp. 1984). * Nonsmoking areas must be designated by posted signs in places of public assembly, including enclosed theatres, indoor recreational facilities, classrooms, elevators, rooms in health care facilities, state owned buildings including office buildings, public transportation vehicles, and other public places with a seating capacity of at least 50 people. Smoking is prohibited in designated nonsmok- ing areas. Restaurants, bowling alleys, and taverns are expressly excluded from coverage. Violation constitutes aminor misdemeanor. Reference Date 1981. OHIO REV. CODE ANN. Section 3791.031 (Page Supp. 1984). Upon a street railway employee's request, one is required to stop smoking in a passenger car. Maximum penalty is $10. Reference Date 1953. OHIO REV. CODE ANN. Sections 4951.57 & 4951.99(c) (Page 1977). 104 Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigarettes or other tobacco products to one under 18 years of age by manufacturers, producers, distributors, wholesalers, or retailers is prohibited, and- selling tobacco products is prohibited in a place without a posted sign prohibiting furnishing of tobacco products- to one under 18 years of age. A first violation constitutes. a fourth degree misdemeanor and subsequent violations constitute a third degree misdemeanor. Reference Date- 1984, OHIO REV. CODE ANN. Section 2927.02 (Page Supp. 1984). Schools and School Health Education » Graded courses of study prescribed for schools include health education with instruction in the use and effects of cigarettes. Reference Date 1980. OHIO REV. CODE ANN. Section 3313.60(E) (Page Supp. 1984). Commerce » No dwelling place may be used to manufacture tobacco for sale, except by members of the family living there, unless it complies with state requirements. Reference Date 1953. OHIO REV. CODE ANN. Section 4107.15 (Page 1980). * No person shall engage in the wholesale or retail busi- ness of trafficking in cigarettes without a license. Refer- ence Date 1959. OHIO REV. CODE ANN. Section 5743.15 (1980). Taxation * The tax rate per pack is 18¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. Health and Safety Regulations ¢« Smoking in a self-service gasoline filling station is prohibited and a no-smoking sign must be posted on each self-service pump island. Reference Date 1979. OHIO REV. CODE ANN. SECTION 3741.14(B)(5)(b) (Page 1980). * Smoking or carrying lighted smoking tobacco is prohibited where fireworks are stored, and a no-smoking sign must be displayed over the entrance to the storage area. Violation is punishable by a fine of between $25 and $500. Reference Date 1953. OHIO REV. CODE ANN. Sections 3743.30 & 3743.99(A) (Page 1980). * Smoking or carrying smoking materials is prohibited in mines. Smoking in or about surface structures is restricted to places where a fire or explosion cannot occur. Reference Date 1984. OHIO REV. CODE ANN. Section 4157.65 (Page Supp. 1984). ¢ Members of the Senate support and desire a tobacco-free young Ohio by the year 2000. Uncodified. SR 154 of the 117th OHIO GENERAL ASSEMBLY (1987). Oklahoma Limitations on Smoking in Public Places Schools and School Health Education * Possession of lighted tobacco is declared a nuisance and * Tobacco is expressly included as a drug in the Drug a public health danger, and is prohibited in elevators, indoor theatres, libraries, indoor exhibits, recreational facilities, and buses, except where “Smoking Permitted” signs are posted in areas separate from the main area. A knowing violation is a misdemeanor punishable by a fine of between $10 and $100. Reference Date 1975. OKLA. STAT. ANN. Title 21, Section 1247 (West 1983). * The "Smoking in Public Places Act” prohibits smoking in a public place not designated as a smoking area. Refer- ence Date 1987. OKLA. STAT. ANN. Title 63, Sections Abuse Education Act of 1972, which requires that the effects of drug use be taught. The purpose of the Act is to ensure the development of a comprehensive drug abuse education program for students in grades one through twelve. Implementation includes inservice teacher training. Reports are to be made to the legislature each year by the State Department of Education regard- ing the status of the program. Reference Date 1972. OKLA. STAT. ANN. Title 70, Sections 1210.221 to 1210.228 (West 1972 & Supp. 1984-1985). 1-1521 to 1-1527 (West Supp. 1988). Commerce Regulation of Sale to and Use of Tobacco Products by Minors * Each manufacturer, wholesaler, warehouseman, jobber, * Furnishing cigarettes, cigarette papers, cigars, snuff, chewing tobacco, and other tobacco products to a minor is prohibited and punishable by a fine of between $25 and $200 and imprisonment of between 10 and 90 days. Any minor in possession of cigarettes or cigarette papers who refuses to tell where and from whom he or she got the cigarettes is guilty of a misdemeanor. If the minor is 16 years of age or older, he or she may be fined up to $5 or be imprisoned for up to five days or both. Minors under 16 years of age are to be referred to juvenile court for action that the court deems proper. One fourth of the collected fines are paid to the complaining witness and the remainder to county road funds. Reference Date 1915. OKLA. STAT. ANN. Title 21, Sections 1241 & 1242 (West Supp. 1988). A minor is defined as a person under 18 years of age. Reference Date 1972. OKLA. STAT. ANN. Title 15, Sec- tion 13 (West 1983). 105 or distributor of cigarettes in Oklahoma must obtain a license from the tax commission. Reference Date 1975. OKLA. STAT. ANN. Title 68, Section 304 (1966). Taxation « The tax rate per pack is 23¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. Health and Safety Regulations * Depositing litter, defined in part as “any flaming or glowing substances..., [or] any substance which may cause a fire,...,"0n roadways or other public property is prohibited and is punishable by a fine of up to $100 or 30 days imprisonment, or both. Courts may require violators to pick up litter on a court directed schedule in lieu of imprisonment. Reference Date 1957. OKLA. STAT. ANN. Title 21, Section 1753.3 (West 1983). * Tobacco use is prohibited in rooms where dairy products are unpacked or exposed. Reference Date 1965. OKLA. STAT. ANN. Title 2, Section 7-205 (West 1973). * No-smoking signs must be posted where fireworks are sold. Reference Date 1969. OKLA. STAT. ANN. Title 68, Section 1623(a) (West Supp. 1984-1985). * Similar provisions are provided for storage and use of explosives for mining. Reference Date 1981. OKLA. STAT. ANN. Title 45, Sections 911(A)(8) & (C)(5) (West Supp. 1984-1985). * Smoking is prohibited in mining areas where flammables or explosives are stored, or in other areas where fire or - explosion hazards exist. No-smoking signs must be - posted. Reference Date 1978. OKLA. STAT. ANN. Title 45, Section 910(10})(B) (West 1979). Oregon Limitations on Smoking in Public Places * Smoking is prohibited in public elevators and “No-Smok- ing” signs must be posted. Violation of the smoking prohibition is punishable by a $10 fine for each violation, and violation of the sign posting requirement is punish- able by a fine of $100. Reference Date 1975. OR. REV. STAT. Section 479.015 (1983). Smoking is prohibited in hospital rooms and other patient care areas unless specifically designated otherwise. Ref- erence Date 1977. OR. REV. STAT. Section 441.815 (1983). Smoking in or carrying lighted smoking instruments into public meetings is prohibited. Violation is punishable by a $10 fine. Reference Date 1973. OR. REV. STAT. Sec- tions 192.710 & 192.990 (1983). Because smoking is found to be a health hazard, smoking is restricted to designated smoking areas in state- operated places of employment. The state’s personnel division is required to adopt rules and standards to imple- ment this provision. This section also requires state agen- cies and departments providing employee lounges to provide smoke-free lounge areas and to prohibit smoking in nonsmoking areas. Offices occupied exclusively by smokers are exempt. Reference Date 1977. OR. REV. STAT. Sections 243.345 & 243.350 (1983). The Oregon Indoor Clean Air Act’s stated policy is to reduce the health hazard of tobacco smoke exposure in confined places by requiring nonsmoking areas in public places, including restaurants, indoor recreational facilities, retail stores, banks, commercial businesses, educational facilities, nursing homes, meeting rooms, grocery stores, and rooms in which jury deliberation oc- curs. The person in charge of the public place is to designate nonsmoking areas and to post appropriate signs. No public place allows smoking in all areas except bars, oftices occupied exclusively by smokers, private social 106 functions under the sponsor's control, retail tobacco busi- nesses, and restaurants with 30 or fewer seats. The Health Division is responsible for adopting rules implementing and enforcing compliance by actions to enjoin repeated violations. Violation of provisions relating - to improper designation of smoking areas and sign post- ing requirements are punishable by a fine totaling no - more than $100 within a 30-day period. Reference Date 1981. OR. REV. STAT. Sections 433.835 to 433.990(5) - (1987). Regulation of Sale to and Use of Tobacco Products by Minors « Endangering the welfare of a minor under 18 years of age - includes furnishing tobacco and smoking paraphernalia and constitutes a class A misdemeanor. Reference Date 1971. OR. REV. STAT. Section 163.575 (1983). Schools and School Health Education * As part of instruction in ethics and morality, the course of - study in public schools includes the effects of smoking. Reference Date 1975. OR. REV. STAT. Section 336.067(d) (1983). Commerce + Every person desiring to engage in the sale of cigarettes as a distributor or wholesaler must obtain a license from - the Oregon Department of Revenue. Reference Date 1965. OR. REV. STAT. Sections 323.105 & 323.107 (1981). Taxation » The tax rate per pack is 27¢ and was last changed in - 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The changes in the interest rate paid on refunds of excess cigarette taxes are defined. Reference Date 1969. OR. REV. STAT. Sections 118.230, 118.350, 118.865, 119.220, 293.250, 305.115, 305.830, 314.105, 323.318, 323.330, 323.401 & 496.385 (1987). * The tax rate for cigarettes sold by common carriers is increased to that of cigarette distributors. Reference Date 1965. OR. REV. STAT. Sections 323.040 & 323.225 (1987). ' Health and Safety Regulations * Discarding lighted tobacco, cigars or cigarettes on forest lands, private roads, public highways, or railroad right of ways is prohibited. Operators of public conveyances must post a copy of this provision. Reference Date 1957. OR. REV. STAT. Section 476.715 (1983). « Persons causing fires as a result of violating the above provision is civilly liable for all expenses of fighting the fire. Reference Date 1971. OR. REV. STAT. Section 477.090 (1983). * During closed season in forest protection districts, smok- ing while working in or traveling through a district is unlawful. Reference Date 1959. OR. REV. STAT. Section 477.510 (1983). * Violation of Section 477.510 is punishable by a fine of up to $1,000 or 60 days imprisonment or both. Reference Date 1963. OR. REV. STAT. Section 477.993(1) (1983). Pennsylvania Limitations on Smoking in Public Places ¢ Smoking is prohibited in hospital patient care areas, nonsmoking patient rooms, and designated nonsmoking public areas of hospitals. Only patients may smoke in designated smoking patient rooms. One who violates this section is subject to a $10 fine and costs of prosecution. Reference Date 1977. PA. STAT. ANN. Title 35, Section 361 (Purdon Supp. 1985). Smoking is prohibited in any auditorium, balcony, or gallery of any theatre. Reference Date 1927. PA. STAT. ANN. Title 35, Section 1225 (Purdon 1977). City councils in first through third class cities may prohibit smoking or carrying lighted tobacco products in retail stores accommodating 300 people or more, or employing 25 or more workers. Regulation may be imposed in stores accommodating 100 or more people and 10 or more employees in third class. However, city councils may not, under this Act, prohibit smoking in any restaurant, restroom, beauty parlor, executive office, or any desig- nated smoking room. Reference Date 1947. PA. STAT. ANN. Title 53, Sections 3702 & 37403(33) (Purdon 1972 Commerce ¢ Persons under 16 years of age are not to be employed in stripping or sorting tobacco. Reference Date 1971. PA. STAT. ANN. Title 43, Section 44 (Purdon Supp. 1985), Provisions governing industrial homework, based on the legislature’s recognition that such work is harmful to society, prohibit manufacturing tobacco in a contractor's or employer’s home without a permit. Continued viola- tions may be enjoined. Labels or other identification marks must be affixed to materials manufactured by home workers. Fines up to $1,000 or imprisonment up to 60 days or both may also be imposed for violations, and $5,000 fines or imprisonment for 60 to 90 days or both will be imposed for a second violation within five years of conviction. Permits may be revoked for conviction. Ref- erence Date 1937. PA. STAT. ANN. Title 43, Sections 491-1 to 491-21.1 (Purdon 1964 & Supp. 1985). No person, unless all of his or her sales of cigarettes are exempt from tax, shall sell any cigarettes within the state without a license. PA. STAT. ANN. Title 72, Section 3168.401 (Purdon 1964). & 1957). Taxation Regulation of Sale to and Use of Tobacco Products by Minors * The tax rate per pack is 18¢ and was last changed in 1970. The Tobacco Institute, The Tax Burden on Tobac- : . . . co: Historical Compilation, 1986, vol. 21, p. 9. * It is a summary offense to furnish cigarettes, cigarette papers, or tobacco in any form to one under 16 years of : . . Health and Safety Regulations age. Violation of this section is punishable by a fine up to $25 for the first offense and up to $100 for the second offense. Subsequent offenses constitute a third degree misdemeanor. Reference Date 1972. PA. STAT. ANN. * Smoking on board any ship within 150 feet of a maritime wharf where petroleum is stored is prohibited, unless the person in control of the wharf gives written permission. A Title 18, Sections 6305 & 6306 (Purdon 1983). knowing violation constitutes a misdemeanor for which 107 the violator may be fined up to $50 or up to six months imprisonment or both. Reference Date 1878. PA. STAT. ANN. Title 55, Sections 442 & 443 (Purdon 1964). * Smoking while handling explosives in a nongassy mine is prohibited. Reference Date 1961.PA. STAT. ANN. Title §2, Section 701-262(j) (Purdon 1966). Rhode Island Limitations on Smoking in Public Places « Smoking is declared a public nuisance and public health danger, and is prohibited in the following public places: elevators, indoor theatres, libraries, art galleries, museums, concert halls, buses, schools, colleges, super- markets, medical offices, and hospitals. Smoking is per- mitted in areas of places listed above that are separate from use by the public. Eating places with a seating capacity of 50 or more people are required to have separate seating arrangements for smokers and non- smokers. No-smoking signs must be posted and the person in control of a public area must make reasonable efforts to prevent smoking. A violation of this section is punishable by a fine between $10 and $100. Bars, nightclubs, lounges, dance clubs, and privately spon- sored social functions are exempt from these provisions. Reference Date 1977. R.l. GEN. LAWS Sections 23- 20.6-1, 23-20.6-2 & 23.20.6-4 (1979 & Supp. 1984). * No-smoking signs must be posted prohibiting smoking in stables and surrounding areas. Reference Date 1976. R.I. GEN. LAWS Sections 23.28.31-2 & 23-28.31-8 (1979). The Workplace Smoking Pollution Control Act requires employers to adopt a smoking policy and post signs for designated smoking areas. Reference Date 1986. R.l. GEN. LAWS Sections 23-20.7-1 to 23-20.7-7 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors « Furnishing any tobacco product to one under 16 years of age is prohibited and violation is punishable by a maxi- mum fine of $250 for each offense. A person under 16 years of age who smokes or chews tobacco in any form in public is subject to a tine of $5. Reference Date 1896. R.1. GEN. LAWS Section 11-9-13 (Supp. 1987). 108 Commerce ¢ Persons under 16 years of age may not be employed in stripping, sorting, manufacturing, or packing tobacco. Reference Date 1943. R.I. GEN. LAWS Section 28-3-9 (1979). ¢ Each person engaged in the business of selling cigarettes in Rhode Island must secure a license from the tax administrator. Referance Date 1939. R.!. GEN. LAWS Section 44-20-2 (1980). Taxation * The tax rate per pack is 25¢ and was last changed in 1986. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The rate of tax on unstamped cigarettes is increased to 12.5 mills for each cigarette. Reference Date 1948. R.1. GEN. LAWS Section 44-20-13 (Supp. 1987). Health and Safety Regulations * No-smoking signs must be posted at gas dispenser is- lands. Reference Date 1976. R.1. GEN. LAWS Section 23-28.22-15 (1979). * Discarding lighted cigarettes, cigars, or ashes where they are likely to cause a forest, brush, grass, or woods fire, and discarding objects from a moving vehicle are prohibited. This section is punishable by a fine between $25 and $100. Reference Date 1970. R.I. GEN. LAWS Section 2-12-9 (1976). Carelessly causing a fire on another's land or on an adjacent highway is punishable by a fine between $25 and $200 or by imprisonment between five and 30 days or both. If causing the fire is willful, punishment is a fine up to $200 or imprisonment between 30 days and five years or both. Reference Date 1970. R.I. GEN. LAWS Section 2-12-10 (1976). South Carolina Limitations on Smoking in Public Places * Smoking on school buses is prohibited while the bus is in operation. Reference Date 1937. S.C. CODE ANN. Sec- tion 59-67-150 (Law. Co-op 1977). Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigarettes, tobacco, cigarette papers, or any substitute therefore, to one under 18 years of age is prohibited. A violation of this section is punishable by a fine between $25 and $100, or by imprisonment for be- tween two months and one year or both. One half of any fine imposed is paid to the informer. Reference Date 1889. S.C. CODE ANN. Section 16-17-500 (Law. Co-op 1985). Commerce * Every person engaged in the business of selling, pur- chasing, or distributing cigars, cigarettes, snuff or smok- ing or chewing tobacco at wholesale or through vending machines must obtain a license to engage in such busi- ness. Reference Date 1962. S.C. CODE ANN. Section 12-21-660 (Law. Co-op 1977). * The South Carolina Tax Commission requires tobacco distributors and purchasers to obtain licenses. Reference Date 1962. S.C. CODE ANN. Section 12-21-670 (Supp. 1987). Taxation * The tax rate per pack is 7¢ and was last changed in 1977. The Tobacco Institute, The Tax Burden on Tobacco: Historical Compilation, 1986, vol. 21, p. 9. Health and Safety Regulations * No-smoking signs must be posted in places where fireworks are stored and sold. Reference Date 1962.S.C. CODE ANN. Sections 23-35-90 & 23-35-100 (Law. Co-op 1977). South Dakota Limitations on Smoking In Public Places * Smoking is prohibited in any hospital or medical or dental clinic, nursing home, public library, museum, indoor theater or concert hall, elementary or secondary school building, public conveyance, jury room, elevator, public meeting, and any building constructed, maintained or supported by tax revenues for public purposes. Res- taurant proprietors may designate a portion of their estab- lishment with a seating capacity of 100 or more persons as nonsmoking. Reference Date 1974. S.D. CODIFIED LAWS ANN. Section 22-36-2 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * Municipalities possess the authority to prohibit furnishing cigarettes to minors or use of cigarettes by minors. Ref- erence Date 1980. S.D. CODIFIED LAWS ANN. Section 9-29-8 (1981). * A minor is defined as a person under 18 years of age. Reference Date 1877. S.D. CODIFIED LAWS ANN. Sec- tion 26-1-1 (1984). * It is a Class 2 misdemeanor to knowingly sell or give any tobacco product to a minor. It is a petty offense for any minor to purchase, attempt to purchase, possess, or consume any tobacco product. Reference Date 1987. S.D. CODIFIED LAWS ANN. Sections 10-46-8.3 & 15-7- 17 (1987). 109 * The use of smokeless tobacco by, or the sale of smoke- less tobacco to minors is prohibited and violation is a petty offense. Reference Date 1986. S.D. CODIFIED LAWS ANN. Sections 26-10-20 & 26-10-21 (Supp. 1987). Commerce * Municipalities possess the power to license and regulate the manufacture and sale of tobacco products. Reference Date 1890. S.D. CODIFIED LAWS ANN. Section 9-34-6 (1981). * Certain fees affecting tobacco, motor vehicles, and motor fuel sales are revised. Reference Date 1955. S.D. CODIFIED LAWS ANN. Sections 10-1-13 & 10-1-16.1 (Supp. 1987). Taxation * The tax rate per pack is 23¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The tax rate on tangible personal property sold through vending machines is increased. Reference Date 1987. S.D. CODIFIED LAWS ANN. Section 10-45-8.2 (Supp. 1987). * The sales tax exemption for the sale of cigarettes is repealed. Reference Date 1935. S.D. CODIFIED LAWS ANN. Sections 10-45-8.2 & 10-45-11 (Supp. 1987). Health and Safety Regulations * Discarding burning tobacco products from a vehicle is prohibited, and is punishable as a Class 2 misdemeanor. Reference Date 1937. S.D. CODIFIED LAWS ANN. Sec- tion 34-35-8 (1977). * No-smoking signs must be posted where fireworks are sold, Reference Date 1971. S.D. CODIFIED LAWS ANN. Section 34-37-10.3 (1977). Tennessee Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigarettes, cigars, pipes, tobacco, or other tobacco products and smoking paraphernalia to a minor under 18 years of age is prohibited. Minors are prohibited from procuring cigarettes, cigars, pipes, smokeless tobacco, or other tobacco products and smoking paraphernalia and are prohibited from misrepresenting their age to obtain these materials. Merchants shall demand identification containing proof of age before they may sell cigarettes to aperson who appears to be aminor. Signs must be posted where smoking materials are sold stating the prohibitions and punishments for violation. Law entorcement officers who send minors, with parental consent, to buy smoking materials are not committing a violation or an act of entrapment. Vendors who violate any of these prohibitions on three occasions are prohibited from selling smoking materials for five years. Each vicla- tion is punishable by a fine up to $500 and imprisonment for up to six months. Reference Date 1981. TENN. CODE ANN. Sections 39-4-411 to 39-4-418 (1982). The dissemination, purchase, or acquisition of smokeless tobacco products to or by a minor is unlawful. Reference Date 1981. TENN. CODE ANN. Sections 39-4-411 to 39-4-417 (Supp. 1987). Commerce + Every person engaged in the business of selling, distribut- ing, or handling tobacco products in Tennessee must obtain a license to engage in such business. Reference Date 1937. TENN. CODE ANN. Section 367-4-1015 (1983). « The type of buriey seed unlawful for sale unless certified is defined. Reference Date 1972. TENN. CODE ANN. Section 43-10-105 (1988). * The licensing fees for retailers of tobacco products are eliminated. Reference Date 1937. TENN. CODE ANN. Sections 67-4-1015 & 67-4-1019 (Supp. 1987). Taxation * The tax rate per pack is 13¢ and was last changed in 1969. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The Unfair Cigarette Sales Law is revised to levy an. additional sales tax on cigarettes and to provide for strict enforcement of the law. Reference Date 1949. TENN. CODE ANN. Sections 47-25-302, 47-25-308 to 47-25- 312 & 67-4-1002 to 67-4-1009 (Supp. 1987). Health and Safety Regulations * No-smoking signs must be posted where fireworks are sold or stored. The presence of smoking materials within 10 feet of where fireworks are stored or sold is prohibited. Violation is punishable by a fine of from $50 to $200 or 30 to 60 days imprisonment or both. Reference Date 1959. TENN. CODE ANN. Sections 68-22-111 & 68-22-114 (Supp. 1984). Smoking is restricted in mines and mining areas where flammable materials are stored. Violation is punishable. by a fine between $50 and $500 or by imprisonment up to six months or both. Reference Dates 1951 and 1953. TENN. CODE ANN. Sections 59-6-103(b), 59-6-117, 59- 6-510 & 59-7-106(b) (1980). Texas Limitations on Smoking In Public Places « Smoking or possession of a burning tobacco product is prohibited in primary and secondary schools, elevators, indoor theaters, libraries, museums, hospitals, public 110 buses, planes, and trains, or as partofa theatrical produc- tion, except in designated areas. Signs must be posted. stating that smoking is prohibited. Failure to post the sign ig a defense to prosecution, as is a failure to provide facilities to extinguish smoking materials. One who violates this section is guilty of a class C misdemeanor. Reference Date 1975. TEX. PENAL CODE ANN. Section 48.01 (Vernon Supp. 1985). Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigarettes or tobacco in any form to one under 16 years of age, without parental consent, is punishable by a fine between $10 and $100. Reference Date 1899. TEX. CIV. CODE ANN. Section 4476-16 (Vernon 1976). Schools and School Health Education * Students are prohibited from smoking at any school re- lated or sanctioned activity on or off public school proper- ty. Reference Date 1987. TEX. EDUC. CODE Section 21.927 (Vernon 1988). * A school health education program relating to smoking and cancer is to be included in the curriculum for students from kindergarten through grade twelve. Uncodified. Act 1985 69th Legislature HCR 2 (1985). Commerce * A person may not engage in business as a distributor, wholesale dealer, or retail dealer of cigarettes unless he has received a permit from the Comptroller of Public Accounts of the State of Texas. Reference Date 1935. TEX. TAX CODE ANN. Sections 154.001 & 154.101 (Vernon 1982). * Neighborhood convenience stores are to sell cigarette papers only if they are accompanied by loose tobacco. Uncodified. Act 1987 70th Legislature HCR 177 (1987). * Cigarette and tobacco taxes and permits as they relate to wholesalers and distributors are defined. Reference Date 1935. TEX. TAX CODE. ANN. Sections 154.001 to 155.110 (Vernon 1988). Taxation * The tax rate per pack is 20.5¢ and was last changed in 1985. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The provisions relating to the payment of cigarette taxes are defined. Reference Date 1981. TEX. TAX CODE ANN. Sections 154.050(b) to 154.052(a) (Vernon 1988). * The administration of the cigarette tax stamp is the duty of the state treasurer. Reference Date 1935. TEX. TAX CODE ANN. Sections 154.041, 154.043, 154.047, 154.055 & 154.056 (Vernon 1988). Health and Safety Regulations ¢ Permitting lighted smoking materials within 10 feet of areas where fireworks are sold is prohibited. No-smoking signs must be posted. The maximum penalty for violation is a fine of up to $1,000, one year’s imprisonment or both. Reference Date 1957. TEX. CIV. CODE ANN. Sections 9205(7) & (11) (Vernon Supp. 1985). Minors are prohibited from carrying a lighted pipe or fire in any form where they will endanger the lives of others. Reference Date 1907. TEX. CIV. CODE ANN. Section 5910a (Vernon Supp. 1985). The 69th Legisiature supports the goal of a smokeless teenage society by the year 2000. Uncodified. Act 1985 69th Legislature HCR 4 (1985). Utah Limitations on Smoking in Public Places * As an offense against the public welfare, smoking in a public place or at a public meeting place is prohibited except in designated smoking areas, unless an entire place is used for a private social function with seating arrangements controlled by the function’s sponsor. Also in workplaces not frequented by the public and where smoke pollution is detrimental to the health or comfort of nonsmoking employees, the local health board is to draw up smoking rules to govern workplace smoking. Persons in control of public places may designate smok- ing areas, except places where smoking is prohibited by the fire marshal or some other law and are responsible for posting appropriate signs and arranging for seating and ventilation to provide smokefree areas. 111 Public place is defined as any enclosed, indoor area used by the general public or serving as a place of work including, but not limited to, restaurants, health care offices, and other commercial establishments, nursing homes, auditoriums, theatres, arenas, meeting rooms, and buildings constructed, maintained, or otherwise sup- ported by tax revenues in whole or in part. In addition, enclosed indoor areas where the proprietor posts no- smoking signs are considered public places. Violation constitutes a class C misdemeanor. Local health boards may also institute court action to enjoin repeated viola- tions. Reference Date 1976. UTAH CODE ANN. Sections 76-10-101, 76-10-106, and 76-10-108 to 76-10-110 (1978). Criminal statutory sections 76-10-106 and 76-10-108 through 76-10-110 are deemed to be public health laws enforceable by the health departments. The Health Department is empowered to adopt rules to implement these criminal provisions. Reference Date 1981. UTAH CODE ANN. Sections 26-15-11 & 26-15-12 (1984). Smoking on any bus except a chartered bus constitutes a class C misdemeanor. The passenger who is in viola- tion may be ejected by the bus driver; other passengers may inform the driver of violators and request their dis- charge. Reference Date 1979. UTAH CODE ANN. Sec- tion 76-10-1506 (Supp. 1983). The Indoor Clean Air Act shall include public conveyan- ces, buses, railway passenger cars, airport terminals, bus stations, railway terminals, elevators, retail stores, and other commercial establishments. Reference Date 1976. UTAH CODE ANN. Sections 76-10-101 to 76-10-110 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors + Furnishing cigarettes or tobacco of any kind to one under 19 years of age, procuring cigarettes, cigars, or tobacco in any form, or allowing one under 19 years of age to smoke in his place of business is punishable as a class C misdemeanor. Reference Dates 1973 and 1974. UTAH CODE ANN. Sections 76-10-103 to 76-10-105 (1978). Cities and towns are empowered to prohibit the furnishing of tobacco to persons under 21 years of age. Reference Date 1898. UTAH CODE ANN. Sections 10-8-47 & 10- 13-9 (1973). Furnishing cigarettes to a minor is prohibited. Reference Date 1930. UTAH CODE ANN. Section 59-18-12 (Supp. 1983). Aperson who controls a tobacco vending machine that is accessible to persons under 19 years of age or who provides tobacco to a person under 19 years of age is guilty of a misdemeanor punishable by a fine between $25 and $100 or by imprisonment up to 60 days for the first offense. Second offenses are punishable by a fine of $50 to $200 or up to 90 days imprisonment. Subsequent offenses are punishable by a fine of $100 to $299 or not less than 90 days imprisonment or both. Signs prohibiting tobacco sales to minors must be posted on each machine. One who violates these provisions is guilty of a nuisance and may be enjoined from such activity, and the building itself may be abated as a nuisance. Reference Date 1933. UTAH CODE ANN. Sections 59-18-18 & 59-18-19 (1974). Schools and School Health Education » The State Board is required to adopt rules that provide for instruction in each grade level on the harmful effects of alcohol, tobacco, and controlled substances. Reference Date 1907. UTAH CODE ANN. Sections 53-14-4 & 53- 14-4.1 (Supp. 1987). 112 Regulation of Advertising Practices * Awarning label that states “Use of this product may cause oral cancer and other mouth disorders and is addictive,” is required on all smokeless tobacco products sold in the state. Reference Date 1986. UTAH CODE ANN. Sections 59-14-501 to 59-14-508 (1987). * Cigarette and other tobacco products advertisements are prohibited on any billboard, streetcar, bus, or any other display except that a cigarette dealer may have a sign in front of his business stating he is a cigarette dealer. Cigarette advertisements may appear in newspapers, magazines and periodicals. Reference Date 1953. UTAH CODE ANN. Section 76-10-102 (1978). Commerce * it shall be unlawful for any person to barter, sell, or offer for sale cigarettes or cigarette papers without having obtained a license therefore from the Utah State Tax Commission. Reference Date 1930. UTAH CODE ANN. Section 59-18-1 (Supp. 1985). « ttis unlawful for any person to sell, offer for sale, give or furnish clove cigarettes in the state. Reference Date 1974. UTAH CODE ANN. Section 76-10-105.3 (Supp. 1987). * tt is unlawful for any person to sell, offer for sale, give or furnish smokeless tobacco or chewing tobacco in the state. Reference Date 1973. UTAH CODE ANN. Sections 76-10-102 & 76-10-111 (Supp. 1987). Taxation “e The tax rate per pack is 23¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. * The “Phase II” changes in the cigarette and tobacco licensing tax laws are clarified and defined. Reference Date 1986. UTAH CODE ANN. Sections 59-14-101, 59- 14-201 to 59-14-209 (1987). * The Tax Code, particularly as it applies to tobacco sales and taxes, is recodified. Reference Date 1953. UTAH CODE ANN. Sections 59-14-101 to 59-14-107 (1987). Health and Safety Regulations * Discarding lighted smoking materials from a moving vehicle, or otherwise discarding substances that may cause fires on highways or wildiands constitutes a mis- demeanor. One who starts a fire as a result of violations may also be liable for the costs incurred in fighting the fire. Reference Date 1951. UTAH CODE ANN. Sections 24- 2-15 & 24-2-18 (1984). * Discarding “any lighted material” from a moving vehicle is prohibited, and violation is punishable by a fine be- tween $25 and $299 for each violation. Courts may also sentence offenders to at least one hour of cleaning up litter. Signs must be posted by the Department of Transportation notifying the public of the statutory provisions. Reference Dates 1941 and 1957. UTAH CODE ANN. Sections 41-6-114(e), 41-6-114.1 & 41-6- 114.2 (1981). Vermont Limitations on Smoking In Public Places * Smoking is prohibited in mills, factories, barns, stables, or other outbuildings belonging to another person and in public buildings in which the person in control has posted no-smoking signs. One who violates this section is sub- ject to a fine up to $5. Reference Date 1892. VT. STAT. ANN. Title 20, Section 2752 (1968). * Each employer shall establish a smoking policy in places of employment. Reference Date 1971. VT. STAT. ANN. Title 18, Chapter 28 subch. 2 (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * Furnishing cigars, snuff, or tobacco in any form to one under 17 years of age is prohibited without the written consent of the minor's parent or guardian. Maximum fine is $20. The person who controls a place where tobacco is sold is required to post a copy of Section 1308 provided by the Secretary of State. Failure to post the copy is punishable by a fine up to $5. Reference Dates 1888 and 1900. VT. STAT. ANN. Title 13, Sections 1308 & 1309 (1974). Schools and School Health Education * Aminimum course of study includes instruction about the health and societal effects of tobacco and is required to be taught in public and approved private schools, as well as in home study programs. Reference Date 1969. VT. STAT. ANN. Title 16, Section 906 (Supp. 1984). Commerce » Minors under 16 years of age are not to be employed in a tobacco manufacturing plant, except that minors over 14 years enrolled in vocational studies may be so employed provided the Commissioner of Labor and In- dustry has inspected and approved the safety of the workplace. Reference Date 1910. VT. STAT. ANN. Title 21, Sections 487 & 438 (1978). Each wholesale dealer and distributor of tobacco products must obtain a license from the Vermont Com- missioner of Taxes. Reference Date 1959. VT. STAT. ANN. Title 32, Section 7731 (1981). Taxation * The tax rate per pack is 17¢ and was last changed in 1983. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. * The exemption for cigarettes from the sales and use tax is repealed, making sales of cigarettes subject to that tax. Reference Date 1969. VT. STAT. ANN. Title 32, Sections 5965, 5967, 5968, 5970, 9741 & 9744 (Supp. 1986). Virginia Regulations of Sale to and Use of Tobacco Products by Minors + The sale of tobacco products to minors under 16 years of age is prohibited. This provision does not apply to cigaret- tes sold in vending machines where a notice is posted. Reference Date 1986. VA. CODE Section 18.2-371.2 (Supp. 1987). Commerce * The Cigarette Sales Below Wholesale Cost Act is repealed. This bill amended VA. CODE Sections 59.1- 285 to 59.1-293 which was later repealed by Act 1986 Ch. 474, 113 + Any person who transports or distributes cigarettes within the State of Virginia must obtain a permit from the Depart- ment of Taxation. Reference Date 1950. VA. CODE Section 58.1-1014 (1984). Taxation + The tax rate per pack is 2.5¢ and was last changed in 1966. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. Health and Safety Regulations * Smoking is prohibited in food-producing workrooms. Violation by a person, business, or corporation is punish- able by a fine of between $25 and $300. Reference Date 1950. VA. CODE Sections 3.1-379 & 3.1 -381 (1983). * Discarding lighted smoking material from a vehicle in or near forest land, brushland, or fields is prohibited. Viola- tion of this section is punishable by a fine between $10 and $100 or imprisonment for up to 30 days for each separate offense or both. Violation leading to causing a fire can also create liability for costs of fighting the fire. Reference Dates 1919 and 1954. VA. CODE Sections 10-64.1 & 10-67 (1978). » When it is determined that a fire hazard exists, smoking is prohibited within 300 feet of forest lands, brushlands, orfields. This section is punishable by a fine between $10 and $500, imprisonment for up to 30 days, or both for each separate offense. Reference Date 1954. VA. CODE Sections 27-54.1 & 27-54.4 (1985). « Smoking is prohibited around mines near flammable or combustible materials. Smoking or carrying smokers’ articles is prohibited in or near oil houses, explosive magazines and other hazardous mine areas. Reference Date 1950. VA. CODE Sections 45.1-39(c), 45.1 -44(j) & 45.1-98(a) (1980). Washington Limitations on Smoking in Public Places « Smoking is prohibited in public places, except in desig- nated smoking areas. Public place means that portion of any building or vehicle used by and open to the public, regardless of whether the building or vehicle is owned in whole or in part by private entities, the State of Washington or other public entity. Public places include, but are not limited to, elevators, public conveyances or transportation facilities, museums, concert halls, theaters, exhibition halls, indoor sports arenas, hospitals, nursing homes, health care facilities or clinics, enclosed shopping centers, retail stores, retail service estab- lishments, financial institutions, educational facilities, tick- et areas, public hearing facilities, state legislative cham- bers and immediately adjacent hallways, public restrooms, libraries, restaurants, waiting areas, lobbies, reception areas, and office workplaces. Intentional viola- tions of Washington's Clean Indoor Air Act are punishable by fines up to $100. Reference Date 1985. WASH. REV. CODE ANN. Sections 70.160.010 to 70.160.100 & 70.160.900 (West Supp. 1988). Unlawful bus conduct, a misdemeanor, includes smoking or carrying lighted smoking materials on municipal transit vehicles if the person knows that such conduct is prohibited and is likely to cause harm to others. Refer- ence Date 1984. WASH. REV. CODE ANN. Section 9.91.025 (Supp. 1985). Regulation of Sale to and Use of Tobacco Products by Minors » Furnishing cigars, cigarettes, cigarette papers, wrappers, or tobacco in any form to one under 18 years of age constitutes a gross misdemeanor, and it is no defense that the person violating this provision believed that the minor was an agent for another. Reference Date 1971. WASH. REV. CODE ANN. Section 26.28.080 (Supp. 1985). 114 Commerce * No person shall engage in the business of a distributor or subjobber of tobacco products without receiving a certifi- cate of registration from the state. Reference Date 1961. WASH. REV. CODE ANN. Section 82.26.050 (1981). * Changes have been made to the regulation of the cigarette industry to eliminate predatory cigarette pricing. Reference Date 1957. WASH. REV. CODE ANN. Sec- tions 19.91.010, 19.91.300, 82.24.500 & 82.24.510 to 82.24.560 (West Supp. 1988). Taxation * The tax rate per pack is 31¢ and was last changed in 1986. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, p. 9. The cigarette tax statutes are consolidated into one chap- ter. In addition, various tax rates and surtax rates on cigarettes have been consolidated. Reference Date 1961. WASH. REV. CODE ANN. Sections 82.24.020, 82.24.060, 82.24.265 & 82.32.270 (West Supp. 1988). Cigarette tax enforcement procedures and policies are provided. Reference Date 1961. WASH. REV. CODE ANN. Sections 82.24.1190, 82.24.1390, 82.24.135 & 82.24.145 (West Supp. 1988). An additional tax of 4 mills per cigarette and an additional tax of 16 3/4 percent of the wholesale price of tobacco products have been levied. The moneys collected will go into the water quality account. Reference Date 1986. WASH. REV. CODE ANN. Sections 70.146.010 to 70.146.080 & 70.146.900, 82.24.027 and 82.32.390 (West Supp. 1988). Health and Safety Regulations * During closed season, any person who starts a fire in forest, brush, range, or grain areas by throwing away lighted smoking materials and who fails to extinguish the fire immediately may be fined from $25 to $100 or im- prisoned for up to two months upon conviction. One who willfully tampers with posted warning notices may also be punished in the same manner. Smoking in forest or brush areas during closed season except in areas free of inflam- mable materials is prohibited. Every conveyance operated in flammable areas must contain a smoking materials disposal receptacle and must have a copy of the no-smoking provision posted. Operators of saw mills and logging camps must also post notices. Violation of the no-smoking notice and provisions constitutes a mis- demeanor. Reference Date 1911. WASH. REV. CODE ANN. Sections 76.04.210 & 76.04.300 (1962). * Carrying lighted pipes within five feet of mine explosives is prohibited unless explosives are in aclosed receptacle. Reference Date 1917. WASH. REV. CODE ANN. Sec- tions 78.40.473 & 78.40.675 (1962). * Smokers’ articles are prohibited in mines. Reference Date 1917. WASH. REV. CODE ANN. Section 78.40.699 (1962). West Virginia Limitations on Smoking in Public Places * Anyone who has lighted smoking materials or who lights smoking materials after entering a factory, business es- tablishment, mill, or workshop where no-smoking notices ate posted commits a misdemeancr, punishable by a fine of $20 to $100 for each violation. Reference Date 1919. W.VA. CODE Section 21-3-8 (1981). All owners or other persons responsible for the operation of any vehicles operated for the public transportation of eight or more persons must post no-smoking signs con- spicuously in the vehicles. Smoking is prohibited in any vehicle in which a no-smoking sign is posted. Violation of this section constitutes a misdemeanor punishable by a fine of not less than $20 nor more than $100. Reference Date 1985. W.VA. CODE Section 8-27-10a (Supp. 1987). Regulation of Sale to and Use of Tobacco Products by Minors * Selling, giving or furnishing cigars, cigarettes, cigarette papers, or tobacco in any form to one under 18 years of age is prohibited and is punishable by a fine between $10 and $25 for the first violation, and between $25 and $300 for each subsequent violation. Reference Date 1891. W.VA. CODE Sections 16-9A-1 to 16-9A-5 (Supp. 1987). Smoking or possession of cigarettes, cigarette papers or any other form prepared to be filled with smoking tobacco for cigarette use by one under 18 years of age is prohibited, and is punishable by a fine up to $5, provided that the minor is immune from prosecution if he discloses the person, firm or corporation who provided the cigaret- tes. Reference Date 1913. W.VA. CODE Section 16-9-5 (1985). Schools and School Health Education + Smoking cigarettes on school grounds or in schoo! build- ings is prohibited. Violation is punishable by a fine of from 115 $1 to $5 for each offense. Reference Date 1913. W.VA. CODE Sections 16-9-7 to 16.9A-4 (Supp. 1987). Regulation of Advertising Practices * Any outdoor billboard advertisement for snuff and chew- ing tobacco products must display one of three health warnings. Reference Date 1891. W.VA. CODE Section 16-9A-5 (Supp. 1987). Commerce * Manufacturing tobacco in one’s home is prohibited. The State Commissioner of Labor is charged with enforce- ment of industrial homework provisions. Violation con- stitutes a misdemeanor, and permits may be suspended or revoked. Reference Date 1939. W.VA. CODE Sections 21-7-1 to 21-7-11 (1981). Taxation + The tax rate per pack is 17¢ and was last changed in 1978. The Tobacco Institute, The Tax Burden on Tobac- co: Historical Compilation, 1986, vol. 21, Pp. 9. Health and Safety Regulations * Discarding lighted smoking materials on forest land, private roads, highways, and railroad right-of-ways is prohibited. Violation constitutes a misdemeanor. Refer- ence Date 1929. W.VA. CODE Section 20-3-6 (1981). Smoking in and around coal mine surface structures is restricted to areas where it will not cause a fire or ex- plosion. Reference Date 1958. W.VA. CODE Section 22-2-53 (1981). Smoking and smokers’ articles are prohibited in coal mines. The mine operator must conduct frequent searches of those entering or already in the mine. Refer- ence Date 1887. W.VA. CODE Section 22-2-57(b) (1981). Wisconsin Limitations on Smoking In Public Places + Wisconsin's Clean Indoor Air Act prohibits smoking in public conveyances, educational facilities, inpatient health care facilities, indoor theatres, offices, public pas- senger elevators, restaurants, retail stores, public waiting rooms, and public buildings. Exceptions include smoking areas designated by posted notices, offices occupied exclusively by smokers, rooms used for private functions under the sponsor's control, restaurants where the liquor sales account for more than 50 percent of the receipts or where the seating capacity is less than 50 persons, privately owned offices, prisons, and manufacturing plants. If the person in control of a building willfully fails to comply with provisions regulating designating and posting notices of smoking areas on or after April 1, 1985, a $25 forfeiture may be levied. After July 1, affected parties or government officials may sue to enjoin repeated violations. Reference Date 1983. WIS. STAT. ANN. Section 101.123 (West Supp. 1984). Schools and School Health Education » All elementary and secondary schools are required to provide education regarding tobacco as part of the Department of Education's critical health care education program. Reference Date 1977. WIS. STAT. ANN. Sec- tion 115.35(1) (West Supp. 1984). Commerce + It is unlawful for a person to manufacture cigarettes in Wisconsin or sell cigarettes in Wisconsin as a distributor, jobber, vending machine operator, or multiple retailer without first obtaining the proper permit to perform such operations from the Department of Justice. Reference Date 1965. WIS. STAT. ANN. Section 139.34 (West 1974). + The retail cigarette license in Milwaukee is good for one year. Reference Date 1897. WIS. STAT. ANN. Section 134.65 (West Supp. 1987). Taxation * The tax rate per pack is 30¢ and was last changed in 1987. The Tobacco Institute, “Cigarette Tax Data,” 1987. ¢ Several technical and minor policy changes in regard to beverages, fuel, alcohol, and tobacco products taxes have been made. tt is illegal to possess untaxed tobacco products. Reference Date 1953. WIS. STAT. ANN. Sec- tions 78.40 to 139.86 (West Supp. 1987). Health and Safety Regulations * Any person who, by smoking or attempting to light or smoke tobacco products, negligently sets fire “to any bedding, furniture, curtains, drapes, house or any household fittings” or any part of the public abode is subject to a fine between $50 and $250, or imprisonment between 10 days and six months or both, together with court costs. Notices to this effect must be posted in each sleeping room. Reference Date 1947. WIS. STAT. ANN. Section 50.58 (West Supp. 1984). Ventilation requirements for public buildings and work places that establish the mandatory minimum quantities of outside air to be supplied to indoor areas may not be waived by the Labor Department unless smoking is prohibited and the owner demonstrates that the air quality is equivalent to that provided by outside air. The Depart- ment is responsible for enforcing compliance. Reference Date 1980. WIS. STAT. ANN. Section 101.025 (West Supp. 1984). Cigars are not to be manufactured in shops located below ground floors. Reference Date 1899. WIS. STAT. ANN. Section 167.22 (West 1974). Wyoming Commerce + Every wholesaler who sells or offers to sell cigarettes in the State of Wyoming must have a license to do so. Reference Date 1951. WYO. STAT. Section 39-6-102 (1985). Taxation + The tax rate per pack is 8¢ and was last changed in 1967. The Tobacco Institute, The Tax Burden on Tobacco: Historical Compilation, 1986, vol. 21, p. 9. 116 Health and Safety Regulations * Discarding “a burning substance” fram a vehicle is punishable by imprisonment up to six months or a fine up to $750 or both. Reference Date 1982. WYO. STAT. Section 6-3-107 (1983). » Smoking around mine surface flammables storage areas is restricted to places where a fire or explosion will not be caused, Reference Date 1903. WYO. STAT. Section 30-2-602 (1983). LOCAL ORDINANCES AND REGULATIONS In addition to the National focus on smoking and health issues, State and city legislatures are increasing efforts to implement their own regulations. Twenty cities with the highest population count were examined for local ordinances covering issues on smoking and health. The cities were (in alphabetical order by city): Baltimore, Maryland; Boston, Massachusetts; Chicago, llinois; Columbus, Ohio; Dallas, Texas; Detroit, Michigan; Houston, Texas; Indianapolis, Indiana; Jacksonville, Florida; Los Angeles, California; Memphis, Tennessee; Milwaukee, Wisconsin; New York, New York; Philadelphia, Pennsylvania; Phoenix, Arizona; San Antonio, Texas; San Diego, California; San Francisco, California; San Jose, California; and Washington, D.C. Due to the magnitude and complexity of tracking local ordinan- ces and regulations, and the mechanisms each municipality uses to codify legislation, this compilation represents a Sam- pling of local legislative efforts. State laws may exist pertaining to issues on smoking and health: however, this compilation only reflects local ordinances and regulations on the city records through January 1988.’ The ordinances and regula- tions have been categorized into the following five topic areas: Smoking in Public Places; Smoking Regulations in the Workplace; Public Safety Regulations; Municipal Tobacco Taxation; and Regulation of Cigarette Sales to Minors. I. Smoking in Public Places Baltimore, Maryland Smoking on streetcars, trackless trolleys, or buses is a mis- demeanor punishable by a $10 maximum fine (Baltimore, MD., Code Article 19, Section 442 (1983), Ord. No. 169 (1945)). Boston, Massachusetts Smoking is restricted in public buildings and in public places (City of Boston Code, Ordinances, Title 2, Section 362 (1980)). Regulations pertaining to smoking include such places as: theaters, public halls, special halls, miscellaneous halls, places of assembly, public buildings, schools, colleges, universities, factories, workshops, mercantile establishments, wharves, docks, warehouses, and passenger and freight elevators (Boston Fire Prevention Code, Ordinances, Chapter 28, Article 30, Sections 30.01 to 30.06 (1979)). Fines for violation are not less than $10 nor greater than $50. Chicago, Illinois it is a misdemeanor to smoke on any public conveyance holding more than seven passengers (Chicago, IL., Code Section 193-7.10 (1955). It is illegal to smoke on any public elevator, and in retail stores employing more than 15 persons (excluding food areas, waiting rooms, restrooms, executive offices, beauty parlors, and areas where merchandise is not exposed), (Chicago, IL., Code Section 193-7.9 (1948)). Smok- ing is prohibited in theaters, churches, and schools (Chicago, IL., Code Sections 90-91 (a)-(g) (1980). Columbus, Ohio Smoking is prohibited in retail stores (Columbus, OH., Code Section 18.1, Ord. No. 237-48), theaters, halls, and auditoriums (Columbus, OH., Code Section 1016 (1919), Ord. No. 22240 (1919)). Dallas, Texas Smoking is prohibited in transit system vehicles, public elevators, conference and meeting rooms, city buildings (ex- cluding Love Field, Convention Center, and Reunion Arena), hospital rooms, libraries, museums, posted areas, nonsmok- ing areas of restaurants seating 50 persons or more (excluding bars), retail stores, theaters, and primary and secondary schools (Dallas, TX., Ord. No. 18961 (1985)). Fines for violation range from $25 to $250. Detroit, Michigan Smoking is prohibited in elevators (Detroit, MI., Code Section 49-3-96, Ord. No. 314-H (1979)). Houston, Texas Smoking is prohibited in public places (Houston, TX., Code Section 21-237(a)). Public places include, but are not limited to: vehicles of public transportation (such as trains, buses, and ferries), elevators, governmental facilities, gymnasiums, concert halls, auditoriums, health care facilities (including hospitals, nursing homes, doctors’ offices, dentists’ offices, and laboratories), libraries, museums, art galleries, theaters, meeting rooms, convention centers, hotels, motels, 1 An ordinance adopted by the Chicago City Council on May 25, 1988 falls outside this survey period. This ordinance bans or restricts smoking in a variety of public places and limits smoking in the workplace. 117 restaurants with a seating capacity of more than 50 persons, commercial establishments (excluding bars), restrooms, retail establishments (excluding tobacco retail shops), educational facilities from day care through college, and public areas of airports (Houston, TX., Code Section 21-236, Ord. No. 86.1311 (1986)). Indianapolls, Indiana Smoking is prohibited in streetcars, buses, elevators, public conveyances, hospital beds, hotel beds, retail selling estab- lishments, and educational occupancies (Indianapolis, IN., Code Section 12-126, Ord. No. 120 (1972)). Smoking is regulated in public service areas of government buildings and public assembly areas of local government buildings. Penal- ties for violation include a $25 fine, attending a free no-smok- ing clinic, or three hours community service in a cancer ward (Indianapolis, IN., Code Section 20-203 (1987))}. Jacksonville, Florida Smoking is prohibited in public libraries and in the Veterans Memorial Coliseum except in restrooms and designated smoking areas. Smoking is allowed by performers as part of a theatrical production or during private gatherings or affairs not open to the general public. Violation is punishable by a fine not more than $25, imprisonment for up to 10 days, or both. (Jacksonville, FL., Code Section 614.125, Supp. 4 (1983)). In places of assembly where the Fire Marshall deems it a public hazard, smoking is also prohibited. In such cases, regulation signs must be posted marking the area nonsmoking (Jackson- ville, FL., Code Section 447.202 (1983)). Los Angeles, California Smoking is prohibited in health care facilities, public meeting and assembly rooms, and retail food marketing estab- lishments (Los Angeles, CA., Code Section 41.50, Ord. No. 159498 (1984)). Additional smoking prohibitions are provided in arenas, gymnasiums, libraries, restaurants having a seating capacity of over 50 persons, areas of primary and secondary schools normally occupied by children, theaters, polling places, airport, train, or bus depot waiting areas or ticket lines, and day care facilities (Ord. No. 162989 (1 987)). Memphis, Tennessee Smoking is prohibited in many public areas including: Mem- phis Area Transit Authority buses, elevators, Mid South Coliseum, Auditorium South Hail, Dixon Meyers Hall, hospital lobbies, hospital waiting rooms, hotels, Cook Convention Cen- ter, public and private restaurants, merchandising stores with more than five employees, and theaters (Memphis, TN., Code Section 20-215, Ord. No. 3517 (1986)). Milwaukee, Wisconsin Smoking is prohibited on public buses (Milwaukee, WI., Code Section 98-15 (1979)) and in theaters (Milwaukee, WI., Code Section 105-49 (1943)). New York, New York Smoking is prohibited in ticketing, boarding, and waiting areas of public transportation facilities, in buses, subways, vans, taxicabs, elevators, concert halls, auditoriums, arenas, in public health care facilities including hospitals, clinics, physi- cal therapy facilities, convalescent homes, and homes for the aged, in public areas of hotels and motels with 25 or more employees, in libraries, museums, galleries, convention halls, in public meeting places, restaurants with a seating capacity 118 of 50 or more persons, restrooms, retail stores employing more than five employees or accommodating more than 150 customers, in pre-primary, primary, and secondary schools, in colleges, trade schools, theaters, places of religious assemb- ly, and in banks employing more than 15 employees (New York, NY., Code Section 17-503 (1988)). Philadelphia, Pennsylvania Smoking is prohibited in any public transportation vehicle, in any place of public assembly seating more than 100 persons, and in any retail store designed to accommodate more than 30 persons, or where more than 25 persons are employed (Philadelphia, PA., Code Section 10-602, enacted in 1943, 1947, and 1948). Phoenix, Arizona Smoking is banned from public places, defined in Section 23-103 to include public transportation vehicles, taxicabs, elevators, enclosed public buildings, government buildings, auditoriums, indoor sports facilities, offices of health care professionals, pharmacies, public areas of hotels and motels, restaurants, restrooms, retail stores, grocery stores, shopping malls, public and private schools, theaters, airport service lines, airport waiting lounges, financial institutions, and child care centers. Fines for violation range from $25 to $100 (Phoenix, AZ., Code Section 23-105 (1986)). San Antonio, Texas Smoking is prohibited in bus and train facilities, taxicabs, elevators, conference rooms, meeting rooms, or any public service areas of city buildings, concert halls, cultural facilities, hospital or nursing home corridors, hospital rooms, nonsmok- ing areas of restaurants, retail stores, service establishments, department stores, grocery stores, clothing stores, shoe stores, hardware stores, laundromats, hair salons, barber shops, public primary and secondary schools, motion picture theaters, airport facilities, banks, and savings and loan facilities (San Antonio, TX., Code Ch. 28.5, Section 2, Ord. No. 62781, passed Par. 24 (1986)). San Dlego, California Smoking is prohibited on public conveyances, elevators, governmental and educational agencies, pharmacies, health facilities, hospital rooms, psychiatric facilities, libraries, museums, galleries, public assembly halls, restaurants with a seating capacity of more than 20 persons must provide non- smoking sections, restrooms, retail stores, retail service establishments, food markets, retail food production estab- lishments, educational facilities, and theaters. Any person violating the Act is subject to fines from $10 to $100 (San Diego, CA., Code Section 45.0103 (1983), Ord. No. 11459 (1974)). San Francisco, California Smoking is prohibited in lobbies, waiting areas, restrooms, and dining areas of restaurants that are specified as nonsmok- ing areas. Owners are required to allocate adequate amounts of space as nonsmoking areas and must inform all patrons of nonsmoking areas (San Fransico, CA., Code Part Il, Ch. V, Article 19A, Ord. No. 298-83 (1983)). San Jose, California Smoking is prohibited during public meetings of government officials, any room, chamber, or place where entertainment events, lectures, or athletic events are held, in public areas of health care facilities, including hallways, waiting rooms, and lobbies, in patient rooms by nonpatients, in nonsmoking areas of restaurants with a capacity to serve more than 50 persons, in retail stores, public elevators, and in theaters (San Jose, CA., Code Section 944.101 to 944-080, Ord. No. 20364 (1980)). Washington, D.C. Smoking is prohibited on public passenger vehicles seating 42 or more passengers, in elevators, in any public hearing or assembly room owned or leased by the District of Columbia, in hallways, waiting rooms, and lobbies of healthcare facilities, in patient rooms, in educational facilities, libraries, in non- smoking areas of restaurants with a seating capacity of more than 50 persons, in retail stores, in nursery, elementary and secondary schools, day care centers, and institutions of higher education (District of Columbia, Code Section 6-912 to Sec- tion 6-917 (1979) amended January 1988, Section 7-100, effective March 29, 1988). il. Smoking Regulations In The Workplace Boston, Massachusetts Personnel of the Department of Health and Hospitals, Emer- gency Medical Services Ambulance Service are forbidden to smoke while engaged in patient care or while driving (MA. Gen. Laws, Chapter 1110, 1st Edition, Rules, Regulations and Standard Operating Procedures, 1.8.3.6. (1981)). Dallas, Texas Employers are required to implement a written policy that protects nonsmokers from second-hand smoke and to estab- lish a procedure for addressing employee complaints. The employer may use existing structural barriers and ventilation systems to create a nonsmoking area, and need not incur additional expenditures. The employer must provide con- spicuous signs to mark the nonsmoking area. An employer may not discharge, discriminate, or retaliate against an employee who exercises his rights under the ordinance (Dai- las, TX., Code Section 41-6 to Section 41-9, Ord. No, 19648 (1987)). Houston, Texas Employers are required to implement and maintain a written smoking policy to accommodate the desires of smokers and nonsmokers in the workplace (Houston, TX., Code Section 21-239, Ord. No. 86-1131 Section 2 (1986)). Los Angeles, California Employers are required to adopt, implement, and maintain a written smoking policy. The policy must provide that employers will try to accommodate the desires of both smokers and nonsmokers in the event of a dispute. An employer need not make additional expenditures to create structural or physical modifications in the workplace. A mini- mum of two-thirds of a lounge or cafeteria must be a nonsmok- ing area; restrooms and employee medical facilities must be nonsmoking areas. Employers must inform employees of the smoking policy and post signs in nonsmoking areas. An employer who makes reasonable efforts to develop and promulgate a smoking policy shall be deemed in compliance with the law (Los Angeles, CA., Code Section 41.50, Ord. No. 159, 498 (1984)). New York, New York Employers with over 15 employees are required to implement and adopt a written smoking policy that provides for a proce- dure to resolve a dispute when an employee desires to work in a smoke-free workplace. The policy must also provide 119 nonsmoking areas, including 50 percent of all lunchrooms, employee medical facilities, auditoriums, classrooms, con- ference rooms, meeting rooms, hallways, elevators, 50 per- cent of each employee lounge, restrooms, and any employee work area designated by the employee as a nonsmoking area. Employers must furnish each employee with a copy of the smoking policy, and post signs in no-smoking areas. Private enclosed offices occupied by smokers are excepted. An employer is prohibited from dismissing, demoting, suspend- ing, or taking any disciplinary action against an employee who exercises his or her rights under the smoking policy (New York, NY., Code Section 17-504 (1 988)). Phoenix, Arizona Employers are required to adopt, implement, and maintain a written smoking policy that makes use of existing ventilation and partitions to accommodate the preferences of smoking and nonsmoking employees. Employers are not required to incur expenditures or make structural changes, but if an accommodation between smokers and nonsmokers cannot be reached, the preference of nonsmokers must prevail. One- halt of all lounges, restrooms, employee medical facilities, hallways, stairways, elevators, conference rooms, meeting rooms, auditoriums, and classrooms must be nonsmoking areas. The employer must announce the smoking policy to employees, post the smoking policy in a conspicuous area, and post signs in all nonsmoking areas. An employer is prohibited from terminating or disciplining an employee when the employee makes a complaint about smoking in the workplace (Phoenix, AZ., Code Section 23-106, Ord. No. 2865 (1986)). San Antonlo, Texas An employer must adhere to certain guidelines when desig- nating all or part of the workplace as a nonsmoking area. An employer is required to have and implement a written policy that conforms to Chapter 28.5 of the Houston Code. The employer must make the written policy available for employee inspection, and the nonsmoking areas must be marked by conspicuous “No-Smoking” signs (San Antonio, TX., Code Ch. 28.5 Section 4, Ord. No. 62791 (1986)). San Diego, California . Smoking is prohibited in places of employment except in designated smoking areas. Employers are required to use existing physical barriers and partitions to minimize the effects of cigarette smoke, but need not incur any additional expense for physical or structural changes. An employer who develops a smoking policy in good faith is deemed in compliance with the Act. Unless the area is designated as a smoking area, a worker may not smoke in lounges, conference rooms, cafeterias, or work areas. Private offices are exempt from the prohibition, and employers must clearly mark all nonsmoking areas (San Diego, CA., Code Section 45.0101 to Section 45.0111 (1986)). San Francisco, California Employers are required to adopt, maintain, and implement a written smoking policy in offices. The policy must require employers to use existing partitions and ventilation to reduce the effects of second-hand smoke. While employers need not incur expenditures to accommodate the desires of smokers and nonsmokers, the preference of nonsmokers must prevail if a solution is not reached. The employer must announce the smoking policy, post it in a conspicuous place, and clearly mark the nonsmoking area with signs. Offices occupied ex- clusively by smokers are exempt from the Act (San Francisco, CA., Code Section 1003, Ord. No. 298-83 (1983)). San Jose, Callfornla Employers are required to adopt, implement, and maintain a written smoking policy, andthe employer must give preference to the requests of nonsmokers. Smoking is prohibited in restrooms, hallways, elevators, conference rooms, meeting rooms, employee medical facilities, classrooms, auditoriums, and two-thirds of each employee lounge. Any employee may designate his or her immediate work area as a nonsmoking area. All employers are required to communicate the smoking policy to employees‘and to post signs in nonsmoking areas. An enclosed workplace occupied exclusively by smokers is exempt (San Jose, CA., Code Section 944.120, Ord., No. 21830 (1984)). lll. Public Safety Regulations Baltimore, Maryland Smoking is prohibited on wharves and piers and in sheds. Smoking is prohibited on any vessel or near a vessel where explosives are being unloaded (Baltimore, MD., Code Article 10, Section 45 (1983)). Smoking is prohibited in or on cars containing explosives, or in the vicinity of explosives, aboard vessels, cars, or barges (Baltimore, MD., Code Article 10, Section 82, Ord. No. 336 (1913)). Boston, Massachusetts Smoking is prohibited in factories, workshops, mercantile establishments, or warehouses where the material being handled in and about the structure may readily be ignited by smoking materials or where such structures are of a combustible construction or if they are considered a fire hazard (Boston Fire Prevention Code, Ordinances, Chapter 28, Article 30, Sections 30.01 to 30.06 (1979)). Chicago, Illinois Smoking is prohibited where certain dangerous substances are kept. Smoking is prohibited in lumberyards (Chicago, IL., Code Section 90-91 (g) (1980), in public assembly units where combustible contents are kept (Chicago, IL., Code Section 90-91(e) (1980)), in “hazardous use rooms” (Chicago, IL., Code Section 90-91 (1980)), and in storage rooms where any highly flammable materials are kept (Chicago, IL., Code Sec- tion 92-56 (1977)). Columbus, Ohio Smoking is prohibited in any room used for dry cleaning (Columbus, OH., Code Section 18.42, Ord. No. 215-42 | (1942). Dallas, Texas Smoking is restricted around certain food products. Smoking is prohibited by workers in food product establishments (Dal- las, TX., Code Section 17-3.3(b) (1985)) and by workers engaged in processing milk or milk products (Dallas, T™., Code Section 26-7, Item 20p (1961)). 120 Detroit, Michigan Smoking is prohibited where combustible fibers are stored (Detroit, Ml., Code Section 19-3-47(2) (1979)), and in areas containing dust producing operations (Detroit, Ml., Code Sec- tion 19-3-47(3) (1979)). Using a cigarette to set fire to any hotel furnishings is prohibited (Detroit, MI., Code Section 42-2-9 (1964)). Houston, Texas Smoking is prohibited near oil wells or oil tanks (Houston, TX., Code Section 31-66), within 50 feet of an automobile accident (Houston, TX., Code Section 8-189), and by drivers of subur- ban buses (Houston, TX., Code 46-147). Indianapolis, Indiana Smoking is prohibited in the area of explosives (Indianapolis, IN., Code Section 12-240(b) & Section 12-248 (1972)), in any room containing a dusty atmosphere (Indianapolis, IN., Code Section 12-196(3) (1972)), in any room where film is handled (Indianapolis, IN., Code Section 12-432 (1972)), in any room where flammable materials are kept (Indianapolis, IN., Code Section 12-378 (1972)), and in finishing rooms or any area used for the storage of flammable finishes (Indianapolis, IN., Code Section 12-310 (1982)). Jacksonville, Florida Smoking is prohibited in the area of explosives and facilities for mixing blasting agents (Jacksonville, FL., Code Section 431.106, Section 431.107, Section 431.109, Section 435.914, & Section 431.112 (1983)), in any room containing a dusty atmosphere, such as lumberyards and woodworking plants (Jacksonville, FL., Code Section 434.103 & Section 441.103 (1983)), in any room where flammable materials are kept (Jacksonville, FL., Code Section 435.607 (1983)), in any area where conditions are such as to make smoking a hazard, i.e., any areas of piers, wharves, warehouses, stores, industrial plants, institutions, buildings under construction, places of assembly, or places where combustible materials are stored or handled (Jacksonville, FL., Code Section 447.202 (1983)), and in finishing rooms or any area used for the storage of flammable finishes (Jacksonville, FL., Code Section 434.103 & Section 435.607 (1983)). Where smoking is permitted, there shall be provided suitable, noncombustible ash trays or match receivers (Jacksonville, FL., Code Section 446.114 (1983)). Los Angeles, California Smoking is prohibited in any public garage or on the premises of any auto fueling station (Los Angeles, CA., Code Section 57.100.37). New York, New York Smoking is prohibited on any vessel storing petroleum oil, in any warehouse, shed, dock, pier, bulkhead, or wharf (New York, N.Y., Code Section C19-168 (1976)), or in any room where food is processed, prepared, or packaged (New York, N.Y., Code Section 81.27 (1981)). Disposal of any cigarette within any building, boat, car, or common carrier, except in ashtrays, is prohibited (New York, NY., Code Section 19-168 (1976)). San Antonio, Texas Smoking is restricted around fuel in airports (San Antonio, TX., Code Section 3-61 (1984)), or within 50 feet of a plane being retueled (San Antonio, TX., Code Section 3-113 (1984)). San Antonio has adopted the Texas Department of Health Rules on Food Sanitation, which prohibits employees from smoking while engaged in food preparation, food service, or dishwash- ing (San Antonio, TX., Ord. No. 59746 (1984)). San Dlego, California Smoking is prohibited near fuel in airports (San Diego, CA., Unitied Port District Code Section 5.05 (1 964)), within 50 feet of the landing pad of heliport and helistop locations (San Diego, CA., Code Section 68.0210 (1970)), in garages (San Diego, CA., Code Section 55.20.4 (1967)), on any municipal wharf or in any municipal warehouse (San Diego, CA., Code Section 63.15.37 (1967)), and within buildings under construc- tion (San Diego, CA., Code Section 68.0131 (1969)). Smoking is prohibited during and up to four hours after apply- ing flammable finishes to bowling alleys (San Diego, CA., Uniform Fire Code Section 55.26.103 (1984)). San Jose, California Smoking is prohibited near airplanes or fuel in airports (San Jose, CA., Code Section 15.04.160 (1950)), and near any park, trail, bridle path, or in any fire risk area (San Jose, CA., Code Section 13.44.130 (1977). IV. Municipal Tobacco Taxation Chicago, lilinols A 10¢ tax is imposed on each pack of 20 cigarettes sold within the city. Each tobacco wholesaler is required to collect the tax from retailers and pay the Comptroller. Wholesalers are re- quired to make invoices for each sale, file quarterly tobacco tax returns, and must purchase tax stamps from the Comptroller before delivery to retailers. Retailers are required to file a sworn inventory on all cigarettes in their control, and must file a report showing tobacco purchases within the proceeding three months. The City Comptroller may appoint someone to affix the stamps; it is forbidden to alter or forge any tax stamp. The Act provides several remedies if the tax is not paid including: seizing cigarettes, bringing jegal action, or revoking all tobacco dealer licenses. The Act provides for $50 to $300 fines for the first offense, $50 to $500 fines for the second offense, and incarceration for not more than three months for the third offense (Chicago, IL., Code Sections 178.1-1 to 178.1-14 (1982)). Los Angeles, California A tax of two mills ($.002) is imposed per cigarette on all cigarettes sold within the city limits. Each retailer is required to obtain a Cigarette Tax Registration Certificate and to register with the City Comptroller who is responsible for col- lecting the tax from the retailer and for paying the collected tax to the city. Retailers are required to keep all necessary records for four years as proof. All delinquent tax payments are subject to interest and penalties, and the city may bring legal action to recover unpaid taxes from retailers or users. The Act provides a taxpayer with a means of obtaining a tax refund if the tax was overpaid, wrongly collected, or paid more than 121 once (Los Angeles, CA., Code Section 21.8.1 to 21.8.11, Ord. No. 127, 689 (1964)). Memphis, Tennessee Acigarette tax of 1¢ is imposed on each pack of 20 cigarettes sold within the city (Memphis, TN., Code Section 36-41 to Section 36-52 (1967)). Each wholesaler must add the cigarette tax to each pack of cigarettes sold to retailers within the city. The retailer in turn should charge the purchaser. The wholesaler must affix stamps to cigarettes showing tax pay- ment before delivery. City officials have access to all pertinent wholesaler records for determination and collection of the tax. The Act provides a refund on all unsalable stamps and provides an exemption for all cigarettes bought by military personnel on a military establishment. San Jose, Callfornia A tax of $.0015 (1 1/2 mills) is imposed on the sale of each cigarette within the city limits. All cigarette distributors (wholesalers) must register with the Director of Finance and must collect and pay the tax to the city. Wholesalers must keep comprehensive records of all cigarette distribution and retain the records for three years. The city is authorized to bring an action to collect the tax. The Act also authorizes harsh penal- ties for nonpayment of taxes, which increase in the amount based upon the length of time the tax is outstanding. Criminal sanctions of a $500 fine or imprisonment for not more than six months are authorized. The Act provides for a refund, if a tax, penalty, or interest is overpaid or wrongfully collected (San Jose, CA., Code Section 4.50.010 to Section 4.50.140 (1967)). Washington, D.C. A tax of 85/100¢ is imposed on each cigarette sold within the city limits. Wholesalers, retailers, and vending machine operators are required to obtain licenses from the Mayor. Retailers are required to affix stamps to cigarette packages to evidence the tax payment. (All persons are prohibited from altering or counterfeiting stamps.) Further, all wholesalers, retailers, and vending machine operators must keep, main- tain, and preserve all relevant records and books. The Mayor is authorized to seize cigarettes, vending machines, and forged stamps for nonpayment of taxes. The Act also provides for penalties and interest for nonpayment. Certain cigarettes are exempt from the Act including: cigarettes sold by the government, cigarettes possessed by licensed wholesalers for sale outside the District, cigarettes possessed by con- sumers, and cigarettes being legally transported within the District. Provision is made for refund of any tax, penalty, or interest wrongfully collected. Requirements for transporting cigarettes within the city limits are specified. (Washington, D.C., Code Section 47-2401 to Section 47-2418 (1982)). V. Regulation of Cigarette Sales to Minors Boston, Massachusetts It is prohibited for any person, except at full retail price, to distribute in or upon any part of the streets, parks, public grounds, public buildings, other public places within the City of Boston, any product containing tobacco or nontobacco cigarette products for any commercial purpose. Violation is punishable by a fine of $200 (City of Boston Code, Ordinan- ces, Title 14, Section 270A (1984)). Chicago, Illinois It is prohibited to sell cigarettes to any person under the age of 18 years and minors under the age of 18 years are prohibited from purchasing or accepting delivery of cigarettes. Sellers are required to post a warning to minors and to request identification from any person who appears to be less than 18 years of age. Minors are prohibited from misrepresenting their age to obtain cigarettes (Chicago, IL., Code Section 178-19.1 to Section 178-19.5 (1982)). It is prohibited to sell cigarettes within 100 feet of schools (Chicago, IL., Code Section 178-18 (1982)). It is also prohibited to install a vending machine where minors are employed, unless the machine is under constant adult super- vision (Chicago, IL., Code Section 178-23 (1982)). Vending machine owners or operators are required to post a warning to minors of the illegality of purchasing cigarettes (Chicago, IL., Code Section 178-18 (1982)). Detroit, Michigan it is prohibited to furnish cigarettes to minors and minors are prohibited from buying, receiving, possessing, or using cigarettes. Minors are also prohibited from misrepresenting their age to obtain cigarettes. It is prohibited to persuade, counsel, or advise any minor to smoke cigarettes (Detroit, MI., Code Section 11-3-1 to Section 11-3-3 (1964)). 122 Jacksonville, Florida It is prohibited to sell, barter, give, exchange, or otherwise distribute any cigarette, cigar, pipe, cigarette rolling papers, tobacco, smoking herb, or any other smoking material, to any person under the age of 18 years. Ignorance or misrepresen- tation of the age of a recipient of any of the smoking materials shall not be a defense to a prosecution. Signs to this effect shall be prominently posted at all times (Jacksonville, FL., Code Section 480.111 (1983)). Violation shall be punishable by $500 fine, 90 days in jail, or both. Milwaukee, Wisconsin It is prohibited to sell cigarettes to a minor under the age of 16 years, and illegal for any person to permit a minor to smoke on premises occupied by the person (Milwaukee, WI., Code Section 106-30 (1956)). San Diego, California It is illegal for any person under the age of 18 years to possess or use tobacco (San Diego, CA., Code Article 8, Section 58.04 (1900}). Further, it is unlawful for any person to sell tobacco to a minor (San Diego, CA., Ord. No. 58 (1890)). San Jose, California tt is prohibited to maintain or operate a cigarette vending machine within 100 feet of a public playground or school (San Jose, CA., Code Section 6.70.110 (1960)). In places having vending machines, a responsible employee must supervise the use of the machine and ensure that it is not operated by minors (San Jose, CA., Code Section 6.70.120 (1960)). Washington, D.C. It is prohibited to sell cigarettes to any minor under the age of 16 years (Washington, D.C., Code Section 22-1120 (1891)). oOMmOnNO OM BWHD = Public Places uses, Streetcars, Trolleys levators nment Build Gymnasiums/Arenas Health e Facuities Libraries Museums tings— Posted Areas blic aurants trooms iWGrocery Stores vention S es Places trative eas urches Banks Child Care Faeilities Warehouses & Factones PPOOMM™ATTULHATEZOP OA Y o 2 Ni ‘sHoOdouDIpU! ‘OOSIDUDJ4 UDS XI ‘OlOjUY UDS 123 >RPOOM™OAEME ATE ZOP ORY Ssiais 31215 ]> nme ARPS 2 g ae OAS IY I: o|> Smoking in the Workplace 25 26 27 28 29 30 34 32 33 34 Nonsmoki 35 Notice to Em 36 Restrooms 37 Retaliation Prohibited 38 Preference for Demands of N 39 ns Required 40 Ventilation, Partition, Se 44 Written 42 Criminat Sanction 43 Limited No. of Em ivate ice Exception edical Wifes Limited to Offices Cafetenas & Lunchrooms sstoOomMs OnumMs Comolaint Procedure Conference & Meeting Rooms Employee Smoking Area arth Exception Hallways, Elevotors. Siairways Lou s or Waiting Rooms No Structure C ied Area Required Required ation 45 46 124 SpROOMMOTA~LATEZOV ORE Safety Regulations 47 48 kenies 49 Combustible Fibers 50 Disposal! of ettes §4 Drivers 52 sty Atmospheres 53 Explosives, Trucks - Vessels 54 Films 55 Firetighters 56 Hotels 57 Milk Products 58 Near Fuel §9 Oil Tanks 60 rks 641 Vehicle Accidents 62 Vessels 63 Warehouses. Gar 64 Wharves, Sheds. Piers 65 , genera 66 Food Products/tsiablisnment 67° Buitdi under Construction and i , SHOPS 125 PEOOMMNOT SATE ZOPOA“L™ x 5 2 ZU ° 51815) 8 181515) 8 e438 |8|8|8 “yes 5|3}2/3|514/8 81S ¥/S1 51819] 8)" § Zz oT$1o = < O|> 2 331 >| ° ¢ Tobacco Taxation 68 69 70 lection Wholesaler 74 72 Fines 73° Inven 74 75 76 77 78 79 80 St 84 Tax im 82 Wholesalers Exempt 83 misc 84 Transportation Restrictions 85 ure eiture of Prop. ilitary Exception and Interest ds ed ation and uired PROQOOMNMNDITA SCAT EZOVPOVP PiS OWIO |= Zjyrjr yn ayo ai> QO 212 21212 |e Oo}? 215 (9 31s w“ 213 1813 |" |F 19 [218 <|2 12] 312215 S o 2 3 Q x Q\e ®1zZ/°/s IRE: = x al? 2Pllt | [E15 | 8] at zial§| 9) 18] 91: 0 ~T, < 3 Z\- ; Sale and Use by Minors 86 87 88 89 90 Misrepresentation red seli suadi , Advisi Possession Premises Owner 9A 92 93 War Display 94 Vending Machines 95 96 chase Unlawtul Misreoresentation 126 The following is a detailed explanation of legislation cited in the narrative section with letter and number codes for use with the charts accompanying that section. Baltimore, Maryland A1 A53 A62 A63 A64 MD. Ann. Code Article 19, Section 142 (1983) Carrying a lighted, smoking instrument on a street car, trackless trolley, or bus is unlawful; violation is a mis- demeanor punishable by a $10 maximum fine for each violation. MD. Ann. Code Article 10, Section 82, Ord. No. 336 (1913) Prohibits smoking in or on cars containing explosives or in the vicinity of explosives, aboard vessels, cars, or barges. MD. Ann. Code Article 10, Section 45 (1983) Prohibits smoking on any vessel or near a vessel unloading explosives. Violation is punishable by a fine of $5 to $25. MD. Ann. Code Article 10, Section 45 (1983) Prohibits smoking in any warehouse on any wharf or pier. MD. Ann. Code Article 10, Section 45 (1983) Prohibits smoking on any wharf, shed, or pier. Boston, Massachusetts B3 B4 B10 B11 MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in passenger and freight elevators. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is restricted in public buildings and at public meetings. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in public halls, special halls, miscellaneous halls, and places of assembly. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Violation is punishable by a fine of not less than $10 nor more than $50. 127 B16 B16 B17 B19 B24 B51 B63 B64 MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in schools, colleges, and univer- sities. MA. City of Boston Code (CBC) Ordinances, Chapter 16, Title 2, Section 362 (1980) The Boston School Department shall institute an educational program in all junior and senior high schools in the city on the harmful effects of smoking. MA. Fire Prevention Code, Ordinances, Chapter 28, Ariicle 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in theatres. MA. Clty of Boston Code, Ordinances, Title 14, Section 270A (1984) No person shail distribute except at full retail price, any product containing tobacco or nontobacco cigarette products for any commercial purpose in or upon any part of the streets, parks, or public grounds. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in factories, workshops, mercan- tile establishments, and warehouses. MA. City of Boston, Department of Health and Hospitals, Emergency Medical Service, Rules, Regulations, and Standard Operating Procedures 1.8.3.6. Department personnel are forbidden to smoke while engaged in patient care or while driving. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in factories, workshops, mercan- tile establishments, and warehouses. MA. Fire Prevention Code, Ordinances, Chapter 28, Article 30, Section 30.01 to 30.06 (1979) Smoking is prohibited in factories, workshops, wharves, docks, and warehouses. Chicago, Illinois C1 c3 c4 C15 C16 C17 c 20 Cc 21 Cc 58 C63 IL. Stat. Ch. 193, Section 193-7.10 (enacted 1955) (amended 1975) Prohibits smoking or carrying a lighted smoking instru- ment in any street car, elevated train, subway or any public conveyance holding more than seven pas- sengers. Violation is punishable by a fine of $50 to $300 for each offense. IL. Stat. Ch. 193, Section 193-7.9 (enacted 1948) (amended 1975) Prohibits carrying or smoking a lighted cigarette on public elevators. Violation is punishable by a fine of $25 to $250 for each offense. IL. Stat. Code Section 90-91(b) (1980) Prohibits smoking in every institutional building except in the administration office on the first floor and in designated smoking rooms. IL. Stat. Code Section 193-7.9 (1948) Prohibits smoking in any retail store in which more than 15 persons are employed. Areas set apart for serving food or beverages, waiting rooms, restrooms, execu- tive offices, beauty parlors, and areas where merchan- dise is not exposed are excluded. Violation is punishable by a fine of $25 to $250. IL. Code Section 90-91 (d) (1980) Prohibits smoking in schools. IL. Code Section 90-91(c) (1980) Prohibits smoking in theaters except in smoking rooms. IL. Code Section 90-91(d) (1980) Prohibits smoking in hangars. IL. Code Section 90-91(d) (1980) Prohibits smoking in churches. IL. Code Section 90-91(a) (1980) Prohibits smoking in any “hazardous room.” IL. Code Section 92-56 prohibits smoking in any highly flammable material storage room. See also Section 129.14 and Section 172.19. IL. Code Section 90-91(g) (1980) Prohibits smoking in any lumberyard or lumber storehouse. 128 cés C68 C70 C71 C72 C73 C77 C80 IL. Code Section 90-91(e) (1980) Prohibits smoking in any public assembly unit where combustible contents are kept. IL. Code Section 178.1-11(a) (1982) Provides that if any person fails to pay the tax, cor- porate counsel may bring an action for payment of the tax on behalf of the city. The mayor may revoke all city license of the tax evader (including tobacco dealers license). IL. Code Sectlon 178.1-7 (1982) Provides that tobacco wholesalers must make an in- voice for each sale of cigarettes and provides that tobacco wholesalers must file a quarterly cigarette tax return showing all tobacco sales by him within the city and to persons outside the city. Section 178.1-2(b) provides that each tobacco wholesaler must purchase tax stamps from the comp- troller before delivery to the retailer. IL. Code Sectlon 178.1-8 (1982) Prohibits walking, altering, or forging any cigarette tax stamp with intent to defraud. IL. Code Section 178.1-1.4 (1982) Fine for first offense is $50 to $300, for second offense is $50 to $500 (within a 180 day period); third offense is a misdemeanor punishable by incarceration for not more than six months. IL. Code Section 178.1-5 (1982) Provides that every retail tobacco dealer must file a sworn inventory of all cigarettes within his control within 10 days of the effective date of the ordinance. The inventory must be filed with the director of revenue and must be accompanied by a report showing all cigarette purchases within the preceeding three months. The retail dealer must then pay taxes on the unstamped cigarettes. IL. Code Sectlon 178.1-7 (1982) Requires wholesale dealers to make a triplicate in- voice showing date of delivery, number of packages, and name of the purchase. IL. Code Section 178.1-4 (1982) Provides that the city comptroller shall appoint some person (wholesaler) to affix tax stamps to any cigarettes under his conirol. c 81 Cc 85 C87 c91 C93 C94 c95 C96 IL. Code Section 178.1-2 (1982) imposes a 10¢ tax on each 20 cigarettes. The wholesaler shall pay the comptroller, the retailer shail pay the wholesaler, and the purchaser shall pay the retailer. IL. Code Section 178.1-12 (1982) The comptroller may seize any cigarettes and vending machine when tax on the cigarettes has not been paid, or stamps affixed. IL. Code Section 178-19.1 (1982) Requires a seller to request identification from any person he believes or has reason to believe is under 18 years of age. Repeated or knowing failure to re- quest identification will result in revocation of tobacco sales license. IL. Code Section 178-19 (1982) Prohibits the sale of cigarettes to any minor under 18 years of age. Section 178-18 prohibits any person from selling cigarettes within 100 feet of any school. IL. Code Section 178-19.2 (1982) Requires every seller of tobacco products to post a warning stating that persons under 18 years of age are subject to a $500 fine for purchasing cigarettes or for misrepresenting their age. IL. Code Section 178-23 (1982) Provides that no cigarette vending machine shall be installed where minors under 18 years of age are employed unless the machine is under constant super- vision by a responsible adult. Further provides that each vending machine must exhibit a sign stating that itis unlawful to sell cigarettes to anyone under 18 years of age. IL. Code Section 178-19 (1982) Prohibits minors under 18 years of age from purchas- ing or accepting delivery of cigarettes. Violation is punishable by a fine of $50 to $500. IL. Code Section 178-19.3 (1982) Prohibits minors from misrepresenting their age, or from using another's identification card, for the pur- pose of obtaining cigarettes. 129 Columbus, Ohio D15 D17 D65 OH. Code Section 81, Ord. No. 237-48 (1919) Prohibits smoking in retail stores employing 25 or more persons or designed to accommodate 200 or more persons. Restrooms are excluded. OH. Code Section 1016 (Code of 1919) Prohibits smoking in theaters, halls, auditoriums, and public buildings. Violation is punishable by a fine of $5 to $500. Columbus, Ohio, City Bulletin (July 26, 1980) Prohibits smoking in public theaters and auditoriums. OH. Code Section 18.42, Ord. No. 215-42 (1942) Prohibits smoking in any rooms used for dry cleaning. Dallas, Texas Ei E2 E3 E4 E6 TX. Code Section 41-2(a)(6) (1985) Prohibits smoking in any transit system vehicle. Viola- tion is punishable by a fine of $25 to $200. TX. Code Section 41-2(a)(6) (1985) Prohibits smoking in any transit system vehicle. Viola- tion is punishable by a fine of $25 to $200. TX. Code Section 41-2(a)(1) (1985) Prohibits smoking in any public elevator. Violation is punishable by a fine of $25 to $200. TX. Code Sectlon 41-2(a)(3) (1985) Prohibits smoking in any conference room, meeting room, or public service facility owned, operated, or managed by the city. Love Field, Dallas Convention Center, Reunion Arena, concert halls, cultural facilities, and common areas of city-owned theaters are excluded. TX. Code Section 41-2(c1 & 2) (1985) Gives hospital patients the right to choose whether to be in a no smoking room. Requires employees or visitors to obtain express approval from a patient before smoking in the patient’s room. TX. Code Section 41-2(a}(b) (1985) Prohibits smoking in libraries. E9 E10 E11 E12 E13 E15 E16 E17 E 27 E33 TX. Code Section 41-2(a)(6) (1985) Prohibits smoking in museums. TX. Code Section 41-2(a)(3) (1985) Prohibits smoking in conference rooms and meeting rooms. TX. Code Section 41-2(a)(5) (1985) Prohibits smoking in any area posted by the owner of a hospital, nursing home, retail establishment, or ser- vice establishment. TX. Code Section 41-2 (1985) Specifies the areas where public smoking is prohibited in Dallas. TX. Code Section 41-4 (1985) Food product establishments must have separate smoking and nonsmoking areas. The areas must be separated by four feet of space. The areas must be adequately ventilated. All non-dining areas of res- taurants must be designated as nonsmoking areas. Establishments seating less than 50 persons; estab- lishments with gross sales of alcohol of greater than 70 percent; and a separated bar area of a food products establishment are excepted. Violation is punishable by fines of $25 to $250. TX. Code Section 41-2(a)(4) (1985) Prohibits smoking in retail or service establishments serving the general public including grocery stores, department stores, and drug stores. Love Field, Dallas Convention Center, Reunion Arena, and common areas of theaters, concert halls, cultural facilites, and common areas of city-owned theaters are excepted. TX. Code Section 41-2(a)(6) (1985) Prohibits smoking in public, primary, or secondary schools. Violation is punishable by fines of $25 to $250. TX. Code Section 41-2(a)(6) (1985) Prohibits smoking in enclosed theaters. Violation is punishable by fines of $25 to $250. TX. Code Section 41-6(1)D) (1987) Provides that the employer must establish a procedure for addressing employee complaints. TX. Code Section 41-6(1)(c) (1987) Provides that the employer need use only existing structural barriers and ventilation system. 130 E34 E 37 E39 E 40 E 41 E 42 E 57 E 66 TX. Code Section 41-6(1)(c) (1987) Provides that the employer shall designate a non- smoking area to minimize nonsmokers involuntary ex- posure to second-hand smoke. TX. Code Section 41-6(3) (1987) Prohibits an employer from discharging, retailing, or discriminating against an employee who: 1) files a complaint or institutes a proceeding; 2) testifies in an instituted procedure; or 3) exercises a right given by this chapter. TX. Code Section 41-6(2) (1987) Provides that conspicuous signs must be posted in a nonsmoking area. TX. Code Section 41-6(1)(c) (1987) Requires nonsmoking areas to be created using the existing structural barriers and ventilation. TX. Code Section 41-6(1) (1987) Provides that employers implement a written smoking policy that protects nonsmokers from second-hand smoke. TX. Code Section 41.1 (1987) Violation is punishable by a fine of $50 to $500. TX. Code Section 26-7 (Item 20p) (1961) Prohibits the use of tobacco by any person engaged in processing milk or milk products. TX. Code Section 17-3.3(b) (1985) Prohibits persons who work in food product estab- lishments from smoking. (While preparing food or while occupying an area used for food preparation). Detroit, Michigan F3 F 49 F 52 MI. Code Section 193-96 (1979). Prohibits smoking in any elevator within the City of Detroit. MI. Code Section 19-3-47(2) (1979) Prohibits smoking in any area where combustible fibers are stored. MI. Code Section 19-3-47(3) (1979) Prohibits smoking in areas containing dust producing or dust-agitating operations. F 56 F 88 F 89 F 91 F92 F 96 MI. Code Section 44-2-9 (1964) Prohibits using a cigarette or cigar to set fire to any furnishings in a hotel. Mi. Code Section 11-3-1 (1964) Prohibits any person from persuading, counseling, or advising any minor to smoke cigarettes. First offense is punishable by a fine not to exceed $25 or imprison- ment not to exceed 30 days. The second offense is punishable by a fine not to exceed $100 or imprison- ment not to exceed 60 days. Mi. Code Section 11-3-3 (1964) Makes it unlawful for any minor to buy, receive, or possess cigarettes. Mi. Code Section 11-3-1 (1964) Prohibits any person from selling, furnishing, or giving away cigarettes to minors. Mi. Code Section 11-3-3 (1964) Prohibits minors from using cigarettes. Mi. Code Section 11-3-2 (1964) Prohibits any minor from misrepresenting his age to obtain cigarettes. Houston, Texas G1 G3 G4 G5 G6 TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including vehicles of public transportation such as trains, buses, or fer- ries. (See Section 21-236). Taxicabs and limosines are excluded. TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including elevators. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including governmental facilities. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including gym- nasiums, concert halls, and auditoriums. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including health care facilities, i.e., hospitals, nursing homes, doctors’ and dentists’ offices, and laboratories. (See Section 21-236). Lobbies and reception areas are excluded. 131 G7 G8 G9 G10 Gi2 G13 G14 G15 G16 G17 G 20 TX. Code Saction 21-237(a) (1986) Prohibits smoking in public places including hotels and motels. (See Section 21-236). Hotel and motel sleep- ing rooms rented to guests are excluded. TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including libraries. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including museums and art galleries. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including meeting rooms and convention centers. (See Section 21-236). The convention center exhibition area is excluded. TX. Code Section 21-237(a) (1986) Institutes a general prohibition on smoking in public places. (See other summaries for details). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including res- taurants (prohibition applies to all commercial estab- lishments). (See Section 21-236). Lounge bar, restaurant bar, and restaurants with a seating capacity of less than 50 persons are excepted. TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including restrooms. (See Section 21-236). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including retail establishments. (Applies to all commercial establishments). (See Section 21-236). Tobacco specialty retail shops are excluded. TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including education- al facilities. (See Section 21-236). (Applies to day care through colleges). TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including theaters. (See Section 21-236). Lobbies are excepted. TX. Code Section 21-237(a) (1986) Prohibits smoking in public places including airports. (See Section 21-236). Gai G51 G59 G 61 TX. Code Section 21-239, Ord. No. 86-1311, Section 2 (1986) Requires employers to implement and maintain a writ- ten smoking policy to accommodate the desires of smokers and nonsmokers. TX. Code Section 46-147 Prohibits drivers of suburban buses from smoking. TX. Code Section 31-66 Provides for no-smoking signs to be placed on each oil well, storage tank, or battery of tanks within the city limits. TX. Code Section 8-189 Prohibits any person from igniting a match, lighter, or flammable object within 50 feet of a vehicle accident. Indianapolis, Indiana H1 H3 H4 H6 H7 H 10 H 12 IN. Code Section 12-126(c) (1972) Prohibits smoking in any streetcar, bus, elevator, or public conveyance; taxicabs are excepted. IN. Code Section 12-126(c) (1972) Prohibits smoking in elevators. IN. Code Section 20-203 (1987) Prohibits smoking in any local government building in all public service areas (any room, corridor, or confined area where the public is required to direct or transact business with local government officials). IN. Code Section 12-126(d)}{2) (1972) Prohibits smoking in bed in a hospital. IN. Code Section 12-126(d)(2) (1972) Prohibits smoking in bed in a hotel. IN. Code Section 20-204 (1987) Prohibits smoking in any public assembly area of any local government building, except in designated smok- ing areas (any room regularly used for public meetings conducted by officials of Indianapolis). IN. Code Section 20-201 (1987) Generally restricts smoking in certain public buildings. (Specific restrictions on other summaries.) H 15 H16 H 51 H 52 H 53 H 54 H 58 H 65 IN. Code Section 12-126(b){1) (1972) Prohibits smoking in retail selling establishments. IN. Code Section 12-126(b)(3) (1972) Prohibits smoking in all ‘Educational Occupancies” (no definition provided for these terms in the ordinance). IN. Code Section 12-240(b) (1972) Prohibits smoking by any person in charge of a vehicle containing explosives. IN. Code Section 12-196(3) (1972) Prohibits smoking in rooms containing a dusty atmos- phere. IN. Code Section 12-240(a) (1972) Prohibits any person in charge of a vehicle containing explosives from smoking. Section 12-248 prohibits smoking while handling explosives. IN. Code Section 12-432 (1972) Prohibits smoking in rooms where film is stored or handled. IN. Code Section 12-378 (1972) Prohibits smoking in rooms where flammable materials are kept. IN. Code Sectlon 12-310 (1982) Prohibits smoking in any area used for the storage of flammable finishes or in any finishing room. Section 12-378 prohibits smoking in all buildings that contain flammable liquids. Jackonsville, Florida 15 111 132 Jacksonville, FL., Code Sectlon 614.125, Supp. 4 (1983) Smoking is prohibited in the Veterans Memorial Coliseum except in restrooms and designated smok- ing areas. Jacksonville, FL., Code Section 614.125, Supp. 4 (1983) Smoking is prohibited in public libraries. Jacksonville, FL., Code Section 447.202 (1983) Smoking is prohibited in places of assembly where the Fire Marshall deems it a public hazard, smoking is also prohibited. In such cases, regulation signs must be posted marking the area nonsmoking. 117 124 150 151 152 153 158 159 163 165 Jacksonvlile, FL., Code Section 614.125, Supp. 4 (1983) Smoking is allowed by performers as part of a theatri- cal production or during private gatherings or affairs not open to the general public. Violation is punishable by a fine not more than $25, imprisonment for up to 10 days, or both. Jacksonville, FL., Code Section 447.202 (1983) Smoking is prohibited in any area where conditions are such as to make smoking a hazard such as any areas of warehouses, stores, industrial plants, institutions, or places where combustible materials are stored or handied. Jacksonville, FL., Code Section 446.114 (1983) Where smoking is permitted, there shall be provided suitable, noncombustible ash trays or match receivers. Jacksonville, FL., Code Section 431.107 (h) (1983) No person shail smoke, carry matches, or any other flame producing device while in or near a vehicle transporting explosives. Jacksonville, FL., Code Section 434.103 & Section 441.103 (1983) Smoking is prohibited in any room containing a dusty atmosphere, such as lumberyards and woodworking plants. Jacksonville, FL., Code Section 431.106, Section 431.107, Section 431.109, Saction 435.914, & Section 431.112 (1983) Smoking is prohibited in the area of explosives and facilities for mixing blasting agents, and in or near a vehicle transporting explosives. Jacksonville, FL, Code Section 447.202 (1983) Smoking is prohibited in any area where conditions are such as to make smoking a hazard such as any areas of warehouses, stores, industrial plants, institutions, or places where combustible materials are stored or handied. Jacksonville, FL., Code Section 447.202 (1983) Smoking is prohibited in any area where conditions are such as to make smoking a hazard i.e., any areas of piers, wharves, sheds, warehouses, stores, industrial plants, institutions, or places where combustible materials are stored or handled. Jacksonville, Fl.., Code Section 434.103 & 435.607 (1983) Smoking is prohibited in any room where flammable materials are kept. 167 186 28 Smoking is prohibited in finishing rooms or any area used for the storage of flammable finishes. Jacksonville, FL., Code Section 447.202 (1983) Smoking is prohibited in any area where conditions are such as to make smoking a hazard such as any areas of industrial plants, institutions, and buildings under construction. Jacksonville, FL., Code Section 480.111 (1983) It is prohibited to sell, barter, give, exchange, or other- wise distribute any cigarette, cigar, pipe, cigarette roll- ing papers, tobacco, smoking herb, or any other smoking material, to any person under the age of 18 years. Ignorance or misrepresentation of the age of a recipient of any of the smoking materials shall not be a defense to a prosecution. Jacksonville, FL, Code Section 480.111 (1983) It is prohibited to sell, barter, give, exchange, or other- wise distribute any cigarette, cigar, pipe, cigarette roll- ing papers, tobacco, smoking herb, or any other smoking material, to any person under the age of 18 years. Ignorance or misrepresentation of the age of a recipient of any of the smoking materials shall not be a defense to a prosecution. Jacksonville, FL., Code Section 480.111 (1983) Signs reflecting the sale and use of tobacco products to minors shail be prominently posted at ail times. Violation shall be punishable by $500 fine, 90 days in jail, or both. Los Angeles, California J5 J6 J8 J 10 133 Los Angeles, CA. Ordinance 162989 (approved 1987) (amending Section 41.50 of Los Angeles, CA., Code) Prohibits smoking in public arenas, gymnasiums, or other building designed for observing sports events. Lobbies are excepted. Los Angeles, CA. Code Section 41.50 (as amended by Ord. No. 159498 (1984)) Prohibits smoking in health care facilities open to visitors. Enclosed areas, set aside and designated as smoking areas are excepted. Los Angeles, CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in indoor areas of public libraries. Los Angeles, CA. Code Section 41.50 (as amended by Ord. 159498, (1984)) Prohibits smoking in meeting and assembly places open to the genera! public as participants or J42 J13 J15 J16 J17 J18 J 20 J 23 J 25 spectators. A smoking area permitted by the statute is excepted. CA. Code Section 41.50 (1984) Institutes a general prohibition on public smoking in specified areas. (See other summaries for details). CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in certain areas of restaurants having a seating capacity of greater than 50 persons. Bars and rooms being used for private functions are excluded. CA. Code Section 41.50 (as amended by Ord. 159498 (1984)) Prohibits smoking in any retail food marketing estab- lishments including grocery stores and supermarkets. Areas set aside for serving food and drink, restrooms, offices, and areas not open to the public are excepted. CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in areas of private elementary and private secondary schools normally occupied by children. CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in any building open to the public for the primary purpose of exhibiting any motion picture, stage production, musical recital, or other event open to public spectators. CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in any indoor polling place. CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in any airport, train, and bus depot, waiting areas or ticket lines. CA. Code Section 41.50 (as amended by Ord. 162989 (1987)) Prohibits smoking in any private day care facility or any private residences licensed as a private day care facility. CA. Code Section 41.50 (amended by Ord. No. 159, 498 (1984)) Provides for nonsmoking areas of not less than two- thirds of the seating capacity or floor space of cafeterias and lunchrooms. 134 J 27 J30 J32 J 33 J34 335 J 36 J 39 J 41 CA. Code Section 41.50 (enacted by Ord. 159, 498 (1984)) The employer must provide a statement that, in any dispute arising between smokers and nonsmokers, an effort willbe made to accommodate the desires of both parties. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Provides that an employer who makes reasonable efforts to develop and promulgate a policy regarding smoking and nonsmoking shall be deemed in com- pliance with the act. Designating the entire workplace as a smoking area is excepted. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Provides that a minimum of two-thirds of a lounge must be a nonsmoking area. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) An employer need not incur any expense to make structural or physical modifications in providing smok- ing areas. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) institutes a general requirement that certain areas of the workplace be designated as nonsmoking areas. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Requires that the employer communicate the smoking policy to employees within three weeks after date of adoption, and to future employees at the time of entry into employment. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Prohibits smoking in restrooms in the workplace. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Requires the employer to post no-smoking signs in nonsmoking areas. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Requires employers to adopt, implement, and maintain a written smoking policy containing minimum require- ments (listed in other summaries). J 42 J 45 J 58 J 68 J 69 J 76 J77 J 78 J79 J81 CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Anemployer who fails to adopt a smoking policy orwho fails to post signs in any area designated under this Article as a nonsmoking area shall be in violation of this Article. Violation is punishable as a misdemeanor. CA. Code Section 41.50 (amended by Ord. 159, 498 (1984)) Prohibits smoking in nurses aid stations or other similar facilities for treatment of employees. CA. Code Section 57.100.37 Prohibits smoking in any public garage or on auto fueling station premises. CA. Code Section 21.8.11 (1964) Provides that the city may recover unpaid tax from any user or retailer of cigarettes who has not complied with the ordinance. CA. Code Section 21.8.3 (1964) Provides that the retailer shall collect the tax from the purchaser at the time of purchase. The retailer is then liable to the city for the amount collected. CA. Code Section 21.8.6 (1964) Provides that delinquent tax payments are subject to interest and penalties as provided in Section 21.05 for delinquency in payment of business tax. CA. Code Section 21.8.9 (1964) Provides that every retailer of cigarettes must keep all records necessary to determine the amount of the tax for a period of four years. The city clerk has the right to inspect the records. CA. Code Section 21.8.10 (1964) Provides for a tax refund if the tax was overpaid, paid more than once, or wrongly collected. CA. Code Section 21.8.5 (1964) Provides that each retailer must register with the city clerk and obtain a “Cigarette Tax Registration Certifi- cate.” The certificate must state the retailer's name, address of the retailer's place of business, and the date the certificate was issued. The certificate must be posted in a conspicuous place. CA. Code Section 21.8.2 (1964) Provides that a tax is imposed on cigarettes in the city of Los Angeles in the amount of two mills per cigarette ($.002) from September 30, 1967. 135 Memphis, Tennessee K1 K3 K5 K6 K7 K 10 K 11 K 12 K13 K 15 K 16 K 70 TN. Code Section 20-25 (1986) Prohibits smoking on all Memphis Area Transit Authority buses. Violation is punishable by a fine of up to $50. TN. Code Section 20-25 (1986) Prohibits smoking on all public elevators. Violation is punishable by a fine of up to $50. TN. Code Section 20-25 (1986) Prohibits smoking in Mid South Coliseum, the Auditorium South Hall, and the Dixon-Meyers Hall, and the Auditorium stage area. Lobbies are excepted. TN. Code Section 20-25 (1986) Prohibits smoking in hospital lobbies and waiting rooms. TN. Code Section 20-25 (1986) Prohibits smoking in hotels. TN. Code Section 20-25 (1986) Prohibits smoking in Cook Convention Center. TN. Code Sectlon 20-25 (1986) Prohibits smoking in areas designated as nonsmoking areas in hospital lobbies and waiting rooms. TN. Code Section 20-25 (1986) institutes a general prohibition in certain public areas. (See other summaries for specific areas). TN. Code Section 20-25 (1986) Prohibits smoking in all public and private restaurants. Restaurants with adequate nonsmoking areas, and rooms being used for private functions are excepted. TN. Code Section 20-25 (1986) Prohibits smoking in all enclosed public areas of any merchandising store with more than five employees. Owner may establish a smoking area in nonshopping areas; tobacco stores are excluded. TN. Code Section 20-25 (1986) Prohibits smoking in theaters. TN. Code Sectlon 36-43 (1967) Provides that the wholesaler should add the cigarette tax for cigarettes sold by retailers within the city. The retailer should charge the tax paid to the consumer. K 75 K77 K 78 K 80 K 81 TN. Code Section 36-51 (1967) Exempts cigarettes bought by military personnel in any military establishment from taxation. TN. Code Section 36-49 (1967) Provides that city officials have access at all reasonable times to all records of wholesalers which are pertinent to determination and collection of the tax. TN. Code Section 36-47 (1967) Provides a refund on unsellable stamps or for stamps on unsellabie products. TN. Code Section 36-46 (1967) Requires the wholesaler to affix stamps showing the tax payment on each pack of cigarettes before delivery to the retailer. TN. Code Section 36-42 (1967) Provides for a cigarette tax of 1¢ per 20 cigarette pack. Milwaukee, Wisconsin 1 L17 L390 L91 L 94 WI. Code Section 98-15 (1979) Prohibits smoking on a public bus operated by the City of Milwaukee. Violation is punishable by a fine of $10 to $50. WI. Code Section 105-49 (1943) Prohibits smoking in theaters or motion picture theaters. Violation is punishable by a fine of $10. WI. Code Section 106-30(3) (1956) Makes it illegal for any person to permit a person under 16 years of age to use cigarettes in or upon premises occupied by him. Violation is punishable by a maxi- mum fine of $10 for the first offense and $35 for the second offense. WI. Code Section 106-30(2) (1956) Prohibits any person from selling cigarettes to any minor under 16 years of age. Violation is punishable by a fine of $25 to $100. WI. Code Section 106-30(4) (1956) The text was not included only a notice that the or- dinance was being renumbered. (The ordinance re- lates to cigarette vending decals and the sale of tobacco to minors). 136 New York, New York M1 M2 M3 M5 M6 M7 M8 M9 NY. Code Section 17-503 (a)1 (1988) Prohibits smoking in all public transportation facilities including ticketing, boarding, and waiting areas of depots. NY. Code Section 17-503 (a2) (1988) Prohibits smoking on all public means of mass transportation, buses, subways, vans, and for-hire vehicles required to be licensed by the city, i.e., taxi cabs. NY. Code Section 17-503 (a)(15) (1988) Prohibits smoking on elevators. NY. Code Section 17-503 (aX8) (1988) Prohibits smoking in concert halls and auditoriums. Adjacent areas designed for smoking are excepted so jong as an area includes no more than 50 percent of the lobby. Section 17-503 (a)(10) prohibits smoking in sports arenas (including bowling alleys). An adjacent area is excepted if area does not amount to over 50 percent of the lobby. This does not apply to the area in the bowling alley directly behind the scoring area. NY. Code Section 17-503 (a)(12) (1988) Prohibits smoking in public health care facilities includ- ing hospitals, clinics, physical therapy facilities, con- valescent homes, and homes for the aged. Offices, lounges designed for smoking, and areas in dining rooms where smoking is not otherwise prohibited are excepted. NY. Code Section 17-503 (a)(6) (1988) Prohibits smoking in hotels and motels with 15 or more employees. Does not apply to private areas. Smoking area 25 feet from main desk is excepted so long as the smoking area does not include greater than 50 percent of the lobby. NY. Code Section 17-503 (aX(7) (1988) Prohibits smoking in libraries. NY. Code Section 17-503 (a){7) (1988) Prohibits smoking in museums and galleries. M10 M12 M13 M14 M15 M16 M17 NY. Code Section 17-503 (a9) (1988) Prohibits smoking in convention halls. Smoking may be permitted in a contiguous area so long as it con- stitutes no more than 50 percent of seating capacity or floor space; in continguous area so long as it con- stitutes no more than 50 percent of the lobby; and at conventions of private groups where persons par- ticipating are individually identified by the sponsor or organizer of the convention. Section 17-503 (a)(11) prohibits smoking in public meeting places when the meeting is conducted for educational, religious, recreational, or political pur- poses; private homes are excepted. NY. Code Section 17-503 (1988) institutes a general prohibition against smoking in specitied public places. (See individual summaries for specific places). NY. Code Section 17-503 (a5) (1988) Prohibits smoking in restaurants with a seating capacity of greater than 50. Bars and a contiguous smoking area that does not take up more than 50 percent of the seating capacity are excepted. Proprietor may exceed the 50 percent smoking maxi- mum by 10 percent if a party of greater than 6 request to be seated and the only available seats are in the nonsmoking section. NY. Code Section 17-503 (a3) (1988) Prohibits smoking in public restrooms. NY. Code Section 17-503 (aX4) (1988) Prohibits smoking in retail stores which accommodate more than 150 persons, or employ more than 15 people. Tobacco products retail stores are excepted. NY. Code Section 17-503 (a}(13), (14) (1988) Prohibits smoking in all pre-primary, primary, and secondary schools. Areas designated for smoking in employee dining areas, lounges, or administrative of- fices are excepted. Section 14 summary: prohibits smoking in all schools not covered in Section 13, such as colleges. Desig- nated employee smoking areas such as dining areas, junchrooms, and lounges are excepted. Smoking areas in student dining areas or lounges are excepted provided that the area does not constitute more than 50 percent of the seating area or floor space. NY. Code Section 17-503 (a}(8) (1988) Prohibits smoking in theaters. Smoking area of less than 50 percent of the lobby is excepted. 137 M 21 M 22 M 25 M 26 M 27 M 28 M 29 M31 M 32 M34 M35 M 36 NY. Code Section 17-503 (a)(11) (1988) Prohibits smoking in places of public assembly when the meeting is being conducted for religious purposes. NY. Code Section 17-503 (a6) (1988) Prohibits smoking in business establishments employ- ing more than 15 employees including banks. NY. Code Section 17-504 (b)(5) (1988) Provides that nonsmoking areas of cafeterias and lunchrooms shall constitute at least 50 percent of seating capacity or floor space (whichever is greater). NY. Code Section 17-504 (b)(3) (1988) Prohibits smoking in auditoriums and classrooms. NY. Code Section 17-504 (b)(5) (1988) Provides for establishment of a procedure to resolve disputes caused by an employee's desire to work in a smoke-free environment. NY. Code Section 17-504 (b)(3) (1988) Prohibits smoking in conference rooms and meeting rooms (unless all present consent). NY. Code Section 17-504 (b)(1) (1988) Allows an employee to designate his or her work area as a nonsmoking area (not less than 8 feet from smoking area). NY. Code Sectlon 17-504 (b)(3) (1988) Prohibits smoking in hallways and elevators. NY. Code Section 17-504 (b)(4) (1988) Requires that at least 50 percent of each employee lounge be designated as a nonsmoking area. NY. Code Section 17-504 (1988) Requires the establishment of certain nonsmoking areas in the workplace. (See other summaries for details). NY. Code Section 17-504 (1988) Requires an employer to furnish each employee with a copy of the smoking policy. NY. Code Section 17-504 (b)(3) (1988) Prohibits smoking in restrooms. M 37 M39 M41 M 42 M 43 M 44 M 45 M50 M53 M64 M66 NY. Code Section 17-504 (b)(6) (1988) Prohibits dismissal, demotion, suspension, discipli- nary action, or negative performance evaluation by employer against an employee who exercises any rights granted under the written smoking policy. NY. Code Section 17-506 (a) (1988) Provides for the posting of no-smoking signs in non- smoking areas. NY. Code Section 17-504 (b) (1988) Provides for implementation, adoption, and notice of a written smoking policy. NY. Code Section 17-508 (1988) Violation of the code by an employer is punishable by the following civil penalties: a) the first violation com- mands a $100 maximum fine; b) the second violation within 12 months commands a $200 maximum fine; and c) the third violation within 12 months commands a $500 maximum fine. Violation of the code by an employee is punishable by a $50 maximum fine. NY. Code Section 17-504 (b) (1988) The act only applies to employers who have more than 15 employees. NY. Code Section 17-504 (b)(1) (1988) Smoking may be permitted in private, enclosed offices, and areas occupied by employees who each request or fail to object to the area being made a smoking area. NY. Code Section 17-504 (b)(3) (1988) Prohibits smoking in employee medical facilities. NY. Code Section C19-165.0 (1976) Prohibits disposing of any cigarette within any building, boat, car, or common carrier except in ashtrays, or receptacles designed for ashes. NY. Code Section C19-168 (1976) Prohibits smoking on any vessel storing petroleum oil. NY. Code Section C19-168 (1976) Prohibits smoking in any warehouse, shed, dock, pier, bulkhead, or wharf. NY. Code Section 81.27 (1981) Prohibits smoking in any room where food is prepared, processed, or packaged. 138 Philadelphia, Pennsylvania N1 N5 N15 N17 PA. Code Section 10-602 (enacted 1943, 1947, and 1948) Prohibits smoking in any vehicle of public transporta- tion. PA. Code Section 10-602(1) (enacted 1943, 1947, and 1948) Prohibits smoking in any indoor place of public as- sembly having a capacity greater than 100 persons. PA. Code Section 10-602(1)(c) (enacted 1943, 1947, and 1948) Prohibits smoking in any retail store which is designed to accommodate more than 30 persons or where more than 25 persons are employed. PA. Code Section 10-602(1)(b) (enacted 1943, 1947, and 1948) Prohibits smoking in any public assembly room having a capacity in excess of 100 persons. Phoenix, Arizona 01 02 03 O04 O5 AZ. Code Section 23-105 (1986) Prohibits smoking on all public transportation vehicles and in all terminals (as defined in Section 23-103). Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in all public places including taxi cabs (see Section 23-103). Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in public elevators. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in all enclosed public buildings in- cluding government buildings. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in auditoriums and indoor sports facilities. Violation is punishable by a fine of $25 to $100. O6 O7 011 012 013 O14 015 016 017 0 20 AZ. Code Section 23-105 (1986) Prohibits smoking in public places including offices of health care professionals and pharmacies (see Sec- tion 23-103). Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in all hotel and motel public areas. Hotel and motel rooms rented to guests and public areas of hotels and motels that conspicuously post a hotice that the hotel or motel does not provide a nonsmoking area are excluded. AZ. Code Article I 4-85, Ord. No. G-969, Section Z (1986) Prohibits smoking in any place where smoking is specifically prohibited by signs. AZ. Code Section 23-105 (1986) Prohibits smoking in public places as specified in Section 23-103 (includes all enclosed buildings). Private residences, bars, pool halls, bowling alleys, private clubs, and recreational facilities are excepted. AZ. Code Section 23-105 (1986) Prohibits smoking in public places including res- taurants as specified in Section 23-103. Violation is punishable by a fine of $25 to $100. Bars and public areas of restaurants that post a notice that no non- smoking area is provided are excepted. AZ. Code Section 23-105 (1986) Prohibits smoking in public places including public restrooms as specified in Section 23-103. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in retail stores, grocery stores, and shopping malls. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in all public and private schools as specified in Section 23-103. AZ. Code Section 23-105 (1986) Prohibits smoking in theaters as specified in Section 23-103. AZ. Code Section 23-105 (1986) Prohibits smoking in airport service lines and airport waiting lounges as specified in Section 23-103. 139 022 023 026 0 28 o31 0 32 033 034 035 0 36 AZ. Code Section 23-105 (1986) Prohibits smoking in financial institutions as specified in Section 23-103. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-105 (1986) Prohibits smoking in child care centers as specified in Section 23-103. Violation is punishable by a fine of $25 to $100. AZ. Code Section 23-106 (A)(1), Ord. No. G-2865 (1986) Prohibits smoking in auditoriums and classrooms. AZ. Code Section 23-106 (A)(1), Ord. No. G-2865. (1986) Prohibits smoking in conference rooms and meeting rooms. AZ. Code Section 23-106 (A)(1), Ord. No. G-2865 (1986) Prohibits smoking in hallways, stairways, and elevators. AZ. Code Section 23-106 (A)(2), Ord. N. G-2865 (1986) Provides for separate, nonsmoking areas of not less than 1/2 of the total floor space or seating capacity of employee lounges. AZ. Code Section 23-106 (A)(3), Ord. No. G-2865 (1986) Employers need not make any expenditures or struc- tural changes to accommodate the preferences of nonsmokers. AZ. Code Section 23-106 (A)(2), Ord. No. G-2865 (1986) Provides for nonsmoking areas in specified areas (see other summaries). AZ. Code Section 23-106 (4)(b), Ord. No. G-2865 (1986) Provides that an employer must announce the non- smoking policy to all employees within 90 days. Employer must post the smoking policy in a con- spicuous area in the workplace. AZ. Code Section 23-106 (A)(1), Ord. No. G-2865 (1986) Prohibits smoking in restrooms. 037 0 38 039 0 40 O41 0 42 0 45 AZ. Code Section 23-107, Ord. No. G-2865 (1986) Prohibits the termination or discipline of employees as a result of acomplaint about smoking in the workplace. AZ. Code Section 23-106 (4a), Ord. No. G-2865 (1986) Provides that if accommodation between smokers and nonsmokers can't be reached, the preference of non- smokers must prevail. AZ. Code Section 23-106 (4)(a), Ord. No. G-2865 (1986) Requires the employer to post no smoking signs in nonsmoking areas and to provide signs to employees who wish to designate their areas as nonsmoking. AZ. Code Section 23-106 (A}(3), Ord. No. G-2865 (1986) Requires an employer to use existing ventilation and partition to accommodate the preferences of smoking and nonsmoking employees. AZ. Code Section 23-106 (A), Ord. No. G-2865 (1986) Requires employers to adopt, implement, and maintain a written smoking policy. AZ. Code Section 23-106, Ord. No. G-2865 (1986) Violation of the act is a petty offense. Violation is punishable by a fine of $300 or less. AZ. Code Section 23-106 (A)(1), Ord. No. G-2865 (1986) Prohibits smoking in medical facilities. San Antonio, Texas P1 P2 P3 TX. Code Ch. 28.5, Section 2(a)(6), Ord. No. 62781 (1986) Prohibits smoking in bus and train facilities. First of- tense is punishable by a fine of $25 to $200; second offense, $50 to $500; third offense, $100 to $1000. Chartered buses are excepted. TX. Code Ch. 28.5, Section 2(a)(6), Ord. No. 62781 (1986) Prohibits smoking in taxicabs. Taxicabs clearly desig- nated by the operator to permit smoking are excepted. TX. Code Ch. 28.5, Section 2(a)(1), Ord. No. 62781 (1986) Prohibits smoking on all public elevators. See P-1 for fines. 140 P4 PS5 P6 P10 P12 P13 P15 P16 TX. Code Ch. 28.5, Section 2(a)(3), Ord. No. 62781 (1986) Prohibits smoking in any conference room, meeting room, or public service area of any facility owned, operated, or managed by the city. Conference rooms or meeting rooms not open to the public are excepted. TX. Code Ch. 28.5, Section 2(a)(4), Ord. No. 62781 (1986) Prohibits smoking in concert halls and cultural facilities, TX. Code Ch. 28.5, Section 2(a)(2), Ord. No. 62781 (1986) Prohibits smoking in a hospital or nursing home cor- ridor providing direct access to patients rooms. Section 2(c) provides that, in hospitals patients may choose to be placed in a nonsmoking room; employees or visitors must obtain express approval from all patients in a patient room prior to smoking. TX. Code Ch. 28.5, Section 2(a)(3), Ord. No. 62781 (1986) Prohibits smoking in city-owned conference rooms and meeting rooms. Conference rooms and meeting rooms not open to the public are excepted. TX. Code Ch. 28.5, Section 2, Ord. No. 62781 (1986) Prohibits smoking in certain public places (detailed in other summaries). TX. Code Ch. 28.5, Section 3, Ord. No. 62781 (1986) Provides for separate smoking and nonsmoking areas in restaurants and food establishments. The smoking section must be separated from the nonsmoking sec- tion by four feet of space; it must be ventilated, desig- nated by signs, and have ash trays. Includes food order areas, food service and eating areas, and restrooms. Excludes restaurants which seat less than 50 patrons; establishments which have more than 70 percent gross sales in alcoholic beverages; and a physically separated bar area of a restaurant. TX. Code Ch. 28.5, Section 2(a)(4), Ord. No. 62781 (1986) Prohibits smoking in all retail and service estab- lishments, including department stores, grocery stores, clothing stores, shoe stores, hardware stores, laundromats, hair salons, and barbershops. TX. Code Ch 28.5, Section 2(a)(6), Ord. No. 62781 (1986) Prohibits smoking in any facility of a public primary or secondary school. P17 P20 P 22 P35 P39 P 41 P 42 P 47 P58 P66 TX. Code Ch. 28.5, Section 2(a)(6), Ord. No. 62781 (1986) Prohibits smoking in all motion picture theaters. TX. Code Ch. 28.5, Section 2(a)(4), Ord. No. 62781 (1986) Prohibits smoking in airport facilities. TX. Code Ch. 28.5, Section 2(a)(4), Ord. No. 62781 (1986) Prohibits smoking in banks and savings and loan facilities. TX. Code Ch. 28.5, Section 4, Ord. No. 62791 (1986) The employer must make the smoking policy available for inspection by employees. TX. Code Ch. 28.5, Section 4, Ord. No. 62791 (1986) Requires conspicuous display of signs prohibiting smoking. TX. Code Ch. 28.5, Section 4, Ord. No. 62791 (1986) Employers must implement a written policy conforming to the chapter. TX. Code Ch. 28.5, Section 4, Ord. No. 62791 (1986) First offense is punishable by a fine of $25 to $200; second offense, $50 to $500; and third offense, $100 to $1000. Workplace restrictions apply only when employer voluntarily designates an area of the workplace as nonsmoking. TX. Code Section 3-61 (1987) Prohibits smoking in a hangar, shop, service station area, fuel storage place, or within 50 feet of refueling in an airport. TX. Code Section 3-113 (1984) Prohibits smoking within 50 feet of an airplane being refueled. TX. Ord. No 59746 (1984) (adopting Texas Depart- ment of Health Rules on Food Sanitation) Section 301.73 p. 14 prohibits employees from smok- ing while engaged in food preparation or service or dishwashing. San Diego, Calitomia Q1 CA. Code Section 45.0103-04 (1983) Prohibits smoking on public conveyances. 141 Q3 a4 Qé6 Qs Q9 Q10 Q12 Q13 Q14 Q15 Q16 CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking on elevators. CA. Code Section 45.0106, Ord. No. 11459 (1 974) Makes the public smoking prohibition applicable to governmental and educational agencies within the city limits. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in pharmacies and health facilities. Private hospital rooms and psychiatric facilities are excepted. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in libraries. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in museums and galleries. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in public assembly halls. CA. Code Sectlon 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in specified public places. Violation is punishable by a fine of $10 to $100. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in restaurants with a seating capacity of greater than 20 persons. Owner must in- form patrons that a no-smoking section is provided. Bars are excepted. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in public restrooms. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in retail stores, retail service estab- lishments, food markets, and retail food production establishments. CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in public places including education- al facilities (Section 45.0102). Q17 Q25 Q28 Q30 Q32 Q33 Q34 Q39 Q 40 Q42 Q 44 CA. Code Section 45.0103-04 (1983), Ord. No. 11459 (1974) Prohibits smoking in theaters. CA. Code Section 45.0103 (1983) Prohibits smoking in places of employment including cafeterias (see Section 45.0102). CA. Code Section 45.0103 (1983) Prohibits smoking in places of employment including conference rooms (see Section 45.0102). CA. Code Section 45.0104 (1983) Provides that an employer who in good faith develops a policy of smoking and nonsmoking shall be deemed in compliance unless the policy designates the entire work area as a smoking area. CA. Code Section 45.0103 (1983) Prohibits smoking in the workplace, including employee lounges (see Section 45.0102). CA. Code Section 45.0104 (1983) Provides that employers need not incur any expense to make structural or physical modifications. CA. Code Section 45.0104 (1983) Provices that specific places be deemed nonsmoking sections. CA. Code Section 45.0105 (1983) Provides that signs must be posted to clearly mark a no-smoking area. CA. Code Section 45.0104 (1983) Requires that employers use existing physical barriers and partitions to minimize the effects of cigarette smoke. CA. Code Section 45.0107 (1983) Violation of this Article is punishable by a fine of $10 to $100. Excludes private offices, motel and hotel meeting and assembly rooms rented to guests, areas and rooms while in use for private social functions, private haspital rooms, psychiatric facilities, jails, bars, tobacco retail stores, and restaurants with a seating capacity of less than 20 persons. CA. Code Section 45.0107 (1983) Provides that no-smoking areas are not required in private offices. 142 Q47 Q63 Q64 Q65 Q67 Qa89g ao Q92 CA. Code Section 505, Ord. No. 145 (1964) Prohibits smoking in posted areas, ramps and aprons, or within fifty feet of hangars, fuel trucks, or fuel loading Stations of airports. CA. Code Section 55.20.4 (1967) Prohibits smoking in garages. CA. Code Section 63.15.37 (1967) Prohibits smoking on any municipal wharf or warehouse. CA. Code Section 55.26.103 (1984) Prohibits smoking within one hour of applying flam- mable finishes to bowling alleys. CA. Code Section 68.0131 (1969) Prohibits smoking in buildings under construction. CA. Code Section 58.04 (1900) Makes it unlawful for any person under 18 years of age to possess tobacco in any form. CA. Ord. No. 58 (1890) Prohibits any person in the city limits from selling cigarettes to a person under 16 years of age. CA. Code Section 58.04 (1900) Makes it unlawful for any person under 18 years of age to use tobacco in any form. San Francisco, California R13 R33 R35 CA, Code Part Il. Ch. V, Article 19A (1983) Prohibits smoking in lobbies, waiting areas, restrooms, and dining areas or restaurants specified as nonsmok- ing areas by the owner. Owners are required to allo- cate adequate amounts of space to meet the needs of smokers and nonsmokers unless the restaurant has been designated entirely nonsmoking. Owner must inform all patrons of nonsmoking areas. CA. Code Section 1003(1){a) (1983) Provides that an employer need not make expendi- tures to accommodate the preferences of smoking and nonsmoking employees (only in office workplaces). CA. Code Section 1003(2)(b) (1983) Requires employers to announce the smoking policy to employees and to conspicuously post the policy in the workplace (only in office workplaces). R38 R39 R 40 R41 R 42 R 44 R 46 CA. Code Section 1003(b) (1983) If employer cannot accommodate the preferences of smokers and nonsmokers, the preferences of non- smokers should prevail (only in office workplaces). CA. Code Section 1003(b) (1983) Requires the employer to clearly mark nonsmoking sections with signs (only in office workplaces). CA. Code Section 1003 (1983) Requires employers to use existing partitions and ven- tilation to reduce the effects of smoke on nonsmokers (only in the workplaces). CA. Code Section 1003 (1983) Requires employers to adopt, implement, and maintain a written smoking policy in office workplaces. CA. Code Section 1005 (1983) Enforcement of violations shall include serving notice to the employer requiring corrections of the violations, obtaining an injunction to enforce the correction of violations, and the prosecution of the employer. The employer shall be liable for a civil penalty not to exceed $500. Each day such violation is committed constitutes a separate offense and shall be punishable as such. CA. Code Section 1004 (1983) The act does not apply to a private enclosed office workplace occupied exclusively by smokers. CA. Code Section 1003 (1983) The act applies only to offices. San Jose, California $3 S4 $5 CA. Code Section 944.030 (added by Ord. No. 20364 (1980)) Prohibits smoking in elevators in public buildings. CA. Code Section 944.040, Ord. No. 20364 (1980) Prohibits smoking in public meetings (where public business is conducted by elected or appointed offi- cials). This applies to indoor rooms, chambers, or places of public assembly. CA. Code Section 944.060, Ord. No. 20364 (1980) Prohibits smoking in any room, chamber, or place where entertainment events, lectures, or athletic events are heid. 143 $6 $10 $13 $15 $17 $ 26 $ 28 S$ 29 $31 $ 32 $34 CA. Code Section 944.050, Ord. No. 20364 (1980) Prohibits smoking in all public and private health care facilities (public areas), including waiting rooms, hallways, and lobbies. Prohibits smoking in patients’ rooms except by the patient (limited to bed space occupied solely by smokers). CA. Code Section 944.040, Ord. No. 20364 (1980) Prohibits smoking during public meetings. CA. Code Section 944.080, Ord. No. 20364 (1980) Prohibits smoking in eating establishments if the res- taurant has a capacity of 50 persons or more. A smok- ing area may be maintained of less than 50 percent of the seating capacity and floor space. Banquet rooms used for private functions are excepted. CA. Code Section 944.070, Ord. No. 20364 (1980) Prohibits smoking in public retail stores when doing business with the general public. Stores not open to the public and tobacco shops are excepted. CA. Code Section 944.060, Ord. No. 20364 (1980) Prohibits smoking in buildings where any motion pic- ture, stage drama, or other performance is held. CA. Code Section 944.120 (A)(1) (1985) Prohibits smoking in workplaces, classrooms, and auditoriums. CA, Code Sectlon 944.120 (A)(1) (1985) Prohibits smoking in all conference and meeting rooms. CA. Code Sectlon 944.120 (A)(4) (1985) Provides that any employee may designate his imme- diate work area as a nonsmoking area. CA. Code Section 944.120 (A)(1) (1985) Prohibits smoking in hallways and elevators. CA. Code Section 944.120 (1985) Provides that not jess than 2/3 of all floor space or seating space of each employee lounge be designated as a no-smoking area. CA. Code Sectlon 944.120 (1985) Requires that certain areas of the workplace be designated as no-smoking areas. $35 S$ 36 $38 $ 39 $41 $44 $45 S 47 $60 S$ 68 $70 $72 CA. Code Section 944.120 (B) (1985) Requires the employer to communicate the smoking policy to employees. CA. Code Sectlon 944.120 (A}(1) (1985) Prohibits smoking in workplace restrooms. CA. Code Section 944.120 (A)(5) (1985) Provides that the preference of nonsmokers should be given precedence in a dispute. CA. Code Section 944.120 (A)(6) (1985) Requires employers to post signs wherever smoking is prohibited. CA. Code 944.120 (A) (1985) Requires employers to adopt, implement, and maintain a written smoking policy. CA. Code Section 944.120 (D)(3) (1985) Provides that a private enclosed workplace occupied exclusively by smokers is exempted from the act. CA. Code Section 944.120 (A)(1) (1985) Prohibits smoking in employee medical facilities. CA. Code Section 15.04.160 (1950) Prohibits smoking within 50 feet of any fuel carrier not in motion or when it is fueling or draining an aircraft. No smoking in hangers. No smoking within 50 feet of aircraft fuel tanks. CA. Code Section 13.44.130 (1977) Prohibits smoking on any park trail, bridle path, or any fire risk area. CA. Code Section 4.50.130 (1967) Any person who owes taxes to the city shall be liable to an action brought in the name of the city for recovery. CA. Code Section 4.50.080 (1967) Requires a distributor (wholesaler) of cigarettes to collect and pay the tax to the city. CA. Code Section 4.50.140 (1967) Any person violating the cigarette tax provisions is guilty of a misdemeanor, punishable by a fine of not more than $500 or by imprisonment for not more than 6 months. S76 S77 $78 $79 S 81 $94 CA. Code Section 4.50.090 (1967) Violation is subject to the following penaities: a) during the original delinquency period, 10 percent of the amount of the tax will be assessed as a penalty; b) if the delinquency period is greater than one month, an additional 10 percent (for a total of 20 percent) plus the amount of tax owed compounded will be assessed as the penalty; c) for cases of fraud, 25 percent of the amount owed is assessed as a penalty in addition to the assessments on a) and b); d) interest on the amount owed, in addition to the penalties, will be assessed at of 1 percent interest per month; and e) no penalty is imposed during a hearing period or appeal period. CA. Code Section 4.50.070 (1967) Requires wholesalers to keep comprehensive records of all cigarette distribution transactions and retain them for three years, CA. Code Section 4.50.120 (1967) Whenever tax, interest, or penalty has been overpaid or wrongfully paid, it may be refunded pursuant to a written claim. CA. Code Section 4.50.060 (1967) Requires all distributors subject to the tax to register with the Director of Finance within 30 days after the operative date of the Act. CA. Code Section 4.50.050 (1967) Imposes a $.0015 per cigarette (1 mills) tax upon the privilege to distribute cigarettes in retail outlets. CA. Code. Section 6.70.110 (1960) Provides that a responsible employee must maintain and supervise the use of vending machines to insure that the machine is not operated by minors. Washington, D.C. T1 T3 T4 144 DC. Code Section 44-223 (1979) Prohibits smoking on any public passenger vehicle seating 12 or more passengers. DC. Code Section 6-913(1)} (1979) Prohibits smoking in any elevator. Elevators in single family dwellings are excepted. DC. Code Section 6-913(3) (1979) Prohibits smoking in any public hearing or assembly room owned or leased by the District of Columbia Government. District of Columbia Armory and Robert F. Kennedy Memorial Stadium are excepted. Té6 T8 T10 T13 T15 T16 T23 T70 T71 DC. Coda Section 6-913(6) (1979) Prohibits smoking in any public health care facility including hallways, waiting rooms, and lobbies. Patients should be placed with patients who have similar smoking preferences. Staff, visitors, and the public shail not smoke in bed space areas of nonsmok- ing patients. DC. Code Section 6-913(4) (1979) Prohibits smoking in educational facilities including libraries (6-912(1)). DC. Code Section 6-913(3) (1979) Prohibits smoking in any public hearing or assembly room owned or leased by the District of Columbia Government. DC. Code Section 6-913.1 (1988 Supp.) Mandates creation of nonsmoking areas in restaurants with a seating capacity of more than 50 persons. Twenty-five percent of the restaurant shall be desig- nated nonsmoking. Newly constructed restaurants shall have 50 percent of the restaurant designated as a nonsmoking area. Nightclubs and taverns are ex- cluded. DC. Code Section 6-913(2) (1979) Prohibits smoking in the public selling area of any retail store. Stores primarily selling tobacco products are excepted. DC. Code Section 6-912-13(4) (as amended by Amendment Act of 1987) Prohibits smoking in any public education facility owned by the District of Columbia Government. In- cludes elementary schools, secondary schools, day care centers, nursery schools, and institutions of higher education. Excludes faculty lounges, smoking areas, and smoking lounges approved by principal or president of college. DC. Code Saction 6-912-913(4) (1979) Prohibits smoking in all educational facilities including nursery schools and day care centers. Faculty lounges are excepted. DC. Code Section 47-2402(d) (1982) Requires each licensed wholesaler to affix stamps to cigarette packages to evidence payment of the tax. DC. Code Section 47-2406 (1982) Prohibits persons from altering, forging, or counterfeit- ting stamps. 145 T74 T76 T77 T78 T80 T81 T83 T 84 T85 DC. Code Section 47-2404 (1982) Requires sellers of cigarettes to obtain various licen- ses from the mayor: wholesaler’s license, retailer's license, and vending machine operator's license. DC. Code Section 47-2411.1 (1982) Failure to pay the tobacco tax will result in penalties and interest in accordance with Sections 47-453 through 47-458. DC. Code Section 47-2408 (1982) Allows the mayor to require wholesalers, retailers, and vending machine operators to keep, maintain, and preserve records, books, and other documents. Also allows the mayor to require various actions to verify and produce records. DC. Code Section 47-2412 (1982) Provides for refund of any tax, penalty, or interest wrongly collected. DC. Code Section 47-2402(d) (1982) Requires wholesaler to affix stamps to all cigarette packages. DC. Code Section 47-2402 (1982) Levies a tax of 85/100 per cigarette. DC. Code Section 47-2403 (1982) Exempts certain cigarettes from scope of taxation: 1) cigarettes sold by United States or District of Columbia Governments; 2) cigarettes in possession of licensed wholesalers for sale outside the limits of the District or for sale to other licensed wholesalers; 3) consumer possession of fewer than 200 cigarettes; and 4) cigarettes being transported. DC. Code Section 47-2405 (1982) Any person transporting unstamped cigarettes must have invoices or delivery tickets in his possession. Otherwise, cigarettes are considered contraband. Violation is punishable by a fine of $25 for each $200 contraband cigarettes. DC. Code Section 47-2409 (1982) The mayor may seize all contaxed cigarettes within the district. All unstamped cigarettes may be seized. All vending machines not in compliance with Section 47- 2404 may be seized. All forged or counterfeit stamps may be seized. All money used in violation of this chapter may be seized. T91 DC. Code Section 22-1120 (1891) Prohibits any person from selling cigarettes to any minor under 16 years of age. Violation is punishable by a fine of $2 to $20 or imprisonment for 5 to 20 days. 146 NATIONAL, STATE AND LOCAL PROGRAMS Cee errr ee ee ee eS Part 1 DESCRIPTIONS OF NATIONAL PROGRAMS This section contains detailed descriptions of smoking cessa- tion and prevention programs developed and disseminated by major voluntary health organizations. These programs are generally available on a Nationwide basis through locai organization chapters or affiliates. Information on program availability at the local level is contained in Part 2 of this section. Descriptions of smoking-related research, preven- tion, and cessation efforts developed by Federal agencies and having a National impact are also included in Part 1 of this section. VOLUNTARY PROGRAMS Voluntary efforts towards smoking education and cessation have greatly increased since the last biennial report. The programs described in this section were developed and dis- seminated by various organizations, including the American Cancer Society, American Heart Association, American Lung Association, General Conference of Seventh-Day Adventists, and American Public Health Association, and include only those programs with a primary focus on smoking. Numerous programs are also available in which smoking cessation or prevention is a component of a total health education or behavior modification plan. For the purposes of this report, only the most commonly implemented and smoking-specific programs are described in detail. The programs listed are implemented through local chapters or affiliates throughout each State and in United States territories and possessions. American Cancer Society Every year, the American Cancer Society’s (ACS) 58 divisions and 3,100 local units reach millions of adults and young people through its smoking education, prevention, and cessation programs. In addition, the society distributes millions of pamphlets, posters, and exhibits on smoking. While smokers are reached throughout the year by mass media efforts and physician counseling, special ACS efforts to reach all smokers include November’s Great American Smokeout and April's Cancer Crusade. Educational programs and FreshStart smoking cessation clinics are conducted on the local level through a comprehen- sive smoking control program that includes mass media ef- forts, legislative initiatives, professional education, and 149 response and referral systems. Heavy emphasis is placed on preparing other facilities, such as hospitals or industries, to assume primary responsibility for helping smokers to quit. Education Programs Education in the prevention of smoking is carried out principal- ly in the schools because young people presumably have not yet established the smoking habit. Programs begin in pre- school, where students are just learning about their bodies and good health habits, and continue through high school. Among the most widely disseminated smoking prevention programs developed by the ACS are the following. * Starting Free, Good Air For Me is a program that helps preschoolers understand that they can leave the room when someone is smoking, tell an adult how smoking makes them feel, and ask an adult not to smoke in their presence. The package contains five different story books, hand puppets, a classroom poster, stickers, coloring books, and home activity sheets. An Early Start To Good Health is a followup program to Starting Free, Good Air For Me, designed for students in grades 1 through 3. The package includes a musical sound filmstrip, teaching guide, wall poster, activity spirit masters, and a letter to parents asking them to review the information with their child. Health Network includes new multi-media teaching units for students in grades 4 through 6. Each unit contains a sound filmstrip TV program interrupted by a simulated commercial message to stimulate followup discussion, a teaching guide with suggested classroom activities, les- son plans and filmstrip script, a wall poster or game, and duplicating masters for the activities detailed in the teaching guide. Healthy Decisions is a software package containing a users manual, help cards, and leader’s guide. The pro- gram is designed to allow students in grades 4 through 6 practice decision making skills. Health Myself is a series of teaching units that can be incorporated into language arts, science, and social studies classes for students in grades 7 through 9. The units focus on the impact of societal influences on smok- ing behavior. The package includes a teaching guide, 10-minute sound color videocassette, activity sheets, and a poster. Cessation Programs Cessation programs are offered in the community through hospitals, worksites, and schools. The ACS trains facilitators to conduct various group programs, but a majority of the materials can be used independently in a self-help format. The following programs are part of the ACS effort. * FreshStart is a smoking cessation clinic that includes a series of four 1-hour group sessions conducted over a 2-week period. The program contains all of the essential information and strategies a participant needs to stop smoking permanently. A FreshStart Facilitator's Guide, containing a summary agenda for each session followed by details of the program's content, is available from ACS. A FreshStart Participant’s Guide is also available. This guide complements the group sessions; however, it is fully self-explanatory and can be used by individuals who have decided to quit smoking without participating in a program. Breaking Free is a smoking information and cessation package for vocational and technical high school stu- dents incorporating group discussion, guest speakers, films, and videos. Many of the techniques outlined in the FreshStart Participant’s Guide are used in a modified format appropriate to the target audience. Quitter’s Guide: Seven Days To Stop Smoking is a self-help manual available, free of charge, through all ACS offices. The manual outlines steps for quitting in seven days and suggests a variety of relaxation and motivation techniques for smokers who wish to quit on their own. Why Quit Quiz is an information package developed by the ACS of Massachusetts. Participants respond to questions regarding their smoking behavior on a quiz and then view a film to determine their score. Guide To Community Action Toward A Smoke-Free In- doors is a guide developed to assist volunteers to effec- tively educate and persuade community decision-makers to adopt voluntary clean indoor air policies. Restaurant managers, hospital and health clinic administrators, per- sonnel managers, store operators, and day care and school administrators are beginning to recognize that they have a responsibility to employees and customers alike to provide clean indoor air. This Guide supplies the basic information and other tools to recruit, inform, and motivate volunteers toward community action. In support of the Surgeon General’s call for a smoke-free society, the ACS has committed its resources to work toward a Smoke-Free Young America By The Year 2000. The Society will expand program efforts that are highly appealing in affect- ing the smoking habits of specific target groups. The following are target groups: vocational-technical high school students; * health care professionals; * expectant parents; 150 ¢ preschool children; and * early adolescents. Program materials based on the application of prevention and cessation techniques, currently believed to have the most potential for success, will be available to support increased program activity. American Heart Association The smoking intervention programs of the American Heart Association (AHA) are designed to prevent young people from starting to smoke and to help those smokers who want to quit. These programs are promoted in three primary delivery sites: schools, places of work, and health care delivery sites. Pro- gram modules are developed at the AHA National Center and tested in the field for one or more years to determine their effectiveness. Modules with a demonstrated benefit are packaged and delivered to affiliates for implementation. Education Programs The AHA focuses primarily on smoking education programs. Most smoking-related programs for youth are designed to allow maximum student involvement with minimum teacher or administrator control. Students work with the teacher to modify the program to best meet their information needs. Adult programs are designed to reach the populations who are at risk through authority figures, such as physicians or employers. The following programs have been developed for specific target audiences. « Heart Health Education Of The Young is a complete program curriculum that can be incorporated into existing health education classes. In-service workshops are held to train teachers in the use of the curriculum and to discuss incorporation of the curriculum into class plans. In a series of 90-minute presentations, students are intro- duced to the heart and circulatory system, the value of exercise and good nutrition, and risk factors, especially the hazards of smoking. The program package includes coloring books, posters, hands-on experiments and in- struments, tapes, filmstrips, videos, games, graphs, and Heart Healthy comic books. Let's Talk About Smoking is a module designed to reach children at the critical point (grades 4 through 6) when many are beginning to experiment with cigarettes. The intervention is designed to teach young people skills to resist the pressure placed on them by their peers to experiment with cigarettes. The effectiveness of the module was confirmed in a 1-year study of students in grade 7. The core of the module is an 11-minute film featuring the comments of junior high school students. Nonsmoking students describe the pressures placed on them by friends and others, the tactics they used to resist these pressures, the reasons they have chosen to remain nonsmokers, and their impressions about smokers, par- ticularly those who say they can quit at any time. Smokers candidly discuss how they would like to quit. The film is used in a 3-day teaching unit in which students engage in open discussions about the pressures to smoke and ways to counter these influences. Save A Sweet Heart is an 11-week program designed to associate nonsmokers and nonsmoking behavior with popular images and to provide a supportive environment to those smokers who want to quit. This is achieved through the use of the same marketing, sociological, and social-psychological tools that cigarette companies employ to create positive images of smokers and to make smoking a socially acceptable practice. The program is conducted by a team of students as an extracurricular activity around the time of Valentine’s Day, which is observed as a nonsmoking day. Before release, the module underwent a rigorous 3-year evaluation employ- ing several thousand students in six Wisconsin senior high schools. The program features a set of five posters that mimic cigarette ads, but portray nonsmokers in the images most popular with teenagers. The posters are placed in strategic locations throughout the campus and rotated periodically in the same way that cigarette ads are rotated on billboards. Heart At Work is an intervention program designed for implementation in the workplace. The program includes modules on hypertension, nutrition, exercise, signals and actions for survival, and smoking reduction. The smoking reduction module consists of two components: a model policy for restricting smoking in the workplace and a self-help cessation kit. The model policy provides com- panies with practical guidance for restricting smoking among employees. Attractive signs are provided for non- smokers to use in designating their offices or work sta- tions as nonsmoking areas. Posters are also included that associate a smoke-free work environment with job satisfaction and success. Calling It Quits is a self-help smoking cessation kit con- tained in the module that was adapted from the Quit It program developed by the National Cancer Institute. This kit is offered to employees who want to quit smoking. Supportive posters are provided that present a powerful message to smokers who are parents of young children. Heart Rx was introduced in 1987 after two years of testing. The program is designed to assist health care providers give patients the necessary information to make important health behavior choices. Health care providers receive information kits for their office and staff as well as several sample information kits for patients. Patient information is available in Spanish and English formats, and is provided to patients free of charge. There is a slight charge for additional provider kits. A sound slide presentation is available for office use through purchase or loan. American Lung Association Toward the goal of making NO SMOKING the social norm in this country, the American Lung Association (ALA) and its 139 affiliates Nationwide conduct a comprehensive range of programs and activities that encourage smokers to quit, 151 prevent those people who do not smoke from beginning, and protect the rights of nonsmokers. The new Smoke-Free Family Campaign, the ALA's response to the Surgeon General's challenge for asmoke-free society by the year 2000, provides smoking prevention, education, and cessation programs, ac- tivities, materials, and messages to individuals, their friends, relatives, and co-workers. The ALA Minority Outreach Initia- tive strives to reduce lung disease and promote lung health in minority populations. Through networking with minority agen- cies and developing culturally appropriate material, such as Freedom From Smoking (R) For You And Your Family, the ALA is addressing the needs of these special populations. Cessation Programs Local ALA affiliates provide a variety of comprehensive smok- ing cessation programs for use by community organizations, businesses, or individuals, several of which are discussed here. The Freedom From Smoking (R) series includes clinics, manuals, and audiovisual presentations and targets a wide variety of audiences through its different formats. Some offices offer the programs in both Spanish and English to better meet the needs of their constituents. Several of these programs are described below. * Freedom From Smoking (R) Self-Help Manuals consist of two colorful, extensively illustrated guides to the quit- ting process. Freedom From Smoking (R) In 20 Days, a basic day-by-day approach to quitting, and A Lifetime Of Freedom From Smoking (R) reinforce smokers’ commitment to their new, nonsmoking lifestyle. Freedom From Smoking (R) Clinics are for smokers who prefer a group approach; most ALA affiliates offer this extensive, Nationally developed, 7-week course led by trained staff or volunteers. Participants receive class in- struction and audiotape materials on developing quitting strategies, dealing with recovery symptoms, managing stress through relaxation and assertiveness techniques, controlling weight, and avoiding recidivism. Some ALA affiliates also sponsor followup maintenance groups for ex-smokers. Freedom From Smoking (R) At Work consists of trained ALA staff who help companies develop a comprehensive approach to reducing smoking at the workplace. Two manuals, Taking Executive Action and Creating Your Company Policy, are available to management and employees to help them develop effective policies on smoking. The Freedom From Smoking (R) self-help clinics and video programs can be adapted to the workplace, and company personnel can be trained by ALA staff to lead the clinics. Special posters are available to help initiate a company-wide campaign on smoking. In Control, a Freedom From Smoking (R) video program, was introduced in the summer of 1985. This is an ap- proach to quitting smoking that individuals with VCRs can use at home; ALA affiliates also have special guides on using the program in group settings at work, physicians’ offices, and other locations. Baseball star Steve Garvey and a psychologist host a 90-minute video program con- sisting of 13 segments to be shown separately. Users also receive a 136-page viewer's guide and a 20-minute audiotape with motivational and relaxation messages. The videotape is available in VHS, BETA, or 3/4-inch versions. Freedom From Smoking (R) For You And Your Baby is a self-help manual for pregnant smokers. Produced in cooperation with the Harvard Community Health Plan, this 10-day, full-color manual is packaged with a poster depicting a series of exercises for pregnant women that adhere carefully to the guidelines set by the American College of Obstetricians and Gynecologists (ACOG), and a relaxation and exercise tape to assist women maintain motivation for quitting smoking. Freedom From Smoking (R) For You And Your Family is a newly introduced self-help manual for the Smoke-Free Family Campaign. This 64-page, full-color manual focuses on specific cessation topics, such as coping strategies, addiction, triggers, and weight gain, rather than on day-to-day approaches to quitting smoking. Education Programs The ALA actively supports comprehensive health education in schools as a means of convincing children not to smoke and to adopt healthy lifestyles. ALA cooperated with the Centers for Disease Control in the development of the comprehensive Growing Healthy Program for children in kindergarten through grade 7. This program is described in detail under the Centers for Disease Control description in the following section. ALA affiliates also offer other Nationally and locally developed smoking education modules and a variety of films, posters, and written materials for classroom use. Most ALA affiliates offer the programs described below. * Biofeedback Smoking Education Project (BIOSEP), of- fered by many ALA affiliates, is a classroom program for students in grades 7 through 12 that was originally developed by the New Hampshire Lung Association. Students conduct laboratory tests on themselves, using sophisticated laboratory equipment, including an Ecolyzer, cardiotachometer, digital thermometer, and tension steadiness machine, loaned to schools by their ALA affiliate. Carbon monoxide levels, pulse rates, skin temperatures and hand tremors are compared in smoking and nonsmoking students. Smokers are measured before and after smoking a cigarette in the classroom. BIOSEP allows students to see firsthand the negative physiological effects of smoking on fellow students who may have no outward signs of poor health. This immedi- ate feedback provides a stimulus for behavior modifica- tion that long-term health threats may not provide. It can also reinforce the behavior of nonsmokers. Hugh McCabe: The Coach's Final Lesson is an 18- minute videotape that documents the jast 8 months of a popular high school football coach’s life. The film depicts the deterioration and death of a lung cancer patient. The film and accompanying teacher's guide are aimed at students in junior and senior high schools. Lungs Are For Life consists of modules that give lessons onsmoking, air pollution, and lung physiology and include teachers’ guides, spirit masters, posters, and other aids. 152 Separate modules are available for children in kindergar- ten through grade 4. * Marijuana: A Second Look is a highly motivational pro- gram that uses the cast of the popular television show Fame to inform children between the ages of 9 to 11 years and their parents of the dangers of marijuana smoking. A packaged classroom kit includes a teaching guide for teachers and youth leaders, aparent’s magazine, a Fame FAN-tastic poster and magazine for students, and posters, buttons, and’stickers. Octopuff In Kumquat is the ALA’s animated feature film designed to present positive health values to children between the ages of 4 and 8. Octopuff is a full-color, 9-minute film that tells the story of an imaginary character named Octopuff who, despite protests from the elders and the children, introduces smoking to the village of Kumquat. Solutions to the resulting environmental problems and Octopuff’s subsequent reformation are ef- fected by the intervention of the village children. A teacher's guide is available to suggest supplementary classroom activities. Smoking And Pregnancy Program, developed by the ALA, consists of information kits for pregnant women and health care providers that discuss the effects of smoking on the health of a pregnant woman and her baby. For the pregnant woman, an information kit, available in English or Spanish, provides a mini-flip chart on how cigarettes affect her baby and why quitting smoking during pregnan- cy will reduce these health risks. The kit also provides a pamphlet that answers common questions about smok- ing and pregnancy, and | Quit Smoking Because | Love My Baby stickers and signs. For the health care provider, an information kit (available in English) provides a coun- seling handbook, a flip chart for use in counseling patients, two full-color posters, and Because You Love Your Baby tent cards. Smoking Deserves A Smart Answer is designed for stu- dents in grades 5 and 6. Health effects of smoking, the social and behavioral motivations related to smoking, the skills for identifying and resisting peer pressure, and the effects of cigarette advertising are addressed. A 1-hour, 5-day curriculum is offered, and packets containing puz- zles, posters, and parent information are distributed to children. In-services and resource folders for classroom activities are provided by the ALA. Students Teach Students is a peer counseling program. High school students are trained as counselors to en- courage elementary students not to smoke. The high school students serve as role models for students in grades 5 and 6 and present information and activities concerning the hazards of smoking. This program can be incorporated into the Smoking Deserves A Smart Answer program on the third day of the 5-day curriculum. Two films are also available at many ALA offices: Death In The West and Feminine Mistake. These films offer students information regarding the health consequences of smoking, the societal pressures to smoke, and alternatives to smoking. Protecting the Rights of Nonsmokers The ALA and its affiliates also conduct public education cam- paigns by distributing written materials such as the ALA leaflet, Second-Hand Smoke: The Facts, disseminating public ser- vice announcements, organizing media appearances, and performing legislative and other public policy activities. These efforts are designed to increase public awareness of the hazards of involuntary or secondhand smoking and protect the right of nonsmokers to breathe smoke-free air. ALA affiliates are able to help companies develop and implement effective policies on smoking. Many ALA affiliates have also been instrumental in the development and enactment of State and local legislation to restrict smoking in public places. Tri-Agency Efforts The National offices of the ALA, the ACS, andthe AHAcreated the Coalition on Smoking OR Health, a public policy project that promotes legislative and regulatory action on smoking. The Coalition tries to maximize effective collaboration at the State and local levels through voluntary and legislative ac- tions, public education activities, and public relations cam- paigns. The Coalition also focuses on National aspects of Federal legislation and lobbying efforts. The Coalition and its sponsoring organizations were instrumental in obtaining the passage and enactment of new Federal warning labels on cigarette packages and advertising. Units have been estab- lished in many States to focus on local legislative efforts, gathering their information from the Coalition and from the clearinghouse described below. The three agencies also established the Tobacco-Free America Project. This project publishes the Tobacco-Free Young Reporter, a quarterly publication with a circulation of 42,000, and acts as a clearinghouse for tobacco-related legis- lative information. The clearinghouse provides information and educational materials to State and local coalitions estab- lished to support local legislative efforts and the project. When there is a need for field response, each agency contacts its constituents at the State and local level. The project has identified the children entering first grade in September 1988 as the Smoke-Free Class of the Year 2000. The children will be offered educational programs every year while they are in school. The project also coordinates the Athletes Against Tobacco program, which was established in December 1986 as a speaker’s bureau for professional and amateur athletes to serve as spokespersons for local coalition offices and other voluntary groups and as role models for children. The athletes are available to speak to groups and visit schools; visits are scheduled through the clearinghouse. A new initiative, Tobacco Free Schools, is a high priority activity for the tri-agency group. They supported a National survey of nonsmoking policies in schools conducted by the National Schoo! Boards Association. Published in June 1987, No Smoking-A Board Member's Guide to Nonsmoking Policies for the Schools is the result of this survey. General Conference of Seventh-Day Adventists In 1959, a Seventh-Day Adventist physician and a minister joined efforts to present a program on the harmful effects of smoking. The result was the Five-Day Plan To Stop Smoking, a plan that has been conducted around the world and has helped several million people to stop smoking. The Breathe-Free Plan to Stop Smoking: The Revised Five-Day Plan in 1985, the Five-Day Plan was revised and renamed the Breathe-Free Plan To Stop Smoking. It consists of eight 2-hour sessions designed to help a smoker break the tobacco habit. This plan emphasizes lifestyle modification strategies, such as encouraging smokers to clarify their values, visualiz- ing new behavior, role playing and modeling, and decision making to develop a positive self-image as a nonsmoker. Among the practical techniques advocated during the first few days to lessen withdrawal symptoms are frequent warm baths, increased fluid intake, regular eating and sleeping habits, extra exercise (particularly after meals), and the avoidance of sedatives and stimulants, such as alcohol, caffeine, spicy foods, and foods high in saturated fats. Films promoting a positive self-image and group-support ses- sions have successfully helped participants to stop smoking. Handout materials encourage participants to be personally involved in their lifestyle change. Because of the interrelation- ships of body, mind, and spirit, the program takes a holistic approach in assisting the individual to use all of his or her resources to make this major behavioral change successfully. Programs are conducted in hospitals, churches, and worksites. More information is available by calling, toll-free, (800)253-3000, (800)253-7077, or (800)247-5627, or by contacting the following organizations. North American Division Health and Temperance Department of the General Conference of Seventh-Day Adventists 6840 Eastern Avenue, N.W. Washington, D.C. 20012 (202)722-6719 Health System Regional Offices Adventist Health System/United States 2221 East Lamar Boulevard Arlington, Texas 76006-7411 (817)649-8700 Adventist Health System/North, East, and Middle America 8800 West 75th Street Shawnee Mission, Kansas 66204 (913)677-8000 Adventist Health System/Loma Linda Loma Linda University Medical Center Post Office Box 2000 Loma Linda, California 92350 (714)824-4302 Adventist Health System/Sunbelt 2400 Bedford Road Orlando, Florida 32803 (305)897-1919 Adventist Health System/West 2100 Douglas Boulevard Post Office Box 619002 Roseville, California 95678-3898 (916)781-2000 Church Regional Offices Pedro Geli, Jr., Director Health and Temperance Department Atlantic Union Conference Post Office Box 1189 South Lancaster, Massachusetts 01561 (617)368-8333 E. Rick Bacchus, Director Health and Temperance Department Canadian Union Conference 1148 King Street, East Oshawa, Ontario L1H 1H8 Canada (416)433-0011 Ron Stretter, Director Health and Temperance Department Columbia Union Conference 5427 Twin Knolls Road Columbia, Maryland 21045 (301)997-2414 William Jones, Director Health and Temperance Department Lake Union Conference Post Office Box C Berrien Springs, Michigan 49103 (616)473-4541 George W. Timpson, Director Health and Temperance Department Mid-America Union Conference Post Office Box 6127 Lincoln, Nebraska 68506 (402)483-4451 Wayne Shepperd, Director Health and Temperance Department North Pacific Union Conference Post Office Box 16677 Portland, Oregon 97216 (503)255-7300 Elbert Anderson, Consultant Church Ministries Pacific Union Conference Post Office Box 5005 Westlake Village, California 91361 (805)497-9457 154 Ralph P. Peay, Director Health and Temperance Department Southern Union Conference Post Office Box 849 Decatur, Georgia 30031 (404)299-1832 Fred Murray, Director Health and Temperance Department Southwestern Union Conference Post Office Box 4000 Burleson, Texas 76028 (817)295-0476 American Public Health Association In 1985, the American Public Health Association (APHA) initiated a major campaign to help achieve the Surgeon General's goal of a smoke-free society by the year 2000. This campaign, the Anti-Tobacco Initiative, coordinates a variety of activities geared toward ending the promotion of tobacco products to the public. The APHA, its 49 State affiliates, and 23 professional sections contribute to the development of these activities. The association formed a number of coalitions and working groups that concentrate on a variety of topics: smoking on airlines, cigarette excise taxes, smoking and minorities, adver- tisements in women’s magazines, and women and smoking. The coalitions focus primarily on planning legislative strategies with a secondary focus on developing interventions for smoking and health. To increase the legislative lobbying strength available for - tobacco-related issues, the Anti-Tobacco Initiative works through the association’s Government Relations Department. - The APHA has been involved in several court cases regarding suits against tobacco companies. The Anti-Tobacco Initiative works extensively with affiliates in States that have limited tobacco laws and activities, developing guidelines, incentives, and models for their use. : FEDERAL PROGRAMS Cigarette smoking has been cited as the single most important preventable cause of premature mortality in the United States. The evidence that cigarette smoking is the primary avoidable cause of death in our society is supported by extensive research. In addition to the Federal legislative efforts described in Chap- ter IV, many Federal agencies have developed programs with a National impact. These include research, demonstration, prevention, and cessation programs that focus on the health of the American population. In accordance with the General Services Administration regulations on smoking in Federally-owned or- operated build- ings, smoking policies have been developed by Federal departments, agencies and offices. Often, these policies include provisions of smoking cessation programs for employees. Although many Federal offices indicated im- plementation of such programs, for the purposes of this report, only programs with a National focus or impact have been described in detail. U.S. Department of Health and Human Services The Department of Health and Human Services (DHHS) is the Federal department responsible for the health and welfare of the Nation. Through the Public Health Service, the DHHS promotes health education, disease prevention, and research projects. The DHHS has spearheaded Federal efforts in the area of smoking and health. For each fiscal year, the various agencies and offices within the DHHS report their expendi- tures on smoking and health (and 14 other prevention priority areas) to the Office of Disease Prevention and Health Promo- tion. Activities and expenditures related to smoking and health in fiscal years 1985 and 1986 are listed in Table 1. (See Table 1.) The following is a more detailed description of the many DHHS activities in the area of smoking and health by agency or office. Alcohol, Drug Abuse, and Mental Health Administration The Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) oversees the efforts of the National Institute for Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the National Institute for Mental Health (NIMH). Programs conducted by NIMH, as reported in the last biennial report, have been transferred to NIDA and NIAAA. NIAAA's Office for Substance Abuse Prevention is currently implementing all NIAAA smoking-related programs. Office for Substance Abuse Prevention (ADAMHA) The Office for Substance Abuse Prevention (OSAP) has developed materials and messages designed to reach preg- nant and nursing women, youth, and those who may influence their behavior, as well as health care providers, educators, and parents. The messages are broad, counseling viewers and readers on the dangers associated with alcohol, tobacco, and other drug use; they urge abstinence from these substances among pregnant and nursing women, all youth, and in- dividuals recovering from dependence on any of these sub- stances. The programs that focus on these populations are described below. ° The OSAP is supporting a major campaign aimed at educating women and their families (with special em- phasis on low-income women) about the dangers as- sociated with using tobacco, alcohol, cocaine, and other illicit drugs during pregnancy. The number of babies born 155 to mothers who have used cocaine is rising, and the costs associated with Fetal Alcohol Syndrome and Fetal Al- cohol Effects are staggering. Many women who are de- pendent on alcohol are also dependent on tobacco, which increases the risk of low birthweight and related problems, inciuding irreversible mental retardation. Near- ly 40,000 babies are born each year with one or more alcohol-related birth defects. The Campaign To Promote Awareness of Alcohol-Re- lated Birth Defects is being conducted in conjunction with the National Council on Alcoholism and other major voluntary organizations. Materials recently released in- clude a NIDA Capsule on Cocaine Babies and an English and Spanish version of Taking Care of Your Baby Before Birth: A Message for Pregnant Women. The latter material is currently being distributed to low-income women through the WIC program of the U.S. Department of Agriculture and the National Clearinghouse for Alcohol and Drug Information. Each publication stresses three lifestyle messages: the importance of eating a nutritious and balanced diet, avoiding drugs and medications, and avoiding cigarette smoking. Messages to help health care providers pass along this information to their patients has also been developed. Distribution is coordinated with the Substance Abuse Subcommittee of the Healthy Mothers, Healthy Babies National! Coalition. in 1987, the OSAP launched a prevention campaign, Be Smart! Don’t Start! — Just Say No!, aimed at 8- to 12-year olds and those who influence their behavior. The cam- paign focused on the non-use of alcohol as the primary behavior component. It also included specific messages about tobacco products and marijuana, because these are seen as gateway drugs, particularly for this age range. The materials include a music video; television and radio public service announcements; a volunteer newsletter that provides technical assistance for implementing the campaign in communities and schools; print materials for students, teachers, and parents; bumper stickers; discus- sion guides; and many more supportive materials. During this year, the OSAP is adding materials with more focus ontobacco products and other drugs. The OSAP will then follow this population of youth and in 1990 pians to launch a Stay Smart! Don't Start! campaign aimed at 11-to 14-year olds. This campaign has been awarded the Ac- tion for Children’s Television Public Service Award and several Markie Awards for excellence. The OSAP has launched an extensive outreach effort aimed at parents to help them empower their children to say no to harmful substances, including tobacco, alcohol, and other illegal drugs. A series entitled, Ten Steps to Help Your Child Say No, includes a parent's guide, a leader’s guide, and a reminder list that can be posted on walls, refrigerators, or bulletin boards within the home or school. The lifestyle messages are designed to help parents assist their children in developing social and other developmentally appropriate skills to refuse nega- tive peer pressure and get involved with positive peer pressure activities and programs. In addition, the OSAP is launching a major training program for parents that will more intensively help parents. The parents will be trained to build the necessary skills to help their children better Table 1 Expenditures on smoking-and-health activities reported by agencies within the Department of Health and Human Services, Fiscal Years 1985 and 1986. Expenditures (dollars in thousands) enc Activity 1985 1986 Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse Attitude and behavior changes in smoking cessation 33 34 Smoking cessation involving the media and social support 21 22 Clean indoor air laws and malefemale smoking differences 56 58 Preventive drug abuse relapse: smoking as a prototype 212 220 Family influence on adolescent smoking 287 299 Asmoking intervention program for school children 157 163 Social learning analysis of smoking cessation clinic 166 172 Adolescent chewing tobacco use and smoking cessation 269 280 Comprehensive smoking prevention 486 505 Factors inhibiting drug use: teacher and peer effects 104 109 Adolescent drug abuse: a social-cognitive approach 67 70 Licit and illicit abused drugs/behavioral interaction 81 84 Prevention of multi-substance abuse in youth 361 374 Analysis of cigarette and coffee use interactions 39 41 The role of father/mother/sibling in adolescent drug use 14 15 New smoking control projects — 350 Office of the Administrator Alcohol, and Drug Abuse and Mental Health Services Block Grant . * Centers for Disease Control * Center for Health Promotion and Education * Behavioral risk factor surveillance 68 75 Smoking-risk reduction 135 300 Smoking and pregnancy 177 380 Other Program Offices Smoking and Health Services Block Grant ‘ * National institutes of Health Division of Research Resources Smoking and health research 622 623 156 Expenditures (dollars in thousands) Agency Activity 1985 1986 National Cancer Institute Smoking education and information 12,389 20,843 Identification of harmful constituents in tobacco smoke 3,786 3,786 Epidemiology to assess smoking risks 4,956 3,422 National Heart, Lung and Blood Institute Smoking cessation 993 989 Smoking prevention/wellness promotion , 665 662 Smoking and heart health 1,244 1,239 National smoking education program 473 470 National Institute on Aging Smoking and the elderly 480 534 National Institute of Child Health and Human Development Behavioral pediatrics 491 742 Fetal pathology 538 160 High-risk pregnancy 176 168 Infant nutrition 37 191 National Center for Nursing Research Smoking control _ 235 Office of the Assistant Secretary for Health National Center for Health Statistics & 1983 National Health Interview Survey-Alcohol and Health Practices Questionnaire “ “* 1985 National Health Interview Survey-Health Practices/ Disease Prevention Questionnaire “* “ 1987 and 1988 National Health Interview Survey “ “ 1988 National Health and Nutrition Examination Survey (NHANES) ill “ “* Office of Disease Prevention and Health Promotion Dissemination of Decision Maker's Guide to Reducing Smoking at the Workplace 8 5 Office on Smoking and Health * Development of a national information and education program 1,000 1,000 Technical information services 950 950 Development of the Surgeon General’s report on the health consequences of smoking 245 272 Biennial report to Congress Smoking and Health: A National Status Report _ 260 Epidemiology 300 75 Pregnancy and infant health initiative _ 300 157 Source: U.S. Department of Health and Human Services. Prevention 86/87: Federal Programs and Progress. U.S. Government Printing Office: Washington, D.C., 1987. * All block grant funding is not displayed here because some funded activities are not prevention, and others are impossible to identify as prevention because detailed reporting is not required. How funds are actually spent is not known unless they are targeted set-asides. ** Multi-purpose survey; dollar amount directly attributable to smoking and health cannot be determined. & The National Center for Health Statistics was transferred administratively from the Office of the Assistant Secretary for Health to the Centers for Disease Control in 1987. # The Office on Smoking and Health was transferred administratively from the Office of the Assistant Secretary for Health to the Centers for Disease Control (CDC) in September 1986. It is now a division in the Center for Health Promotion and Education, CDC. (The Center for Health Promotion and Education is now called the Center for Chronic Disease Prevention and Health Promotion (CCDPHP), CDC.) defend themselves against societal, environmental, and personal pressures to use tobacco, alcohol, or other drugs. The OSAP has awarded grants to 131 programs across the country to heip prevent alcohol and other drug problems among high-risk youth. High-risk youth are often at risk for problems with many substances, such as cigarettes, chewing tobacco, alcohol, and other drugs, including solvents, stimulants, barbituates, and narcotics. lt is expected that these demonstration programs will yield valuable information that will help communities prevent these problems and intervene with those who have developed problems with these substances. Materials will be developed as a result of these programs. In addition, the OSAP is currently reviewing and assess- ing existing materials that have prevention and interven- tion messages for reaching high-risk youth. Resource lists willbe developed along with innovative strategies for reaching this underserved population. These efforts are being coordinated with many of the Federal agencies working with high-risk youth. Experts and researchers are also sharing their knowledge so that the OSAP staff and others are especially sensitive and responsive to the needs of high-risk families and communities. The OSAP is working with the American Medical Associa- tion, the American Academy of Pediatricians, the American Academy of Family Physicians, ACOG, HRSA, IHS, NIDA, and others to develop messages and materials for primary care providers about alcohol, tobac- co, and other drug problems, especially among adoles- cents. Resource materials have been identified. The cur- rent focus is on effective communication strategies for delivering pertinent drug and alcohol information to the primary care physicians. Finally, the OSAP publishes a bimonthly newsletter, Prevention Pipeline: An Alcohol and Drug Awareness Service, to ensure a flow of information about alcohol and drug prevention efforts among Federal, State, voluntary, professional, and community organizations. Research findings on smoking and its relation to alcohol and other drug use are published in the newsletter in abstract form. New materials that focus on refusal skills, lifestyle change, motivation, and related aspects of prevention are also listed. In addition, the newsletter carries notices of important prevention and intervention meetings and con- ferences, most of which include smoking prevention as a topic. National Institute on Drug Abuse (ADAMHA) In the mid-1970s, the National Institute on Drug Abuse was assigned a leadership role by the DHHS in the investigation of the behavioral aspects of tobacco use, particularly addiction to and dependence upon cigarette smoking. The results of NIDA-sponsored research have been reported in a series of research monographs including Number 17, Research on Smoking Behavior, and Number 23, Cigarette Smoking as a Dependence Process. The 1979 Surgeon General’s Report on Smoking and Health contained the entire NIDA research monograph Number 26, The Behavioral Aspects of Smoking, which provided a summary of biological, behavioral, and psychosocial research on cigarette smoking behavior. Results of NIDA research on nicotine dependence have also been described in the second Triennial Report to Congress on Drug Abuse and Drug Abuse Research (1987) and in the Surgeon General's Report on Nicotine Addiction (1988). Since this time, NIDA has maintained a leadership role through the administration of a well-balanced research pro- gram. Most recently, NIDA published a compilation of research results and guidelines in Monograph Number 48, Measurement in the Analysis and Treatment of Smoking Behavior, which addresses some of the basic and applied research questions related to smoking and tobacco use. This publication is the result of NIDA-sponsored research activities that examine the fundamental problems concerning survey methodology, measurement, and topography of cigarette smoking behavior. Monograph Number 63, Prevention Re- search: Deterring Drug Abuse Among Children and Adoles- cents, reviews research results from a number of psychosocial-based studies in preventive intervention aimed 158 at deterring the onset of cigarette smoking amongchildren and adolescents. Currently, NIDA’s Tobacco Science Program characterizes cigarette smoking and tobacco use as an addictive disorder. The program views self-administration of nicotine as a prototypical model of drug abuse behavior, and considers tobacco a gateway drug that can lead to the use of other drugs. Significant NIDA studies focus on the role of nicotine in establishing and maintaining smoking behavior, the effects of nicotine on withdrawal symptoms, the development of biochemical markers to increase validity of self-report in sur- vey research, the development of more effective techniques for modifying or preventing smoking behavior, assessment of the biological generality of nicotine’s reinforcing actions, iden- tification of brain nicotine receptors, continued assessment of the loss and gain of tolerance to nicotine, and better delineations of neurohormonal mechanisms of nicotine action. NIDA’s pioneering efforts in the area of smoking cessation include studies that examined the effects of learning-based interventions, aversion conditioning, and maintenance proce- dures, which include contractual management and structured group support. Current efforts that show promise include an examination of the determinants of relapse and strategies for successful self-control and disease model programs. Results of such efforts may open new and exciting approaches to the understanding, prevention, and treatment of smoking be- haviors. The results have broad implications for prevention and treatment of other addictive behaviors. In the area of prevention, NIDA supported research to identify effective means of preventing smoking and tobacco use among children and youth. Research results from several school-based prevention programs indicate that interventions based on social learning and developmental theories may be effective in training children to resist pressures to smoke. In recent years, research has shown that the development of various habitual behaviors is similar. NIDA-supported re- searchers have examined promising approaches to smoking prevention and applied them to the prevention of alcohol and other drug abuse. Among these approaches are sociai skills interventions that have significantly reduced alcohol and marijuana use among junior high school students. These efforts have received considerable benefits from the ex- perience of NIDA researchers in basic research, prevention, and intervention efforts with other drugs. Centers For Disease Control The Centers for Disease Control (CDC), within the Public Health Service (PHS), is the Federal Agency charged with protecting the public health of the Nation by providing leadership and direction in the prevention and control of diseases and other preventable conditions and responding to public health emergencies. Within the CDC, efforts to prevent the use of tobacco and to evaluate the effects of tobacco use are concentrated in the Center for Chronic Disease Prevention and Health Promotion (CCDPHP), the Center for Environmental Health and Injury Control (CEHIC), and the 159 National Institute for Occupational Safety and Health (NIOSH). The CDC actively supports epidemiologic research and interventions in which smoking is considered a major risk factor affecting health. Center for Chronic Disease Prevention and Health Promo- tlon (CDC) The Center for Chronic Disease Prevention and Health Promotion (CCDPHP) of the CDC (See # in Table 1.) has developed and is implementing two smoking education programs in schools throughout the United States. "Growing Healthy” is aimed at students in preschool through grade 7. “Teenage Health Teaching Modules” focus on teenage students. Both programs are described in detail below. “Growing Healthy” is a combination of the Primary Grades Health Curriculum Project (PGHCP), developed by the CCDPHP and the American Lung Association (ALA), and the Schoo! Health Curriculum Project (SHCP), deveioped in 1969 by the National Clearinghouse for Smoking and Health (now the Office on Smoking and Health). The subject of smoking and health is integrated into a cur- riculum for teaching good health practices through an understanding of and appreciation for body systems and functions and through the development of a positive self-image. The curriculum consists of separate units of study for students in kindergarten through grade 7. For children in kindergarten through grade 3, complete sets of print and audiovisual materials accompany each of the four cur- riculum units. Publications, films, filmstrips, tapes, models, pupil-prepared games, and other materials are available. Formal teacher training workshops are avail- able nationwide, and training can be scheduled if several schools in one city or county are interested in implementing the program. For students in grades 4 through 7, the curriculum con- sists of separate units of study, each organized around a particular body system. Each unit can be taught in an 8- to 10-week period. The four units, Our Digestion, Our Nutrition, Our Health, About Our Lungs and Our Health, Our Health and Our Hearts, and Living Well with Our Nervous System, focus respectively on the digestive, respiratory, cardiovascular, and nervous systems. Exten- sive print and audiovisual materials have been designed to complement the curriculum, such as publications, films, filmstrips, tapes, models, pupil-prepared games, and other activity materials. The “Teenage Health Teaching Modules” (THTM) is a comprehensive health education curriculum for junior and senior high school students. It is designed to provide adolescents with the knowledge, skills, and under- standing to act for themselves and others in ways that are health-enhancing with respect to their immediate health needs and the long-term consequences of behaviors that they may try or establish during the adolescent years. THTM is being used in at least one school in every State. The CDC developed the program through a contract with the Education Development Center (EDC). In an effort to combine the principles of adolescent developmental theory with behaviors thought to be health-promoting, THTM developed the concept of health tasks: the physi- cal, mental, emotional, and social tasks that adolescents need to develop to their full health potential. This program helps students to develop skills relevant to smoking, such as decision-making, and evaluating and interpreting in- formation. One of the modules addresses “Protecting Oneself and Others: Smoking, Drinking and Drugs.” Another module addresses smokeless tobacco. Results from a rigorous evaluation of the efficacy of THTM will be released in January 1989. Descriptive information, price lists, and copies of the modules are available from EDC. The CDC also provides information and single copies for purposes of further project development and distribution, and will grant rights to reprint the modules under a Government-held license. Requests for such rights should be in writing to the Division of Adolescent and Schoo! Health, CCDPHP. Teacher training is recommended as an adjunct to use of the modules in schools; professional services for show- casing, technical assistance, and teacher training are now available. An evaluation package to assist THTM users in assessing program and outcome effects is being developed and field-tested. The CDC has also developed programs to monitor the prevalence of nutrition-related problems and behavioral risk factors among high-risk populations. Components of these State-based programs that relate to smoking are described below. * The CCDPHP is involved in surveillance of smoking behavior through the Behavioral Risk Factor Surveillance System. Under this system, 39 States and the District of Columbia conduct ongoing assessments of the prevalence of key behavioral risk factors that contribute directly to the 10 leading causes of mortality and mor- bidity. Factors related to smoking, alcohol consumption, exercise, weight, and seatbelt use are surveyed routinely. Behavioral epidemiological research activities atthe CDC include the study of smoking behavior and its deter- minants. The September 1987 Morbidity and Mortality Weekly Report supplement included all major research reports on the psychosocial determinants of smoking among adolescents. * The Pregnancy Nutrition Surveillance System (PNSS) is designed to monitor the prevalence of nutrition-related problems and behavioral risk factors among high-risk pre-natal populations. Under this system, 12 States and the District of Columbia collect data from prenatal clinics and from nutrition and food assistance programs for pregnant women, such as the Special Supplemental Food Program for Women, Infants, and Children (WIC). Nutrition risks such as pregravid underweight, inade- quate weight gains and anemia, as well as behavioral risk factors, such as smoking and alcohol use by pregnant women, are related to low birthweight and infant or fetal death. By quantifying preventable nutrition and be- havioral risk factors among low-income pregnant women, intervention efforts can be focused on women at high risk 160 for adverse pregnancy outcomes. These data can yield trends to permit evaluation of intervention efforts. * The CDC, through State health agencies, is working with communities to prioritize and address leading behavioral risks through risk-reduction interventions. Using be- havioral risk factor surveillance data and other informa- tion, 75 percent of all Planned Approach to Community Health (PATCH) intervention programs have identified smoking as a priority target for risk reduction. In addition, the CDC is providing State smoking risk reduction coor- dinators to State health departments to increase resour- ces for smoking prevention. The first two coordinators under this initiative are located in Maryland and Missouri. The CDC has also developed programs to support the efforts of State and local health departments, national voluntary organizations’ local chapters, health maintenance organiza- tions, and other organizations that are interested in promoting the use of smoking prevention or cessation interventions for women and in particular, pregnant women. * The CCDPHP has developed a series of problem- and population-specific community intervention guides to as- sist local health departments apply community interven- tion strategies. The first such guide, entitled “Smoking Control Among Women,” presents practical guidelines for systematically developing prevention and cessation programs for women inthe workplace, in schools, through private and public health care providers, and through other community institutions. In 1986, the CCDPHP established cooperative agree- ments with the States of Colorado, Missouri, and Maryland in 1986 to implement the Smoking Cessation in Pregnancy (SCIP) project. The primary outcome being tested is the ability of public prenatal clinic and WIC staff to help women quit smoking and remain abstinent during their pregnancies. The project is also studying the relationship between smoking and low birthweight for this high-risk population. The project is fully implemented in Colorado and Missouri. As of September 1988, over 1,000 pregnant smokers had enrolled in the study in Colorado and over 300 had enrolled in Missouri. Field testing began in October 1988 in Maryland to be followed by enrollment starting in December. Once these programs are fully operational, other States will receive CDC assistance in incorporating these methods into their existing prenatal clinical and WIC services. in collaboration with the University of Alabama-Birming- ham, the March of Dimes, and the ALA, the CCDPHP has developed the “Handbook to Plan, Implement, and Evaluate Smoking Cessation Programs for Pregnant Women.” Approximately 5,000 copies of this handbook will be distributed to maternal and child health program managers in the public and private sectors. The intent of the handbook is to transfer the intervention technologies developed as a result of university trials and the Smoking Cessation in Pregnancy project to cessation/main- tenance assistance activities throughout the country. Office on Smoking and Health (CDC) The Office on Smoking and Health (OSH) a division of the Center for Chronic Disease Prevention and Heaith Promotion, is the focal point for all Department of Health and Human Services (DHHS) activities related to smoking and health. Following the release of the 1964 Report of the Advisory Committee to the Surgeon General, the Public Health Service established a National Clearinghouse for Smoking and Health as part of its Chronic Disease Control Program. Later, the Clearinghouse was transferred to the Centers for Disease Control. In March 1978, the Clearinghouse was relocated from Atlanta, Georgia, to the Office of the Assistant Secretary for Health in Washington, D.C., to form the nucleus of the OSH. In September 1986, in an attempt to strengthen the OSH’s Research-Epidemiology capacity, the OSH was administra- tively transferred to the Center for Health Promotion and Education, now the Center for Chronic Disease Prevention and Health Promotion, of the Centers for Disease Control. The OSH remains geographically located in the Washington, D.C. area. - The OSH coordinates the DHHS smoking education, preven- tion, and research efforts both Nationally and internationally, and stimulates smoking and health intervention programs and activities at the State and local level. Another major respon- sibility of the OSH is preparing and disseminating the Department’s annual report on the health consequences of smoking. Since 1980, these reports have described the following subject areas in depth on the Health Consequences of Smoking for: * 1980, Women; ¢ 1981, The Changing Cigarette; e 1982, Cancer; * 1983, Cardiovascular Disease; * 1984, Chronic Obstructive Lung Disease; ¢ 1985, Cancer and Chronic Lung Disease in the Workplace; * 1986, Involuntary Smoking; and ¢ 1988, Nicotine Addiction. The 1986 Involuntary Smoking report examined the evidence that even the lower exposure to smoke received by the non- smoker carries a health risk. This report is a critical review of all the available scientific evidence pertaining to the health effects of environmental tobacco smoke on nonsmokers. The report concluded that involuntary smoking is a cause of dis- ease, including lung cancer, in healthy nonsmokers and that the children of parents who smoke, compared with the children of nonsmoking parents, have an increased frequency of respiratory infections, increased respiratory symptoms, and Slightly smaller rates of increase in lung function as the lung matures. Moreover, the simple separation of smokers and nonsmokers within the same air space may reduce, but does 161 not eliminate, the exposure of nonsmokers to environmental tobacco smoke. The 1988 Nicotine Addiction report examined in detail the specific topic of nicotine addiction. Careful examination of the data revealed that cigarettes and other forms of tobacco are addictive. Extensive research has shown that nicotine is the drug in tobacco that causes addiction. In addition, the proces- ses that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. Scientific and Technical Information The OSH collects and analyzes scientific information to estab- lish and evaluate Federal policies on smoking. The OSH maintains the Technical Information Center (TIC) on Smoking and Health, a repository for published information on tobacco, smoking, and health. The TIC has acquired nearly 60,000 publications and possesses the computer and microfilm tech- nologies to provide special searches, references, and abstracts. Hard copies of materials are given to researchers on request. The TIC responds to approximately 5,000 techni- cal inquiries from researchers each year. The TIC publishes a series of technical publications, including the bimonthly Bulletin on Smoking and Health (abstracts of published litera- ture on smoking, tobacco, and health); and an annual Bibliog- raphy on Smoking and Health. The OSH bibliographic data collection is now available for direct, on-line access through Dialog Information Services, Inc. Epidemiology Shortly after its transfer to the CDC, the OSH established an Epidemiology Branch to conduct new scientific studies and surveys, analyze existing data sources, and provide technical and scientific assistance to researchers, health departments, and other health professionals interested in specialized data collection or analysis. The first task of the Epidemiology Branch was to conduct detailed trend analyses of smoking- related variables from data collected in the National Health Interview Surveys of the National Center for Health Statistics. In-depth analysis has also been conducted in the 1986 Adult Use of Tobacco Survey (some of the data from this survey are included in this report). The Branch also began identifying all National data banks that included questions on smoking. Where feasible, copies of the data banks are obtained and included in the repository of smoking surveys maintained by the Branch. A National survey of teenage smoking behavior is planned for implementation in 1989. Public Information The OSH conducts public information and education programs to advise the public about the adverse health con- sequences associated with smoking and other forms of tobacco use. These programs are carried out through the development and distribution of public service advertising and print material, with the assistance of an advertising agency under contract with the OSH. The OSH has two concurrent public service advertising cam- paigns: one addressed to the adult smoker and the other to teenagers. The teen campaign, which has been co-sponsored by other health agencies, has included a series of award- winning music-video television announcements, including Peer Group, Cigarette Mash, Smoking Kisses, and Smoking’s Out. In addition to the programs cited above, the OSH distributes printed public service announcements to high school and college newspapers on a biennial basis. As these newspaper ads are seen by the majority of students, they represent an effective vehicle to discourage smoking among young people. In 1985, at the request of the Secretary of Health and Human Services, the OSH began an initiative related to the risk of smoking during pregnancy. This program reached out to preg- nant girls and women and to the Nation's providers of prenatal care with the message, “If you’re pregnant and still smoking, remember: now, you’re smoking for two. And that’s two good reasons to quit.” In 1987, a new initiative was launched, which repeated the 1985 theme and introduced a new, accompanying theme, “There’s a baby in the house, please don't smoke.” The new campaign introduced television and radio public service an- nouncements, consumer and professional materials, posters, and a sticker for parents. Itis based on the finding of the 1986 Surgeon General's Report on the Health Consequences of Involuntary Smoking that children of parents who smoke have a higher frequency of respiratory infections. In addition to the programs listed above, the OSH public information branch answers approximately 40,000 public in- quiries annually through its clearinghouse. Worksite Smoking Cooperative Agreement The OSH participates in a cooperative agreement with the Rhode Island Department of Health and the CDC's Center for Environmental Health and Injury Control (CEHIC), to study the effects of biological monitoring on the outcome of worksite smoking policies and cessation programs. This study began in December 1987 and will continue for 3 years. CDC Tobacco Working Group To coordinate tobacco-related research at CDC, the OSH established a CDC Tobacco Working Group. The Working Group meets bimonthly to share epidemiological findings and exchange information. tt is attended regularly by investigators and staff from the Center for Chronic Disease Prevention and Health Promotion, and from the Center for Environmental Health, the Center for Prevention Services, the Epidemiology Program Office, the National Institute for Occupational Safety and Health, and the Office of Program Planning and Evalua- tion. The OSH has prepared a compendium of Summaries of CDC Projects and Activities Related to the Use of Tobacco, which is available upon request. National Advisory Committee The OSH is responsible for staffing the interagency Commit- tee on Smoking and Health. Mandated by the Comprehensive Smoking Education Act of 1984, this Committee advises the Secretary of DHHS on smoking and health issues. The Com- mittee, comprised of 25 members who represent various Federal and non-Federal agencies, became fully operational in 1986. The chairman of the Committee is the Surgeon General of the PHS, Or. C. Everett Koop. A detailed review of the Committee activities is provided in Chapter III of this Report. 162 Office on Smoking and Health Publications List Public Information What you don’t know will hurt you. (PHS) 83-50197 A guide to smoking and your health. Fold-down pamphlet: 1983. No more butts. (PHS) 83-50199 A guide to quitting smoking. Fold-down pamphlet: 1983. How anon-smoker can help a smoker become an ex-smoker. (PHS) 83-50200 Fold-down pamphlet: 1983. If your kids think everybody smokes ...they don’t know everybody. (PHS) 83-50201 A parent’s guide to smoking and teenagers. Fold-down pamphlet: 1983. A Self-Test for Smokers. (CDC) 75-8716 There are three short tests in this booklet to help you find out what you know about cigarette smoking and how you fee! about it. 8 photocopied pages: October 1983. Teenage Cigarette Smoking Self-Test: A Discussion Leader’s Guide. (PHS) 82-50189 This self-test was designed to help teenagers understand their feelings about cigarette smoking. The booklet con- sists of a leader's guide followed by eight duplicating masters. 1982. Why People Smoke Cigarettes. (PHS) 83-50195 This statement on cigarette smoking has been developed from testimony delivered before the U.S. Congress by William Pollin, NIDA. 5 pages: 1985. Pregnant? That’s two good reasons to quit smoking. (PHS) 83-50198 Fald-down pamphiet: 1985. (English version) Embarazada? He aqui dos buenas razones para dejar de fumar. (PHS) 83-50198 SP Fold-down pamphlet: 1985. (Spanish version) Is Your Baby Smoking? If someone in your household is smoking, then your baby is smoking, too. (CDC) 87-8401 Fold-cown pamphlet: 1987. (English version) Esta fumando su bebe? Si alguien esta fumando en su casa, su bebe tambien esta fumando. (CDC) 87-8402 Fold-down pamphlet: 1987. (Spanish version) Technical Publications Smoking and Health Bulletin. Abstracts of technical literature. Quarterly. Bibliography on Smoking and Heaith. Annual cumulation of Smoking and Health Bulletins. Earlier editions of the bibliography, from 1970-1988 are availabie as long as supplies last. State and Local Programs on Smoking and Health. A collection of smoking prevention programs, aimed at children and adolescents, school-based programs, com- munity and patient education, worksite programs, mass medical campaigns, and individual self-help and counsel- ing. 151 pages. 1985. Smoking and Health-A National Status Report. A survey of National, State, and local programs; categorizes ail State legislation concerning smoking; reviews smoking and health research sponsored by the Federal Government and three major voluntary health organizations; reviews smoking and prevalence over the past 30 years, and examines promising intervention Strategies. 467 pages. 1986. Directory of On-Going Research in Smoking and Health. Summaries of research projects. 1984-85 issue only. A Physician Talks About Smoking. Developed for physicians and other health care profes- sionals who are called upon to speak to medical and lay audiences on smoking and health. Booklet: 55 pages. (Slides available for purchase, National Audiovisual Center, (301)763-1896.) A Decision Maker's Guide to Reducing Smoking at the Worksite. A publication designed to answer questions about smok- ing and its impact on business and to offer information, policies, and programs to reduce smoking. Booklet: 42 pages. (Photocopies only). The Surgeon General's reports on the Health Consequences of Smoking: 1980—Women 1981~-The Changing Cigarette (out of print) 1982-—Cancer 1983—Cardiovascular Lung Disease 1984—Chronic Obstructive Lung Disease 1985—Cancer and Chronic Lung Disease in the Workplace 1986—Involuntary Smoking 1988—Nicotine Addiction. 1989-25 Years of Progress. Posters Pregnant? That's two good reasons to quit smoking. Poster: 1985 (English version). Embarazada? He aqui dos buenas razones para dejar de fumar. Poster: 1985 (Spanish version). 163 Animal Posters Fish poster—Don’t you get hooked. 16" x 21" color poster. (English and Spanish). Bunny poster-This is a dumb bunny. 16" x 21” color poster. (English). Cigarette Mash Poster 17° x 22" color poster. (English). Center for Environmental Health and Injury Control (CDC) The Center for Environmental Health and Injury Control (CEHIC) of the CDC is conducting four research and analysis projects on smoking and heaith, two in the Division of Environ- mental Health Laboratory Sciences (EHLS) and two in the Division of Environmental Hazards and Health Effects (EHHE). These research and analysis projects are described in detail below. * The EHLS is developing a sensitive assay for serum cotinine to measure levels of cotinine in persons with low levels of smoking exposure, such as passive smoking exposure. Current serum cotinine assays are either too insensitive to detect passive smoking levels or are not validated. To prepare for the National Health and Nutrition Examination Survey (NHANES) III, in which thousands of cotinine measurements will be taken, the EHLS is developing immunologic and gas chromatography/mass spectrometry (GC/MS) methods for serum cotinine measurement. The GC/MS method for serum cotinine is approximately 50 percent complete and appears to have adequate sensitivity for detecting levels of cotinine from passive smoking. As a followup project, the EHLS will perform serum cotinine measurements on NHANES Ill participants. The objective of this study is to determine cotinine levels ona set of persons who are representative of the non-institu- tionalized civilian population in the United States. This knowledge will allow prevalence estimates of the amount of passive smoking exposure that occurs in the United States. Cotinine levels will be measured for each survey participant. Analysis on the samples should begin in October 1988. The EHHE, in conjunction with the Office on Smoking and Health, is currently conducting the Rhode Island Workplace Smoking Reduction Program. The program began in October 1987, and will conclude in October 1990. The program's objective is to evaluate the effects of measuring saliva cotinine on smoking behavior in the workplace. The program seeks to determine whether or not feedback on passive smoking levels, added to a standard cessation and education program, will reduce the overall level of smoking and exposure to tobacco smoke in the workplace. This method will be compared to the effect of a stand-alone education program. The EHHE is also conducting a program in conjunction with the New York City Department of Health. The program’s objective is to determine the effect of restric- tions on smoking in the workplace on knowledge, at- titudes, and practices. Self-administered written ques- tionnaires were completed by Department of Health employees. Saliva cotinine samples were collected at the same interview. The questionnaires will be read- ministered in the summer of 1988, and a second saliva cotinine sample will be collected. Results are not yet available, but are expected by March 1989. Natlonal Institute for Occupational Safety and Health (CDC) The National Institute for Occupational Safety and Health (NIOSH) conducts research on the causes of work-related iliness and injuries, recommends workplace standards, responds to requests for investigation of apparent occupation- al health problems, and supports training of professionals in the field. The NIOSH research efforts relating to problems of smoking and clean indoor air focus on work-related hazards and exposure or interaction with tobacco smoke. The NIOSH has identified the 10 leading work-related dis- eases andinjuries and has developed comprehensive preven- tion strategies to reduce or eliminate these problems. In general, the strategies include four parts: definitions, descrip- tions of the nature of the problem, depiction of the preventive measures that can be taken immediately, and depiction of the knowledge required to move forward. Other smoking-related health problems include occupational cancers and occupa- tional cardiovascular diseases; occupational lung disease has the top priority. The 10 strategy plans guide the NIOSH research activities. Copies of the strategy plans are available from the Association of Schools of Public Health. The NIOSH has a wide range of research work in progress that deals with the interaction of smoking with worksite hazards and exposures. In a related area, the NIOSH is cooperating with the World Health Organization in the development of a technical paper on smoking and occupation, which will be promulgated worldwide. Health Resources and Services Administration The Health Resources and Services Administration (HRSA) supports a variety of smoking prevention and cessation activities through its offices. Programs are aimed at specific populations, and several are aimed specifically at the HRSA employees. The Maternal and Child Health program currently provides support to 12 Special Projects of Regional and National Sig- nificance that include smoking as a risk behavior. One project in Baltimore, Maryland, focuses efforts on low-income mothers for a smoking cessation program. Ten projects in the prenatal program include smoking as one of the risk behaviors. Another project that emphasizes decreasing risk behavior in adolescents includes smoking as one of the nine risk behaviors. Positive results from these 164 projects willbe made available to State and local maternal and child health programs. In the area of health professions and nursing education, many of the grant-supported activities in curriculum development, demonstration, and training for health care delivery include smoking as a part of the health promotion aspects. Some of the specific programs are: » Area Health Education Centers Family Medicine Department Grants; + Family Medicine Residency and Training Grants; * General Internal Medicine, Pediatrics Residency, and Training Grants; * Nursing Demonstration Project Grants; « Nurse Practitioner and Nurse Midwife Grants; and * Special Nursing Project Grants. The Primary Care programs and the National Health Service Corps continue to support efforts to help their patients stop ~ smoking. Over one-half of the health promotion and disease prevention (HP/DP) clinics that are Federally supported or staffed indicate smoking cessation programs as an area of special HP/DP emphasis. Further, smoking cessation is an integral part of the lifecycles approach to health care service delivery. Hence, smoking cessation is: + integrated as part of risk assessment in prenatal care; + taught as part of anticipatory guidance in pediatric care; » included in the HP/DP activities for adolescent patients; + part of the adult wellness programs, with specific em- phasis on adults who have other risk factors, such as hypertension and use of birth control pills; and * part of the geriatric care program, reinforcing the role modeis that older Americans provide for others. The HRSA recommended a policy for smoking cessation in all Community and Migrant Health Centers; increasingly, the centers are becoming smoke-free. The HRSA maintains on-the-job health and safety for many Federal employees and supports efforts to inform employees about smoking and health. The Federal Employees Health Units throughout the country reported 170 smoking cessation and education programs that have reached 11,000 people. Indian Health Service The Indian Health Service (IHS), as a public health agency, promotes the practice of healthy lifestyles in American Indian communities. The IHS provided a model for Indian com- munities by making all IHS facilities smoke-free. The IHS set a goal to make nonsmoking the social norm and reduce ail opportunities for the consumption of tobacco. Efforts are now being focused on the maintenance of health by encouraging individuals to eliminate habits that are detrimental and self- destructive. Proper diet, cessation of smoking and alcohol abuse, and an increase in fitness activities are major priorities for the IHS. Specific community education on the effects of tobacco products is an integral part of ail HP/DP activities. Special programs and teaching materials were developed for high-risk communities, including tribes in Alaska, and high-risk groups, including adolescents, that target the hard-to-reach popula- tions of tobacco users. Smoking at tribal council meetings has been banned by some communities. Health and Fitness Fairs are sponsored by many tribes throughout the Nation, em- phasizing individual responsibility for health. The IHS is con- tinuing its health promotion and disease prevention emphasis throughout Fiscal Year 1988. National Institutes of Health The National Institutes of Health are responsible for the scien- tific investigation of health problems facing the Nation. Of the nine Institutes, three reported programs, directly related to smoking and health, that have an impact on National health concerns. The primary responsibilities of these Institutes and their smoking-related programs are described below. National Cancer Institute (NIH) Through the continuation of its comprehensive research pro- gram in cancer control combined with efforts in health promo- tion and information dissemination, the National Cancer institute (NCI) can identify strategies with the greatest effectiveness in preventing the onset of tobacco use or in promoting smoking cessation. National Cancer Institute Publications List Not Far Enough: Women vs. Smoking. A Workshop for Women’s Group and Women’s Health Leaders. NIH Pub- lication No. 87-2949, 1987. Summarizes the proceedings and recommendations of a national conference on women and smoking sponsored by the NCI and the Advocacy institute. Schwartz, J.L. Review and Evaluation of Smoking Cessation Methods: The United States and Canada, 1978-1985. U.S. Department of Health and Human Services, Public Health Service, National Cancer Institute, NIH Publication No, 87-2940. April 1987. 200 pages. Provides a detailed analysis of both published and unpublished cessation methods and techniques and success rates, from the United States and Canada. The Health Consequences of Using Smokeless Tobacco: A Report of the Advisory Committee to the Surgeon General. U.S. Department of Health and Human Services, Public Health Service, DHHS Publication No. (NIH) 86-2874, 165 1986. 195 pages. The first Surgeon General’s report to focus exclusively on the health effects of smokeless tobacco use. Glynn, T.J., Manley, M.W. How to Help Your Patients Stop Smoking: A National Cancer Institute Manual for Physicians. NIH Publication No. 89-3064, 1989. Based on the results of NCI trials, this guide describes brief tech- niques physicians can use to help patients stop smoking. Media Strategies for Smoking Control: Guidelines. NIH Publi- cation No. 89-3013, 1989. This guide provides practical advice and strategies on how to use the media effectively for smoking cdntrol issues, particularly at the local level. Boyd, G.M. and Darby, C.A. (eds.) Smokeless Tobacco Use in the United States. National Cancer Institute Monograph No. 8, 1989. A monograph which summarizes current issues related to smokeless tobacco use including current prevalence estimates, cancer risks due to smokeless use, and intervention approaches. Chew Or Snuff Is Real Bad Stuff: A Guide to Make Young People Aware of the Dangers of Using Smokeless Tobacco. A guide for use in schools and other settings to reach youth about the hazards of snuff and chewing tobacco use. Quit for Good: A Practitioner's Stop Smoking Guide. NIH Publication No. 89-1825, 1989. A guide for the primary care physician on howto help their patients stop smoking. Glynn, T.J. Essentials Elements of School-Based Smoking Prevention Programs. In press, Journal of School Health 59(5), 1989. NIH consensus statement on the essential elements for school-based smoking control programs. Glynn, T.J. School Programs to Prevent Smoking, the Nation- al Cancer Institute Guide to Strategies That Succeed. In press, NIH, 1989. Guide to the selection of effective school based smoking prevention initiatives with a sample list of appropriate curricula. Smoking Policy Questions and Answers, a series of 10 separate publications providing brief, practical advice about contemporary smoking policy issues. ° Health Effects of Environmental Tobacco Smoke * Implementation of Smoking Policies » Strategies for Selecting Smoking Cessation Programs * Costs and Benefits of Smoking Restrictions in the Workplace * Smoking in the Workplace: Ventilation * Smoking in the Workplace: Legal Issues * Smoking Policies and the Unions * Smoking Policies and Health Care Institutions * Smoking and the Female Workforce * Smoking and the Blue Collar Workforce Intervention Programs The Smoking, Tobacco, and Cancer Program The NCI Smoking, Tobacco, and Cancer Program (STCP) within the Division of Cancer Prevention and Control (DCPC) serves as the focal point for the NCI's research, disease prevention, and health promotion activities related to tobacco use and cancer. In Fiscal Year 1988, the STCP has allocated more than $39 million to activities for controlling smoking and tobacco use. The majority of these funds will be used for intervention and prevention initiatives. The primary objective of the STCP is to decrease the incidence of cancers caused by, or related to, smoking and the use of other tobacco products. The programs of the STCP may be summarized within five broad categories: basic research, intervention initiatives, target population initiatives, information dissemination and research applications, and surveillance. The STCP supports intervention projects in eight areas, in addition to the Community Intervention Trial for Smoking Cessation. These projects are all aimed at producing reliable prevention or cessation methodologies to reduce smoking prevalence in the Nation. More than 10 million individuals in 25 States and over 200 cities are affected by these efforts. The results of these efforts are expected to yield sufficient data to develop large scale demonstration and implementation studies by 1990, leaving the next decade for the dissemination of those strategies. The eight individual approaches are described below. School-Based Intervention Program Eight prevention-intervention initiatives based in schools were supported in Fiscal Year 1988 in rural, urban, and suburban areas across the country; two school-based trials were com- pleted at the end of Fiscal Year 1986. The target audience includes approximately 170,000 students in grades 3 through 12 for the current eight trials. Intervention approaches under examination include a variety of smoking prevention curricula and programs. An important aspect of these efforts is the focus on longitudinal followup; several of the projects entail evalua- tion of the long-term effects of programs that have already proved effective in the short-term. The goal of the STCP in this area is development or refinement of school-based curricula that have the potential for broad dissemination to the Nation’s schools. These intervention efforts include: * A Comprehensive Approach to the Prevention of Smoking; + Late Adolescent Smoking: Process Analysis and Deterrence; « School and Family-Oriented Cancer Prevention Program; 1 e Evaluation of School-Based Smoking Prevention; « A State-Wide Approach to Adolescent Tobacco-Use Prevention; * Smoking Prevention: The Youth Health Promotion Program; * Longitudinal Evaluation of a School Anti-Smoking Program; and * Smoking Prevention Training for High-Risk Youth. Minimal Interventions The STCP is supporting seven intervention efforts to deter- mine the long-term effectiveness of self-help resources; i.e., pamphlets, manuals, books, audiotapes, and other materials. These trials test a variety of self-help approaches, affecting over 200,000 individuals. The trials are expected to result in several self-help programs for smoking cessation and relapse prevention and kits that can be disseminated to smokers through community, worksite, and health care settings. The trials supported in Fiscal Year 1988 were: ° Self-Help Smoking Cessation at the Worksite; ¢ Stress and Social Support in the Self-Quitting of Smoking; * Cancer Control by Self-Help Smoking Interventions; » A Study of Self-Help Smoking Cessation and Maintenance; * Self-Help Strategies in Long-Term Smoking Cessation; ¢ Self-Help Models and Manuals for Smoking Cessation; and + Effectiveness of Self-Help Smoking Cessation Strategies. Physician- and Dentist-Delivered Interventions The STCP goals for physician- and dentist-delivered interven- tions include the development of effective and durable inter- vention methods and the development of effective methods to train and influence physicians, dentists, and their office staff in counseling smokers. Six physician- and dentist-delivered intervention trials are funded through the NCI. The trials use a variety of approaches in a range of medical and health settings, including medical schools, private offices, and health maintenance organizations. Through these projects, nearly 40,000 patients are receiving interventions from their physicians; over 700 physicians and dentists receive training or instructions on ways to intervene with patients who smoke. Trials currently supported include: * Compliance with Nicotine-Bearing Chewing Gum; * Physician Counseling for Smoking Cessation; Physician and Dentist Intervention for Smoking Cessation; * Smoking Cessation Delivered in Physicians’ Offices; Evaluation of Physician and Dentist Interventions for Smoking Prevention and Cessation; and ¢ Tobacco Reduction in an HMO: A Model for Cancer Control. Mass Media Interventions More than five million people are being exposed to smoking control messages through five mass media intervention trials funded by the NCI. Smoking intervention in this area involves a variety of approaches, including different mass media chan- nels, combinations of media and school-based programs, and combinations of media and community intervention programs. Efforts currently being supported include: ¢ Mass Media and Prevention of Adolescent Smoking; * Approaches to Comprehensive Smoking Prevention; e A Su Salud — A Media and Community Demonstration; * Smoking Prevention Through Mass Media and Schooi Programs; and « Community Interventions for Cancer Prevention. Biack-American Interventions The NCI currently supports eight intervention projects to ad- drass smoking prevention and cessation in the black popula- tion. Intervention strategies include the use and potential role of black physicians in delivering smoking cessation strategies, school-based skills training, smoking prevention programs, self-help smoking cessation approaches, and community- based smoking prevention and cessation campaigns. A prin- cipal consideration in the design of intervention strategies for blacks is tailoring those strategies to relevant demographic, socioeconomic, and cultural factors. Projects currently being supported include: ¢ Black Physicians and Smoking Intervention Strategies; * A Self-Help Quit Smoking Program for Black Americans; « Community Mobilization for Smoking Cessation; and * Primary Prevention of Cancer in Black Populations. Hispanic-American Interventions The NCI has three intervention projects that are aimed at Hispanics and one media trial, A Su Salud, that focuses primarily on Hispanics. These approaches include smoking campaigns, school-based prevention strategies, group ses- sions, community organization and training, and systems of social support for coping with stress. These efforts stress the design of culturally appropriate interventions that take into account the important issues related to Hispanic smoking behavior. The three Hispanic projects currently funded are: * Smoking Prevention Among New York Hispanic Youth; * Smoking Prevention in Hispanic Adolescents; and ¢ Smoking Cessation Intervention in Hispanics. 167 Smokeless Tobacco Interventions The goals of the STCP intervention efforts in the area of smokeless tobacco are to identify the pattern of use and the major factors that influence its use, and to implement and evaluate intervention strategies to minimize the prevalence of smokeless tobacco use. The eight intervention projects currently funded are: * Curtailing Use of Smokeless Tobacco Through 4-H Clubs; * Smokeless Tobacco: Onset, Prevention, and Cessation; ¢ Project Shout: Smokeless Tobacco Prevention in Public Schools; « Smokeless Tobacco Cessation for Adults in Dental HMOs; ¢ Tobacco Use Prevention Among Native Americans; * Smokeless Tobacco Use Prevention Through Little League; « Prevention of Smokeless Tobacco Use During Adolescence; and « Prevention of Smokeless Tobacco Use in Children. Women's Interventions The STCP intervention efforts aimed at women emphasize approaches that relate to smoking patterns unique to women. The approaches take into consideration a variety of influenc- ing factors; i.e., the media, the multiple and increasingly complex roles of women in society, fears of weight gain, and stress management. The five projects currently funded include: « Effect of Competence and Peer Support on Women’s Smoking; « Smoking Cessation for Women in an HMO Population; ¢ Prevention and Cessation of Smoking by Nursing Students; * Smoking Cessation Intervention Trial for Pregnant Women; and « Enhancing Smoking Cessation by Weight Gain Prevention. Community Intervention Trial for Smoking Cessation The Community Intervention Trial for Smoking Cessation was initiated in September 1986 to establish a Nationwide cooperative intervention program in 22 communities in the United States and Canada. This trial is the largest inthe STCP and will involve almost two million people in the testing of smoking cessation strategies delivered through community organizations and social institutions. Heavy smokers (25 or more cigarettes per day), who are at greatest risk for cancer and who have shown the least reduction in smoking in the last 2 decades, are the prime target audience. Following the 2-year planning and protocol development phase, the most promis- ing intervention methodologies from all other ongoing STCP research trials are being evaluated for broad applicability to this trial. The resulting protocol will be tested during a 4-year intervention period, and the impact will be monitored among heavy and light-to-moderate smokers. The results of the inter- vention protocol and trial will provide a model to communities around the Nation that want to establish effective smoking control programs. Office of Cancer Communications (NCI) Through its press activities and answers to public inquiries, the NCl responds to questions about its tobacco research and control programs and the overall tobacco problem. The NCI assists journalists and health professionals in preparing accurate reports on tobacco-related issues. In its Cancer Prevention Awareness Program, the NCI uses a variety of informational and educational approaches to motivate Americans to avoid the use of all tobacco products. The mass media, health care providers, and health-concerned organiza- tions are priority channels for communicating and reinforcing this key cancer prevention message. OCC has historically tried to increase the involvement of health professionals in counseling patients about cessation of tobacco use. In collaboration with the American Cancer Society a kit directed toward physicians was developed. Called “Quit for Good: A Practitioner's Stop Smoking Guide,” the kit is being promoted separately by both NCI and ACS, with each organization packaging it with supporting materials, including self-help booklets. The guide, which was extensively pretested during development, is based on the protocol result- ing from STCP physician and dentist intervention trials. This new protocol includes involvement of the entire office support staff in identifying smokers and encouraging and supporting their quit attempts. Included in the new kits are waiting room materials and chart reminders to focus the physician, office staff, and patients on smoking cessation. The "Pharmacist’s Helping Smokers Quit” kit, similar to physician and dentist kits, was developed in 1986 in collabora- tion with the American Pharmaceutical Association (APA). A distinctive feature of this pragram is its focus on drug interac- tions with smoking. The kit contains a pharmacist’s guide, counter cards, posters, and sets of take-home materials for 25 patients. The program was launched in June 1986 ata Nation- al news conference—more than 40,000 kits have been dis- tributed. OCC plans to work with APA to revise kit materials in late 1989 before a new wave of promotions to pharmacists. "A Guide to Make Young People Aware of the Dangers of Using Smokeless Tobacco” was developed and promoted by the NCI and the Amrican Academy of Otolaryngology-Head and Neck Surgery, Inc. The guide is an aide for teachers in providing adolescent boys (ages 10-18 years) with information about the social influences and health consequences of using smokeless tobacco. NCI and the Academy have promoted the materials to school-related organizations and through media attention during the AAO sponsored "Through With Chew" on the anniversary of the death of Sean Marsee, an Oklahoma youth who died of oral cancer related to his use of smokeless tobacco. The Office of Cancer Communications has collaborated with the Office on Smoking and Health to develop and promote four television public service campaigns that refer viewers to OCC materials or the Cancer Information Service toll-free number. NCI resources are available to health professionals and the public to aid in the prevention or cessation of tobacco use. Copies of all materials are available free of charge by writing to the NCI, Office of Cancer Communications, Building 31, Room 10A24, Bethesda, Maryland 20892. The materials available to professionals and the general public include: ¢ Quit For Good brochure for use by physicians and den- tists; ¢ Helping Smokers Quit brochure for use by pharmacists; * Clearing The Air brochure on cessation techniques; * Guia Para Dejar De Fumar Spanish language booklet for selt-help smoking cessation; * Why Do You Smoke self-test; « Chew Or Snuff is Real Bad Stuff brochure on smokeless tobacco; e Cancer Prevention Brief: Tobacco, an overview of the relationship of smoking to health problems; and * Resources For Smokeless Tobacco Education list of materials available on smokeless tobacco. The NCI also supports a toll-free telephone inquiry system that supplies information about cancer and contacts for additional information. The Cancer Information Service (CIS) toll-free number is 1-800-4-CANCER. National Heart, Lung, and Blood Institute (NIH) The primary responsibility of the National Heart, Lung, and Blood Institute (NHLBI) is the scientific investigation of heart, blood vessel, lung, and blood diseases. The Institute oversees the research, demonstration, prevention, education, control, and training activities in these areas. To enable the rapid transfer of research-generated knowledge into the mainstream of clinical medicine and personal health practices, the Institute administers four educational programs designed to alert health professionals, patients, and the public to new knowledge for preventing and controlling cardiovascular, pulmonary, and blood diseases. Education Program The NHLBI Smoking Education Program was created to reduce smoking-related cardiovascular and pulmonary dis- ease by developing and marketing educational materials and programs for physicians, other health care providers, and specialized patient populations. The program emphasizes the importance of clinical opportunities: unique “teachable mo- ments” when an intervention by a physician or other health 168 care provider can have a profound impact on a smoker's behavior. Several studies support the premise that a brief, but firm, message from a physician about smoking cessation during a routine office visit can be the critical factor in a patient's decision to quit smoking. Program materials include a variety of tools and publications that support this strategy. The program also addresses smoking at the worksite, where employee health programs provide an effective means of risk factor reduction and where smoking policies are growing in popularity. Selected items available from the program include the following. * Clinical Opportunities For Smoking Intervention: A Guide For The Busy Physician identifies simple steps physicians and other office personnel can take to encourage smoking cessation among patients. The guide describes a variety of methods that can be used to change patients’ smoking behavior; e.g., adapting the waiting room to prepare patients for intervention, capitalizing on the physical examination, and steps to prevent relapse. The interventions are easily integrated into the physician's clinical setting. Clinical Opportunities For Smoking Intervention: A Slide Program For Physicians is a training kit for physicians, medical students, and other professionals on smoking cessation and how to set up an intervention program within a clinical setting. The kit contains 110 slides, a script, an audio tape of the script, instructions, and a resource package of supporting materials. Kits are available on loan from the NHLBI. Proceedings: National Working Conference On Smoking Relapse is a special issue of Health Psychology that provides a summary of the current state of knowledge about smoking relapse. Information is included on vari- ables that contribute to relapse, mechanisms of relapse, and nicotine’s role in relapse prevention. School-Based Opportunities For Tobacco Use iInterven- tion is a guide for physicians that describes how they can play an important role in preventing children from using tobacco by working with community schools. The guide encourages professionals to serve as resources to schools and promote the use of effective programs developed by other agencies or organizations. We Can't Go On Like This is a series of seven video segments produced as part of the Multiple Risk Factor Intervention Trial. These segments are useful for patient education, individual and group therapy, maintenance sessions, dis- cussion groups, experimental and established efforts, and many others. It's Your Business: Smoking Policies For The Workplace summarizes the proceedings of a workshop that brought corporate managers and health experts together to dis- cuss smoking policies. Brief examples of how selected companies instituted policies are provided. * The Physician’s Guide: How To Help Your Hypertensive Patients Stop Smoking presents a four-step minimal smoking cessation procedure that emphasizes patient 169 commitment and physician followup. A more intensive strategy is also described. ¢ NHLBI Smoking Education Program Strategy Develop- ment Workshop For Minorities: A Summary Report presents the background and recommendations from a workshop convened to define a minority focus for the NHLBI Smoking Education Program. The main body of the report is organized according to minority group; i.e., blacks, Hispanics, Asians, Pacific Islanders, and American Indians. Other materials inglude the NHLBI Smoking Education Pro- gram: Planning Workshop For Professional And Patient Education Summary Report; Facts About... Smoking And Chronic Obstructive Lung Diseases; Facts About...Smoking And Your Heart; It’s Your Business: A Guide To Heart And Lung Health At The Workplace; and With Every Beat Of Your Heart: An Ideabook For Community Heart Health Programs. National Institute of Child Health and Human Development (NIH) The National Institute of Child Health and Human Develop- ment (NICHD) Office of Research Reporting prepared and distributes the brochure Facts About Pregnancy and Smoking. Approximately 50,000 copies of this pamphlet have been distributed over the past 2 years; it has been reprinted and is available for physicians and clinics to distribute to patients. Material from this fact sheet was incorporated into the packet of health education materials distriouted in conjunction with the Secretary of the DHHS’ Initiative on Smoking and Preg- nancy. This packet, sent to 33,000 physicians and other providers of health care, reached virtually all physicians, clinics, and offices that provide prenatal care in the United States, Puerto Rico, and the Virgin Islands. As part of its continuing effort to inform women of the hazards associated with smoking, the NICHD, in conjunction with the Division of Maternal and Child Health, funded a Healthy Mothers, Healthy Babies project. The project entailed the distribution of health education materials to 10 States that lacked the resources to develop similar materials. Developed by the New York State Health Department, the materials have won numerous awards for their effectiveness in conveying to pregnant women four important health messages: stop smok- ing, receive regular prenatal care, avoid alcohol consumption, and follow a healthy diet while pregnant. These materials, available in both English and Spanish, will form the basis for Statewide Healthy Mothers, Healthy Babies programs in the 10 States. The Institute is setting up a smoking intervention program for pregnant women that will be implemented by obstetricians and other primary care providers during patient visits. The project is being implemented in collaboration with the American Col- lege of Obstetricians and Gynecologists (ACOG). Three dif- ferent intervention strategies will be evaluated in terms of their effectiveness, feasibility, and cost. One strategy involves min- imal interaction between the obstetrician, his or her staff, and the patient, and includes distribution of a self-help guide with some instruction as to its use. A second approach includes application of the first strategy pilus some followup at scheduled prenatal visits; a third approach incorporates the first two approaches and establishes an individual in the obstetrician’s office who maintains regular telephone contact with the patient. Obstetricians interested in participating in this project will be identified through ACOG. They will be assigned to one of the three intervention strategies orto a control group. The control group will continue providing advice that obstetricians currently give to women who smoke. As the most important risk factor currently known to affect low birthweight, smoking offers potential for intervention. This project provides smoking intervention strategies for obstetricians to use as part of regular prenatal care during pregnancy. Office of Disease Prevention and Health Promotion (OASH) The Office of Disease Prevention and Health Promotion (ODPHP), within the Office of the Assistant Secretary for Health (OASH), coordinates all prevention activities of the PHS. The ODPHP coordinates policy development, program planning and development, and information dissemination in disease prevention and health promotion matters. The ODPHP leads, oversees, and monitors PHS activities related to achievement of the 1990 Health Objectives for the Nation. As part of its Workplace Health Promotion initiative, the ODPHP commissioned and disseminated two reports on worksite smoking, A Decision Makers Guide To Reducing Smoking At The Worksite, produced in cooperation with the Office on Smoking and Health, and the National Survey Of Worksite Health Promotion. The latter report found that over two-thirds of worksites surveyed offer smoking control activities. The ODPHP has several schoo! health activities related to smoking. In an advisory capacity, the ODPHP works with the OSH in planning an in-depth teen health survey and with the CDC in developing a smoking and smokeless tobacco com- ponent for two National school health curricula. The results of a National Adolescent Schoo! Health Survey, which includes smoking and smokeless tobacco, will be ready by Fall 1988. The ODPHP also worked with the ACS over the past 4 years to conduct anti-smoking workshops in Latin-American countries. The U.S. Preventive Services Task Force, created by the ODPHP to recommend age-and sex-specific areas for clinical screening and preventive interventions, reviewed smoking cessation counseling and followup by physicians and other health care providers in clinical settings. These recommenda- tions appeared in the May 20, 1988, issue of the Journal of the American Medical Association. Finally, smoking cessation is one of the six key health messages addressed in the ODPHP public education campaign for Healthy Older People, aimed at reducing dependency, disability, and disease among older Americans. In addition, the ODPHP provided staff support for the smoking workgroup of the Surgeon General's Workshop on Health 170 Promotion and Aging. The ODPHP is represented on the Interagency Committee on Smoking and Health and the ACS Tobacco-Related Research Coordinating Committee. Office of Minority Health (OASH) The Office of Minority Health (OMH), within the OASH, was created in response to the growing public health planning needs of minority populations in the Nation. The OMH focuses efforts on health promotion programs and research projects that will respond to the needs of these populations. In the area of smoking and health, the OMH funds a Minority Community Health Coalition Demonstration Grant Program which has a smoking and health component. A project entitled Community Coalition For Minority Health: Diet-Smoking-Blood Pressure Control In Nashville Blacks, is being conducted by the Meharry Medical College in Nashville, Tennessee. This project will establish a coalition of organizations to reduce mortality from cardiovascular disease and cancer among blacks in Nashville/Davidson County. This goal will be achieved by planning and implementing programs designed to reduce the associated risk factors of diet, obesity, smoking, and high blood pressure. Specific project objectives are: + to develop networks of communication between health professionals and lay workers interested in mounting intensive prevention programs that will have an impact on a large number of blacks in Nashville; * to transform existing disease prevention and health promotion programs that reduce exposure to the four risk factors into a black framework and implement them in black churches and other suitable community organizations; and * to evaluate the effectiveness of such community net- works and community interventions. In addition to Meharry Medical College, key member organiza- tions of the coalition include the AHA; the ALA; the Metro Government (Department of Health); Healthfare, Inc.; the Interdenominational Ministerial Alliance; and the Young Women’s Christian Association (YWCA). Specific interven- tions will begin with disease risk assessments performed at a series of health fairs held at four churches and the subsequent conduct of health education programs. Some interventions will be based on input from focus groups involving representatives from the target population. For the smoking cessation com- ponent, the project is using the ALA manual, Freedom From Smoking For You And Your Family. Other materials may be developed or existing ones modified for use in a smoking awareness program. Department of Defense As the Nation's largest employer, the Department of Defense (DoD) is responsible for the health and wellbeing of its employees throughout the Nation and worldwide. In response to the Surgeon General's report on involuntary smoking, the DoD Directive 1010.10, Health Promotion, established a health promotion policy within DoD to improve and maintain military readiness and the health of DoD personnel. The Directive places increased emphasis on educational programs regarding health risks associated with smoking, use of drugs and alcohol, diet, lack of exercise, and hypertension. The goals of the DoD program for smoking prevention and cessation are to create a social environment that supports abstinence and discourages use of tobacco products, to cre- ate a healthy environment, and to provide smokers with assis- tance in quitting. Smoking is prohibited in auditoriums, conference rooms, classrooms, buses, vans, elevators, and, unless adequate space and ventilation are available to ensure a healthy environment for nonsmokers, in eating areas, and common work areas. Branches of DoD are not allowed to participate in tobacco product manufacturer’s or distributor's promotional programs, activities, or contests aimed primarily at DoD personnel. A framework that established program goals and organized the four Armed Services’ programs into a coherent and com- prehensive DoD approach to smoking reduction was com- pleted in April 1986, and revised in November 1986, to increase the reduction goals. Specifically, the program goals are to reduce the rates of smoking and use of other tobacco products among personnel on active duty to levels significant- ly below civilian rates; this will be accomplished by lowering the current rates by at least 10 percent each year. The DoD will provide information, motivation, education, and cessation programs on smoking reduction to DoD beneficiaries and employees. To minimize the effects of smoking on non- smokers, the DoD will specify designated places and times where smoking can occur. As of October 1987, the authorized age for the purchase of tobacco products in the overseas military resale system was raised to a minimum of 18 years of age. This policy will apply to all service personnel, family members, and ali other authorized patrons of military resale outlets. Meetings to plan and share information have been held and are ongoing with the ACS, the AHA, the ALA, the NCI, and the OSH. The DoD Smoking Working Group and individual repre- sentatives from each of the four Armed Services have met with an ACS representative to discuss strategies for developing a DoD equivalent to an ACS division. The purpose of this division will be to obtain materials and disseminate information to military locations outside the continental United States. Print and audiovisual materials have been obtained from voluntary and Federal agencies at no cost or purchased by the American Forces Information Service, an office within the Office of the Assistant Secretary for Defense for Public Affairs. The ACS agreed to provide printed materials worth over $60,000 at no cost to DoD for use at overseas locations. The AHA has underwritten over $20,000 to furnish its Heart At Work kit at no cost to DoD. Other direct support for the Department's anti-smoking program has included provision of master sets of ACS films and slides that DoD can produce for use outside the United States. In addition, training support for facilitators of smoking cessa- tion programs has been provided. Representatives from the ACS assisted the Department of the Air Force in two facilitator training classes at two overseas locations during the latter part 171 of 1986. Classes were held for the Departments of the Army and Navy in May 1987. The DoD conducted surveys on smoking behavior patterns in each of the four Armed Services, among DoD personnel, and among the DoD civilian population in the United States and worldwide locations. The results of these surveys are avail- able in the Updated Report on Smoking and Health in the Military, published by the Department in July 1987. U.S. Department of the Alr Force The Air Force offers smoking cessation classes to all person- nel who request them. The Consumer Health Education Division of the Air Force Medical Service Center provides advice and assistance in starting smoking cessation classes. All Air Force medical facilities are required to offer smoking cessation classes to those who want to quit, and smoking is prohibited in any Air Force medical facility. Medical personnel are required by the Surgeon General of the Air Force to set a good example by not smoking in the presence of patients. In addition, Nicorette chewing gum is available in all pharmacies by medical prescription. Tobacco sales have been discon- tinued at all Air Force medical treatment facilities. U.S. Department of the Army The Army’s anti-smoking campaign emphasizes voluntary cessation by educating and informing soldiers, civilians, retirees, and family members. Education programs have been developed to stress the dangers of tobacco use and the benefits of quitting. Cessation programs are offered for in- dividuals who want to quit. The Army is working with the ACS to provide free cessation clinics at military bases in Korea and Germany. The Army’s smoking policy, effective July 1986, bans the use ot tobacco products during basic training and restricts their use in other military courses. Army training centers and service schools have included anti-tobacco information in the curriculum. U.S. Department of the Navy The Navy's hospitals, clinics, and Family Service Centers periodically hold smoking cessation classes that accom- modate 8 to 15 attendees. These classes model either the ACS or the ALA cessation programs. The Navy has also developed materials in support of the ACS Great American Smokeout. Four hundred packets of information on the Smokeout were mailed to Navy commands worldwide. Naval medical and dental personnel are prohibited from smok- ing in the presence of patients. Tobacco products cannot be sold within medical and dental facilities, and all naval hospitals are required to offer group programs in smoking cessation. Educational classes stress health risks of tobacco use in basic training and general military training for all Navy personnel. Assistance in smoking cessation efforts is generally offered by group clinics rather than self-help materials. U.S. Marine Corps The Marine Corps developed and is implementing a Tobacco Use Prevention And Cessation Program. The intent is to ensure that all Marines are aware of the detrimental health consequences of tobacco use and the benefits of not using tobacco products. The program strategy has been designed to create an environment that supports abstinence and dis- courages the use of tobacco products, to create a healthy work environment, and to provide smokers with the encouragement and professional assistance necessary to stop smoking. The Marine Corps implementation plan includes education arid information, assistance and referral, promotion and publicity, and program evaluation. Family Service Centers and Drug and Alcohol Counseling Centers will be used to provide smoking cessation and tobacco education programs. Veterans Administration The Veterans Administration (VA) operates diverse programs to benefit veterans and members of their families. These benefits include compensation payments for disability or death related to military service, pensions, education and rehabilitation, and a medical program incorporating nursing homes, clinics, and 172 medical centers. Public Law 98-160 authorizes the VA to provide preventive health services to any veteran under care. Smoking cessation has been emphasized as an important preventive interven- tion. All major VA health facilities have developed smoking policies to restrict areas in which smoking is permitted and have implemented aggressive smoking education and cessa- tion programs. Currently, 27 VA medical centers have banned the sale of tobacco products in VA canteens and an additional 26 medical centers are awaiting approval of their request to do the same. information and Referral Services Many organizations and government agencies maintain libraries of materials on smoking and health. Pamphlets, audiovisual materials, media presentations, posters, and other educational materials are available upon request by contacting the agency or organization. Several hotlines offer service to the community by providing free information on the hazards of smoking and tips to quit the habit. Some organiza- tions also furnish addresses of programs that can provide further information and assistance to people who wish to stop smoking. Organizations and programs with these types of services are listed below. American Cancer Society 90 Park Avenue New York, New York 10016 (212)382-2169 (800)ACS-2345 American Heart Association National Center 7320 Greenville Avenue Dallas, Texas 75231 (214)750-5300 172 American Lung Association 1740 Broadway New York, New York 10019-4374 (212)315-8700 Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control Building 3 1600 Clifton Road, N.E. Atlanta, Georgia 30333 (404)639-3699 General Conference of Seventh-Day Adventists Heatth and Temperance Department 6840 Eastern Avenue, N.W. Washington, D.C. 20012 (202)722-6790 National Audiovisual Center Order Section IQ Washington, D.C. 20409 (301)496-4236 National Cancer Institute 9000 Rockville Pike Building 31, 4A-18 Bethesda, Maryland 20892 (301)496-4000 (800)4-CANCER National Heart, Lung, and Blood Institute Smoking Education Program 9000 Rockville Pike Building 31, 4A-21 Bethesda, Maryland 20892 (301)496-1051 National Institute for Child Health and Human Development Department of Health and Human Services Building 31, Room 2A-32 9000 Rockville Pike Bethesda, Maryland 20892 (301}496-1711 Office of Disease Prevention and Health Promotion Department of Health and Human Services Mary E. Switzer Building Room 2132 330 C Street, S.W. Washington, D.C. 20201 (202)245-7611 Office on Smoking and Health Centers for Disease Control Park Building, Room 1-58 5600 Fishers Lane Rockville, Maryland 20857 Public Inquiries: (301)443-1575 National Cancer Institute supports a toll-free telephone inquiry system called the Cancer Information System (CIS), which supplies information about cancer and smoking-related sources to the general public. Each CIS office provides free Technical Information Center Office on Smoking and Health Centers for Disease Control Park Building, Room 1-16 5600 Fishers Lane Rockville, Maryland 20857 Technical Inquiries: (301)443-1690 printed materials on subjects ranging from types of cancer and treatment to advice on how to talk with cancer patients. The CIS numbers for all States is (800)4-CANCER. PART 2 STATE AND LOCAL PROGRAMS The following section contains a directory of smoking- and health-related programs implemented at the State and local level throughout the Nation. While not a complete listing of all programs offered to the public, this directory includes descriptions of over 1,500 programs. These programs 173 represent the efforts of voluntary groups; State, county, and focal departments of heaith; hospitals and clinics; and private organizations in each State and in the Virgin Islands, Guam, and Puerto Rico. Following this listing is a description of efforts of smoking and health advocacy groups. STATE AND LOCAL PROGRAMS ALABAMA 0001. ALABAMA DEPARTMENT OF PUBLIC HEALTH, 0003. AMERICAN CANCER SOCIETY, ALABAMA 644 State Office Bullding, Montgomery, Alabama DIVISION, 402 Office Park Drive, Suite 300, 36111. Birmingham, Alabama 35223. Program Title: Program Title: Heatth Department Activities. Contact: James J. McVay, M.P.A., Director (205)261-5095. Description: The department gives ongoing assistance to agencies, cor- porations, and other worksites in establishing nonsmoking policies and related programs, and participates, in conjunction with the American Lung Association or American Heart As- sociation, inthe annual Worksite Health Promotion Health Fair with a booth on smoking issues. Participants at this fair are recruited for smoking cessation programs. The health office conducts a smoking cessation program for various audiences but most efforts are geared toward educa- tional awareness. Local health departments are provided with in-service training in a smoking cessation program for preg- nant women. Some other educational efforts include: 1) a 15-day television public service series entitled Tobacco Use: Your Health, presented by the State health officer, Claude Earl Fox, M.D., M.P.H.; 2) Statewide distribution of taped radio public service announcements on smoking issues, also by Dr. Fox; 3) setting up a survival station at the State Health Department during the annual Great American Smokeout; and 4) the establishment, by the department, of a Certificate of Recognition program to recognize ex-smokers. 0002. AMERICAN CANCER SOCIETY, ALABAMA DIVISION, 402 Office Park Drive, Suite 300, Birmingham, Alabama 35223. Program Title: FreshStart. Contact: Ms. Anita G. Wright, Public Education Director (205)879-2242 or (800)292-4935. Description: The American Cancer Society offers FreshStart programs and materials free of charge and also trains instructors to conduct in-house smoking cessation programs for organizations. For more information, see the detailed program description in Part 1. 175 Smokeless Tobacco. Contact: Ms. Anita G. Wright, Public Education Director (205)879-2242 or (800)292-4935. Description: The American Cancer Society provides educational materials to adults and youth on the dangers of smokeless tobacco, including films, videos, pamphlets, and slides. 0004. AMERICAN HEART ASSOCIATION, ALABAMA AFFILIATE, 1449 Medical Park Drive, Post Office Box 9097, Birmingham, Alabama 35213. Program Title: Calling It Quits. Contact: Mr. James A. McDermott, Program Director (205)592-7100. Description: Calling tt Quits is a self-help program designed to help the smoker quit on his or her own. Materials developed by the American Heart Association National Center are used. For more information, see the detailed program description in Part 1. 0005. AMERICAN HEART ASSOCIATION, ALABAMA AFFILIATE, 1449 Medical Park Drive, Post Office Box 9097, Birmingham, Alabama 35213. Program Title: In Control. Contact: Mr. James A. McDermott, Program Director (205)592-7100. Description: The American Lung Association’s In Control home video smoking cessation program is offered through this Heart As- sociation affiliate. For more information, see the detailed pro- gram description in Part 1. AMERICAN HEART ASSOCIATION, ALABAMA AFFILIATE, 1449 Medical Park Drive, Post Office Box 9097, Birmingham, Alabama 35213. 0006. Program Title: Save A Sweet Heart. Contact: Mr. James A. McDermott, Program Director (205)592-7100. Description: The Save A Sweet Heart program is a series of activities to promote nonsmoking among junior and senior high schoo! students. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. 0007. Program Title: Freedom From Smoking At Work. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0008. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. Program Title: Freedom From Smoking Self-Help. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. Description: A behavior modification program is presented in the form of two self-help manuals; the first manual helps a person stop smoking and the second manual helps a person stay off cigarettes. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. 0009. Program Title: Freedom From Smoking Instructor Training. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. 176 Description: The American Lung Association encourages staff, volunteers, and paid leaders to attend a training workshop and to train others. The trained workshop leader can serve as a Freedom From Smoking clinic coordinator responsible for the organiza- tion, promotion, administration, recruitment, selection, and training of clinic leaders. 0010. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. Program Title: In Control. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. Description: The American Lung Association's In Control videocassette smoking cessation program is available for purchase or loan. more information, see the detailed program description in art 1. 0011. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. Program Title: Marijuana: A Second Look. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. Description: This program targets students in grades 4 through 6 and is available to schools and community groups. For more infor- mation, see the detailed program description in Part 1. 00012. AMERICAN LUNG ASSOCIATION OF ALABAMA, 900 South 18th Street, Post Office Box 55209, Birmingham, Alabama 35255. Program Title: Chronic Obstructive Pulmonary Disease Study. Contact: Mr. James L. Hughes, Executive Director (205)933-8821. Description: The American Lung Association (ALA) of Alabama par- ticipates in the Chronic Obstructive Pulmonary Disease. Prevention Trial at the University of Alabama. ALA promotes screenings at appropriate functions, assists in publicizing and promoting the study, and provides 50 percent of the financial support for a Recruitment Volunteer Coordinator. ALA con- tinues to promote the Association’s Awards and Grants pro- gram and encourages the submission of quality projects in smoking cessation. 0013. CULLMAN COUNTY HEALTH DEPARTMENT, 500 Logan Avenue, S.W., Post Office Box 1678, Cullman, Alabama 35056-1678. Program Title: Smoking Cessation During Pregnancy. Contact: Sylvia Morris, M.D., M.P.H., Assistant Medical Director (205)734-1030. Description: The program targets pregnant and post-partum women inthe Women, Infants, and Children (WIC) program. Utilizing materials developed at the educational level of the WIC patients and including positive reinforcement, buddy system, and smoking aversion techniques, this program’s goal is to promote smoking cessation among pregnant women. 0014. DEPARTMENT OF PUBLIC HEALTH, Post Office Box 488, Anniston, Alabama 36202. Program Title: A Pregnant Woman’s Self-Help Guide To Quit Smoking. Contact: Pamela P. Beale, R.N., M.S.M., Health Education Coor- dinator, Public Health Area IV (205)236-3274. Description: Clinic staff introduce and explain the 10-day smoking cessation program to women during the initial maternity visit or Women, Infants, and Children program visit. If the client wishes to enroll, a contract is signed. The clinic staff will discuss the guide provided to the client. On subsequent visits, progress is evaluated and reinforced. The program is evaluated by compiling statistics on quit rates of clients who enter and complete the program. 0015. MOBILE COUNTY HEALTH DEPARTMENT, 251 North Bayou Street, Post Office Box 2867, Mobile, Alabama 36652. Program Title: Anti-Smoking Campaign For Mobile County. Contact: Ms. Susan Stiegler, Director, Health Promotion (205)690-8158. Description: Three surveys aimed at health care providers, private-sector businesses, and service industries were conducted to obtain data on smoking policies, tobacco use, and compliance with local ordinances restricting the sale and use of tobacco products. The results of these surveys will support the non- smoking campaign and assist in establishing smoking policies and ordinances. A worksite smoking cessation program, FreshStart, is offered to any organization upon request. The local chapter of the American Cancer Society offers the Fresh- Start program, in cooperation with the Health Department, free of charge. ALASKA 0016. AMERICAN CANCER SOCIETY, ALASKA DIVISION, INC., 406 West Fireweed Lane, Suite 101, Anchorage, Alaska 99503. Program Title: FreshStart. Contact: Ms. Carol Wheeler, Program Director (907)277-8696. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0017. AMERICAN CANCER SOCIETY, ALASKA DIVISION, INC., 406 West Fireweed Lane, Suite 101, Anchorage, Alaska 99503. Program Title: Quitter’s Guide. 177 Contact: Ms. Carol Wheeler, Program Director (907)277-8696. Description: Quitter’s Guide - 7-Day Plan To Help You Stop Smoking Cigarettes is a pamphlet distributed to individuals and physicians upon request. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, ALASKA AF- FILIATE, INC., 2330 East 42nd Avenue, Anchorage, Alaska 99508. 0018. Progam Titie: In Control. Contact: Ms. Lynn McCarthy, Programs and Communications Director (907)563-3111. Description: The American Lung Association’s smoking cessation video program, In Control, is available for rent or purchase. For more information, see the detailed program description in Part 1. 0019. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: Alaska Smoke-Free Line. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: This program consists of a 24-hour toll-free line for Alaskans throughout the State to call for tips on quitting smoking and for additional support. Taped messages give callers information on cessation programs, weight control, exercises, alternative behaviors, and other important information regarding the maintenance of a nonsmoking lifestyle. At the end of the tape, the caller can request followup from a smoking cessation counselor. 0020. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: Freedom From Smoking. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: Seven-week courses meet once a week to offer a systematic, group support approach to quitting smoking and maintaining anonsmoking lifestyle. For more information, see the detailed program description in Part 1. 0021. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Sulte 2, Anchorage, Alaska 99510. Program Title: Freedom From Smoking At Work. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. 0022. 178 Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: A set of two manuals offers a day-by-day approach to quitting smoking and maintaining a nonsmoking lifestyle. For more information, see the detailed program description in Part 1. AMERICAN’LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. 0023. Program Title: Growing Healthy. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: This is a comprehensive health education curriculum for kindergarten through grade 7. The program uses films, slides, pamphlets, records, cassettes, books, and resource people to supply information on healthy attitudes, behaviors, and life- styles. The program has been validated by the National Dif- fusion Network of the United States Department of Education. Longitudinal studies have been done on the project with signiticant changes reported in knowledge, attitude, and be- havior. Teacher training must be conducted before implemen- tation can take place. Support and commitment of the school’s administration are required. 0024. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: in Control. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: The American Lung Association’s In Control videocassette program is available. For more information, see the detailed program description in Part 1. 0025. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: Lungs Are For Life. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: The American Lung Association’s Lungs Are For Life modules are offered to area schools. For more information, see the detailed program description in Part 1. 0026. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: Octopuff In Kumquat. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: The American Lung Association’s Octopuff In Kumquat pro- gram is offered to area grade schools. For more information, see the detailed program description in Part 1. 0027. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. Program Title: Smoking And Pregnancy. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: The purpose of this program is to reduce the incidence of maternal smoking in Alaska by providing smoking cessation counseling and materials to women of childbearing age and pregnant women and by training health care providers on smoking intervention techniques. For more information, see the detailed program description in Part 1. 0028. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Sulte 2, Anchorage, Alaska 99510. Program Title: School Health Speakers Bureau. Contact: Ms. Deborah Williams, Executive Director (907)276-5864. Description: School presentations are geared for small or general assem- bly size groups of students. Themes of presentations include The Ten Rules Of Lung Health and A Nonsmoking Lifestyle. AMERICAN LUNG ASSOCIATION OF ALASKA, 605 Barrow Street, Suite 2, Anchorage, Alaska 99510. 0029. 179 Program Title: Smoking At The Workplace. Contact: Ms. Nancy Babb Stone, Program Director (907)276-5864. Description: This program is designed to help employers develop and implement nonsmoking policies and to help smoking employees quit by offering smoking cessation opportunities. Consultation services, smoking cessation classes and materials, and seminars are offered on an ongoing basis. DEPARTMENT OF HEALTH AND SOCIAL SER- VICES, Kodiak Health Center, Post Office Box 1216, Kodiak, Alaska 99615. 0030. Program Title: Education Of Smoking Risks. Contact: Ms. Rae Jean Blaschka, Public Health Nurse (907)486-3319. Description: in each of the villages on Kodiak Isiand, a 1-hour program on the risks of smoking and chewing tobacco is presented to elementary, junior high school, and senior high school stu- dents. The program uses materials from the American Cancer Society, American Lung Association, American Heart As- sociation, and Alaska Native Medical Center's Health Educa- tion Department. An audiovisual presentation is followed by discussion, with students listing the pressures to smoke or chew and the reasons why tobacco use is harmful. DEPARTMENT OF HEALTH AND SOCIAL SER- VICES, Kodiak Health Center, Post Office Box 1216, Kodiak, Alaska 99615. 0031. Program Title: FreshStart. Contact: Ms. Rae Jean Blaschka, Public Health Nurse (907)486-3319. Description: The American Cancer Society’s FreshStart program is offered twice a year to the general public. For more information, see the detailed program description in Part 1. 0032. SEVENTH-DAY ADVENTIST CHURCH, 1515 East Tudor Road, Anchorage, Alaska 99507. Program Title: Breathe-Free Pian To Stop Smoking. Contact: Mr. David J. Strike (907)562-2721. Description: The Breathe-Free Plan is supplemented with respiratory charts, films, X-rays, and evaluation of participants’ pulmonary function tests. One month after completion of the program, participants are invited to a dinner, where their cessation success is measured. The program is held every 3 months for 25 to 40 persons each session. For more information, see the detailed program description in Part 1. ARIZONA 0033. AMERICAN CANCER SOCIETY, ARIZONA 0036. AMERICAN CANCER SOCIETY, ARIZONA DIVISION, INC., CENTRAL REGION, 634 West DIVISION, INC., SOUTHERN REGION, 634 West Indian Schoo! Road, Phoenix, Arizona 85013. indian School Read, Phoenlx, Arizona 85013. Program Title: Program Title: FreshStart. FreshStart. Contact: Contact: Ms. Carrie Bruner, Program Coordinator Ms. Courtney Upton, Program Coordinator (602)264-5861. (602)790-2600. Description: Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0034. AMERICAN CANCER SOCIETY, ARIZONA DIVISION, INC., EAST VALLEY REGION, 634 West Indian School Road, Phoenix, Arizona 85013. Program Title: FreshStart. Contact: Ms. Mardy Sears, Program Coordinator (602)890-0717. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0035. AMERICAN CANCER SOCIETY, ARIZONA DIVISION, INC., NORTHERN REGION, 634 West Indian School Road, Phoenix, Arizona 85013. Program Title: FreshStart. Contact: Ms. Ann Kuriz, Program Coordinator (602)526-3800. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 180 The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0037. AMERICAN CANCER SOCIETY, ARIZONA DIVISION, INC., WEST VALLEY REGION, 634 West Indian School Road, Phoenix, Arizona 85013. Program Title: FreshStart. Contact: Ms. Suzanne Gaither, Program Coordinator (602)972-0788. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0038. AMERICAN CANCER SOCIETY, ARIZONA DIVISION, INC., WESTERN REGION, 634 West Indian School Road, Phoenix, Arizona 85013. Program Title: FreshStart. Contact: Ms. Chris Bergman, Program Coordinator (602)855-4357. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0039. AMERICAN HEART ASSOCIATION, ARIZONA AFFILIATE, 1445 East Thomas Road, Phoenix, Arizona 85014-5794. Program Title: Heart At Work. Contact: Mr. Willi Baer, Program Director (602)277-4846. Description: Heart At Work is a health promotion program aimed at employees in business, industry, and other organizations. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, ARIZONA AFFILIATE, 1445 East Thomas Road, Phoenlx, Arizona 85014-5794. 0040. Program Title: Putting Your Heart Into The Curriculum. Contact: Mr. Willi Baer, Program Coordinator (602)277-4846. Description: This program is a series of four curriculum guides divided into four grade-level components. The materials include modules onthe circulatory system, heart disease prevention, risk factor modification, nonsmoking, and nutrition. AMERICAN HEART ASSOCIATION, ARIZONA AFFILIATE, 1445 East Thomas Road, Phoenix, Arizona 85014-5794. 0041. Program Title: Save A Sweet Heart. Contact: Mr. Willi Baer, Program Director (602)277-4846. Description: This program is a campaign to promote nonsmoking among junior and senior high school students. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, ARIZONA AFFILIATE, 1445 East Thomas Road, Phoenix, Arizona 85014-5794 0042. Program Title: Speakers’ Bureau. Contact: Mr. Willi Baer, Program Director (602)277-4846. Description: A speakers’ bureau provides an ongoing service to com- munities by training informed volunteers to talk to various groups, such as the Kiwanis Club and PTA groups, on the prevention of cardiovascular disease. ARIZONA LUNG ASSOCIATION, 102 West McDowell Road, Phoenix, Arizona 85003. 0043. Program Title: In Control. Contact: Ms. Patrice Quarg, Program Director (602)258-7505. Description: This self-help program includes a videocassette, viewers’ guide, and audiocassette. In Control can be purchased or ranted from the Arizona Lung Association. For more informa- tion, see the detailed program description in Part 1. 0044. ARIZONA LUNG ASSOCIATION, 102 West McDowell Road, Phoenix, Arizona 85003. Program Title: Marijuana: A Second Look. Contact: Ms. Patrice Quarg, Program Director * (602)258-7505. 181 Description: This package program directed towards students in grades 4 through 6 is available to schools and community groups. For more information, see the detailed program description in Part 1. 0045. ARIZONA LUNG ASSOCIATION, 102 West Mc- Dowell Road, Phoenix, Arizona 85003. Program Title: Self-Help Materials. Contact: Ms. Patrice Quarg, Program Director (602)258-7505. Description: All Freedom From Smoking manuals are available to the public for a nominal fee. Additional books available include the Kick-It-Kit and the new American Lung Association’s manual, Freedom From Smoking For You And Your Family. ARIZONA LUNG ASSOCIATION, 102 West McDowell Road, Phoenix, Arizona 85003. 0046. Program Title: SMOKEBUSTERS! Contact: Ms. Patrice Quarg, Program Director (602)258-7505. Description: This medically supervised behavior modification program using Nicorette gum is offered to the general public every 2 months. The group instructor uses the American Lung Association's manuals, Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking. The group meets for six 1-1/2-hour sessions. A questionnaire is given to par- ticipants at the end of the program to evaluate the course and facilitators. For more information on the Freedom From Smok- ing manuals, see the detailed program description in Part 1. 0047. ARIZONA LUNG ASSOCIATION, 102 West McDowell Road, Phoenix, Arizona 85003. Program Title: Smoking Cessation Program For Pregnant Women. Contact: Ms. Jeanne A. Cahill, Program Associate (602)258-7505. Description: This pilot program, scheduled to begin in spring 1988, focuses on pregnant smokers. Objectives include increasing the knowledge of the consequences of smoking for the individual and the effects of smoking on the fetus, promoting awareness of alternative behaviors to smoking, and increasing the skills needed for cessation and relapse prevention. Health educa- tion materials related to maternal and child health will be distributed. The course consists of five small group sessions that last 1 and 1/2 hours each. The American Lung Association's manual, Freedom From Smoking For You And Your Baby, is used in the program. 0048. ARIZONA LUNG ASSOCIATION, 102 West McDowell Road, Phoenix, Arizona 85003. Program Title: SMOKEBUSTERS! In The Workplace. Contact: Ms. Patrice Quarg, Program Director (602)258-7505. Description: The SMOKEBUSTERS! program can be conducted at the worksite for companies that are interested in offering the course to their employees. Assistance in writing a company smoking policy is available from the Arizona Lung Association. 0049. COLORADO RIVER INDIAN TRIBES, Route 1, Box 23-B, Parker, Arizona 85344. Program Title: Smoking And Alcohol Abuse. Contact: Ms. Mona Fernandez, Administrative Director (602)669-9211. Description: This program determines the prevalence of tobacco and al- cohol use in the 12- to 24-year-old age group by conducting a random survey of the population. Individuals found to be at high risk of alcohol or tobacco abuse are referred to aware- Ness groups, education groups, or treatment. Activities are conducted to introduce problem solving, decision making, coping, and communication skills. Outreach and intervention activities also are conducted, including health education on the benefits of decreasing the number of cigarettes smoked. The younger population is exposed to prevention activities. Participants are tracked from entry to referral to other program components in order to evaluate Participation level, frequency of participation, and involvement in referral components. Par- ticipants are pre- and posttested to ascertain knowledge in- crease. Personal profile data collected at intake is analyzed at 6-month intervals to evaluate any significant change or improvement in behavior or attitude levels. 0050. MARICOPA COUNTY DEPARTMENT OF HEALTH SERVICES, 1825 East Roosevelt, Phoenix, Arizona 85006. Program Title: Clinic-Based Smoking Cessation. Contact: Ms. Christine Liberato, Chief, Bureau of Health Education (602)258-6381. Description: A one-time class is held for women attending county primary care clinics for prenatal care. The class is scheduled once a month, with routine followup and evaluation at 3-month, 6- month, and 1-year intervals. A strong emphasis is placed on the effects of smoking on the unborn child and the prevention of relapse. 0051. MARICOPA COUNTY DEPARTMENT OF HEALTH SERVICES, 1825 East Roosevelt, Phoenix, Arizona 85006. Program Title: Worksite Smoking Cessation. Contact: Ms. Christine Liberato, Chief, Bureau of Health Education (602)258-6381. Description: The health department developed this program for working women aged 18 to 34 with high school education, a group found to be most at risk for smoking. A one-time, 1-hour class on smoking cessation is offered in-house at a selected com- pany. Participants may attend on company time. !n addition to the class, information on smoking and smoking cessation is distributed and displayed throughout the program year. Various smoking cessation self-help materials and information on smoking risks are distributed at the program kick-off event. Motivational inserts are included with employee paychecks before class meetings and throughout the program year. Posters on the risks of smoking are displayed on employee bulletin boards throughout the worksite, and articles on smok- ing and smoking cessation are printed and distributed via the employee newsletter. 0052. OFFICE OF HEALTH PROMOTION AND EDUCA- TION, ARIZONA DEPARTMENT OF HEALTH SERVICES, 3008 North Third Street, Suite 103, Phoenix, Arizona 85012. Program Title: Smokeless Tobacco. Contact: Jack Dilienberg, D.D.S., Chief, Office of Dental Health (602)255-1866. Description: This educational project was developed last year in coopera- tion with the Office of Dental Health. The project provides information and curriculum guides on smokeless tobacco to schools and other groups by request. 0053. OFFICE OF HEALTH PROMOTION AND EDUCA- TION, ARIZONA DEPARTMENT OF HEALTH SERVICES, 3008 North Third Street, Suite 103, Phoenix, Arizona 85012. Program Title: Perinatal Care Program. Contact: Ms. Lisa Hulette, Division of Family Health (602)255-1875. Description: As part of this program, smoking assessment and referrals for cessation classes are offered to clients. 0054. OFFICE OF HEALTH PROMOTION AND EDUCA- TION, ARIZONA DEPARTMENT OF HEALTH SERVICES, 3008 North Third Street, Suite 103, Phoenlx, Arizona 85012. Program Title: Rocky Mountain Free Challenge. Contact: Mr. Brick Lancaster, Chief (602)230-5833. Description: Arizona is planning to cooperate with eight other Rocky Moun- tain States in establishing goals and projects for a tobacco- free society during 1988. 0055. PIMA COUNTY HEALTH DEPARTMENT, 888 South Crayeroft, Tucson, Arizona 85711. Program Title: Pregnant And Stop Smoking. Contact: Ms. Karen Fields, Community Nutrition Division (602)745-6783. Description: Pregnant And Stop Smoking is a grant-funded program that has been in effect since the spring of 1986. The target audience is low-income, minority, pregnant women who are enrolled in the Women, Infants, and Children program. The program’s objective is to encourage these women to quit or cut back on their smoking habit. This goal is accomplished through counseling; consumer literature, such as Quit Tip handouts, in English and Spanish; and incentives, such as T-shirts and refrigerator magnets for those who successfully stop smoking. 0056. PULMONARY ASSOCIATES, P.A., 1112 East McDowell Road, Phoenix, Arizona 85006. Program Title: Quitting With Nicorette. Contact: Bonnie Fahy, R.N., Program Coordinator (602)258-4951. Description: The program involves six sessions with Ms. Fahy, a pul- monary Clinical nurse specialist, over a 3-month period. The individualized sessions teach smoking avoidance techniques, as well as proper dosage and use of Nicorette chewing gum. The cost of the six sessions is approximately $175 and may be covered by insurance. Anyone referred by a physician may enter the program. ARKANSAS 0057. AMERICAN CANCER SOCIETY, ARKANSAS DIVISION, INC., 5520 West Markham Street, Little Rock, Arkansas 72205. Program Title: FreshStart. Contact: Ms. Barbara Brill, Health Educator (501)661-2207. Description: The American Cancer Society’s FreshStart smoking cessation clinic is available. For more information, see the detailed program description in Part 1. 0058. ARKANSAS DEPARTMENT OF HEALTH, 4815 West Markham Street, Little Rock, Arkansas 72201. Program Title: Health Department Activities. Contact: Ms. Barbara Brill, Health Educator (501)661-2207. Description: The Arkansas Department of Health trains instructors in the smoking cessation program and conducts employee stop smoking programs. Several of the activities are associated with the American Cancer Society and its programs. The Health Department’s training program teaches volunteers throughout the State to conduct the American Cancer Society’s FreshStart program. The training programs are scheduled four to five times a year. Forty-seven professionals employed by hospitals, businesses, YMCAs, health main- tenance organizations, and other facilities have been trained. Other activities associated with the American Cancer Society include program development and training for the Smoke-Free Young America 5-Year Plan. Educational programs for voca- tional and technical students were part of this plan. Also, the Great American Smokeout Campaign was promoted to par- ticipants at the Third Annual State Health Education Con- ference through an exhibit booth displaying buttons, stickers, and quit guides. Smoking cessation programs available at the Department of Health include three smoking cessation clinics and one self- help video smoking cessation program. Also, a variety of pamphlets, booklets, and posters are provided upon request, and health educators give presentations to schools, civic groups, churches, and other interested groups. 0059. SEVENTH-DAY ADVENTIST CHURCH COM- MUNITY SERVICES, Fifth and Archer Street, Mammoth Spring, Arkansas 72554. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Ms. Polly Johnson or Ms. Lorraine Graham, Coordinators (501)257-2159. Description: The Seventh-Day Adventists’ Nationally-implemented program is offered. For more information, see the detailed program description in Part 1. 0060. WHITE COUNTY MEMORIAL HOSPITAL, Post Office Box 809, Searcy, Arkansas 72143. Program Title: Freedom From Smoking Clinics. Contact: Ms. Roxie Troiliett or Ms. Kathi Shores, Coordinators (501)268-6121. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. CALIFORNIA AMERICAN CANCER SOCIETY, CALIFORNIA DIVISION, INC., BUTTE-GLENN-TEHAMA UNIT, 114 West Seventh Avenue, Chico, California 95926. 0061. Program Title: FreshStart. Contact: Ms. Phyllis Bond, Executive Director (916)342-4567. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered at no cost to participants. For more information, see the detailed program description in Part 1. 184 0062. AMERICAN HEART ASSOCIATION, GREATER LOS ANGELES AFFILIATE, INC., 3550 Wilshire Boulevard, Fifth Floor, Los Angeles, California 90010. Program Title: Heart At Work. Contact: Ms. Annamarie Shaw, Program Coordinator (213)385-4231. Description: The American Heart Association's Heart At Work program is offered. For more information, see the detailed program description in Part 1. 0063. AMERICAN HEART ASSOCIATION, GREATER LOS ANGELES AFFILIATE, INC., 3550 Wilshire Boulevard, Fifth Floor, Los Angeles, California 90010. Program Title: Heartbeat 2010. Contact: Ms. Marilyn Cowan, Program Coordinator (213)385-4231. Description: This is a computer software program for students in grade 5. The program includes a tutorial describing short- and long- term effects of smoking, and a simulation that allows students to practice choosing not to smoke. A pre- and posttest is administered to students to evaluate knowledge and skills gained. 0064. AMERICAN HEART ASSOCIATION, GREATER LOS ANGELES AFFILIATE, INC., 3550 Wilshire Boulevard, Fifth Floor, Los Angeles, California 90010. Program Title: Rx Your Prescription For A Healthy Heart. Contact: Ms. Annamarie Shaw, Program Coordinator (213)385-4231. Description: Rx Your Prescription For A Healthy Heart is a plan for distribut- ing materials to physicians’ offices and their patients. The smoking component includes a self-help cessation kit, Calling it Quits, developed by the American Heart Association. For more information, see the detailed program description in Part 1. 0065. AMERICAN LUNG ASSOCIATION OF ALAMEDA COUNTY, 295 27th Street, Oakland, California 94612-3894. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Kris Hammar, Program Consultant (415)893-5474. Description: The American Lung Association's Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ALAMEDA COUNTY, 295 27th Street, Oakland, Callfornia 94612-3894. 0066. 185 Program Title: Freedom From Smoking Clinics. Contact: Ms. Kris Hammar, Program Consultant (415)893-5474. Description: The American Lung Association’s Freedom From Smoking Clinics are offered. A tee of $50 is charged to all participants to cover material costs and instructors’ salaries. For more information, see the detailed program description in Part 1. 0067. AMERICAN LUNG ASSOCIATION OF ALAMEDA COUNTY, 295 27th Street, Oakland, California 94612-3894. Program Title: Freedom From Smoking Clinics For Teens. Contact: Ms. Kris Hammar, Program Consultant (415)893-5474. Description: Freedom From Smoking For Teens, a new program based on the American Lung Association adult program, is designed to assist teen smokers in quitting. It is offered in high schools and conducted by teachers or counselors who have been trained by the American Lung Association. Students participate in 11 sessions and learn principles of behavior modification to stop smoking. Videotapes, training manuals, and worksheets are included. 0068. AMERICAN LUNG ASSOCIATION OF ALAMEDA COUNTY, 295 27th Street, Oakland, California 94612-3894. Program Title: Freedom From Smoking Clinics In The Workplace. Contact: Ms. Mary Ellen O'Neill Creighton, Program Coordinator (415)893-5474. Description: Smoking cessation clinics and consultation on the develop- ment and implementation of successful smoking policies are offered to employers and employees at the worksite. Smokers’ behavioral changes are evaluated at the end of the clinics. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ALAMEDA COUNTY, 295 27th Street, Oakland, Callfornia 94612-3894. 0069. Program Title: Smoking And Pregnancy. Contact: Ms. Kris Hammar, Program Consultant (415)893-5474. Description: This program is designed to encourage and assist pregnant smokers in quitting smoking during pregnancy. For more information, see the detailed program description in Part 1. 0070. AMERICAN LUNG ASSOCIATION OF CALIFOR- NIA, 424 Pendleton Way, Oakland, Callfornia 94621. Program Title: Smoke-Free Family Programs. Contact: Ms. Sylvia Scarborough, Director, Community Health (415)638-5864. Description: The Freedom From Smoking programs are offered in the workplace, in high schools, for the general public in the com- munity, and for pregnant women in prenatal clinics. Also, self-help materials are promoted through the media and during presentations by guest speakers. New plans include em- phasis on peer education for high schoo! students. The California State Office works with 19 affiliates to promote and provide consultation on all programs offered in the State. 0071. AMERICAN LUNG ASSOCIATION OF CONTRA COSTA AND SOLANO COUNTIES, 105 Astrid Drive, Pleasant Hill, California 94523-4399. Program Title: Freedom From Smoking Clinics. Contact: Ms. Michelle Munn, Smoking Cessation Coordinator (415)935-0472. Description: The American Lung Association’s Freedom From Smoking clinics are offered. A minimal fee is charged to all participants in order to cover material costs and instructors’ salaries. For more information, see the detailed program description in Part 1. 0072. AMERICAN LUNG ASSOCIATION OF CONTRA COSTA AND SOLANO COUNTIES, 105 Astrid Drive, Pleasant Hill, California 94523-4303. Program Title: Freedom From Smoking In The Workplace. Contact: Ms. Michelle Munn, Smoking Cessation Coordinator (415)935-0472. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0073. AMERICAN LUNG ASSOCIATION OF CONTRA COSTA AND SOLANO COUNTIES, 105 Astrid Drive, Pleasant Hill, California 94523-4303. Program Title: Smoking Prevention And Wellness Promotion. Contact: Ms. Bernadeen Valdez, Program Director (415)935-0472. Description: This program consists of a 1-hour presentation using a variety of visual aids and activities to help young people understand the following concepts: 1) the joy and importance of good health, with special reference to the respiratory system; 2) the harmful effects of using chemical substances, particularly tobacco (inhaling and chewing) and marijuana; 3) alternatives to reasons why young people begin using harmful substances; and 4) understanding peer pressure and ways to say no. Training is available for parents and teachers. 0074. AMERICAN LUNG ASSOCIATION OF SACRAMENTO-EMIGRANT TRAILS, 909 12th Street, Sacramento, California 95814. Program Title: Smoking Cessation. Contact: Ms. Cecilia Kleeberg, Program Coordinator (916)444-5864. Description: The American Lung Association of Sacramento-Emigrant - Trails offers three year-round smoking cessation programs: Freedom From Smoking clinics, Freedom From Smoking Self- Help Manuals, or the In Control videotape. The smoking cessation program also offers: 1) the development and im- plementation of the nonsmoking policy; 2) workplace smoking cessation orientations; 3) training for smoking cessation clinic leaders; and 4) a broad spectrum of brochures and videos on the health etfects of smoking, especially for pregnant smokers and teenagers. 0075. AMERICAN LUNG ASSOCIATION OF SAN FRANCISCO, 562 Mission Street, Suite 203, San Francisco, California 94105-2910. Program Title: Freedom From Smoking. Contact: Irene Reveles-Chase, M.P.H., Program Associate (415)543-4410. Description: The Freedom From Smoking programs are offered in the — workplace, in high schools, for the general public in the community, and for pregnant women in prenatal clinics. Also, self-help materials are promoted through the media and during presentations by guest speakers. For more information, see the detailed program description in Part 1. 0076. AMERICAN LUNG ASSOCIATION OF SANTA CLARA AND SAN BENITO COUNTIES, 1469 Park Avenue, San Jose, California 95126. Program Title: Ash Kickers Club. Contact: Ms. Margaret W. Leathers, Director of Programs (408)998-LUNG. Description: Ex-smokers meet monthly in a support group atmosphere to enjoy social activities, discussion, or speakers on relevant topics. Members are also given the opportunity to help others to stop smoking or remain abstinent. 0077. AMERICAN LUNG ASSOCIATION OF SANTA CLARA AND SAN BENITO COUNTIES, 1469 Park Avenue, San Jose, Callfornia 95126. Program Title: CLASP —- Counseling Leadership Against Smoking Pres- sures. Contact: Ms. Margaret W. Leathers, Director of Programs (408)998-LUNG. Description: . This community-based project is aimed at young people in the effort to prevent the onset of regular tobacco use in early adolescence, teaching techniques to recognize and resist the pressure to smoke. Using the concept of the adolescent peer group and social modeling theory, the program employs a team of four to six high school students who visit each grade-7 classroom for one semester. Through the semester, a total of four 1-day sessions are presented, the first three at biweekly intervals and the fourth session 2 to 3 weeks after the third session. To evaluate the effectiveness of CLASP, two control schools were used. Grade 7 was surveyed in September, December, and June in all of the schools, and a carbon monoxide breath test was administered to 50 percent of the students to increase the reliability of the self-report measure. 0078. AMERICAN LUNG ASSOCIATION OF SANTA CLARA AND SAN BENITO COUNTIES, 1469 Park Avenue, San Jose, Callfornia 95126. Program Title: Free Line. Contact: Ms. Margaret W. Leathers, Director of Programs (408)998-LUNG. Description: The Free Line is a hotline for people who wish to quit smoking. Callers speak to volunteers who are ex-smokers and provide inspirational and informative messages. A psychologist and other resource staff are also on call. 0079. AMERICAN LUNG ASSOCIATION OF SANTA CLARA AND SAN BENITO COUNTIES, 1469 Park Avenue, San Jose, California 95126. Program Title: Freedom From Smoking. Contact: Ms. Margaret W. Leathers, Director of Programs (408)998-LUNG. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0080. AMERICAN LUNG ASSOCIATION OF SANTA CLARA AND SAN BENITO COUNTIES, 1469 Park Avenue, San Jose, California 95126. Program Title: Smoking And Pregnancy. Contact: Ms. Margaret W. Leathers, Director of Programs (408)998-LUNG. Description: This program addresses the smoking and pregnancy problem by educating medical personnel. For more information, see the detailed program description in Part 1. 0081. AMERICAN LUNG ASSOCIATION OF SUPERIOR CALIFORNIA, 2732A Cohasset Road, Chico, Callfornia 95926. Program Title: Freedom From Smoking. Contact: Ms. Jeanne Jelke, Executive Director (916)345-5864. Description: The American Lung Association’s Freedom From Smoking programs are offered. Literature and information on the hazards of smoking and tobacco are also provided to in- dividuals, schools, and other agencies. For more information, see the detailed program description in Part 1. 0082. AMERICAN LUNG ASSOCIATION OF VENTURA COUNTY, Post Office Box 1627, Ventura, California 93002-1627. 187 Program Titie: Freedom From Smoking. Contact: Ms. Charlotte Hill, Program Coordinator (805)643-2189. Description: The American Lung Association’s Freedom From Smoking Program is offered. For more information, see the detailed program description in Part 1. CALIFORNIA STATE DEPARTMENT OF HEALTH SERVICES, 714 P Street, Sacramento, California 95814. 0083. Program Title: Smoking And Pregnancy. Contact: Ms. Kris Hammer, Project Director (415)893-5474. Description: Working in conjunction with the American Lung Association of Oakland, the Department of Health developed this program to increase the awareness of pregnant women who smoke on the harmful effects of smoking on the unborn and to provide assistance to women who want to stop smoking. A media campaign includes radio public service announcements, billboards, and distribution of literature through doctors’ offices and clinics. A second component includes physician and support staff training to improve the counseling received from the health care provider by the pregnant smoker during her prenatal visits. Referrals to smoking cessation programs fol- low counseling sessions. In addition, group classes, self-help kits, and a self-paced videotape stop smoking program are provided. CALIFORNIA STATE DEPARTMENT OF HEALTH SERVICES, NORTH COUNTY HEALTH SER- VICES, 714 P Street, Sacramento, California 95814. 0084. Program Title: COHELP (Community Oriented Healthy Lifestyle Program). Contact: Ms. Shimon Camiel, Project Coordinator (619)671-2100. Description: COHELP is part of the State's Health Education Risk Reduc- tion Program. This six-session smoking cessation program emphasizes positive decision making; understanding why people smoke; identification of smoking triggers; use of alter- native coping strategies; stress management through exer- cise; assertiveness training and constructive thinking; techniques for coping with withdrawal; use of interpersonal and social support systems; and long-term maintenance strategies. The outcome objectives expected for each year are: 1) that 75 percent of the participants completing the program, or 60 individuals, will have quit smoking by the end 188 of the program; 2) that 45 percent of this group will be off cigarettes at the 3-month followup; and 3) that 25 percent of those completing the smoking cessation program will maintain cessation behaviors at the 9-month followup. 0085. CALIFORNIA STATE DEPARTMENT OF HEALTH SERVICES, RIVERSIDE COUNTY HEALTH .- DEPARTMENT, 714 P Street, Sacramento, California 95814. Program Title: Health Yourself. Contact: Manzoor Massey, Ph.D., Project Director (714)787-2781. Description: Smoking cessation classes are offered in four or seven ses- sions with the goal that participants permanently quit or reduce the number of cigarettes smoked. The American Cancer Society and American Lung Association materials are used. Two hundred people are expected to participate in the pro- gram each year. The outcome objectives expected for each year are: 1) that 70 percent of the participants completing the program will have quit smoking by the end of the class; 2) that 60 percent of the quitters will be smoke-free at the 3-month followup; and 3) that 80 percent of the 3-month smoke-free participants will maintain cessation behaviors at the 9-month followup. 0086. COLFAX SEVENTH-DAY ADVENTIST CHURCH, Post Office Box 333, Colfax, California 95713. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Ms. Joyce Gray, Personal Ministries Leader (916)346-8844. Description: The Seventh-Day Adventists’ smoking cessation program is - offered. For more information, see the detailed program description in Part 1. 0087. COUNTY OF ORANGE HEALTH CARE AGENCY, .- PUBLIC HEALTH AND MEDICAL SERVICES, 515 North Sycamore, Santa Ana, California 92701. Program Title: Smoking Risk Reduction. Contact: Ms. Molly Brenner, Program Coordinator (714)834-8597. Description: Smoking cessation classes are offered to all county employees. Each employee is given 1 hour free time for each ~ class. Classes are taught by staff trained by the American Cancer Society. There is a materials fee of $7. COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH, HEALTH EDUCATION SERVICES, 3575 11th Street Mall, Riverside, California 92501. 0088. Program Title: Freedom From Smoking Clinics. Contact: Ms. Debbie Weems, Program Coordinator (714)787-2781. Description: The American Lung Association’s Freedom From Smoking clinics are offered to county employees and the general com- munity. For more information, see the detailed program description in Part 1. COUNTY OF RIVERSIDE DEPARTMENT OF HEALTH, HEALTH EDUCATION SERVICES, 3575 11th Street Mall, Riverside, California 92501. 0089. Program Title: FreshStart. Contact: Ms. Debbie Weems, Program Coordinator (714)787-2781. Description: The American Cancer Society’s FreshStart program is offered to county employees and the general public. For more information, see the detailed program description in Part 1. 0090. COUNTY OF SANTA CRUZ HEALTH SERVICES AGENCY, 1080 Emeline Avenue, Post Office Box 962, Santa Cruz, California 95061. Program Title: Smoking Pollution Control. Contact: Ms. Bernadette Zavala, Program Coordinator (408)425-2511. Description: The Smoking Pollution Control program is responsible for public education about local smoking pollution control or- dinances. The objectives of the program are to inform non- smokers of their rights under local ordinances, assist affected businesses in complying with ordinance requirements, and assist the health officer with enforcement and complaint resolution. These objectives are accomplished through presentations to schools, businesses, and other community groups; media efforts including public service announcements and radio, television, or newspaper interviews and articles; information and referral; and distribution of printed materials. The Smoking Education Coalition, sponsored by the local American Cancer Society, American Heart Association, and American Lung Association, was established to promote adoption of smoking pollution control ordinances by local cities, comprehensive school health education including programs about smoking, and smoking cessation programs. 189 The Smoking Pollution Control program works closely with the Smoking Education Coalition in accomplishing mutual goals. 0091. COUNTY OF SHASTA DEPARTMENT OF PUBLIC HEALTH, HEALTH SERVICES AGENCY, 2650 Hospital Lane, Redding, Callfornia 96001. Program Title: Public Smoking Cessation. Contact: Stephen J. Plank, M.D., Program Coordinator (916)225-5591. Description: A cessation clinic, using Nicorette as a major coping techni- que, is available to the public. Other programs are also avail- able in collaboration with the American Lung Association and American Cancer Society. 0092. COUNTY OF SHASTA DEPARTMENT OF PUBLIC HEALTH, HEALTH SERVICES AGENCY, 2650 Hospital Lane, Redding, California 96001. Program Title: Smoking Cessation For County Employees. Contact: Stephen J. Plank, M.D., Program Coordinator (916)225-5591. Description: A smoking cessation program, using Nicorette as a major coping technique, is available to all county employees. For county employees who do not succeed with Nicorette, the county pays 50 percent of the charges for more formal programs. COUNTY OF YOLO DEPARTMENT OF PUBLIC HEALTH, HEALTH SERVICES AGENCY, 10 Cot- tonwood Street, Woodland, California 95695. 0093. Program Title: FreshStart. Contact: Ms. Michele Quillin, Program Coordinator (916)666-8648. Description: The American Cancer Society’s FreshStart program is offered twice a year to county employees. The program is presented in five 1-1/2-hour sessions. The FreshStart program is supple- mented with the videotape "We Can't Go On Like This” and guest speakers. For more information on FreshStart, see the detailed program description in Part 1. 0094. MARIN GENERAL HOSPITAL, 250 Bon Alr Road, Greenbrae, California 94904. Program Title: Smoke Stoppers. Contact: Ms. Marlene Holland, Director of Education and Health Promotion (415)925-7450. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessation; and Phase Ill provides an ongoing support and maintenance system. 0095. MEMORIAL MEDICAL CENTER, 1700 Coffee Road, Modesto, California 95355. Program Title: Smoke Stoppers. Contact: Mr. Chuck Cipponeri, Program Coordinator (209)525-4500 ext.6681. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase ! prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessation; and Phase Il! provides an ongoing support and maintenance system. 0096. MERCY HOSPITAL HEALTH PROMOTION, 2740 M Street, Merced, California 95340. Program Title: Self Psych Hypnosis. Contact: Ms. Jerri Randrup, Program Coordinator (209)384-6528. Description: Learning the secret of Self Psych Hypnosis, as taught by hypnotist Jim Hoke, is accomplished in one session. For the $70 fee, each participant receives an instruction sheet, a two-sided cassette tape (used during self hypnosis), and a 2-1/2-hour group session that includes three hypnotic induc- tions with Jim Hoke. Sessions are positive and upbeat, and relaxation is a key during the group hypnosis. Mr. Hoke has a high success rate in helping people become ex-smokers, but freely admits that each person quits on his or her own. Spon- sored by the American Lung Association of Central California and Mercy Hospital, Self Psych Hypnosis is available every 4 months. MONTEREY COUNTY HEALTH DEPARTMENT, EMPLOYEE HEALTH PROMOTION, 1270 Natividad Road, Salinas, California 93906. 0097. 190 Program Title: Smoking Cessation. Contact: Ms. Linda McGlone, Program Coordinator (408)757-1061. Description: Activities include contests, the American Cancer Society's FreshStart program, the Stanford Heart Disease Prevention’s Quit Smoking program, and guided self-help sessions. 0098. PALOALTO MEDICAL FOUNDATION, 385 Homer Avenue, Palo Alto, California 94301. Program Title: Stop Smoking. Contact: Cynthia Schultz, M.A., Director of Health Education (415)853-2960. Description: This small group program includes: preparation for quitting by identifying individual smoking patterns and reasons for smok- ing; problem solving to recognize situations that trigger smok- ing and to develop alternative behaviors; smoke-holding, a mild aversion technique; learning to cope with negative feel- ings without the use of cigarettes; relaxation methods, such as deep breathing, imagery, and self-hypnosis; group discus- sion, which encourages the sharing of problems and promotes mutual support; and development of strategies for long-term maintenance. Nicorette gum may be used by participants with physician approval. Evaluation includes participant feedback at the end of the program and telephone followup at 6 months and 1 year. 0099. SAINT JOHN’S HOSPITAL AND HEALTH CEN- TER, 1328 22nd Street, Santa Monica, California 90404. Program Title: Freedom From Smoking. Contact: Michele Bonant, M.P.H., Coordinator (213)829-8443. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0100. SAINT JOHN’S HOSPITAL AND HEALTH CEN- TER, 1328 22nd Street, Santa Monica, California 90404. Program Title: Individualized Smoking Cessation Counseling. Contact: Patricia Wuertzer, R.N., M.S.N., Coordinator (213)315-6100. Description: Counseling for adult smokers, including cardiac, pulmonary, and cancer patients, is offered on an individual basis. The American Lung Association's booklet, Freedom From Smok- ing In 20 Days, is utilized as a guide for behavior change. Counseling sessions are scheduled as needed to facilitate the desired change in lifestyle. 0101. SEVENTH-DAY ADVENTIST CHURCH, 2222 East Olive Avenue, Merced, California 95340. Program Title: Breathe-Free Pian To Stop Smoking. Contact: Mr. Richard Kelley, Pastor (209)383-4449. Description: The Seventh-Day Adventists’ cessation program is offered. For more information, see the detailed program description in Part 1. 0102. SIMI VALLEY ADVENTIST HOSPITAL, 2975 North Sycamore Drive, Simi Valley, California 93065. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Mr. Bob Stotz, Program Coordinator (805)527-2462. Description: The Seventh-Day Adventists’ cessation program is offered. This program also relies on materials developed by the American Cancer Society and the American Lung Association. For more information, see the detailed program description in Part 1. SOLANO COMMUNITY COLLEGE COMMUNITY SERVICES, 4000 Suisun Valley Road, Sulsun City, California 94585. 0103. Program Title: Helping Smokers Quit. Contact: Ms. Christina March, Director (707)864-7115. Description: This program, held at Kaiser Hospital, is based on a 4-week, 16-hour group interaction approach to smoking cessation. The class prepares smokers to quit by encouraging each par- ticilpant to examine smoking behavior, rethink problems, define motives for quitting, try different solutions, and recog- nize the ability to quit. The program, held twice weekly for 4 weeks, is divided into three phases: self-appraisal and under- standing of the techniques of quitting smoking; adjustment to the idea of quitting with an experimental 2 days off, relying 191 heavily on group support, and reappraisal; and development of a plan to stay off cigarettes. Materials and films are donated by the Solano County Unit of the American Cancer Society. 0104. SOLANO COMMUNITY COLLEGE COMMUNITY SERVICES, 4000 Sulsun Valley Road, Suisun City, California 94585. Program Title: Quit Smoking Clinic With Hypnosis. Contact: Ms. Christina March, Director (707)864-7115. Description: The Quit Smoking Clinic consists of 3 weekly sessions cover- ing preparation, cessation, and reinforcement techniques. Light forms of hypnosis are used in the workshop. The par- ticipant is led through relaxation exercises and given hypnotic suggestions to ensure his or her success. The clinic cost for each participant is $45, which includes a Quit Smoking Kit. This program is limited to 25 participants. SOUTHERN CALIFORNIA PERMANENTE MEDI- CAL GROUP, 4747 Sunset Boulevard, 2nd Floor, Los Angeles, California 90027. 0105. Program Title: Stop Smoking. Contact: Susan Hook, M.S., Program Consultant (213)667-6867. Description: A smoking cessation program of 8 weekly meetings is con- ducted to help participants break the smoking habit as com- fortably as possible. A positive orientation is adopted that helps clients handle their stress in a healthy manner. The program incorporates positive cognitions, general activity, exercise and relaxation techniques, and alternatives to smok- ing. Emphasis is placed on change in self-concept from smoker to nonsmoker, assertiveness, and effective conflict resolution. At a patient’s option and with his or her physician's prescription, Nicorette may be used. Pamphlets prepared by the staff, the American Heart Association, and the American Cancer Society help participants understand what they must do to kick the habit permanently. There is a fee for the program and nonmembers as well as members may participate. 0106. STANISLAUS COUNTY DEPARTMENT OF PUBLIC HEALTH, 820 Scenic Drive, Modesto, California 95350. Program Title: Keep The Beat And Say No To Tobacco. Contact: Ms. Dorene McDonald, Program Coordinator (209)571-5341. Description: This is a cross-grade peer education program utilizing stu- dents in grade 7 to provide a 2-day (1 hour each day) educa- tional program for grade-6 students. The peer educators are trained and divided into teams. Each team provides ap- proximately four to six presentations at their feeder schools. This program runs through the school year; each year approximately 80 peer educators contact 15,000 students. Program Title: Smoke Stoppers. Contact: Ms. Lorie Cullum, Director (916)661-3961 ext.501. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessation; and Phase Ill provides an ongoing support and maintenance system. COLORADO 0107. WOODLAND MEMORIAL HOSPITAL, NATIONAL CENTER FOR HEALTH PROMOTION, 1325 Cot- tonwood Street, Woodland, California 95697. 0108. AMERICAN CANCER SOCIETY COLORADO DIVISION, INC., 2255 South Oneida, Denver, Colorado 80224. Program Title: FreshStart. Contact: Ms. Jennifer Scott, Public Education Director (303)758-2030. Description: The American Cancer Society’s FreshStart smoking cessation clinic is offered. For more information, see the detailed program description in Part 1. AMERICAN CANCER SOCIETY COLORADO DIVISION, INC., 2255 South Oneida, Denver, Colorado 80224. 0109. Program Title: Taking Control. Contact: Ms. Jennifer Scott, Public Education Director (303)758-2030. Description: The newest prevention-oriented program for the American Cancer Society is titled Taking Control and focuses on life- style, nutrition, and environment. Taking Control covers nega- tive lifestyle habits such as tobacco use, sun exposure, and occupational hazards. 0110. AMERICAN LUNG ASSOCIATION OF COLORADO, FLATIRONS/NORTH REGION, 1000 Alpine Avenue, Suite 290, Boulder, Colorado 80302. Program Title: Freedom From Smoking. Contact: Ms. Karen Hutchinson, Program Director (303)442-8205. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. _O111. AMERICAN LUNG ASSOCIATION OF COLORADO, DENVER METRO REGION/STATE OFFICE, 1600 Race Street, Denver, Colorado 80206. Program Title: 192 Freedom From Smoking. Contact: Ms. Michelle McCardless, Program Director (303)388-4327. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0112, AMERICAN LUNG ASSOCIATION OF COLORADO, PIKES PEAK REGION, 809 North Cascade Avenue, Colorado Springs, Colorado 80903. Program Title: Freedom From Smoking. Contact: Ms. Doris Ralston, Program Director (303)635-2564. Description: . The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0113. AMERICAN LUNG ASSOCIATION OF COLORADO, SOUTH REGION, 119 West 6th Street, Suite 100, Pueblo, Colorado 81003. Program Title: Freedom From Smoking. Contact: Mr. Tony Marostica, Program Director (303)543-5864. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0114. AMERICAN LUNG ASSOCIATION OF COLORADO, WEST REGION, 359 Main Street, Grand Junction, Colorado 81501. Program Title: Freedom From Smoking. Contact: Ms. Dot Hoskin, Program Director (303)245-2120. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. COLORADO DEPARTMENT OF HEALTH, 4210 East 11th Avenue, Denver, Colorado 80220. 0115. Program Title: Colorado Cancer Control. Contact: Ed DeAntoni, Ph.D., Director (303)331-8288. Description: The objective of the Cancer Control program is to identify variables related to successful worksite smoking cessation programs. Cancer Control establishes smoking cessation programs in a variety of State government agencies and evaluates each according to a predesigned research and evaluation model. Based upon these findings, the program will then promote smoking policy development and cessation programs for the worksite in the private sector and among other public-sector employers. The cessation methodology utilizes EASE (Employer Assisted Smoking Elimination) developed by the American Lung As- sociation of Eastern Missouri. The evaluation criteria to measure program impact include the number of cessation programs established, quit rates, and prevalence rate chan- ges within participating agencies versus nonparticipating agencies. The objectives of the Smoking Prevention program are to determine the variables that encourage and discourage 193 smoking and the use of other tobacco products among Colorado youth and to design, implement, and evaluate inter- ventions focusing on those variables. The program identifies and evaluates existing school smoke-free policies and prevention and cessation programs and subsequently promotes the establishment of proven models among Colorado school districts. The program consults with the Drug- Free Schools Program (Colorado Department of Education). Evaluation criteria include number of programs established, prevention and cessation program effectiveness, and prevalence rate changes. COLORADO DEPARTMENT OF HEALTH, 4210 East 11th Avenue, Denver, Colorado 80220. 0116. Program Title: Colorado Low Birthweight Prevention Project. Contact: Ms. Nancy Salas, LBW Coordinator (303)331-8572. Description: The project objective is to develop strategies for reducing the incidence of low birthweight (LBW). The project funds prenatal counselors in four local public health prenatal programs to assist women in reducing risk taking behaviors. The target population includes women who smoke, use alcohol, are severely anemic, or are gaining weight inadequately. Ap- proximately 50 percent of the women using State-funded prenatal clinics are at risk of LBW due to these preventable risks. The project also educates women using State-funded family planning services regarding the importance of quitting smoking and alcohol use in order to reduce the risk of LBW. 0117. COLORADO DEPARTMENT OF HEALTH, 4210 East 11th Avenue, Denver, Colorado 80220. Program Title: Smoking Cessation In Pregnancy. Contact: Ms. Nancy Salas, LBW Coordinator (303)331-8572. Description: The institutional objective of this program is to work through cooperative agreement with the Centers for Disease Control in developing smoking cessation methods that can be in- tegrated into prenatal and Women, Infants, and Children (WIC) program services offered by existing staff. In providing smoking cessation and maintenance of cessation assistance to prenatal smokers, approximately 17 percent of the women who were smoking at the time of prenatal and WIC enrollment are expected to quit smoking during pregnancy. Among women who receive maintenance assistance following quit- ting smoking either before or after enrollment, 50 percent are expected to maintain their cessation through 6 weeks post partum. COLORADO DEPARTMENT OF HEALTH, 4210 0118. East 11th Avenue, Denver, Colorado 80220. Program Titie: State Employee Risk Reduction Program. Contact: Ms. Jane Pritzl, Director (303)331-8233. Description: This program is designed to encourage and facilitate the development of worksite risk reduction efforts for State employees and to provide an incentive for the elimination of one of its most costly (in human and economic terms) health behaviors, i.e., smoking. Objectives for this program include: 1) the implementation of a differential insurance rate favoring nonsmokers; 2) the es- tablishment of a consortium of State agencies that meet regularly to develop worksite risk reduction activities for State employees; and 3) the distribution of and assistance with the administration of health risk appraisals for State employees. 0119. EL PASO COUNTY HEALTH DEPARTMENT, 501 North Foote Avenue, Colorado Springs, Colorado 80909-4598. Program Title: The Colorado Springs Smoking Ordinance. Contact: Mr. James Easton, Program Director (303)578-3137. Description: To support the Colorado Springs Smoking Ordinance, presen- tations are available, upon request, to civic groups, industry, manufacturing, and food service establishments. The program is a lecture presentation, currently without graphics, that seeks to inform selected audiences about how the ordinance con- trols tobacco smoke in work and public places. it describes how the ordinance affects work and public places in terms of signage, work practices, and policies. Informal evaluation is conducted through monitoring subsequent compliance and complaint frequency. EL PASO COUNTY HEALTH DEPARTMENT, 501 North Foote Avenue, Colorado Springs, Colorado 80909-4598. 0120. Program Title: Smoking And Your Health. Contact: Ms. Julie Castle, Program Coordinator (303)578-3108. Description: The Smoking And Your Health program is presented, on request, to schools, community agencies, and individuals. The presentation is modified for the target audience and varies in length from 30 to 55 minutes. It is a prevention program, using audiovisuals from the media library and the American Cancer Society. Focus is on the health hazards of tobacco and 194 reasons notto use any kind of tobacco, the benefits of quitting, and quitting tips. . 0121. JEFFERSON COUNTY HEALTH DEPARTMENT, 260 South Kipling Street, Lakewood, Colorado 80226. Program Title: Freedom From Smoking Clinics. Contact: Angela Tinnes, R.N., Program Coordinator (303)232-6301 ext.224. Description: The American Lung Association's Freedom From Smoking clinics are available to the general public and maternity clinic prenatal patients twice a year. Handouts and films are provided by the American Lung Association. For more infor- mation, see the detailed program description in Part 1. 0122. PORTER MEMORIAL HOSPITAL, 2525 South Downing Street, Denver, Colorado 80210. Program Title: Porter Stop-Smoking Clinic. Contact: Mr. Steve Gomes, Program Coordinator (303)778-5778. Description: The Health Promotion Center presents a 6-day stop-smoking program every month. Each of the six classes involves films and presentations. The core of this program is an extensive group of behavior change skills designed to bring about a deep-seated change of feelings as well as nonsmoking be- . havior. Followup meetings are held every month. Recently, a 2-year evaluation of this program was conducted, using thiocyanate to determine smoking status. : PUEBLO CITY-COUNTY HEALTH DEPART- MENT, 151 Central Main Street, Pueblo, Colorado- 81003-4297. 0123. Program Title: Smoking Education. Contact: Mr. Dan Otoupalik, Program Director (303)544-8376. Description: The Health Education Division, in conjunction with the local American Lung Association, helps sponsor and coordinate- such activities as school health fairs, school classroom presentations on smoking prevention, and smoking clinics. WEBB-WARING LUNG INSTITUTE, University of Colorado Health Science Center, 4200 East Ninth Avenue, Denver, Colorado 80262. 0124. Program Title: Cigfinale Training And Education Program. Contact: Louise M. Nett, R.N., R.R.T., Pulmonary Program Specialist (303)270-8231. Description: The major focus of this resource and education program is the training of health professionals in smoking cessation techni- ques. Integrating a smoking cessation message into usual practice is the theme of the program. Teaching kits for the health professionals to use with their patients are being developed. Health professionals are encouraged to use biological tests to motivate smokers to consider quitting. The center serves as a focal and National resource in smoking cessation education. A monthly newsletter with a column on smoking is published for physicians. A 1-week continuing education program covering all topics relating to smoking cessation is offered. Also, local and regional 1-day programs covering the role of the health professional in smoking cessa- tion are offered. A tobacco museum is maintained to teach health professionals about paraphernalia used in consump- tion of tobacco. The center also offers direct public education programs and does clinical research with smokers. CONNECTICUT 0125. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Danbury Unit Office, 57 James Street, Danbury, Connecticut 06810. Program Title: Connecticut Division Stop Smoking. Contact: Mr. Bill Finch, Executive Director (203)748-2803. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0126. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Danbury Unit Office, 57 James Street, Danbury, Connecticut 06810. Program Title: Don’t Get Hooked On Smoking. Contact: Mr. Bill Finch, Executive Director (203)748-2803. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0127. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Danbury Unit Office, 57 James Street, Danbury, Connecticut 06810. Program Title: FreshStart. 195 Contact: Mr. Bill Finch, Executive Director (203)748-2803. Description: The American Cancer Society's FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0128. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Danbury Unit Office, 57 James Street, Danbury, Connecticut 06810. Program Title: Smoking And Pregnant Women. Contact: Mr. Bill Finch, Executive Director (203)748-2803. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0129. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Eastern Fairfield County Unit Office, 16 Sherman Court, Falrfleid, Connecticut 06430. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Suzanne Hiatt, Executive Director (203)259-2203. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0130. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Eastern Fairfleld County Unit Office, 16 Sherman Court, Fairfield, Connecticut 06430. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Suzanne Hiatt, Executive Director (203)259-2203. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0131. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Eastern Falrfleld County Unit Office, 16 Sherman Court, Falrfleld, Connecticut 06430. Program Titie: FreshStart. Contact: Ms. Suzanne Hiatt, Executive Director (203)259-2203. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 0132. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Eastern Fairfield County Unit Office, 16 Sherman Court, Fairfleld, Connecticut 06430. Program Title: Smoking And Pregnant Women. Contact: Ms. Suzanne Hiatt, Executive Director (203)259-2203. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Hartford Unit Office, 670 Prospect Avenue, Hartford, Connecticut 06105. 0133. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Mary Jo Cicchetti, Executive Director (203)233-9691. 196 Description: A guided group self-help program led by a trained instructor is offered. tt is scheduled over four 2-hour sessions or eight 1-hour sessions. 0134. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Hartford Unit Office, 670 - Prospect Avenue, Hartford, Connecticut 06105. Program Title: Don't Get Hooked On Smoking. Contact: Ms. Mary Jo Cicchetti, Executive Director (203)233-9691. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the - hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0135. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Hartford Unit Office, 670 Prospect Avenue, Hartford, Connecticut 06105. Program Title: FreshStart. Contact: Ms. Mary Jo Cicchetti, Executive Director (203)233-9691. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0136. AMERICAN CANCER SOCIETY, CONNECTICUT. DIVISION, INC., Greater Hartford Unit Office, 670 Prospect Avenue, Hartford, Connecticut 06105. - Program Title: Smoking And Pregnant Women. Contact: Ms. Mary Jo Cicchetti, Executive Director (203)233-9691. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greenwich Health Association, 189 Mason Street, Greenwich, Connecticut 06830. 0137. Program Title: Connecticut Division Stop Smoking. Contact: Mr. Peter Flierl, Executive Director (203)643-2168. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0138. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greenwich Health Association, 189 Mason Street, Greenwich, Connecticut 06830. Program Title: Don’t Get Hooked On Smoking. Contact: Mr. Peter Flierl, Executive Director (203)643-2168. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0139. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greenwich Health Association, 189 Mason Street, Greenwich, Connecticut 06830. Program Title: FreshStart. Contact: Mr. Peter Flierl, Executive Director (203)643-2168. Description: The American Cancer Society's FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0140. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greenwich Health Association, 189 Mason Street, Greenwich, Connecticut 06830. Program Title: Smoking And Pregnant Women. Contact: Mr. Peter Flierl, Executive Director (203)643-2168. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0141. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Manchester Unit Office, 243 East Center Street, Manchester, Connecticut 06040. Program Title: Connecticut Division Stop Smoking. Contact: Ms, Gertrude Sutcliffe, Executive Director (203)869-0200. Description: A guided group self-help program led by a trained instructor is offered. is scheduled over four 2-hour sessions or eight 1-hour sessions. 0142. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Manchester Unit Office, 243 East Center Street, Manchester, Connecticut 06040. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Gertrude Sutcliffe, Executive Director (203}869-0200. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0143. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Manchester Unit Office, 243 East Center Street, Manchester, Connecticut 06040. Program Title: FreshStart. Contact: Ms. Gertrude Sutcliffe, Executive Director (203)869-0200. Description: The American Cancer Society’s FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0144. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Manchester Unit Office, 243 East Center Street, Manchester, Connecticut 06040. Program Title: Smoking And Pregnant Women. Contact: Ms. Gertrude Sutcliffe, Executive Director (203)869-0200., Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0145. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Middlesex/Meriden/Wallingford Unit Office, Route 66, Meriden Road, Middletown, Connecticut 06457. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Catherine Mantilla, Executive Director (203)235-4439. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0146. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Middlesex/Meriden/Wallingford Unit Office, Route 66, Meriden Road, Middletown, Connecticut 06457. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Catherine Mantilla, Executive Director (203)235-4439. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0147. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Middlesex/Meriden/Wallingford Unit Office, Route 66, Meriden Road, Middletown, Connecticut 06457. Program Title: FreshStart. Contact: Ms. Catherine Mantilla, Executive Director (203)235-4439. Description: The American Cancer Society's FreshStart program is of- fered. For more information, see the detailed program description in Part 1. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Middlesex/Meriden/Wallingford Unit Office, Route 66, Meriden Road, Middletown, Connecticut 06457. 0148. 198 Program Title: Smoking And Pregnant Women. Contact: Ms. Catherine Mantilla, Executive Director (203)235-4439. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0149. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New Britain Unit Office, 80 Whit- Ing Street, Plainville, Connecticut 06062. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Francine Lachance, Executive Director (203)793-0203. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0150. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New Britaln Unit Office, 80 Whit- Ing Street, Plainville, Connecticut 06062. Program Title: Don't Get Hooked On Smoking. Contact: Ms. Francine Lachance, Executive Director (203)793-0203. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New Britain Unit Office, 80 Whit- ing Street, Plainville, Connecticut 06062. 0151. Program Title: FreshStart. Contact: Ms. Francine Lachance, Executive Director (203)793-0203. Description: The American Cancer Society's FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0152. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New Britain Unit Office, 80 Whit- ing Street, Plainville, Connecticut 06062. Program Title: Smoking And Pregnant Women. Contact: Ms. Francine Lachance, Executive Director (203)793-0203. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0153. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New London Unit Office, 120 Broad Street, New London, Connecticut 06320. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Anne Smith, Executive Director (203)477-1478. Description: A guided group self-help program ied by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0154. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New London Unit Office, 120 Broad Street, New London, Connecticut 06320. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Anne Smith, Executive Director (203)477-1478. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0155. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New London Unit Office, 120 Broad Street, New London, Connecticut 06320. Program Title: FreshStart. Contact: Ms. Anne Smith, Executive Director (203)477-1478. Description: The American Cancer Society’s FreshStart program is of- fered. For more information, see the detailed program descrip- tion in Part 1. 0156. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., New London Unit Office, 120 Broad Street, New London, Connecticut 06320. Program Title: Smoking And Pregnant Women. Contact: Ms. Anne Smith, Executive Director (203)477-1478. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0157. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Northwestern Unit Office, 8 Church Street, Torrington, Connecticut 06790. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Helen Bunnell, Executive Director (203)482-8576. Description: A guided group self-help program led by a trained instructor is offered. kt is scheduled over four 2-hour sessions or eight 1-hour sessions. 0158. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Northwestern Unit Office, 8 Church Street, Torrington, Connecticut 06790. Program Title: Don't Get Hooked On Smoking. Contact: Ms. Helen Bunnell, Executive Director (203)482-8576. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0159. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Northwestern Unit Office, 8 Church Street, Torrington, Connecticut 06790. 199 Program Title: FreshStart. Contact: Ms. Helen Bunnell, Executive Director (203)482-8576. Description: The American Cancer Society’s FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0160. AMERICAN CANCER SOCIETY, CONNECTICUT : DIVISION, INC., Northwestern Unit Office, 8 Church Street, Torrington, Connecticut 06790. Program Title: Smoking And Pregnant Women. Contact: Ms. Helen Bunnell, Executive Director (203)482-8576. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0161. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Norwich/Quinebaug Unit Office, 115 Lafayette Street, Norwich, Connecticut 06360. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Linda Gilpin, Executive Director (203)887-2547. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0162. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Norwich/Quinebaug Unit Office, 115 Lafayette Street, Norwich, Connecticut 06360. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Linda Gilpin, Executive Director (203)887-2547. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 200 0163. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Norwich/Quinebaug Unit Office, - 115 Lafayette Street, Norwich, Connecticut 06360. Program Title: FreshStart. Contact: Ms. Linda Gilpin, Executive Director (203)887-2547. Description: The American Cancer Society's FreshStart program is of- fered, For more information, see the detailed program descrip- tion in Part 1. 0164. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Norwich/Quinebaug Unit Office, 415 Lafayette Street, Norwich, Connecticut 06360. Program Title: Smoking And Pregnant Women. Contact: Ms. Linda Gilpin, Executive Director (203)887-2547. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0165. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., South Central Unit Office, 8 Lunar Drive, Woodbridge, Connecticut 06525. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Debra Stout, Executive Director (203)389-5324. Description: A guided group self-help program led by a trained instructo is offered. tt is scheduled over four 2-hour sessions or eigh 1-hour sessions. 0166. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., South Central Unit Office, 8 Luna Drive, Woodbridge, Connecticut 06525. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Debra Stout, Executive Director (203)389-5324. Description: Young people aged 9 to 18 become involved in grou participation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., South Central Unit Office, 8 Lunar Drive, Woodbridge, Connecticut 06525. 0167. Program Title: FreshStart. Contact: Ms. Debra Stout, Executive Director (203)389-5324. Description: The American Cancer Society's FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0168. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., South Centra! Unit Office, 8 Lunar Drive, Woodbridge, Connecticut 06525. Program Title: Smoking And Pregnant Women. Contact: Ms. Debra Stout, Executive Director (203)389-5324. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0169. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Southern Fairfield Unit Office, Landmark Square, 5 Brook Street, Norwalk, Connecticut 06852. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Sandra Sadie, Public Education Director (203)853-0100. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. 0170. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Southern Fairfield Unit Office, Landmark Square, 5 Brook Street, Norwalk, Connecticut 06852. Program Title: Don't Get Hooked On Smoking. 201 Contact: Ms. Sandra Sadie, Public Education Director (203)853-0100. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Southern Fairfield Unit Office, Landmark Square, 5 Brook Street, Norwalk, Connecticut 06852. 0171. Program Title: FreshStart. Contact: Ms. Sandra Sadie, Public Education Director (203)853-0100. Description: The American Cancer Society’s FreshStart program is of- fered. For more information, see the detailed program description in Part 1. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Southern Fairfield Unit Office, Landmark Square, 5 Brook Street, Norwalk, Connecticut 06852. 0172. Program Title: Smoking And Pregnant Women. Contact: Ms. Sandra Sadie, Public Education Director (203)853-0100. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0173. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Waterbury Unit Office, 155 Grove Street, Waterbury, Connecticut 06710. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Nancy Hein, Executive Director (203)756-8888. Description: A guided group self-help program led by a trained instructor is offered. It is scheduled over four 2-hour sessions or eight 1-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Waterbury Unit Office, 155 Grove Street, Waterbury, Connecticut 06710. 0174. Program Title: Don’t Get Hooked On Smoking. Contact: Ms. Nancy Hein, Executive Director (203)756-8888. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Waterbury Unit Office, 155 Grove Street, Waterbury, Connecticut 06710. 0175. Program Title: FreshStart. Contact: Ms. Nancy Hein, Executive Director (203)756-8888. Description: The American Cancer Society’s FreshStart program is of- fered. For more information, see the detailed program description in Part 1. 0176. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Greater Waterbury Unit Office, 155 Grove Street, Waterbury, Connecticut 06710. Program Title: Smoking And Pregnant Women. Contact: Ms. Nancy Hein, Executive Director (203)756-8888. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. 0177. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Windham Unit Office, 29 Ivanhill Street, Willimantic, Connecticut 06226. Program Title: Connecticut Division Stop Smoking. Contact: Ms. Joan Volkmann, Executive Director (203)423-2589. Description: A guided group self-help program led by a trained facilitator is 202 offered. tt is scheduled over four 2-hour sessions or eight 1-hour sessions. 0178. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Windham Unit Office, 29 Ivanhill Street, Willimantic, Connecticut 06226. Program Title: Don't Get Hooked On Smoking. Contact: Ms. Joan Volkmann, Executive Director (203)423-2589. Description: Young people aged 9 to 18 become involved in group par- ticipation activities and receive educational information on the ~ hazards of smoking. The program is designed for use by schools and other groups and is scheduled over two 2-hour sessions or four 1-hour sessions. 0179. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Windham Unit Office, 29 Ivanhill Street, Willimantic, Connecticut 06226. Program Title: FreshStart. Contact: Ms. Joan Volkmann, Executive Director (203)423-2589. Description: The American Cancer Society's FreshStart cessation pro- gram is offered. For more information, see the detailed pro- gram description in Part 1. 0180. AMERICAN CANCER SOCIETY, CONNECTICUT DIVISION, INC., Windham Unit Office, 29 Ivanhili - Street, Willimantic, Connecticut 06226. Program Title: Smoking And Pregnant Women. Contact: Ms. Joan Volkmann, Executive Director (203)423-2589. Description: The risks of smoking during pregnancy are presented to pregnant women during two 2-hour sessions. AMERICAN HEART ASSOCIATION, CONNEC- TICUT AFFILIATE, 71 Parker Avenue, Meriden, Connecticut 06540. 0181. Program Title: Let’s Talk About Smoking. Contact: Ms. Kathy Biederman, Program Coordinator (203)634-4532. Description: A 13-minute film with teacher's guide for students in grade 7 is available. Film includes peers talking about smoking and not smoking. 0182. AMERICAN HEART ASSOCIATION, CONNEC- TICUT AFFILIATE, 71 Parker Avenue, Meriden, Connecticut 06540. Program Title: Save A Sweet Heart. Contact: Ms. Kathy Biederman, Program Coordinator (203)634-4532. Description: This program involves a series of activities to promote non- smoking among junior and senior high school students. For more information, see the program description in Part 1. 0183. AMERICAN HEART ASSOCIATION, CONNEC- TICUT AFFILIATE, 71 Parker Avenue, Meriden, Connecticut 06450. Program Title: Smoking Cessation — Self-Help. Contact: Ms. Kathy Biederman, Program Coordinator (203)634-4532. Description: The American Heart Association's self-help smoking cessa- tion program is used and pamphlets are distributed. For more information, see the detailed program description in Part 1. 0184. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. Program Title: Audiovisual Library. Contact: Mr. Richard F. Straub, Director, Smoking and Health Programs (203)289-5401 . Description: The American Lung Association of Connecticut makes avail- able a library of 20 to 25 different films that target different age groups, on the subject of lung disease, air conservation, and cigarette smoking. 0185. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. Program Title: Biomonitoring. 203 Contact: Ms. Lori A. Tatsapaugh, Director, Community Health Programs (203)289-5401. Description: The American Lung Association's Biofeedback Smoking Education Project is offered to students in grades 7 to 9. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. 0186. Program Title: Freedom From Smoking. Contact: Mr. Richard F. Straub, Director, Smoking and Health Programs (203)777-6821. Description: The American Lung Association’s Freedom From Smoking program is offered to individuals and to corporations for worksite wellness programs. A minimal fee is charged to all participants in order to cover material costs and instructors’ salaries. For more information, see the detailed program description in Part 1. 0187. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. Program Title: Freedom From Smoking Self-Help Series. Contact: Ms. Monica Lord, Program Associate (203)289-5401. Description: The American Lung Association’s Freedom From Smoking self-help series is offered at a cost of $7 each. For more information, see the detailed program description in Part 1. 0188. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. Program Title: In Control. Contact: Ms. Monica Lord, Program Associate (203)289-5401. Description: in Control, a smoking cessation videocassette program, is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. 0189. Program Title: Lung Health Curriculum (Grades K-6). Contact: Ms. Lori A. Tatsapaugh, Director, Community Health Programs (203)289-5401. Description: This program offers a comprehensive and sequential lung health curriculum, packaged for individual grade levels. Educators are supplied with information and easy-to-follow lesson plans to incorporate this material into the existing school health curriculum. Each kit contains the following items: 1) ateacher’s guide with detailed lesson plans, teacher background information sheets and optional activities; 2) spirit masters comprising enrichment activities for each lesson; 3) posters designed for use as either bulletin board displays or visual aids; and 4) student booklets (25 in each kit), geared to the reading level of each grade, to reinforce lessons. 0190. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06198. Program Title: Marijuana: A Second Look. Contact: Ms. Lori A. Tatsapaugh, Director, Community Health Programs (203)289-5401. Description: This program, designed for children ages 9 to 11, emphasizes the skills kids can use in resisting peer pressure to experiment with marijuana and other drugs. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF CONNEC- TICUT, 45 Ash Street, East Hartford, Connecticut 06108. 0191. Program Title: Nursery School Activity Box. Contact: Ms. Lori A. Tatsapaugh, Director, Community Health Programs (203)289-5401. Description: The American Lung Association of Connecticut has produced 204 a Nursery School Activity Box designed to aid young children in the development of positive health habits. The kit contains: 1) a teacher's guide with detailed lesson plans, including a hand puppet named Sammy the Snake who tells about the harmful effects of Suffocating Smoke; 2) activities such as a coloring book and an innovative and colorful bingo game that leads children to a discussion of healthy habits and also teaches the universal no-smoking symbol; and 3) take-home - material for parents concerning secondhand smoke, choking, and childhood respiratory diseases. 0192. COMMUNITY HEALTH CARE CENTER PLAN, INC., 150 Sargent Drive, New Haven, Connecticut 06511. Program Title: Free And Clear. Contact: Ms. Barbara Katz, Health Education Coordinator (203)787-3141 ext.363. Description: Pamphlets on smoking produced by the American Lung As- sociation are distributed. Monthly classes are offered. Audiovisual loan programs are available. Consultation on industrial smoking policies is offered. CONNECTICUT DEPARTMENT OF HEALTH SERVICES, OFFICE OF HEALTH EDUCATION - SMOKING, 150 Washington Street, Hartford, Connecticut 06106. 0193. Program Title: Health Department Smoking. Contact: Ms. Janet St. Clair (203)566-3844. Description: - This office handles several programs related to Connecticut - smoking laws, smoking cessation, school programs, worksite smoking policy, and general information. The worksite program involves interpretation of the smoking laws and technical assistance with the establishment of policies for State agencies, municipalities, and private busi- nesses. In the schools, the Office of Health Education imple- ments a Teen Wellness Check, disseminates a directory of curriculum resources for education and referrals for cessation programs, interprets the laws, and provides technical assis- tance with the establishment of policies governing smoking- and the use of tobacco products. The office publishes quarter- ly listings of smoking cessation clinics throughout the State, maintains a cessation resource directory for referrals, and provides assistance to State agencies, municipalities, and private businesses in promoting cessation. in addition, the office provides information and assistance to members of the public, the media, State agencies, local heaith departments, and community agencies regarding smoking, passive smoking, smokeless tobacco, and Connecticut smoking laws. It maintains a complaint system documenting problems with smoking in restaurants and retail food stores and worksites. Other responsibilities include monitoring legis- lation and providing information to State legislators regarding proposed laws regulating smoking or use of tobacco products. The office also assists in promoting legislation protecting nonsmokers and restricting smoking. HARTFORD HOSPITAL, HEALTH AND LIFE- STYLES PROGRAM, 80 Seymour Street, Hartford, Connecticut 06115-0729. 0194. Program Title: Smokeless/Health Education/Policy Implementation. Contact: Mr. William Martens, Director, Health and Lifestyles (203)524-2124, Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0195. HARTFORD HYPNOSIS CENTER, 111 Pearl Street, Room 601, Hartford, Connecticut 06103. Program Title: Cessation Through Hypnosis. Contact: Mr. David J. Norton, Director (203)522-2320. Description: Therapy for smoking cessation is designed around the resour- ces and strengths of each client. One-to-one counseling and group support services are both available. 0196. INSTITUTE FOR BETTER HEALTH, INC., Hospital of Saint Raphael, 111 Sherman Avenue, New Haven, Connecticut 06511. Program Title: Smokeless. Contact: Ms. Ursula A. Kolb, Director of Health Promotion (203)789-3031. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 205 MIDDLETOWN DEPARTMENT OF HEALTH, Municipal Building, DeKoven Drive, Post Office Box 1300, Middletown, Connecticut 06457-1300. 0197. Program Title: FreshStart. Contact: Leon F. Vinci, M.P.H., Director of Health (203)344-3474, Description: The American Cancer Society’s FreshStart program is offered to coincide with the Great American Smokeout. For more information, see the detailed program description in Part 1. 0198. MIDDLETOWN DEPARTMENT OF HEALTH, Municipal Building, DeKoven Drive, Post Office Box 1300, Middletown, Connecticut 06457-1300. Program Title: Great American Smokeout. Contact: Leon F. Vinci, M.P.H., Director of Health (203)344-3474. Description: In 1987, high school students participated in the Great American Smokeout. Students and school employees pledged not to smoke for a 24-hour period. A buddy system was employed. One local clothing store donated 100 T-shirts for participants and a local apple orchard donated 30 pounds of apples, a healthy snack alternative to a cigarette. Educa- tional posters were displayed in the halls and cafeteria. Approximately 400 students were exposed to this program. 0199. MIDDLETOWN DEPARTMENT OF HEALTH, Municipal Bullding, DeKoven Drive, Post Office Box 1300, Middletown, Connecticut 06457-1300. Program Title: Public Education. Contact: Leon F. Vinci, M.P.H., Director of Health (203)344-3474. Description: The Middletown Department of Health’s Risk Reduction Pro- gram conducts public education programs concerning smok- ing, with local radio and newspaper cooperation. Other activities have included live interviews with former smokers who had successfully kicked the habit and a cold turkey raffle in which turkeys were won by several of the persons attending. 0200. MILFORD DEPARTMENT OF HEALTH, MEDICAL DIVISION, 2051 Bridgeport Avenue, Milford, Connecticut 06460. Program Title: Stop Smoking. Contact: George Kraus, M.D., Program Director (203)783-3285. Description: The Milford Hospital program is cosponsored by the Milford Health Department. The program is six sessions, two sessions each week for 3 weeks. The program is based on the American Cancer Society's self-help, stop smoking techniques. There is a $50 fee for the class. 0201. NEW LONDON HEALTH DEPARTMENT, 120 Broad Street, New London, Connecticut 06320- 5787. Program Titie: FreshStart. Contact: Ms. Rita Metcalf, Program Coordinator (203)447-8304. Description: The American Cancer Society’s FreshStart program is offered four times a year: two programs for county employees and two programs for the general public. For more information, see the detailed program description in Part 1. NORTH CENTRAL DISTRICT HEALTH DEPARTMENT, Post Office Box 340, A.D. Higgins Building, North Main Street, Enfleld, Connecticut 06802. 0202. Program Title: No Butts About It. Contact: Meg Fulton, M.P.H., Program Director (203)745-0383. Description: No Butts About It (NBAI) is a tobacco prevention and cessation support program designed specifically for students in grades 5 through 10. The primary objective of NBAI is to equip youth with the knowledge and the skills to make a well-informed personal choice concerning the use of tobacco, and also to provide support, guidance, and tools to aid those desiring to stop using tobacco. The program approach is multifaceted, focusing on factual information, self-esteem, interpersonal skills, relaxation tech- niques, coping skills, resistance strategies, responsibility recognition and acceptance, and goal and value setting. In order to address this large number of issues, audiovisual materials, large and small group discussion, dramatization, mini-lectures, biofeedback devices, and high-level participant interaction are incorporated into a 9- to 11-week program. At the completion of the program each participant receives a certificate. 206 Sessions are designed to be presented during 45- to 60- minute time intervals at a frequency of once a week for a 9- to 11-week duration. Implementation at the middle and high school levels has revealed that No Butts About It fits quite well within the regular health or health-science curriculum. 0203. NORWALK DEPARTMENT OF HEALTH, 137 East Avenues, Norwalk, Connecticut 06851. Program Title: Clean Air In The Workplace: The | Quit Smoking Program. Contact: Ms. Rhonda Collins, Health Education Coordinator (203)854-7977. Description: This is a 28-day program offered to municipal employees. It is a comprehensive, in-house program including daily group meetings, daily video presentations, daily readings and ac- - tivities, stress management, weight control, and methods to deal with habit and the psychological as well as the physiological addiction. 0204. QUINNIPIACK VALLEY HEALTH DISTRICT, 1141 Dixwell Avenue, Chimney Square, Hamden, Connecticut 06514. Program Title: Great American Smokeout. Contact: Ms. Deborah Culligan, Deputy Director (203)776-8283. Description: The district participates in the smokeout by distributing materials to town employees on smoking cessation. Ap- proximately 1,000 persons receive these materials in Novem-— ber of each year. 0205. QUINNIPIACK VALLEY HEALTH DISTRICT, 1141 Dixwell Avenue, Chimney Square, Hamden, Connecticut 06514. Program Title: Just Say No Fair. Contact: Ms. Deborah Culligan, Deputy Director (203)776-8283. Description: This program, presented in a health fair format, focuses on substance abuse and safety. The program is designed for children in grades 4 to 6 and travels from school to school. It is set up in agym or cafeteria, with the children coming through with their teacher and classmates. One of the booths relates - to smoking and smokeless tobacco. Live specimens of lung tissue and a mouth with cancer are displayed. A game is played that simulates breathing as if one had emphysema. - Materials, including a comic book, are handed out and children are encouraged to share these with their families. 0206. TOWN OF MANCHESTER, 41 Center Street, Manchester, Connecticut 06040. Program Title: Smoking Cessation Workshop. Contact: Carolyn Bountress, R.N.C., Senior Health Program Coordinator (203)647-3173. Description: The program is offered on an as-requested basis to senior citizens in the community. The American Cancer Society's 7-Day Quit program is used. There are four 2-hour sessions over a 3-week period. The program is informational, suppor- tive and incorporates a 48-hour quit period midway in the program. 0207. WEST HAVEN DEPARTMENT OF HEALTH, Post Office Box 312, West Haven, Connecticut 06516- 0312. Program Title: Smoke Cessation Class. Contact: Eric Triffin, M.P.H., Health Educator (203)934-3421 ext.300. Description: A four-session smoke cessation class is offered twice each year. The series includes elements of stress management, biofeedback, nutrition, and exercise, along with quitting tech- niques and support. There are 6-month and 1-year evaluations. DELAWARE 0208. AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Suite 202, Wilmington, Delaware 19806. Program Title: Freedom From Smoking Clinics. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0209. AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Sulte 202, Wilmington, Delaware 19806. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: This self-help program includes a 32-page manual, a poster progress chart for pregnant mothers, and a pocket reminder. An audiocassette tape featuring aerobics and relaxation exer- cises is also available. For more information, see the detailed program description in Part 1. 207 AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Suite 202, Wilmington, Delaware 19806. 0210. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: The American Lung Association's newest Freedom From Smoking self-help manual is offered. For more information, see the detailed program description in Part 1. 0211. AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Suite 202, Wilmington, Delaware 19806. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: The American Lung Association’s Freedom From Smoking Self-Help Manuals are offered. For more information, see the detailed program description in Part 1. 0212. AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Suite 202, Wilmington, Delaware 19806. Program Title: In Control. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: In Control, a videocassette smoking cessation program, is offered. The program also includes a workbook and audiocas- sette tape. For more information, see the detailed program description in Part 1. 0213. AMERICAN LUNG ASSOCIATION OF DELAWARE, 1021 Gilpin Avenue, Suite 202, Wilmington, Delaware 19806. Program Title: School Health Education. Contact: Ms. Deborah P. Brown, Program Director (302)655-7258. Description: Various curriculum programs are designed for students in grades kindergarten through 12. The programs are prevention orisnted and contain information about basic good health habits. 0214. DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES, DIVISION OF PUBLIC HEALTH, Robbins Bullding, 802 Silver Lake een and Walker Road, Dover, Delaware 19901. Program Title: Stop Smoking. Contact: Mr. Lionel de Bernard, Health Educator (302)736-4754. Description: The Office of Health Education provides a free smoking ces- sation program. The program is available to any interested businesses, State agencies, or other group or institution with a minimum of 15 registrants. This seven-session course is designed to provide participants with the knowledge and skills to cope with the urge to smoke. The program includes an evaluation about smoking, a step-by-step plan for quitting, coping techniques recognizing the differences between psychological and physical withdrawal symptoms, stress management and relaxation techniques, and above all, how to remain motivated in order to remain a nonsmoker. Followup sessions to reinforce the skills developed in the program are conducted after 1 year. Because this is a health education program, success is not determined solely by the number of participants who quit smoking after attending this course. The office also distributes television public service an- nouncements for smoking prevention and works with the Division's Adolescent Health Program on smoking prevention activities for teens. The office provides information and self- help kits on request, and consults with workplace health promotion programs related to smoking policies. DISTRICT OF COLUMBIA 0215. AMERICAN CANCER SOCIETY, DISTRICT OF COLUMBIA DIVISION, INC., 1825 Connecticut Avenue, N.W., Washington, District of Columbia 20009. Program Title: FreshStart. Contact: Ms. Jevita Kilpatrick, Director of Public Education (202)483-2600. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0216. AMERICAN CANCER SOCIETY, DISTRICT OF COLUMBIA DIVISION, INC., 1825 Connecticut Avenue, N.W., Washington, District of Columbia 20009. Program Title: Youth Education. Contact: Ms. Caron Gwynn, Health Education Director (202)483-2600. Description: The American Cancer Society's in-school health education teaching series is used for all grades. For more information, - see the detailed program description in Part 1. 0217. AMERICAN HEART ASSOCIATION, NATION’S CAPITAL AFFILIATE, 2233 Wisconsin Avenue, N.W., Post Office Box 32409, Washington, District of Columbia 20007. Program Title: Heart At Work. Contact: Ms. Deborah Edwards, Program Associate (202)337-6400. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 0218. AMERICAN HEART ASSOCIATION, NATION’S CAPITAL AFFILIATE, 2233 Wisconsin Avenue, N.W., Post Office Box 32409, Washington, District of Columbia 20007. Program Title: Save A Sweet Heart. Contact: Amber Thornton-Washington, M.P.H., Director of Programs (202)337-6400. Description The American Heart Association’s Save A Sweet Heart series is conducted in schools by students. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF THE DIS- TRICT OF COLUMBIA, 475 H Street, N.W., Washington, District of Columbia 20001. 0219. Program Title: Freedom From Smoking. Contact: Coordinator, Smoking or Health Programs (202)682-5864. Description: The American Lung Association’s Freedom From Smoking clinics and self-help kits are available. For more information, see the detailed program description in Part 1. 0220. AMERICAN LUNG ASSOCIATION OF THE DISTRICT OF COLUMBIA, 475 H Street, N.W., Washington, District of Columbia 20001. Program Title: How To Cope With Pressure To Smoke. Contact: Ms. Veronica Brown, Coordinator, Child/Youth Programs (202)682-5864. 209 Description: This is a smoking prevention program aimed at students in grade 6, but can be modified for all age groups. It is presented in three 45-minute sessions to all public school classes in the District of Columbia. The first session is a film presentation featuring characters and situations to which the students can relate. The audience is invited to enter a poster contest for the three best illustrations of the health hazards of smoking. The second session concentrates on a biofeedback demonstration of the immediate effects of smoking one cigarette. The third session involves the issue of cigarette advertising and culminates in the awarding of prizes for the poster contest. AMERICAN LUNG ASSOCIATION OF THE DISTRICT OF COLUMBIA, 475 H Street, N.W., Washington, District of Columbia 20001. 0221. Program Title: No Smoking During And After Pregnancy: Advocacy On Behalf Of The Unborn. Contact: Ms. Veronica Brown, Coordinator, Child/Youth Programs (202)682-5864. Description: A two-tiered approach for motivating pregnant women not to smoke during and after pregnancy has been developed by health care providers. Innovative techniques are used with prenatal counseling of program participants to motivate the smokers among them to quit and remain nonsmokers and nonsmokers to become advocates of the nonsmoking lifestyle on behalf of the unborn, newborn, and growing child. 0222. AMERICAN LUNG ASSOCIATION OF THE DISTRICT OF COLUMBIA, 475 H Street, N.W., Washington, District of Columbia 20001. Program Title: Nonsmokers’ Rights. Contact: Coordinator, Smoking or Health Programs (202)682-5864. Description: This program has been set up to promote smoke-free indoor environments by raising the awareness of people who live and work in the District of Columbia as to the many benefits of smoke-free work and home environments. The program also attempts to develop grassroots support for legislation to restrict smoking in the workplace and works with businesses that are interested in setting up nonsmoking policies. FLORIDA 0223. AMERICAN CANCER SOCIETY, FLORIDA DIVISION, INC., 1001 South MacDill Avenue, Tampa, Florida 33629. Program Title: FreshStart And Education. Contact Person: Ms. Vicki Pleasant, Director of Public Education (813)253-0541. Description: Health and science education programs are presented to students in grades kindergarten through 12. Programs em- phasize the hazards of smoking and personal health informa- tion and decisions. The American Cancer Society's FreshStart program is offered throughout the State. For more information, see the detailed program description in Part 1. 0224. AMERICAN HEART ASSOCIATION, FLORIDA AFFILIATE, 1213 16th Street North, Post Office Box 33035, St. Petersburg, Florida 33705-8035. Program Title: Smoking Education Programs. Contact: Ms. Mary A. Nowakowski, Program Vice President (813)894-7400. Description: This office includes smoking cessation and education programs in some of its worksite programs. Smoking, as a risk factor, is also discussed in program efforts directed at target populations in the community and in schools. These efforts include a combination of prevention and behavioral change activities and educational messages. The organization is also involved in the Smoke-Free Class of 2000 project that focuses on children who will graduate from high school in the year 2000. Educational materials are being designed for these children and their parents. AMERICAN LUNG ASSOCIATION OF BROWARD-GLADES-HENDRY, INC., 2020 South Andrews Avenue, Fort Lauderdale, Florida 33316. 0225. Program Title: Freedom From Smoking. Contact: Mr. David R. Just, Program Director (305)524-4657. Description: Both the Freedom From Smoking clinics and self-help ap- proaches developed by the American Lung Association are offered. For more information, see the detailed program descriptions in Part 1. 210 0226. AMERICAN LUNG ASSOCIATION OF - BROWARD-GLADES-HENDRY, INC., 2020 South Andrews Avenue, Fort Lauderdale, Florida 33316. Program Title: Smoking And Pregnancy. Contact: Mr. David R. Just: Program Director (305)524-4657. Description: Material designed and provided by the American Lung As- sociation, in addition to some information collected by the local chapter, is sent to area health care professionals. For more information, see the detailed program description in Part 1. 0227. AMERICAN LUNG ASSOCIATION OF BROWARD-GLADES-HENDRY, INC., 2020 South Andrews Avenue, Fort Lauderdale, Florida 33316. Program Title: Smoking Deserves A Smart Answer. Contact: Mr. David R. Just, Program Director (305)524-4657, Description: This smoking prevention program is designed for students in grades 5 and 6. For more information, see the detailed pro- - gram description in Part 1. 0228. AMERICAN LUNG ASSOCIATION OF BROWARD-GLADES-HENDRY, INC., 2020 South Andrews Avenue, Fort Lauderdale, Florida 33316. Program Title: . Students Teach Students. Contact: Mr. David R. Just, Program Director (305)524-4657. Description: High school students serve as counselors and role models to elementary students. This program can be incorporated into - the Smoking Deserves A Smart Answer program on the third . day of the 5-day curriculum and is offered free of charge. For more information, see the detailed program description in - Part 1. AMERICAN LUNG ASSOCIATION OF DADE- MONROE, INC., 830 Brickell Plaza, Miami, Florida ~ 33131. 0229. Program Title: | Love My Lungs. Contact: Douglas Barnicle, M.S., Program Director (305)377-1771. Description: The program for grades kindergarten through 9 focuses on tobacco smoking and its effects on the respiratory system. Lung exhibits, videos, and a smoking doll are accompanied by asong of vibrant respiratory health, | Love My Lungs. Over 10,000 elementary and junior high students were visited last year. One of the program goals is to encourage teachers to incorporate the educational content in the curriculum. 0230. AMERICAN LUNG ASSOCIATION OF FLORIDA, NORTHEAST BRANCH, Post Office Box 8127, Jacksonville, Florida 32239. Program Title: Freedom From Smoking Clinics. Contact: Ms. Ernestine Curry, Program Associate (904)743-2933. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0231. AMERICAN LUNG ASSOCIATION OF FLORIDA, NORTHEAST BRANCH, Post Office Box 8127, Jacksonville, Florida 32239. Program Title: Marijuana: A Second Look. Contact: Ms. Ernestine Curry, Program Associate (904)743-2933. Description: The American Lung Association’s Marijuana: A Second Look is offered. For more information, see the detailed program description in Part 1. 0232. AMERICAN LUNG ASSOCIATION OF SOUTHEAST FLORIDA, INC., 2701 North Australian Avenue, West Palm Beach, Florida 33407. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Denee J. Martin, Managing Director (305)659-7644. Description: The American Lung Association's Freedom From Smoking 211 self-help manuals are available. For more information, see the detailed program description in Part 1. 0233. AMERICAN LUNG ASSOCIATION OF SOUTHEAST FLORIDA, INC., 2701 North Australian Avenue, West Palm Beach, Florida 33407. Program Title: In Control. Contact: Ms. Denee J. Martin, Program Administrator (305)659-7644. Description: The American Lung Association's In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF SOUTHEAST FLORIDA, INC., 2701 North Australian Avenue, West Palm Beach, Florida 33407. 0234. Program Title: Smoke-Free America Billboard Contest. Contact: Ms. Denee J. Martin, Program Administrator (305)659-7644. Description: This program was designed to educate students and the general public on the deleterious health effects of smoking. For more information, see the detailed program description in Part 1. 0235. AMERICAN LUNG ASSOCIATION OF SOUTHEAST FLORIDA, INC., 2701 North Australian Avenue, West Palm Beach, Florida 33407. Program Title: Students Teach Students. Contact: Ms. Kathy Andio, Program Administrator (305)659-7644. Description: High school students serve as counselors and role models for students in grade 5. For more information, see the detailed program description in Part 1. 0236. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST FLORIDA, 1436 Royal Palm Square Boulevard, Fort Myers, Florida 33919-1049. Program Title: Freedom From Smoking Clinics. Contact: Ms. Stephanie Welch, Director of Program Development (813)275-7577. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0237. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST FLORIDA, 1436 Royal Palm Square Boulevard, Fort Myers, Florida 33919-1049. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Stephanie Welch, Director of Program Development (813)275-7577. Description: The American Lung Association's Freedom From Smoking self-help manuals for pregnant women are available. Optional items include: I'm a Smoke-free Baby infant T-shirt, exer- cise/relaxation tape, Because | Love My Baby pamphlets and poster, No Smoking — I'm Breathing for Two pin, and No Smoking — Baby Breathing sign. For more information, see the detailed program descriptions in Part 1. 0238. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST FLORIDA, 1436 Royal Palm Square Boulevard, Fort Myers, Florida 33907. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Stephanie Welch, Director of Program Development (813)275-7577. Description: The American Lung Association’s Freedom From Smoking self-help manuals are available. For more information, see the detailed program description in Part 1. 0239. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST FLORIDA, 1436 Roya! Palm Square Boulevard, Fort Myers, Florida 33907. Program Title: In Control. Contact: Ms. Stephanie Weich, Director of Program Development (813)275-7577. Description: The American Lung Association's In Control videocassette program is offered. For more information, see the detailed program description in Part 1. 0240. BAPTIST HOSPITAL, 1000 West Moreno Street, Post Office Box 17500, Pensacola, Florida 32522. Program Title: Smoke Stoppers. Contact: Raymond Rappa, R.N., M.S., Health Education Specialist (904)434-4747. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase I! provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and maintenance system. 0241. BOCA RATON COMMUNITY HOSPITAL, INC., 900 Meadows Road, Boca Raton, Fiorida 33432. Program Title: Smokeless. Contact: Ms. Sally Sweigart, Health Education Coordinator (305)393-4063. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0242. BREVARD COUNTY INTERAGENCY ON SMOK- ING AND HEALTH, 1274 South Florida Avenue, Rockledge, Florida 32955. Program Title: Community Smoking Cessation. Contact: Mr. Jim Richardson, Health Educator (305)727-1480. Description: This program is conducted six times a year, twice in each distinct population area of the county. The program consists of a 2-hour session each night for 5 consecutive nights. Program content includes the effects of smoking on the body, the physical and psychological benefits of quitting, awareness of the smoker's habit, behavior modification to combat the smoking habit, and methods to curb relapse. 0243. BREVARD COUNTY PUBLIC HEALTH UNIT, 1744 Cedar Street, Rockledge, Florida 32955. Program Title: Patient Counseling And Smoking Cessation. Contact: Mr. Jim Richardson, Health Educator (305)727-1480. Description: This program consists of individual or small group counseling on smoking cessation. The target group is the maternity and family planning patients of the County Public Health Unit. Counseling is done on a volunteer basis during clinic hours. Materials from voluntary health agencies and idea sheets are used to guide the patient toward a quit day and to develop both short- and long-term coping strategies. 0244. BROWARD COUNTY PUBLIC HEALTH UNIT, DISTRICT 10, 2421 Southwest 6th Avenue, Fort Lauderdale, Florida 33315. Program Title: Maternal Health Clinics. Contact: Ms. Ellen G. Feiler, Health Education Director (305)467-4807. Description: As part of a prenatal class presented to all maternity clients, the danger of smoking during pregnancy is discussed. 0245. BROWARD COUNTY PUBLIC HEALTH UNIT, DISTRICT 10, 2421 Southwest 6th Avenue, Fort Lauderdale, Florida 33315. Program Title: U-Turn To Health. Contact: Ms. Ellen G. Feiler, Health Education Director (305)467-4807. Description: One segment of a health promotion program offered quarterly to Health Department employees is devoted to smoking. The session illustrates the health hazards of smoking and offers both motivation to never start and tips for quitting. Referral to community smoking cessation programs is also provided. DADE COUNTY DEPARTMENT OF PUBLIC HEALTH, DISTRICT 11, 1350 Northwest 14th Street, Miami, Florida 33125. 0246. Program Title: Freedom From Smoking. Contact: Mr. William Glenn, Program Coordinator (305)623-3520. Description: The American Lung Association's Freedom From Smoking curriculum is implemented in a community setting. For more information, see the detailed program description in Part 1. 213 DADE COUNTY DEPARTMENT OF PUBLIC HEALTH, DISTRICT 11, 1350 Northwest 14th Street, Miami, Florida 33125. 0247. Program Title: Lifestyle And Pregnancy. Contact: Ms. Sandra G. Schaps, Health Educator (305)623-3520. Description: This program emphasizes the danger of smoking during preg- nancy to prenatal patients of the Department of Public Health. This health concern is addressed in the lifestyle session of the prenatal curriculum. In addition, poster messages with a strong statement on smoking and pregnancy are displayed throughout the six satellite clinics. DADE COUNTY DEPARTMENT OF PUBLIC HEALTH, DISTRICT 11, 1350 Northwest 14th Street, Miami, Florida 33125. 0248. Program Title: Stop Smoking. Contact: Ms. Lori Jordahl, Training Specialist (305)623-3520. Description: This five-session program is offered to health department employees as requested. The program uses a special monitor to measure expired air carbon monoxide levels in participants taking part in the program. Carbon monoxide levels are tested daily, and the information is used as feedback to the par- ticipant, testifying to body detoxification as a result of quitting smoking. In addition, smokers look at the reasons they smoke and develop behavioral approaches to combat these reasons. 0249. DUVAL COUNTY PUBLIC HEALTH UNIT, 515 West Sth Street, Jacksonville, Florida 32206. Program Title: Community Education. Contact: Ms. Delores M. Unsicker, Director, Health Education Description: The Public Health Unit implements a primary care program based on individual case management. Each patient, who is a smoker, is counseled on health risks and offered smoking cessation information. Other activities include participation in the American Cancer Society’s Great American Smokeout, public service announcements, presentations to schools, and employee Wellness Fairs. DUVAL COUNTY PUBLIC HEALTH UNIT, 515 0250. West 6th Street, Jacksonville, Florida 32206. Program Title: FreshStart. Contact: Ms. Delores M. Unsicker, Director, Health Education Description: The program is conducted by the health education staff quarterly. For more information, see the detailed program description in Part 1. ESCAMBIA COUNTY HEALTH DEPARTMENT, Post Office Box 12604, 2251 North Baylen Street, Pensacola, Florida 32501. 0251. Program Title: The Smoking Sam/Sametha Program. Contact: Mr. Ferd Chappa, Health Educator (904)435-6574. Description: Hour-long presentations are made to area schools as re- quested. As many as 300 presentations are made during a school year. Using a mannequin of a man and a woman, the effects of smoking on the heart, lungs, and brain are shown. The objective is to teach children at an early age the harmful effects of smoking. 0252. ESCAMBIA COUNTY HEALTH DEPARTMENT, Post Office Box 12604, 2251 North Baylen Street, Pensacola, Florida 32501. Program Title: Freedom From Smoking Clinics. Contact: Mr. Ferd Chappa and Ms. Kelly Shaw, Health Educators (904)435-6574. Description: This American Lung Association program is offered to the community four times a year. For more information, see the detailed program description in Part 1. 0253. FLORIDA DENTAL ASSOCIATION, 3021 Swann Avenue, Tampa, Florida 33609. Program Title: Oral Cancer Education Program. Contact: Mr. Robert M. MacDonald, Assistant Executive Director for Information Services (813)877-7597. Description: One of the predisposing factors in the development of cancer is longstanding chronic irritation, and among the most com- mon irritants are tobacco and tobacco smoke. The Florida Dental Association, in affiliation with the American Dental 214 Association, conveys this message in a booklet designed to reinforce the knowledge that smoking is hazardous to oral health. Also available are dental information packets, includ- ing material that deals with the hazards of smoking. Posters, pamphlets, desk signs, and tent cards are available, all with a no-smoking message. 0254. FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES, 1317 Winewood Boulevard, Tallahassee, Florida 32399-0700. Program Title: Chronic Disease. Contact: Mr. William Mahoney, Chronic Disease Program Supervisor (904)488-2901. Description: Service delivery is handled by each of the 67 county public health units individually. Technical assistance, referral and consultation is provided to the health units by the Chronic Disease Program of the Department of Health. Chronic Dis- ease staff are responsible for program-specific technical as- sistance to county public health units. State-of-the-art information and materials are available. County health unit staff are encouraged to network and cooperate with local Cancer Society and Lung Association affiliates to avoid duplication of programs and encourage cooperative efforts. 0255. FLORIDA HOSPITAL, CORPORATE/COM- MUNITY HEALTH SERVICES, 601 East Rollins Street, Orlando, Florida 32803. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Ms. Susan Sands, Program Coordinator (305)897-1929. Description: The Seventh-Day Adventists’ Breathe-Free Plan To Stop Smoking is offered at community locations and corporate sites. One-on-one counseling is also available. For more information, see the detailed program description in Part 1. 0256. FLORIDA HOSPITAL, CORPORATE/COM- MUNITY HEALTH SERVICES, 601 East Rollins Street, Orlando, Florida 32803. Program Title: Smokeless. Contact: Ms. Susan Sands, Program Coordinator (305)897-1929. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. NAPLES WELLNESS CENTER, NAPLES COM- MUNITY HOSPITAL, INC., Post Office Box 2507, Naples, Florida 33939. 0257. Program Title: Smokeless. Contact: Mr. Henry Trollinger, Assistant Director (813)263-8817. Description: The Smokeless system, developed by the American institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0258. NICOTINE WITHDRAWAL CLINIC, 2999 Hartley Road, Suite 201, Jacksonville, Florida 32217. Program Title: Stop Smoking. Contact: Ms. M. Eileen Wiggins, President (904)262-3585. Description: This comprehensive medical treatment administered by a licensed physician for the cessation of smoking, addresses both the physiological effects and the psychological aspects of smoking. The process involves the administration of medication to eliminate the unpleasant withdrawal symptoms. The patients receive instructions on diet, stress management, and cognitive behavior modification to counteract the smoking habit. A trained staff monitor the patients’ progress and suc- cess periodically, for up to 1 year. NICOTINE WITHDRAWAL CLINIC, 4700 North Habana, Sulte 500, Tampa, Florida 33614. Program Title: Walk Away From Smoking Once And For All. 0259. Contact: Ms. M. Eileen Wiggins, President (813)875-6114. Description: The Nicotine Withdrawal Clinic offers a comprehensive medi- cal treatment administered by a licensed physician for the cessation of smoking. The treatment addresses both the physiological effects and the psychological aspects of smok- ing and involves the administration of medication to eliminate 215 or greatly decrease the unpleasant withdrawal symptoms normally associated with nicotine addiction. The patients also receive instructions on diet, stress management, and cogni- tive behavior modification to counteract the smoking habit. 0260. ORANGE COUNTY HEALTH DEPARTMENT, 832 West Central Boulevard, Post Office Box 3187, Orlando, Florida 32802-3187. Program Title: Lite Skill Management. Contact: Mr. Bill L. Toth, Senior Human Services Program Analyst (305)244-2620. Description: Health Department educators are routinely asked to address the Life Skill Management Classes taught to students in grade 9 in local schools. During these hour-long sessions, smoking is discussed in context with the leading causes of death in the United States. The objective is to reduce the tendency to give in to peer pressure to smoke. 0261. PASCO COUNTY HEALTH DEPARTMENT, 7511 Little Road, New Port Richey, Florida 34654. Program Title: Stop Smoking. Contact: : Bonnie B. Sitko, M.P.H., Health Education Director (813)847-0035. Description: - This program combines techniques used in the American Lung Association’s Freedom From Smoking program and the American Cancer Society’s FreshStart program. The six-ses- sion program covers why people smoke, the physical aspects of smoking, cessation, the physical and emotional reaction to cessation, and the body’s natural state of health. These clas- ses are offered to employees and patients, free of charge, but are not yet available to the general public. 0262. ST. MARY'S HOSPITAL, INC., 901 45th Street, West Palm Beach, Florida 33407. Program Title: Smokeless. Contact: Ms. Sally D. Chester, Program Coordinator (305)844-6300. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. GEORGIA AMERICAN CANCER SOCIETY, GEORGIA DIVISION, INC., 1422 West Peachtree Street, N.W., Atlanta, Georgla 30309. 0263. Program Title: FreshStart. Contact: Ms, Jeanne Y. Byrd, Director, Public Education (404)892-0026. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0264. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Marie Bautista-Foley, Health Educator (404)872-9653. Description: The American Lung Association’s Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgla 30365. 0265. Program Title: Carbon Monoxide Screening. Contact: Ms. Marie Bautista-Foley, Health Educator (404)872-9653. Description: Using an ecolyzer, individuals are screened for carbon monoxide. Participants are given their reading and a chart explaining the health effects resulting trom that level of carbon monoxide. The screening is performed in conjunction with an educational display that promotes nonsmoking. The primary sites for screening are health fairs and corporations. The program is available on request. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. 0266. 216 Program Title: Freedom From Smoking Clinics. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0267. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Pledmont Avenue, N.E., Atlanta, Georgla 30365. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: The American Lung Association’s Freedom From Smoking For You And Your Baby program is offered. For more information, see the detailed program description in Part 1. 0268. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgla 30365. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: As a new component to the American Lung Association's Smoke-Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 0269. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: Freedom From Smoking In 20 Days. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: This American Lung Association's Freedom From Smoking self-help cessation manual is offered. For more information, see the detailed program description in Part 1. 0270. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: In Control. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: The American Lung Association’s in Control videocassette smoking cessation program is offered. For more information, see the detailed program description in Part 1. 0271. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: Self-Help Plus. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: This 4-week, four-session smoking cessation clinic is based on the self-help concept. For more information, see the detailed program description in Part 1. 0272. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Piedmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: Smoking And Pregnancy. Contact: Ms. Sandra W. Colt, Program Director (404)872-9653. Description: The American Lung Association’s Smoking and Pregnancy program is offered. Training workshops for health care providers on counseling pregnant smokers are available on request. For more information, see the detailed program description in Part 1. 0273. AMERICAN LUNG ASSOCIATION OF ATLANTA, INC., 723 Pledmont Avenue, N.E., Atlanta, Georgia 30365. Program Title: Speakers’ Bureau On Smoking And Health. 217 Contact: Ms. Marie Bautista-Foley, Health Educator (404)872-9653. Description: Pulmonary physicians, respiratory therapists, and health educators are available for presentations on smoking and health. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgia 30080. 0274. Program Title: Freedom From Smoking At Work. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgla 30080. 0275. Program Title: Freedom From Smoking Groups. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description. Two group cessation programs are offered: Freedom From Smoking clinic, a seven-session program, and In Control Plus, anine-session program utilizing the In Control videocassette. For more information, see the detailed program descriptions in Part 1. 0276. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgla 30080. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The following American Lung Association programs and materials are available: Freedom From Smoking In 20 Days, A Lifetine Of Freedom From Smoking, Freedom From Smoking For You And Your Family, Freedom From Smoking For You And Your Baby, and the In Control videotape. For more information, see the detailed program descriptions in Par 1. 0277. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgia 30080. Program Title: Lungs Are For Life. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The American Lung Association’s Lungs Are For Life program is offered. For more information, see the detailed program description in Part 1. 0278. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgia 30080. Program Title: Marijuana: A Second Look. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The American Lung Association's Marijuana: A Second Look program is offered. For more information, see the detailed program description in Part 1. 0279. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgla 30080. Program Title: Octopuff In Kumquat. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The American Lung Association's health education program, Octopuff In Kumquat, is offered. For more information, see the detailed program description in Part 1. 0280. AMERICAN LUNG ASSOCIATION OF GEORGIA, 2452 Spring Road, Smyrna, Georgla 30080. Program Title: Smoking And Pregnancy. Contact: Ms. Jeanne Nelson, Program Executive (404)434-5864. Description: The American Lung Association’s Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 218 0281. DEKALB COUNTY BOARD OF HEALTH, Central Health Center, 440 Winn Way, Post Office Box 987, Decatur, Georgia 30031. Program Title: Smoking And Pregnancy. Contact: Laitan Ogundare, M.P.H., Health Educator (404)766-3743. Description: The American Lung Association's Smoking and Pregnancy program is offered. Fér more information, see the detailed program description in Part 1. 0282. DOUGHERTY COUNTY HEALTH DEPARTMENT, 2031 Newton Road, Post Office Box 3048, Albany, Georgia 31708-4201. Program Title: Smoking And Pregnancy. Contact: Ms. Cheryl A. Henley, Program Coordinator (912)439-4153. Description: The American Lung Association's Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 0283. FULTON COUNTY HEALTH DEPARTMENT, 99 Butler Street, S.E., Atlanta, Georgia 30303. Program Title: Smoking Cessation. Contact: Ms. Bery! Davis, Coordinator of Health Education (404)572-2406. Description: The Fulton County smoking cessation program provides clas- ses and self-help options to Fulton County employees. The American Lung Association's Freedom From Smoking clinic is offered; the self-help options include In Control and Freedom From Smoking In 20 Days. For more information, see the detailed program descriptions in Part 1. GEORGIA DEPARTMENT OF HUMAN RESOUR- CES, DIVISION OF PUBLIC HEALTH, 878 Peachtree Street, N.E., Atlanta, Georgia 30309. 0284. Program Title: FreshStart. Contact: Ms. Peggy Lee, Adult Health Coordinator (912)264-3961 ext.303. Contact: Ms. Peggy Lee, Adult Health Coordinator (912)264-3961 ext.303. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to clients in health department programs, to the general public in six counties, and to heatth unit staff. For more information, see the detailed program description in Part 1. NICOTINE WITHDRAWAL CLINIC OF COASTAL GEORGIA, 2410 Parkwood Drive, Brunswick, Georgla 31520. 0285. Program Title: Nicotine Withdrawal. Contact: Ms. Pat Medlin, Program Coordinator (912)262-0068. Description: This program includes a medically administered treatment that can decrease the body’s craving for nicotine, thereby lessen- ing the severity of withdrawal symptoms. The program con- fronts both the physiological and psychological problems that arise when a person stops smoking. Treatment consists of a counseling session dealing with behavior modification, stress management, and diet followed by a brief medical history. An injection of vitamins and minerals begins the withdrawal process, followed by supplemental oral medications for 15 days. There is a lifetime service warranty to ensure that each patient reaches the goal of becoming a nonsmoker. 0286. SOUTHEAST HEALTH UNIT, GEORGIA DEPARTMENT OF HUMAN RESOURCES, 1101 Church Street, Waycross, Georgia 31501. Program Title: Prenatal And Family Planning. Contact: Ms. Bunchy McClelland, Health Educator (912)285-6026. Description: The prenatal program of five 30-minute sessions is available in the southeast area. The risks of smoking and cessation techniques are discussed. Materials used include: 1) American Lung Association videocassette Because You Love Your Baby; 2) March of Dimes handouts Be Good To Your Baby Before It’s Born, Mom Kits, and Smoking And The Two Of You; and 3) U.S. Department of Health and Human Ser- vices booklet Pregnant, That’s Two Good Reasons To Quit. The family planning program patients are advised of the risks of smoking when taking birth control pills. 0287. WAYNE COUNTY HEALTH DEPARTMENT, Post Office Box A, Jesup, Georgla 31545. 219 Program Title: FreshStart. Contact: Mr. Gene Clary, Program Coordinator (912)427-2042. Description: The American Cancer Society's FreshStart program is offered to the public on request. For more information, see the detailed program description in Part 1. 0288. WILDWOOD LIFESTYLE CENTER AND HOSPITAL, Coosa Valley Health District, Wildwood, Georgia 30757. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Charles H. Cleveland, M.P.H., Smoking Cessation Coor- dinator (404)820-1474. Description: Two Seventh-Day Adventists’ programs are offered. The first is a 7-day evening program usually conducted for the Chat- tanooga community in a public building. The second is a live- in stop-smoking program at the lifestyle center. Live-in programs of 7 and 24 days feature lectures, complete physi- cals, and a special nonstimulating diet. For more information, see the detailed program description in Part 1. 0289. WOMEN'S WELLNESS CENTER, DEKALB GENERAL HOSPITAL, 2701 North Decatur Road, Decatur, Georgia 30033. Program Title: t Quit. Contact: Gail Winston, R.N., Coordinator, Lifestyle and Health Educa- tion (404)297-2222. Description: | Quit is a 6-week tapering off program. Participants change brands, establish a stop date within the 7-week time frame, and taper at their own speed to achieve success. This program emphasizes positive cognitions, exercise, relaxation, and guided imagery; videotapes, lectures, and handouts supple- ment the group support atmosphere. To reinforce behavior change and to help avoid relapse, a support group is held on a monthly basis. This program is offered to the community and is available to business and industry. 0290. WOMEN’S WELLNESS CENTER, DEKALB GENERAL HOSPITAL, 2701 North Decatur Road, Decatur, Georgla 30033. Program Title: Quitters. Contact: Gail Winston, R.N., Coordinator, Lifestyle and Health Education (404)297-2222, Description: Quitters is an informal support group to reinforce positive behavior change and self-concept to support smoking cessa- tion and avoid relapse. Two-hour meetings are held once a month, year round. Primarily a discussion group, the leader will use written and audiovisual materials to supplement the group-chosen topic for the month. Open to participants of | Quit and the community at large, Quitters can also be presented to business and industry. GUAM 0291. GUAM DEPARTMENT OF PUBLIC HEALTH AND SOCIAL SERVICES, OFFICE OF HEALTH EDUCATION, Post Office Box 2816, Agana, Guam 96910. Program Title: Health Education Risk Reduction. Contact: Mr. David B. Rosario, Health Education Administrator and Frances Limtiaco-Standi Soldier, M.P.H., Health Educator (734)2931-6 ext.208. Description: The Health Education Risk Reduction (HERR) program is designed to reduce risk factors including cigarette smoking, alcohol, and drug use, poor dietary habits, sedentary lifestyle, and stress. A 4-hour workshop is offered on request to all worksites, organizations, schools, and the general public. The workshop emphasizes identifying health risk factors, im- proving lifestyles, and gaining motivation to change unhealthy behaviors. Two health risk assessment surveys have been conducted under the HERR program. One study determined the prevalence of six major behavioral risk factors, including smoking and tobacco use, among the working adult popula- tion; the other examined health-related behavior of middle school students. The assessment is being used to plan health pramotion programs for the schools and community. 0292. GUAM DEPARTMENT OF PUBLIC HEALTH AND SOCIAL SERVICES, OFFICE OF HEALTH EDUCATION, Post Office Box 2816, Agana, Guam 96910. Program Title: Smoking Cessation And Education Programs. Contact: Mr. David B. Rosario, Health Education Administrator and Frances Limtiaco-Standi Soldier, M.P.H., Health Educator (734)2931-6 ext.208. Description: The Office of Health Education works cooperatively with other governmental agencies and nonprofit organizations such as the American Cancer Society, Guam Unit, in the marketing and implementation of its Growing Healthy school program and other smoking cessation and prevention efforts. The office also provides referral services to private and public organizations and clinics offering smoking cessation clinics. In 1986, several members of Guam’s community, under the leadership of the Office of Health Education, began drafting specific objectives and recommendations pertaining to preventive health services, health protection, and health promotion. Strategies to reduce tobacco use involve smoking cessation programs, education campaigns to increase public awareness, education for young people to persuade them not to start smoking, physician counseling, employer and worksite involvement, and legislation. HAWAII 0293. AMERICAN CANCER SOCIETY, HAWAII PACIFIC DIVISION, INC., Community Services Center Building, 200 North Vineyard Boulevard, Honolulu, Hawaii 96817. Program Title: FreshStart. Contact: Mrs. Dotty Morgan, Public Education Director (808)531-1662. Description: . The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0294. AMERICAN LUNG ASSOCIATION OF HAWAII, 245 North Kukui Street, Honolulu, Hawaii 96817. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Julie Young, Director of Health Education (808)537-5966. Description: The American Lung Association's Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. 0295. AMERICAN LUNG ASSOCIATION OF HAWAIl, 245 North Kukul Street, Honolulu, Hawali 96817. Program Titie: Don’t Let Your Lungs Go To Pot. Contact: Ms. Julie Young, Director of Health Education (808)537-5966. Description: This program is geared for students in grades 4 to 12. It con- sists of a discussion of the similarities and differences in the effects of tobacco and marijuana on the growing body, utiliz- ing posters, real lung specimens, and printed handouts. Films are made available as part of this program. This curriculum is offered in a slightly modified form for adult groups. Programs are available Statewide. 0296. AMERICAN LUNG ASSOCIATION OF HAWAII, 245 North Kukul Street, Honolulu, Hawall 96817. Program Title: Freedom From Smoking Clinics. Contact: Ms. Julie Young, Director of Health Education (808)537-5966. Description: The American Lung Association's Freedom From Smoking clinics are offered. A minimal fee is charged to all participants in order to cover material costs and instructors’ salaries. Programs are offered Statewide. For more information, see the detailed program description in Part 1. HAWAI HEART ASSOCIATION, 245 North Kukul Street, Honolulu, Hawali 96817. 0297. Program Title: Don't Start Smoking Contest. Contact: Ms. Barbara Bianchi, Communications and Training Director (808)538-7021. Description: This contest for children in grades 1 through 6 was cospon- sored by the Hawaii Heart Association, the American Lung Association of Hawaii, the American Cancer Society, and KHNL TV-13. Communications directors for the three health agencies worked with KHNL staff to develop a contest in which children, using cartoon characters featured in KHNL 221 programming, created a four-frame storyboard on the theme Don’t Start Smoking. Thirty-five winners were selected from each grade, with three top winners from each grade, and one Statewide winner. Prizes were toys, contributed by a toy com- pany. The Statewide winner was featured in a 30-second public service announcement, produced by KHNL, explaining her winning entry. The promotion was conducted during April and May with the winner announced at Ala Moana Centerstage in August to create a back-to-school connection for the information release. The groups involved plan to conduct the contest again in the next fiscal year. 0298. HAWAII STATE DEPARTMENT OF HEALTH, Post Office Box 3378, Honolulu, Hawali 96801. Program Title: Patient Education On Hazards Of Smoking. Contact: Ms. Jackie Berry, Acting Planner and Coordinator, Office of Family Planning (808)735-3558. Description: This program, designed for teen and adult women receiving services in State funded or operated family planning and maternal and infant care clinics, provides group health educa- tion on the hazards of smoking while using birth control pilis or while pregnant. Individual counseling is also provided. 0299. HAWAIISTATE DEPARTMENT OF HEALTH, Post Office Box 3378, Honolulu, Hawali 96801. Program Title: Risk Reduction Project. Contact: Ms. Nicola Miller, Coordinator, Risk Reduction Project (808)732-2291. Description: The Risk Reduction Project plans small scale, special initia- tives on lifestyle risk factors including smoking. In 1987, the Risk Reduction Project developed the Smoking in Worksite Conference. The Risk Reduction Project supports the Chronic Disease Branch by advocating and implementing any new smoking laws. The project's Health Risk Appraisal Program includes smoking as a risk factor and refers smoking participants to cessation services. 0300. HAWAII STATE DEPARTMENT OF HEALTH, Post Office Box 3378, Honolulu, Hawail 96801. Program Title: Smoking Information Resource Services. Contact: Christine Ling, M.P.H., Chief, Health Promotion and Education (808)548-5886. Description: Films, pamphlets, professional literature, consultation ser- vices, and referrals are provided to the community on the hazards of tobacco smoking and passive smoking. 0301. HAWAII STATE DEPARTMENT OF HEALTH, Post Office Box 3378, Honoluiu, Hawall 96801. Program Title: Telephone Survey. Contact: Mr. Eric Tash, Coordinator (808)548-6246. Description: The telephone survey collects and disseminates data about smoking in the State of Hawaii. 0302. HAWAII STATE DEPARTMENT OF HEALTH, Post Office Box 3378, Honolulu, Hawali 96801. Program Title: Tobacco Task Force Of Governor's Conference. Contact: Mr. Julian Lipsher, Project Director, Governor's Conference (808)735-8581. Description: The Task Force develops strategies to achieve the Governor's Conference objectives related to smoking and health adopted in 1985. IDAHO 0303. AMERICAN CANCER SOCIETY, IDAHO DIVISION, INC., 1609 Abbs Street, Post Office Box 5386, Bolse, idaho 83705-0386. Program Title: FreshStart. Contact: Ms. Shelli P. Clemens, Program Director (208)343-4609. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0304. AMERICAN HEART ASSOCIATION OF IDAHO, Alrport Plaza Office, 3295 Elder Street, Suite 140, Boise, idaho 83705. Program Title: Heart At Work. Contact: Mr. Don Bich, Executive Director (208)384-5066. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION OF IDAHO, Alrport Plaza Office, 3295 Elder Street, Suite 140, Boise, Idaho 83705. 0305. 222 Program Title: Heart Health Education Of The Young. Contact: Mr. Don Bich, Executive Director (208)384-5066. Description: The American Heart Association's Heart Health Education Of The Young program is offered. For more information, see the detailed program description in Part 1. 0306. DISTRICT SEVEN HEALTH DEPARTMENT, Post Office Box 1855, 254 E Street, Idaho Falls, Idaho 83403. Program Title: Chewing 'N Dipping: The Price Of A Pinch. Contact: Ms. Elyse Baird, Program Coordinator (208)522-0310 ext.156. Description: A 50-minute classroom program is available upon request from individual schools for health classes, grades ~ ‘o 12. The students are introduced to: 1) the positive a negative aspects of chewing tobacco; 2) a brief history of its use; 3) the health consequences of its use; 4) marketing strategies of the tobacco industry; and 5) techniques for dealing with peer pres- sure. A videotape introduces spokesmen from the American tobacco industry and health officials. Students are en- couraged to make responsible decisions to use or not use smokeless tobacco products. Students also complete an anonymous survey on tobacco use. DISTRICT SEVEN HEALTH DEPARTMENT, Post Office Box 1855, 254 E Street, Idaho Falls, idaho 83403. 0307. Program Title: Choose Health. Contact: Ms. Karen McGahan, Program Coordinator (208)522-0310. Description: Worksite risk-reduction classes, once designed to teach only cardiac risk-factor awareness, have been modified to include cancer-awareness content. Smoking is used as a catalyst to lead a discussion of cardiac risks into cancer risks and high- light the message that smoking is one of the few risk factors that qualifies as a major consideration in both diseases. Handouts from all major smoking cessation organizations are utilized. This program is supported by the Idaho Cancer Coordinating Committee. 0308. DISTRICT SEVEN HEALTH DEPARTMENT, Post Office Box 1855, 254 E Street, Idaho Falls, Idaho 83403. Program Title: Tobacco Awareness Program. Contact: Jane McLaughlin, R.N., Program Coordinator (208)522-0310. Description: The Tobacco Awareness Program has been implemented to reduce tobacco use in the schools. Minors cited by school authorities for use of tobacco are referred by the court system to the health department where they are scheduled to attend a 3-hour class at their own expense ($25). The monthly classes include information on the consequences of tobacco use and screening for oral cancer. The objectives of the program are to inform students of the major risks of tobacco use, to give an oral screening by a dental hygienist, and to enable the students to make effective decisions. Videos, film strips, physiological testing machines, and role modeling are used DISTRICT SEVEN HEALTH DEPARTMENT, Jef- ferson County Courthouse, School District Num- ber 251, Rigby, Idaho 83442. 0309. Program Title: School Tobacco Education Program. Contact: Ms. Maryn Graham, Program Coordinator (202)745-7297. Description: Instruction in the dangers of tobacco use is provided for stu- dents in grades 6, 8, and high school by: 1) teachers using films and printed materials; 2) upper-class peer groups teach- ing students in grade 6; 3) public health nurses offering 223 physiologic screenings (blood pressure, pulse, fine motor movement, carbon monoxide levels); and 4) adult subjects demonstrating before and after smoking physiologic measure- ments. The program is funded by the Idaho Cancer Coordinating Committee. 0310. IDAHO DEPARTMENT OF HEALTH AND WEL- FARE, DIVISION OF HEALTH, Statehouse, Bolse, Idaho 83720-9990. Program Tit!e: School Tobacco Education Program. Contact: Ms. Joanne Mitten, Health Education Specialist (208)334-5933. Description: The School Tobacco Education Program is a set of curriculum activities related to the prevention of tobacco use implemented at the grade-6 level in Idaho schools. Activities focus on the prevention of smoking as well as the use of smokeless tobac- co. The program emphasizes skills related to positive self- esteem and uses biofeedback equipment in some of the activities. 0311. IDAHOLUNG ASSOCIATION, 2621 Camas Street, Bolse, Idaho 83705. Program Title: Freedom From Smoking Clinics. Contact: Mr. William H. Smith, Executive Director (208)344-6567. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0312. IDAHOLUNG ASSOCIATION, 2621 Camas Street, Boise, Idaho 83705. Program Title: Freedom From Smoking For You And Your Baby. Contact: Mr. William H. Smith, Executive Director (208)344-6567. Description: The American Lung Association's Freedom From Smoking For You And Your Baby program is offered. For more information, see the detailed program description in Part 1. 0313. IDAHOLUNG ASSOCIATION, 2621 Camas Street, Bolse, idaho 83705. Program Title: Freedom From Smoking In 20 Days. Contact: Mr. William H. Smith, Executive Director (208)344-6567. Description: The American Lung Association's Freedom From Smoking In 20 Days self-help manual is available. For more information, see the detailed program description in Part 1. 0314. IDAHOLUNG ASSOCIATION, 2621 Camas Street, Boise, idaho 83705. Program Title: In Control. Contact: Mr. William H. Smith, Executive Director (208)344-6567. Description: The American Lung Association’s !n Control program is offered. For more information, see the detailed program description in Part 1. 0315. KOOTENAI MEDICAL CENTER, 2003 Lincoin Way, Coeur d’Alene, Idaho 83814. Program Title: Smokeless. Contact: Ms. Becky Reagan, Program Coordinator (208)667-6441. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. ILLINOIS 0316. ABRAHAMLINCOLN MEMORIAL HOSPITAL, 315 Elghth Street, Lincoln, Iltinols 62656. Program Title: Smoke Stoppers. Contact: Ms. Gayle Lessen, Administrator's Secretary (217)732-2161 ext.426. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase III provides an ongoing support and main- tenance system. The total cost of the program is $140. Hospital employees are reimbursed one-half the cost after 6 months of continuously not smoking and the other half after 1 year of continuously not smoking. AMERICAN CANCER SOCIETY, ILLINOIS DIVISION, INC., 37 South Wabash Avenue, Chicago, Illinois 60603. 0317. Program Title: Antismoking Programs For Youth And Adults. Contact: Ms. Shirley Anderson, Associate Director, Prevention and Early Detection (312)372-0471. Description: Educational programs and support materials regarding the 224 prevention and cessation of tobacco use are provided free of charge. Programs include speakers and films, video, and filmstrips targeted to specific age audiences. The FreshStart four-session smoking cessation programs are also available. For more information, see the detailed program description in Part 1. 0318. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, Illinois 60138. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: The Biofeedback Smoking Education Project sponsored by the American Lung Association is offered to area schools and organizations. For more information, see the detailed program description in Part 1. 0319. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Eilyn, Illinois 60138. Program Title: Community Education and Speakers’ Bureau. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400, Description: Presentations are offered educating the public on the health hazards of smoking and on smoking cessation techniques. These programs are available to interested community, professional, and service organizations. 0320. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, illinois 60138. Program Title: Community Information Requests. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: This program researches, compiles, and distributes informa- tion on subjects related to smoking and health using a clearing-house approach. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, lilinols 60138. 0321. Program Title: Educational School Programs. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: Presentations and group discussions are held on the health hazards of smoking and reasons for cigarette and marijuana smoking in order to prevent and discourage their use. These Programs are for students in kindergarten through grade 8. 0322. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, litinols 60138. Program Title: Health Fairs and Displays. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: American Lung Association pamphlets, posters, buttons, and other materials are displayed and offered free to groups as re- quested for the education of the public on issues related to smoking and health. 225 0323. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, Illinois 60138. Program Title: Hypnosis Clinics. Contact: Ms. Beth M. ‘Barnes, Program Coordinator (312)469-2400. Description: Group hypnosis clinics are conducted by a professionally trained hypnotist to aid in the cessation of smoking. 0324. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Eilyn, illinois 60138. Program Title: Marijuana Education Programs. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: Students, PTA, and other community organizations are intro- duced to newsmagazines and other educational materials trom the American Lung Association’s program, Marijuana: A Second Look. Also, a limited number of parent news- magazines are distributed throughout the community. 0325. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, illinois 60138. Program Title: Freedom From Smoking Clinics. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: The American Lung Association’s Freedom From Smoking clinics are offered. Corpo are encouraged to host an on-site program for employees. For more information, see the detailed program description in Part 1. 0326. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, Itlinols 60138. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: Two self-help programs are offered: 1) Freedom From Smok- ing In 20 Days, a self-help manual based on behavior modification to facilitate smoking cessation; and 2) In Control, a home video program teaching the smoker how to quit by using behavior modification. 0327. AMERICAN LUNG ASSOCIATION OF DU PAGE AND MCHENRY COUNTIES, 526 Crescent Boulevard, Post Office Box 590, Glen Ellyn, iilinols 60138. Program Title: Worksite Employee Assistance For Long Term Health (WEALTH). Contact: Ms. Beth M. Barnes, Program Coordinator (312)469-2400. Description: Worksite Employee Assistance for Long Term Health is a comprehensive worksite smoking policy program for com- panies and corporations in Du Page and McHenry Counties. The program assists in the organization and implementation of smoking cessation programs on-site at interested com- panies. The goal is to promote nonsmoking worksites for the safety and health of the employees. AMERICAN LUNG ASSOCIATION OF MID-EAST- ERNILLINOIS, 110 West Water Street, Post Office Box 437, Pontiac, IllInois 61764. 0328. Program Titie: Educational Programs. Contact: Ms. Carol Winters, Program Director (815)844-3480. Description: A number of American Lung Association programs are avail- able for use in schools including Smoking Deserves A Smart Answer. For more information, see the detailed program description in Part 1. 0329.. AMERICAN LUNG ASSOCIATION OF MID-EAST- ERN ILLINOIS, 110 West Water Street, Post Office Box 437, Pontiac, Illinois 61764. Program Title: Freedom From Smoking At Work. Contact: Ms. Carol Winters, Program Director (815)844-3480. 226 Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0330. AMERICAN LUNG ASSOCIATION OF MID-EAST- ERNILLINOIS, 110 West Water Street, Post Office Box 437, Pontiac, Illinois 61764. Program Title: Freedom From Smoking Clinics. Contact: Ms. Carol Winters, Program Director (815)844-3480. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF MID-EAST- ERN ILLINOIS, 110 West Water Street, Post Office Box 437, Pontlac, Illinois 61764. 0331. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Carol Winters, Program Director (815)844-3480. Description: The American Lung Association’s Freedom From Smoking self-help manuals are available on request. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF MID-EAST- ERNILLINOIS, 110 West Water Street, Post Office Box 437, Pontiac, Iilinols 61764. 0332. Program Title: Smoking And Pregnancy. Contact: Ms. Carol Winters, Program Director (815)844-3480. Description: The American Lung Association’s Smoking And Pregnancy self-help program is available. For more information, see the detailed program description in Part 1. 0333. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, Ilinols 60560. Program Title: Freedom From Smoking Clinics. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The American Lung Association's Freedom From Smoking clinics are offered to the community. Corporations are en- couraged to sponsor the program in the workplace for employees who smoke. For more information, see the detailed program description in Part 1. 0334. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, Hlinols 60560. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The Freedom From Smoking For You And Your Baby, 10-day self-help program, is offered. For more information, see the detailed program desoription in Part 1. 0335. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, iilinols 60560. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The American Lung Association's Freedom From Smoking For You And Your Family program is offered. For more information, see the detailed program description in Part 1. 0336. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, Illinois 60560. Program Title: Freedom From Smoking At Work. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 227 0337. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, Iilinols 60560. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The American Lung Association's Freedom From Smoking self-help manuals are offered. For more information, see the detailed program description in Part 1. 0338. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkville, Illinois 60560. Program Title: In Control. Contact: Ms. Nancy Klossing, Program Director (312)553-7000. Description: The American Lung Association's In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0339. AMERICAN LUNG ASSOCIATION OF NORTH CENTRAL ILLINOIS, 402 Countryside Center, Yorkvlile, lillnols 60560. Program Title: School Health Programs. Contact: Ms. Becky Yingling, Program Associate (312)553-7000. Description: A variety of school health education programs are offered for students using films, videos, prepared curriculum material, and in-school presentations to enhance programs. Topics in- clude cigarette smoking, smokeless tobacco, marijuana, and general lung heath. Students take part in role-play situations. 0340. CHICAGO HEART ASSOCIATION, 20 North Wacker Drive, Chicago, Illinois 60606. Program Title: Heartline. Contact: Bette Naysmith, M.P.A., Program Director (312)346-4675. Description: Through the Heartline public education program, information is disseminated on smoking cessation and on smoking as a major risk factor for cardiovascular diseases. Educational films, pamphlets, and posters are available to community groups and to individuals. These materials are distributed at health fairs and through hospitals and community agencies. Volunteer speakers are available. 0341. CHICAGO LUNG ASSOCIATION, 1440 West Washington Boulevard, Chicago, IlllInois 60607. Program Title: Esta Su Vida Yendose En Humo? Contact: Ms. Barbara Dore, Program Coordinator (312)243-2000 ext.64. Description: The foreign language departments of high schoois and col- leges in Cook County receive the bilingual (Spanish/English) pamphiet Is Your Life Going Up In Smoke? This innovative presentation catches the attention of the young people and is one of the only methods that can effectively reach the Spanish-speaking population. The message in the pamphlet encourages young people to remain or become nonsmokers. Tips on quitting are also included. When the pamphlet is sent to the students of a language department, the teachers are sent a sheet of suggested activities. Tea are also asked to respond to an evaluation of the program. 0342. CHICAGO LUNG ASSOCIATION, 1440 West Washington Boulevard, Chicago, Illinois 60607. Program Title: Freedom From Smoking At Work. Contact: Ms. Nedra Katz, Director, Smoking and Community Health (312)243-2000. Description: This ongoing program, available to all corporations in the Cook County area, focuses on developing smoking policies. Smok- ing cessation classes are provided on-site to smokers who want to quit. For more information, see the detailed program description in Part 1. CHICAGO LUNG ASSOCIATION, 1440 West Washington Boulevard, Chicago, Illinois 60607. 0343. Program Title: How To Conduct A Stop-Smoking Clinic. Contact: Ms. Barbara Dore, Program Coordinator (312)243-2000. 228 Description: A2-day training program is offered to persons interested in: ganizing and conducting smoking cessation clinics in th community, hospital, or workplace. Participants are trained conduct the Chicago Lung Association's cessation clinic Y Can Be In Control. The training clinic uses a training man complete with background information on smoking and heal and communication skills. The film "Is It Worth Your Life’ shown. 0344. CHICAGO LUNG ASSOCIATION, 1440 We Washington Boulevard, Chicago, Illinois 6060 - Program Title: Quit Smoking Self-Help Kit. Contact: Ms. Nedra Katz, Director, Smoking and Health Education (312)243-2000. Description: Upon request, a packet of self-help material is distributec - smokers who want to quit. This packet contains a self-h test booklet, pamphlets, tips on quitting, tips on control weight, a goal-setting sheet, a button, and a bookmark. A included is a list of the smoking cessation clinics that are c ducted in the community. Subjective evaluation of t program has been conducted. 0345. CHICAGO LUNG ASSOCIATION, 1440 W: Washington Boulevard, Chicago, Illinois 606C Program Title: Smoking Deserves A Smart Answer. Contact: Ms. Barbara Dore, Program Coordinator (312)243-2000. Description: This smoking prevention program disseminates informatio: school children ages 9 through 12. For more information, : the detailed program description in Part 1. 0346. CHICAGO LUNG ASSOCIATION, 1440 W: Washington Boulevard, Chicago, Illinois G606C Program Title: You Can Be In Control Smoking Clinic. Contact: ; Ms. Nedra Katz, Director, Smoking and Health Education (312)243-2000. Description: A variation on the American Lung Association’s Freed From Smoking program is offered. The materials used incl posters, questionnaires, smoking cessation kits, time cha daily record cards, worksheets, contracts, buddy car progress charts, and films. Certificates are awarded to the; ticipants. Individuals trained by the Chicago Lung Associai act as teachers. This program was developed by both University of illinois, Chicago Circle Campus, Department of Psychology, and the Chicago Lung Association. 0347. CHICAGO MEDICAL SOCIETY (COOK COUNTY), 515 North Dearborn Street, Chicago, Hlinols 60610. Program Title: Tel-Med (Direct Line to Health Information). Contact: Ms. Sheila G. Danaher, Senior Manager (312)670-2550. Description: Operating as part of the national Tel-Med, Inc., of Colton, California, the Chicago Medical Society provides a switchboard service that gives callers access to taped medi- cal information. Of the 215 available tapes, 8 deal with smok- ing and health. Titles of these tapes are: Do You Want to Stop Smoking?, Reducing the Risks of Smoking, Gimmicks to Help You Stop Smoking, Weight Control While Quitting Smok- ing, Why a Woman Should Quit Smoking, How Smoking Af- fects Your Health, What Do You Get Out of Smoking?, and Effects of Cigarette Smoking on the Nonsmokers. The switchboard is staffed by an operator. Approximately 2,000 callers a week use this service. The telephone number of the switchboard is (312)670-3670. 0348. CITY OF CHICAGO DEPARTMENT OF HEALTH, 50 West Washington Street, Chicago, illinois 60602. Program Title: Smoking Cessation Classes in The Workplace. Contaet: Ms. Hazel A. Domangue, Director, Employee and Inter- governmental Relations (312)744-4276. Description: Smoking cessation classes are conducted once a month by health employees who were trained by the American Cancer Society. The program is available to municipal employees. Over 100 employees have gone through the program, one- third of whom have kicked the habit. The program consists of written materials, films, and class discussions. At the end of the 4-day course, certificates and IQ pins are awarded. Clas- ses are free and are held at noon in various health facilities throughout the city. COPLEY HEALTH AWARENESS CENTER, Lin- coln and Weston Avenues, Aurora, lilinols 60505. 0349. Program Title: | Quit Smoking. Contact: Ms. Gayle lennarelia and Ms. Corrin Wallace (312)844-1000 ext.4739 and 4737. 229 Description: This six-session clinic led by a qualified team of health profes- sionals is designed to help individuals break the cigarette habit. A group format is used to generate a support system. All facets of the cigarette habit are explored and a variety of techniques are offered to modify this behavior calmly and without weight gain. An encouraging balance of education, motivation, and mutual support is offered. 0350. FREEPORT MEMORIAL HOSPITAL, 1045 West Stephenson, Freeport, Illinois 61032. Program Title: Smokebreakers. Contact: Sarajane Goers, R.N., Patient Care Coordinator (815)235-4131 ext.367. Description: The Smokebreakers program is scheduled quarterly and upon request. It consists of six 1-1/2-hour sessions. Methods employed are the behavior modification theory, pathophysiol- ogy, stress-reduction techniques, and diet management. Goals are set by the smoker after consultation and self- contracting. The cost of the program is $40. 0351. GOTTLIEB MEMORIAL HOSPITAL, 8700 West North Avenue, Melrose Park, IlilInols 60160. Program Title: How To Quit Smoking. Contact: Ms. Carolyn Merriman, Program Coordinator (312)451-4060. Description: This course consists of eight 1-hour sessions designed to help a person stop smoking. The program addresses physiologi- cal and psychological aspects of smoking cessation using the techniques of nicotine fading and focused smoking. During the course, participants identify their smoking cues, learn how to modify their daily routine to remove these cues, discuss methods of coping with the new identity of nonsmoker, and develop strong group support for the changes each participant is experiencing. 0352. GOTTLIEB MEMORIAL HOSPITAL, 8700 West North Avenue, Melrose Park, Illinois 60160. Program Title: Stop Smoking Clinics. Contact: Ms. Carolyn Merriman, Program Coordinator (312)451-4060. Description: This 6-week program of behavior modification helps partici- pants quit smoking or at least reduce the number of cigarettes they smoke. A step-by-step plan to quit smoking is taught. This plan incorporates self-control and relaxation techniques. Films, a slide show, and a buddy system are used. Each par- ticipant keeps a written record of his or her progress. These records help both to evaluate the clinic’s success and to develop self-understanding in participants. {f the participant attends all six of the sessions, half of the initial fee is refunded. Awards are presented to individuals who have quit smoking by the end of the program. 0353. HYPNOSIS FOUNDATION OF CHICAGO, INC., 3317 West 95th Street, Evergreen Park Station, Chicago, Illinols 60642. Program Title: Smoking Cessation By Hypnosis. Contact: Mr. Ronald R. Tatar, Executive Director (312)233-9600. Description: Hypnosis is used to aid individuals who have made a positive decision to quit smoking. One private office visit is frequently adequate. Those who are unable to visit the office may util- ize a cassette tape approved for sale by the FDA as a non- medical device, entitled Smoking Cessation Through Positive Thinking. 0354. ILLINOIS DEPARTMENT OF PUBLIC HEALTH, 535 West Jefferson Street, Springfield, Illinois 62761. Program Title: Smoking Cessation Trainers Clinic. Contact: Mr. Steve Knobloch, Chief Public Health Educator (217)785-2060. Description: The program's objective is to train a representative from each State agency as a clinic leader of the American Lung Association's Freedom From Smoking (FFS) program and to have these trained clinic leaders provide cessation clinics at their workplaces, distribute self-help smoking cessation materials, and offer support and encouragement to interested individuals. The program has trained and certified over 50 State agency personnel as FFS clinic leaders to date. 0355. ILLINOIS INTERAGENCY COUNCIL ON TOBACCO AND DISEASE, 1440 West Washington Boulevard, Chicago, Illinois 60607. Program Title: Rockford Local Council Rally For Grade Four and Springfield Local Youth Council Rally For Grade Six. Contact: Ms. Marjorie Molyneaux, Executive Director (312)243-2000. 230 Description: These programs are held in the spring. They are aimed at teachers, parents, and students. The latest medical informa- tion on tobacco use is presented at the time in children’s lives when they are tempted to start using tobacco. Other features of the programs include bands, films, banners, and athletic stars. Average attendance at Rockford is 3,000. Average attendance at Springfield is 1,000. 0356. ILLINOIS INTERAGENCY COUNCIL ON TOBACCO AND DISEASE, 1440 West Washington Boulevard, Chicago, IIlinols 60607. Program Title: Survey Of Illinois Hospitals. Contact: Ms. Marjorie Molyneaux, Executive Director (312)243-2000. Description: In an effort to determine the smoking practices and programs of hospitals in Illinois, the Interagency Council conducted a survey of 316 health care organizations that provided inpatient beds. Survey results were tabulated according to the size of the hospital. The following is a list of the subjects covered in the survey: type of hospital (private, mental health, Veterans Administration); patient choice regarding having a nonsmok- ing room; cigarette sales on the premises; provision of smok- ing education programs for the community; prohibitions on smoking in nurses’ stations; provision of smoking education programs for the staff; smoking policies in the emergency room, labor and delivery room, pediatrics, and x-ray therapy departments; and smoking in other areas of the hospital such as the lobby and the cafeteria. The data show that patients are not being consistently given a choice of a nonsmoking room; that cigarettes are sold in most of the larger hospitals; that few hospitals provide smoking programs for the patients, community, or the staff; and that few hospitals provide non- smoking areas within the lobby or cafeteria. 0357. INGALLS MEMORIAL HOSPITAL, One Ingalls Drive, Harvey, lilinois 60426. Program Title: | Quit Smoking Clinic. Contact: Ms. Susan Fine, Program Coordinator (312)333-2300 ext.5123. Description: This program is available to the general public as a clinic, to hospital inpatients on closed-circuit television, as well as to area businesses as an employee inservice. It focuses on the medical hazards associated with smoking and the problems of weight control, physical fitness, and stress management while quitting, and provides a forum for discussions of why par- ticipants have chosen to smoke. Alternatives to smoking (such as changes in behavior), nutrition, and activities involved in maintaining general physical health are topics for meetings. Group meetings also provide motivation and support to poten- tial quitters. In addition to the group discussions, speakers, brochures, posters, buttons, and films are used to convey the nonsmoking message. Approximately 50 people attend each clinic. Registration fee is $20, with a $10 rebate for full attendance. 0358. LEECOUNTYHEAL.H DEPARTMENT, 144 North Court, Dixon, Illinois 61021. Program Title: Freedom From Smoking. Contact: Judy Hartzell, R.N., Coordinator of Health Promotion and Screening (815)284-3371, Description: The Lee County Health Department sponsors a nonsmoking program in cooperation with the American Lung Association, entitled Freedom From Smoking. Programs are held on an as-needed basis and duration is approximately 6 to 7 weeks. For more information, see the detailed program description in Part 1. 0359. LOGAN COUNTY HEALTH DEPARTMENT, 2120 West 5th Street Road, Lincoin, Illinois 62656. Program Title: Community Education. Contact: Marcia Dowling, R.N., 8.S.N., Education Coordinator (217)735-2317. Description: The Logan County Health Department has been involved in smoking and health in four ongoing programs. Prenatal in- struction is offered to county residents and to pregnant high school students. These programs are offered twice yearly as Baby Care classes and Birth Education For Adolescents to Reduce Risks classes. Dangers of smoking during pregnan- cy are discussed. Pamphiets are also provided. Programs on smoking and smokeless tobacco are available to schools when desired. A display of smoking and smokeless tobacco literature was provided for 9 days at the Logan County Fair and 1 day at the Mount Pulaski Fall Festival. In addition, pul- monary function testing was done to interested participants. Smoking and smokeless tobacco information is available at the health department for interested persons. MACOUPIN COUNTY PUBLIC HEALTH DEPART- MENT, 227 East First South Street, Carlinville, Ilinols 62626. 0360. Program Title: Freedom From Smoking. Contact: Kent Tarro, M.S., R.D., Assistant Administrator (217)854-5761. 231 Description: The Public Health Department offers the American Lung Association's Freedom From Smoking programs: group ces- sation, self-help, and self-help during pregnancy. There is a fee for materials. For more information, see the detailed program descriptions in Part 1. 0361. MASON COUNTY HEALTH DEPARTMENT, 118 West Market, Havana, Illinois 62644. Program Title: Freedom From Smoking Clinics. Contact: Nina Krueger, R.N., Program Director (309)543-2201. Description: The American Lung Association's Freedom From Smoking clinics are held every quarter and are available to all Mason County residents. Pregnant women and mothers with young children are especially targeted. For more information, see the detailed program description in Part 1. 0362. MCDONOUGH COUNTY HEALTH DEPART- MENT, 303 East Jefferson, Macomb, Illinois 61455. Program Title: Smoking: The Decision Is Yours. Contact: Ms. Shirlee Jobe, Community Health Promoter (309)837-9951. Description: Smoking: The Decision Is Yours is a slide and tape presen- tation that points out the health risks of smoking and en- courages viewers not to smoke. The presentation is supplemented by brochures on smoking given to the audience and is available upon request. 0363. MCDONOUGH COUNTY HEALTH DEPART- MENT, 303 East Jefferson, Macomb, Iilinois 61455. Program Title: Ounce Of Prevention. Contact: Ms. Shirlee Jobe, Community Health Promoter (309)837-9951. Description: Ounce Of Prevention is an ongoing weekly newspaper article that features information about smoking and related health problems. It is published several times a year. 0364. MICHAEL REESE HEALTH PLAN, LAKESHORE HEALTH CENTER, 2545 South Dr. Martin Luther King Drive, Chicago, Illinois 60616. Program Title: You Can Be In Control. Contact: Sandra Villalaz-Dickson, R.N., M.P.H., Manager, Health Education (312)842-7117. Description: You Can Be In Control is a behavioral approach to smoking cessation developed by the Chicago Lung Association in col- laboration with the University of Illinois, Department of Psychology. This program is offered at least five or six times a year and consists of six 1-1/2-hour sessions conducted in a 4-week period. The target audience is primarily members and their families, but the general Chicago population is also recruited. 0365. NORTHCARE MEDICAL GROUP, 467 Deming Place, Chicago, Illinois 60614. Program Title: You Can Be In Control. Contact: Ms. Gretchen VanNatta, Director of Health Education and Patient Communication (312)248-7100. Description: This six-session, 4-week quit-smoking program is designed to help break routines associated with smoking. The program emphasizes behavior modification through gradual reduction techniques. Discussion includes the effects of smoking ces- sation on appetite, stress, and general health. Group support and interaction are emphasized. Literature is provided. Programs are given at NorthCare health centers and at company worksites. 0366. SAINT FRANCIS MEDICAL CENTER, CENTER FOR SPORTS MEDICINE AND HEALTH FITNESS, 530 Northeast Glen Oak Avenue, Peoria, Illinois 61637, Program Title: Smokeless. Contact: Ms. Terry Galvin Matthews, Program Coordinator (309)655-CIGS(2447). Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0367. ST. THERESE MEDICAL CENTER, EDUCATION- AL SERVICES AND COMMUNITY OUTREACH DEPARTMENT, 2615 West Washington Street, - Waukegan, illinois 60085. Program Title: FreshStart. Contact: Ms. Noreen Paulsen, Community Education instructor (312)360-2702. Description: The American Cancer Society's FreshStart cessation program is offered. For more information, see the detailed program description in Part 1. 0368. STEPHENSON COUNTY HEALTH DEPART- wen 15 North Galena Avenue, Freeport, Iilinols 1032. Program Titie: Smoking Intervention Program. Contact: Mr. Martin Tinberg, Public Health Administrator (815)235-8271. Description: The Smoking Intervention Program is a planned series of in- terventions designed to modify smoking behavior of pregnant women during their term of pregnancy. The target group of the program is high-risk women enrolled in the department's Women, Infants, and Children program. The objective is to have 5 percent of the program participants quit smoking before the end of their pregnancies. 0369. VILLAGE OF SKOKIE HEALTH DEPARTMENT, Post Office Box 309, 5127 Oakton Street, Skokie, iinois 60077. Program Title: Skokie Stop Smoking Clinic. Contact: Mr. Lowell Huckleberry, Director of Health (312)673-0500. Description: This smoking cessation program is offered every 6 months and is available to all residents. Pregnant women are espe- cially targeted. The program consists of six classes that util- ize behavior modification and group support for smoking cessation. The classes meet once a week and build up to quit night, when everyone in the group quits. Materials are provided and the instructor is available for individual counsel- ing as needed. Participants who have been unable to quit or who have resumed smoking are encouraged to repeat the series. A $10 incentive deposit is returned to those participants who stop smoking. Tab ee qe 232 INDIANA 0370. AMERICAN LUNG ASSOCIATION OF CENTRAL INDIANA, 8777 Purdue Road, Sulte 310, Indlanapolls, Indiana 46268-3109. Program Title: Freedom From Smoking. Contact: Mr. Joseph A. Caparo, Program Director (317)872-9685. Description: The American Lung Association's Freedom From Smoking clinics and self-help manuals are offered. For more information, see the detailed program descriptions in Part 1. AMERICAN LUNG ASSOCIATION OF CENTRAL INDIANA, 8777 Purdue Road, Sulte 310, Indlanapolls, Indiana 46268-3109. 0371. Program Title: Growing Healthy. Contact: Ms. Patricia Ritz, Program Associate (317)872-9685. Description: Growing Healthy, the primary grades’ health curriculum project, focuses on the negative aspect of smoking in two programs aimed at students in grade levels kindergarten through 3, and 4 through 6. For more information, see the detailed program description in Part 1. 0372. AMERICAN LUNG ASSOCIATION OF CENTRAL INDIANA, 8777 Purdue Road, Suite 310, indianapolls, Indiana 46268-3109. Program Title: Peer Influence Smoking Education. Contact: Mr. Joseph A. Caparo, Program Director (317)872-9685. Description: The Peer Influence program focuses on students in grades 5, 6, and 7. Specially trained high school students talk about the health hazards of smoking, encouraging them never to start, or if they have, to stop. 0373. AMERICAN LUNG ASSOCIATION OF INDIANA, 8777 Purdue Road, Suite 310, Indianapolis, Indiana 46268-3109. Program Title: Athletes Against Tobacco. 233 Contact: Ms. Kellie A. Pavese, Program Coordinator (317)872-9685. Description: Volunteer athletes have joined with the American Lung Association of Indiana and Senator Richard Lugar to assist in Statewide efforts to encourage young people not to start the cigarette habit. The athletes serve as role models to speak out on the dangers of tobacco use. The athletes are used in programs and events aimed at young people, such as boys and girls clubs, youth rallies, and school events. Radio and television spots are aired to promote the hazards of tobacco use. Membership cards and posters are distributed to young people so that they may become active members of Athletes Against Tobacco. Club or school organizations may request a list of athletes available. 0374. AMERICAN LUNG ASSOCIATION OF INDIANA, 8777 Purdue Road, Sulte 310, Indianapolis, Indiana 46268-3109. Program Title: Freedom From Smoking Starter Session. Contact: Ms. Kellie A. Pavese, Program Coordinator (317)872-9685. Description: These starter sessions are designed to motivate smokers who want to quit to take the first step. The sessions are held once a month in convenient locations. The program introduces the self-help manuals Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION 8777 Purdue Road, Suite 310, Indiana 46268-3109. OF INDIANA, Indianapolis, 0375. Program Title: Growing Healthy. Contact: Ms. Kellie A. Pavese, Program Coordinator (317)872-9685. Description: Growing Healthy is the title of two companion curriculum projects, the School Health Curriculum Project for grades 4 through 7 and the Primary Grades Health Curriculum Project for kindergarten through grade 3. For more information, see the detailed program description in Part 1. 0376. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST INDIANA, INC., 7 East Columbia Street, Post Office Box 4136, Evansville, Indiana 47711. Program Title: Freedom From Smoking. Contact: Ms. Beth Thompson, Managing Director (812)422-3402. Description: The American Lung Association's Freedom From Smoking program is offered. Corpor are invited to host on-site programs for employees. For more information, see the detailed program description in Part 1. 0377. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST INDIANA, INC., 7 East Columbla Street, Post Office Box 4136, Evansville, Indiana 47711. Program Title: Freedom From Smoking At Work. Contact: Ms. Beth Thompson, Managing Director (812)422-3402. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0378. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST INDIANA, INC., 7 East Columbla Street, Post Office Box 4136, Evansville, Indlana 47711. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Beth Thompson, Managing Director (812)422-3402. Description: The American Lung Association's Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking self-help manuals are offered. For more information, see the detailed program descriptions in Part 1. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST INDIANA, INC., 7 East Columbla Street, Post Office Box 4136, Evansville, Indiana 47711. 0379. Program Title: Smoking And Pregnancy. Contact: Ms. Beth Thompson, Managing Director (812)422-3402. Description: The American Lung Association's Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 234 0380. AMERICAN LUNG ASSOCIATION OF SOUTH- WEST INDIANA, INC., 7 East Columbia Street, Post Office Box 4136, Evansville, Indiana 47711. Program Title: Smoking Education For The Middle Schools. Contact: Ms. Audrey Ferguson, Field Representative (812)234-5448, Description: This program is for students in grades 4, 5, and 6. Through a variety of activities and videos, children learn about the health effects of smoking cigarettes, breathing secondhand smoke, and using marijuana. 0381. INDIANA STATE BOARD OF HEALTH, 1330 West Michigan Street, Post Office Box 1964, indianapolls, Indiana 46206-1964. Program Title: FreshStart Plus. Contact: Mr. Roger McClain, Director of Health Education (317)633-0267. Description: This program uses a modified American Cancer Society FreshStart program. The stop smoking clinic consists of six sessions meeting twice weekly, with followup meetings 2 weeks and 1 month later. Ongoing support groups are also of- fered, providing additional training in the skills that are intro- duced in the FreshStart Plus program, such as stress management, assertiveness, fitness, and nutrition. The smoking cessation sessions are 1-1/2 to 2 hours in length, depending upon materials discussed. FreshStart Plus is open to all State Board of Health employees. 0382. INDIANA STATE BOARD OF HEALTH, 1330 West Michigan Street, Post Office Box 1964, Indianapolis, Indiana 46206-1964. Program Title: Growing Healthy. Contact: Mr. Roger McClain, Director of Health Education (317)633-0267. Description: The State Board of Health and the American Lung Associa- tion are working cooperatively in the promotion and support of this comprehensive, sequential health education curriculum for kindergarten through grade 7. The curriculum is the first of its kind to receive national validation from the United States Department of Education. There are currently 35 school cor- porations and 30,487 school children participating in the cur- riculum; each year new school corporations are added. For more information on this American Lung Association program, see the detailed program description in Part 1. 0383. INDIANA STATE BOARD OF HEALTH, 1330 West Michigan Street, Post Office Box 1 964, Indianapolis, Indiana 46206-1 964. Program Title: Risk Factor Surveillance. Contact: Mr. Roger McClain, Director of Health Education (317)633-0267. Description: The Risk Factor Surveillance program is an ongoing survey to collect information on health habits in Indiana. The survey, which involves adults 18 years and over, is done by computer- assisted telephone interviews on a monthly basis during evening hours and on weekends. Questions regarding diet are asked, as well as ones Pertaining to specific demographics. for whom anonymity is maintained, are selected using a technique called random-digit dialing method. Survey results are used for program planning and evaluation purposes. 0384. INDIANA STATE BOARD OF HEALTH, 1330 West Michigan Street, Post Office Box 1964, Indianapolis, Indiana 46206-1964. Program Title: Smokeless Tobacco Resource Materials. Contact: Mr. Roger McClain, Director of Health Education (317)633-0267. Description: Several resources are available from the Division of Health Education regarding smokeless tobacco. Smokeless Tobac- co: Are You Feeling The Pinch? is a full-color pamphlet dis- cussing the dangers of smokeless tobacco use. The pamphlet has color photographs of the oral effects of smoke- less tobacco use, a message from Carlton Fisk of the Chicago White Sox, and a fictitious letter from a young girl explaining why she finds smokeless tobacco a disgusting habit. The Smokeless Tobacco Resource Materials file contains a copy of the pamphlet, a smokeless tobacco fact sheet, State and National educational resource lists, asummary of the Surgeon General's report, a summary from the Inspector General's report, and a copy of the smokeless tobacco law. The Spittin’ Image: A Smokeless Tobacco Teaching Guide For Grades Four Through Seven is also available. - It Was produced in cooperation with the Utah Department of Health. Several films and filmstrips are available for free loan to indiana residents from the film library. 0385. INDIANA STATE BOARD OF HEALTH, 1330 West Michigan Street, Post Office Box 1 964, Indlanapolis, indiana 46206-1964. Program Title: Worksite Smoking Policies. Contact: Mr. Roger McClain, Director of Health Education (317)633-0267. 235 Description: Resources are available to businesses, industries, and agen- cies interested in developing a worksite smoking policy. Infor- mation is available on health hazards of smoking and secondhand smoke, suggested readings, films and videotapes, and suggested policies. 0386. LA PORTE COUNTY HEALTH DEPARTMENT, Court House Square, La Porte, Indiana, 46350. Program Title: The Choice Is Yours. Contact: Ms. Betty Conjalka, Public Health Nurse (219)326-6808. Description: After introducing and showing the film "The Choice Is Yours,” the Smoking Sam mannequin is used to demonstrate the results smoking has on the lungs. Smoking Sam has glass jar lungs filled with angel hair. As it smokes a cigarette and the smoke goes into the lungs, the angel hair gradually turns yellow then brown. 0387. LA PORTE COUNTY HEALTH DEPARTMENT, Court House Square, La Porte, Indiana 46350. Program Title: Smoking Coloring Book. Contact: Ms. Betty Conjalka, Public Health Nurse (219)326-6808. Description: The Smoking Coloring Book of the American Cancer Society is presented to each student during nonsmoking presenta- tions to first-grade classes. The nurse reads the book and ex- plains the meaning of the topic on each page. She has already colored the book so that they will know what it will look like after they color it. After reading the book, students are given the opportunity to ask questions and give comments on what they learned from the presentation. 0388. MARION COUNTY HEALTH DEPARTMENT, 222 East Ohio Street, Indlanapolls, indiana 46204. Program Title: Smoking And Pregnancy and Smoking And The Pill. Contact: Mr. Brian Lucas, Heaith Educator (317)633-9731 Description: The programs are both one-time, 15-20-minute sessions utiliz- ing slides, posters, and informational packets designed to inform clients of the risks posed by smoking and encourage clients to cut down or quit smoking. The clients’ smoking behaviors are noted on their charts and monitored to provide some sense of the programs’ effectiveness. 0389. SAINT MARGARET HOSPITAL AND HEALTH CENTERS, 5454 Hohman Avenue, Hammond, In- diana 46320. Program Title: You Can Be In Control. A Stop Smoking Class. Contact: Ms. Marjorie Wenzel, Program Coordinator (219)933-2071. Description: This program is based on the Chicago Lung Association model that offers a step-by-step plan to smoking cessation. The interval system allows each individual to become active- smoker. Assistance is offered through self-control! techni- ques, relaxation techniques, group support, and weekly contracts. 0390. VIGO COUNTY HEALTH DEPARTMENT, 201 Cherry Street, Terre Haute, Indiana 47807. Program Title: FreshStart. Contact: Ms. Angela Ferree, Coordinator of Adult Services (812)238-8436. Description: The American Cancer Society’s FreshStart program is offered to the general public and also to Federal prison inmates. For more information, see the detailed program description in ly involved through self-direction in learning to be a non- Part 1. lOWA 0391. AMERICAN CANCER SOCIETY, IOWA DIVISION, Program Title: INC., Post Office Box 65710, West Des Moines, Heart At Work. lowa 50265-0710. Contact: Program Title: Mr. William Cardamon, Director of Community Programs FreshStart. (515)224-1025. Contact: Description: Ms. Leslie Jurgensen, Program Director (515)253-0147, Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered throughout the State. For more information, see the detailed program description in Part 1. 0392. AMERICAN HEART ASSOCIATION, IOWA AF- FILIATE, 1111 Office Park Road, West Des Moines, lowa 50265. Program Title: Heart Health Education Of The Young. Contact: Mr. William Cardamon, Director of Community Programs (515)224-1025. Description: The American Heart Association’s Heart Health Education Of The Young program is offered. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, IOWA AF- FILIATE, 1111 Office Park Road, West Des Moines, lowa 50265. 0393. 236 The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 0394. AMERICAN HEART ASSOCIATION, IOWA AF- FILIATE, 1111 Office Park Road, West Des Moines, lowa 50265. Program Title: Heart Rx. Contact: Mr. William Cardamon, Director of Community Programs (515)224-1025. Description: The American Heart Association's Heart Rx program is offered. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, IOWA AF- FILIATE, 1111 Office Park Road, West Des Moines, lowa 50265. 03985. Program Title: Let’s Talk About Smoking. Contact: Mr. William Cardamon, Director of Community Programs (515)224-1025. Description: The American Heart Association's Let's Talk About Smoking program is offered. For more information, see the detailed ‘ program description in Part 1. AMERICAN HEART ASSOCIATION, IOWA AF- FILIATE, 1111 Office Park Road, West Des Moines, lowa 50265. 0396. Program Title: Save A Sweet Heart. Contact: Mr. William Cardamon, Director of Community Programs (515)224-1025. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 0397. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Wainut, Des Moines, lowa 50309. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: The American Lung Association's Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. 0398. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Walnut, Des Molnes, lowa 50309. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: The American Lung Association's Freedom From Smoking For You And Your Baby self-help program is offered. For more information, see the program description in Part 1. 0399. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Walnut, Des Moines, lowa 50309. Program Title: Freedom From Smoking For You And Your Family. 237 Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: The American Lung Association's Freedom From Smoking For You And Your Family program is offered. For more information, see the detailed program description in Part 1. 0400. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Wainut, Des Moines, lowa 50309. Program Title: I'll Never Smoke. Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: Junior high school students serve as counselors and role models for students in kindergarten through grade 6. Smok- ing is discouraged by illustrating the effects of smoking on the smoker and the nonsmoker, and by emphasizing decision making. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Walnut, Des Moines, lowa 50309. 0401. Program Title: In Control. Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: The American Lung Association’s In Contro! smoking cessation program is offered. A 13-segment videocassette, 20-minute audiocassette and workbook are used and may be purchased or borrowed at no cost. For more information, see the detailed program description in Part 1. 0402. AMERICAN LUNG ASSOCIATION OF IOWA, 1321 Walnut, Des Moines, lowa 50309. Program Title: Stop Smoking Clinic. Contact: Ms. Carol L. Sipfle, Director of Smoking Intervention (515)243-1225. Description: Nine-week smoking cessation support groups are cospon- sored by the American Lung Association of lowa and lowa State University. The first 3 weeks of the program prepare smokers to quit and then group members quit. The following 6 weeks focus on maintenance of the nonsmoking behavior. The program is based on 18 years of research by Harry Lando, Ph.D., of lowa State University. 0403. IOWA DEPARTMENT OF PUBLIC HEALTH, Lucas State Office Buliding, Fourth Floor, Des Molnes, lowa 50319-0075. Program Title: Health Department Activities For iowa. Contact: Ms. Monica H. Eischen, Chief, Bureau of Health Promotion (515)281-6779. Description: The Department of Public Health provides technical assis- tance to business industry and State agencies in developing and establishing worksite smoking policies, sponsors smok- ing-related conferences, facilitates smoking withdrawal clas- ses for State employees, and serves as a clearinghouse for smoking-related information and resource material including smokeless tobacco. Requests from management about new legislation and from employees who believe the law is not being enforced receive responses. The Bureau of Health Promotion provides smoking withdrawal classes for State employees based on the American Cancer Society's FreshStart program. The classes are conducted by anurse consultant. For more information, see the description in Part 1. The bureau also has information about smoking withdrawal methods, local resources that offer classes, statistics about the numbers of smokers, passive smoke issues, etiology of smoking, and smokeless tobacco. This information is provided upon request. A smokeless tobacco package, developed for distribution to schools throughout lowa, includes resource materials, a teaching packet, and slides. The package was produced by the Department of Public Health, Voluntary Health Organiza- tion, University of lowa, lowa Coalition for Comprehensive School Health Education, and others. 0404. MERCY HOSPITAL, HEALTH PROMOTION, West Central Park at Marquette, Davenport, lowa 52804. Program Title: Smoke Stoppers. Contact: Ms. Claudia Cox, Program Coordinator (319)383-1000. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for 238 cessation; and Phase Ill provides an ongoing support and maintenance system. 0405. MERCY HOSPITAL WELLNESS PROGRAM, 701 10th Street S.E., Cedar Rapids, lowa 52403. Program Title: Smoke Stoppers. Contact: Ms. Lee Anne Houtz, Health Promotion Coordinator (319)398-6591 Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase I prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase lil provides an ongoing support and maintenance system. 0406. ST. JOSEPH MERCY HOSPITAL, 84 Beaumont Drive, Mason Clty, lowa 50401. Program Title: Freedom From Smoking. Contact: Ms. Jean Torgerson, Consumer Health Education (515)424-7393. Description: The self-help smoking cessation and maintenance materials developed by the American Lung Association are offered to inpatients, outpatients, and hospital employees. Individual counseling is available. For more information, see the detailed program description in Part 1. 0407. ST. JOSEPH MERCY HOSPITAL, 84 Beaumont Drive, Mason City, lowa 50401. Program Title: Smoke Stoppers. Contact: Robert Mason, Director, Health Consultation Services (515)424-7889. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and maintenance system. KANSAS 0408. THE AMERICAN CANCER SOCIETY, KANSAS DIVISION, INC., 3003 Van Buren, Topeka, Kansas 66611. Program Title: FreshStart. Contact: Ms. Stacy Hoogstraten, Vice President for Public Education (913)267-0131. Description: The American Cancer Society's FreshStart program is of- fered. A variety of pamphlets, poster, and films about smok- ing are also available from the society. For more information, see the detailed program description in Part 1. 0409. THE AMERICAN CANCER SOCIETY, ‘KANSAS DIVISION, INC., 3003 Van Buren, Topeka, Kansas 66611. Program Title: Smokeless Squares. Contact: Ms. Stacy Hoogstraten, Vice President for Public Education (913)267-0131. Description: : Smokeless Squares is a smokeless tobacco kit developed by medical professionals, teachers, and the American Cancer Society for students in kindergarten through grade 6 to show the dangers of all tobacco products. It-contains a video presentation designed and performed by children and suggests lesson plans for the teachers. 0410. THE AMERICAN CANCER SOCIETY, KANSAS DIVISION, INC., 3003 Van Buren, Topeka, Kansas 66611. Program Title: Trouble in A Pinch. Contact: Ms. Stacy Hoogstraten, Vice President for Public Education (913)267-0131 Description: Trouble in A Pinch is a smokeless tobacco kit developed by medical professionals, teachers, and the American Cancer Society for students in grades 7 through 12 to show the dangers of all tobacco products. It is a five-part series featur- ing video presentations by WDAF-TV of Kansas City. This is a straightforward factual program including interviews with the Surgeon General, Kansas City Royal George Brett, and the mother of a young man who died from cancer after using smokeless tobacco. Lesson plans and discussion questions accompany the video. 0411. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. Program Title: : Hugh McCabe: The Coach's Final Lesson. Contact: Ms. Mavis Glenn, Program Secretary (913)272-9290 or (800)432-3957. | Description: 239 As part of the Smoke-Free Family Program, this video is avail- able on a free loan basis to schools, organizations, medical facilities, and individuals. A variety of pamphlets in the area of smoking education are also available; the catalog will be sent upon request. For more information, see the detailed program description in Part 1. 0412. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. Program Title: Freedom From Smoking Facilitators’ Training Session. Contact: Ms. Roberta Kunkle, Smoking Education Consultant (913)272-9290 or (800)432-3957. Description: This program is for persons interested in becoming stop smok- ing clinic leaders. During the training, prospective instructors explore the concepts, philosophy, materials, and techniques that are incorporated into Freedom From Smoking clinics. Audiovisual materials are shown and group dynamic skills are practiced. In order to be certified, instructors agree to main- tain the integrity of the program, conduct at least one clinic a year, and schedule all clinics through the American Lung Association of Kansas. Cost of the training is $30. 0413. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. Program Title: Freedom From Smoking For You And Your Baby, Clinics For Pregnant Women. Contact: Ms. Roberta Kunkle, Smoking Education Consultant (913)272-9290 or (800)432-3957. Description: This is a group program for pregnant smokers based on the self-help book, Freedom From Smoking For You And Your Baby. The clinics are scheduled on request, usually through schools or health departments. For more information on the self-help manual, see the detailed program description in Part 1. 0414. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. Program Title: Freedom From Smoking Public Clinics. Contact: Ms. Roberta Kunkle, Smoking Education Consultant (913)272-9290 or (800)432-3957. Description: Clinics are held four times a year in Topeka-Kansas City metropolitan area and in Wichita. They are also offered in various areas of the State. The cost is $50 for each par- ticilpant. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. 0415. Program Title: Freedom From Smoking Workplace Clinics. Contact: Ms. Roberta Kunkle, Smoking Education Consultant (913)272-9290 or (800)432-3957. Description: This program is provided at the request of employers. tt is delivered at the worksite, during working hours or at the close of the workday. Groups are open to employees and members of their families. The cost is $50 a person, with a minimum of 12 participants. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. 0416. Program Title: Self-Help Smoking Cessation Manuals. Contact: Ms. Mavis Glenn, Program Secretary (913)272-9290 or (800)432-3957. Description: The following manuals are available upon request: Freedom From Smoking In 20 Days, A Lifetime of Freedom From Smok- ing, Freedom From Smoking For You And Your Baby, and Freedom From Smoking For You And Your Family. The prices vary from $5 to $7. For more information, see the detailed program descriptions in Part 1. 240 0417. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604, Program Title: Smoke-Free Class Of 2000 Project. Contact: Ms. Jan Michel, Director of Communications (913)272-9290 or (800)432-3957. Description: A coalition of the American Lung Association, the American Cancer Society, and the American Heart Association has been formed to work together on the Smoke-Free Class Of 2000 Project. Planning is now underway to involve a number of first-grade students. This is an ongoing program that will follow these students as they progress through elementary and secondary school. The goal of the coalition is to make this the first class to graduate without any students who are smokers. Through this program, the coalition is helping the Surgeon General reach the goal of a Smoke-Free Society by the year 2000. 0418. AMERICAN LUNG ASSOCIATION OF KANSAS, 4300 Drury Lane, Post Office Box 4426, Topeka, Kansas 66604. Program Title: Smoking Education. Contact: Ms. Roberta Kunkle, Smoking Education Consultant (913)272-9290 or (800)432-3957. Description: A variety of special programs include: Business Consult- ations On Smoking Policy; Employee Education And Aware- ness Programs; School Education Programs; and Educational Programs For Organizations. These programs can be designed to meet a variety of needs. JOHNSON COUNTY DEPARTMENT OF PUBLIC HEALTH, 6000 Lamar, Room 140, Mission, Kansas 66202. 0419. Program Title: FreshStart. Contact: Anita Sauerwein, R.N., Health Promotion Coordinator (913)791-5660. Description: The American Cancer Society's smoking cessation program is offered to adult smokers in the community. For more infor- mation on this American Cancer Society program, see the detailed program description in Part 1. 0420. JOHNSON COUNTY DEPARTMENT OF PUBLIC HEALTH, 6000 Lamar, Room 140, Mission, Kansas 66202. Program Title: Personal Wellness. Contact: Anita Sauverwein, R.N., Health Promotion Coordinator (913)791-5660. Description: As part of an adult health and fitness program, counseling and referral is offered to smokers. One-hour individual sessions, which include physical assessment and counseling, are of- fered at the worksite or by appointment at county health clinics. The program offers the opportunity to assess lifestyle and health risks with focus on reducing risks of heart attack, can- cer, and stroke. A computerized health risk appraisal is per- formed for each participant. For those who report a smoking history, appraisal results will include relevant facts on smok- ing and health with referral to local programs and resources to help them quit. A pamphlet library carrying a wide variety of information from Federal and State health agencies, American Cancer Society, American Lung Association, American Heart Association, and others is available to all par- ticipants. An evaluation of health goals determined during a private counseling session is offered at 1 month and again at 6 months. 0421. KANSAS DEPARTMENT OF HEALTH AND EN- VIRONMENT, Forbes Field, Topeka, Kansas 66620-0001. Program Title: Task Force On Hazards Of Tobacco Consumption. Contact: Jenny Ransom, M.A., Adult Health Promotion Administrator (913)296-1226. Description: Atask force chaired by the Kansas Department of Health and Environment and representatives from State and community health agencies meets monthly to network resources and publicize the hazards of tobacco consumption to Kansans. This task force provides free consultation and materials on the hazards of tobacco consumption. The following agencies are represented on the task force: The Kansas Department of Health and Environment, Social Rehabilitation Services, American Cancer Society, American Lung Association, Department of Human Resources, American Heart Associa- tion, Topeka/Shawnee County Health Department, Kansas Department of Education, Wichita/Sedgwick County Health Department, Kansans For Non-Smokers Rights, and Kansas Department on Aging. RENO COUNTY HEALTH DEPARTMENT AND HOME HEALTH AGENCY, 209 West Second, Hutchinson, Kansas 67501. 0422. 241 Program Title: School Age Smoking Education. Contact: Virginia Garst, R.N., PATCH Smoking Cessation Task Force Chair (316)663-6721. Description: An annual school education program of one to two hours is presented to students in grades 7 and 8. Through videos, films, and speakers, this program provides insight into the health impact of smoking and awareness of advertising promotions and peer pressures regarding smoking. Pre- and posttest evaluation surveys are completed to measure impact of information. 0423. RENO COUNTY HEALTH DEPARTMENT AND HOME HEALTH AGENCY, 209 West Second, Hutchinson, Kansas 67501. Program Title: Smoking Cessation Clinics. Contact: Carolyn Carter, R.N., Public Health Nurse Supervisor (316)663-6721. Description: . Smoking Cessation Clinics are available to the employees of area businesses on an as requested basis. There are four or five day or evening sessions over a 2- to 3-week period. Clients develop and conduct their own smoking cessation plans by utilizing methods of both the American Cancer Society's FreshStart Program and the American Lung Association’s programs encouraging lifestyle behavior chan- ges based on knowledge and information about self and smoking. ST. JOHN'S HOSPITAL, Post Office Box 5201, Sallna, Kansas 67402-5201. 0424. Program Title: Stop Smoking Clinics. Contact: Ms. Peg Romine, Program Coordinator (913)827-5591. Description: Stop Smoking Clinics are based on the American Cancer Society's FreshStart program. The clinic utilizes education, mutual support, and behavior modification principles to deal with addiction and withdrawal, litestyle changes, and relapse prevention. For more information, see the detailed program description in Part 1. TOPEKA-SHAWNEE COUNTY HEALTH AGENCY, 1615 West 8th Street, Topeka, Kansas 66606. 0425. Program Title: FreshStart. Contact: Linda Bonnel, R.N., Health Promotion Supervisor (913)233-8961. Description: The American Cancer Society's FreshStart smoking cessa- tion program is offered quarterly through the City-County Health Agency. Although the fee is $20, services are not denied to those unable to pay. The class is offered to the com- munity as well as in conjunction with a corporate wellness program. For more information, see the detailed program description in Part 1. KENTUCKY 0426. AMERICAN CANCER SOCIETY, KENTUCKY DIVISION, INC., Medical Arts Bullding, 1169 East- ern Parkway, Loulsville, Kentucky 40217. Program Title: FreshStart. Contact: Ms. Joyce Compton, Public Education Director (502)459-1867. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. Also four sessions to train instructors are scheduled each year. For more information, see the detailed program description in Part 1. 0427. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Offlce Box 969, Louisville, Kentucky 40201. Program Title: Freedom From Smoking At Work. Contact: Ms. Joan Stafford, Health Educator (502)363-2652. Description: This program provides smoking education, policy develop- ment, and smoking cessation for the workplace, combining all the smoking related services provided by the American Lung Association of Kentucky in a complete package. For more information, see the detailed program description in Part 1. 0428. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. Program Title: Freedom From Smoking Clinics. Contact: Mr. Mike Staufacker, Health Education Director (502)363-2652. Description: The American Lung Association's Freedom From Smoking 242 clinics are offered. For more information, see the detailed program description in Part 1. 0429. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Joan Stafford, Health Educator (502)363-2652. Description: The American Lung Association’s Freedom From Smoking self-help program for pregnant women is offered. For more information, see the detailed program description in Part 1. 0430. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Ken- tucky 40201. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Mr. Mike Staufacker, Health Education Director (502)363-2652. Description: The American Lung Association’s Freedom From Smoking Self-Help Manuals are offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. 0431. Program Title: Growing Healthy. Contact: Mr. Mike Staufacker, Health Education Director (502)363-2652. Description: The American Lung Association's Growing Healthy educa- tional program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. 0432. Program Title: In Control. Contact: Mr. Mike Staufacker, Health Education Director (502)363-2652. Description: The American Lung Association’s In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0433. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. Program Title: Lungs Are For Lite Modules. Contact: Mr. Mike Staufacker, Health Education Director (502)363-2652. Description: These classroom teaching modules, introducing health ac- tivities, are available to area schools. For more information, see the detailed program description in Part 1. 0434. AMERICAN LUNG ASSOCIATION OF KEN- TUCKY, Post Office Box 969, Louisville, Kentucky 40201. Program Title: Smoking And Pregnancy Kit. Contact: Ms. Joan Stafford, Health Educator (502)363-2652. Description: The American Lung Association's Smoking And Pregnancy program is offered to area health care personnel. For more information, see the detailed program description in Part 1. 0435. COOPER/CLAYTON, Department of Community Dentistry, Chandler Medical Center, M-129, University of Kentucky, Lexington, Kentucky 40506-0027. Program Title: The Cooper/Clayton Method To Stop Smoking. 243 Contact: Thomas M. Cooper, D.D.S., Professor, Department of Com- munity Dentistry and Richard R. Clayton, Ph.D., Professor, Department of Sociology (606)233-5281 or (606)257-4420. Description: The Cooper/Clayton method is taught in 1-hour support group sessions offered weekly to a maximum of 20 persons. The program operates on a rolling admissions basis. The par- ticipant is required to attend 24 weekly group sessions, the equivalent of 1 full day or 3 working days. The target audience is heavy smokers, those smoking from 30 to 80 cigarettes a day. The program is based on the assumption that virtually all heavy smokers are addicted to nicotine. During the first 2 weeks of the program the smokers record their daily consump- tion of cigarettes. Beginning with week 3, the participants use nicotine polacrilex on a fixed-dose regimen and do so for a total of 6 weeks. Beginning with week 9, the participants begin a phased backdown off the nicotine polacrilex so that at week 24 they have not smoked for 22 weeks and they are complete- ly free of nicotine. During the weekly group sessions, various topics are covered including factors related to relapse, weight gain and how to avoid it, the role of nicotine in the brain and body, and how to cope with stress as an adult nonsmoker. The sessions are completely positive in tone and do not emphasize the negative consequences of smoking. 0436. KENTUCKY DEPARTMENT FOR HEALTH SER- VICES, HEALTH PROMOTION BRANCH, 275 East Main Street, Frankfort, Kentucky 40621. Program Title: Great American Smokeout. Contact: Ms. Edie Crews, Program Coordinator (502)564-71 12. Description: The Great American Smokeout is conducted in State agen- cies in Frankfort as well as in local health departments throughout the State. It is conducted annually in November and activities last for a week. Activities include voluntary sign- ups for participation, cessation information, and followup evaluation. Through the followup evaluation, it has been determined that for those employees who do not smoke during the 24-hour period of the Smokeout, there is a high success rate of quitting permanently. 0437. KENTUCKY DEPARTMENT FOR HEALTH SER- VICES, HEALTH PROMOTION BRANCH, 275 East Main Street, Frankfort, Kentucky 40621. Program Title: Smoking Cessation Program For State Employees. Contact: Ms. Edie Crews, Program Coordinator (502)564-7112. Description: The Health Promotion Branch serves as a resource in guiding employees to smoking cessation programs when requested. Self-help programs are also available upon request. 0438. LEXINGTON-FAYETTE COUNTY HEALTH DEPARTMENT, 650 Newton Pike, Lexington, Kentucky 40508. Program Title: Stop-Smoking Clinics. Contact: Carol Vaughn, R.N., Director, Special Services (606)252-2371. Description: The program consists of six weekly 1-hour sessions offered to employees free of charge. Participants are taught interven- tion techniques and provided with information on the health effects of smoking. Positive reinforcement through group in- teraction plays a major role in the program's implementation. 0439. MAXICARE KENTUCKY, INC., 870 Corporate Drive, Suite 402, Lexington, Kentucky, 40503. Program Title: Smoking Cessation Clinics. Contact: Ms. Susan Paavola, Health Education Director (606)223-4554. Description: This organization conducts smoking cessation clinics using the materials and guidelines provided by the American Cancer Society and the American Lung Association. 0440. THE NORTON LIFESTYLE CENTER, 226 East Broadway, Louisville, Kentucky 40202. Program Title: Smoke Stoppers. Contact: The Norton Careline (502)562-7018. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase Il provides the techniques, guidance, support, and structure for cessa- tion; and Phase [Il provides an ongoing support and maintenance system. 0441. THREE RIVERS DISTRICT HEALTH DEPART- MENT, Route 5, Box 16A, Owenton, Kentucky 40359. Program Title: Tobacco Education. Contact: Ms. Carol L. Donnelly, Health Educator (502)484-3412. Description: The program is offered twice monthly, for 3 months each semester. Each session is 45 minutes in length. Students in grade 4 are tested before and after participation in the program on their knowledge of the effects of tobacco on the body. Films, pamphiets, models, games, and other audiovisual aids are used. 0442. WEDCODISTRICT HEALTH DEPARTMENT, Post Office Box 226, Highway 36, Carlisle, Kentucky 40311. Program Title: FreshStart. Contact: Lee Rose, R.N., Program Director (606)289-2188. Description: The American Cancer Society's FreshStart program is offered to all prenatal, hypertension, and diabetic patients, free of . charge. For more information, see the detailed program description in Part 1. LOUISIANA 0443. AMERICAN CANCER SOCIETY, LOUISIANA DIVISION, INC., Masonic Temple Building, Suite 700, 333 St. Charles Avenue, New Orleans, Louisiana 70130-3118. Program Title: Education Programs. Contact: Mr. Garrett G. Stearns, Executive Vice President (504)523-2029. Description: The American Cancer Society’s educational programs are offered. For more information, see the detailed program “descriptions in Part 1. 0444. AMERICAN CANCER SOCIETY, LOUISIANA DIVISION, INC., Masonic Temple Building, Suite 700, 333 St. Charles Avenue, New Orleans, Louisiana 70130-3118. Program Title: FreshStart. Contact: Mr. Garrett G. Stearns, Executive Vice President (504)523-2029. Description: The FreshStart program is offered free of charge throughout the State. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, LOUISIANA, INC., 105 Campus Drive East, Post Office Box 159, Destrehan, Louisiana 70047-0159. 0445. Program Title: Calling It Quits. Contact: Mr. Paul A. Baricos, Program Director (504)764-8711. Description: The American Heart Association's self-help smoking cessation brochure, Calling tt Quits, is available upon request. 0446. AMERICAN HEART ASSOCIATION, LOUISIANA, INC., 105 Campus Drive East, Post Office Box 159, Destrehan, Louisiana 70047-0159. Program Title: in Control. Contact: Mr. Paul A. Baricos, Program Director (504)764-8711. Description: The home video smoking cessation program, in Control, is available through the American Heart Association's Heart At Work worksite health promotion program. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, LOUISIANA, INC., 105 Campus Drive East, Post Office Box 159, Destrehan, Louisiana 70047-0159. 0447. Program Title: Save A Sweet Heart. Contact: Mr. Paul A. Baricos, Program Director (504)764-8711. Description: The American Heart Association's Save A Sweet Heart 245 program is conducted in schools by students. For more information, see the detailed program description in Part 1. 0448. AMERICAN LUNG ASSOCIATION OF LOUISIANA, 333 St. Charles Avenue, Suite 500, New Orleans, Louisiana 70130-3180. Program Title: Freedom From Smoking In 20 Days. Contact: Mr. Ben Fontaine, Director of Community Programs (504)523-5864. Description: The American Lung Association's Freedom From Smoking self-help manuals are offered for the cost of $10. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF LOUISIANA, 333 St. Charles Avenue, Suite 500, New Orleans, Louisiana 70130-3180. 0449. Program Title: Group Hypnosis. Contact: Mr. Ben Fontaine, Director of Community Programs (504)523-5864. Description: Group hypnosis is conducted by a certified group hyp- notherapist at sites throughout the State. It is a 90-minute clinic given five times a year at a cost of $35 a person. This program is available to the general public and as an individual- ized program for businesses and corporations. The group is hypnotized three times during the clinic, and all receive support literature and a followup tape cassette. LOUISIANA DEPARTMENT OF HEALTH AND 0450. HUMAN RESOURCES, OFFICE OF PREVENTIVE AND PUBLIC HEALTH SERVICES, 325 Loyola Avenue, Post Office Box 60630, New Orleans, Louisiana 70160. Program Title: Patient And Community Education. Contact: Mr. Joseph D. Kimbrell, Deputy Assistant Secretary for Programs (504)568-5050. Description: The Chronic Disease Section promotes patient and com- munity information on the health hazards of smoking through counseling individual clients in the hypertension control and prenatal clinics and through community presentations to groups. 0451. OUACHITA PARISH HEALTH UNIT, 2913 Desiard Street, Post Office Box 4460, Monroe, Louisiana 71211. Program Title: Louisiana High Blood Pressure Control. Contact: Nursing Supervisor of the Ouachita Parish Health Unit and Assistant Nursing Supervisor of the West Monroe Health Unit (318)362-3400 and (318)322-3554. Description: This program, which targets black male adolescents, seeks to control and prevent chronic cardiovascular disease by control- ling important risk factors, such as cigarette smoking, hyper- tension, exercise accordance, and imbalanced diet. The program also serves as a referral source for private- and public-sector physicians who can use the program's patient education and counseling resources to enhance patient compliance with the physician's treatment plans. 0452. THE WELLNESS INSTITUTE, 2901 General de Gaulle Drive, Sulte 106 B, New Orleans, Louisiana 70114. Program Title: Smokefree. Contact: Harold H. Dawley, Jr., Ph.D., Program Director (504)361-1845. Description: Smokefree is a comprehensive worksite smoking control, dis- couragement, and cessation program developed over a 14- year period. Smoking control consists of consultation on restricting smoking at the worksite along with providing no smoking signs. Smoking discouragement involves the place- ment of 12 different posters using humor to emphasize quit- ting throughout the worksite. The Smokefree smoking cessation program is offered in conjunction with smoking con- trol and discouragemeht and is available in three different for- mats. The first smoking cessation format is a self-help program consisting of the book Smokefree — How to Stop Smoking in Nine Easy Steps and the audiotape HypnoQuit — How to Stop Smoking through Self-Hypnosis, and three packs of Quit-Stiks, smoking substitutes made from natural cin- namon sticks. The second format involves the use of the self- help program in conjunction with a workshop. The third format involves the use of the self-help program in conjunction with a group program of eight 1-hour sessions over a 3-week period. Followup is available for all three cessation formats. Smokefree is research based and has been used in several funded research studies with over 15 articles published in various professional journals relating to its effectiveness. MAINE 0453. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. Program Title: An Early Start To Good Health. Contact: Ms. Connie Reed, Assistant Public Education Director (207)729-3339 or (800)482-0113. Description: The American Cancer Society’s primary grades smoking education program is offered. For more information, see the detailed program description in Part 1. 0454. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. Program Title: FreshStart. Contact: Ms. Vicki Johnson Purgavie, Public Education Director (207)729-3339 or (800)482-0113. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0455. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. Program Title: Health Myself. Contact: Ms. Connie Reed, Assistant Public Education Director (207)729-3339 or (800)482-0113. Description: This three-unit teaching kit is designed for students in grades 7 through 9. For more information, see the detailed program description in Part 1. 0456. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. 246 Program Title: Health Network. Contact: Ms. Connie Reed, Assistant Public Education Director (207)729-3339 or (800)482-0113. Description: This program, designed for students in grades 4 through 6, is a followup to An Early Start to Good Health. For more information, see the detailed program description in Part 1. 0457. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. Program Title: Healthy Decisions. Contact: Ms. Connie Reed, Assistant Public Education Director (207)729-3339 or (800)482-01 13. Description: This computer software program is designed for students in grades 4 through 6. For more information, see the detailed program description in Part 1. 0458. AMERICAN CANCER SOCIETY, MAINE DIVISION, INC., 52 Federal Street, Brunswick, Maine 04011. Program Tithe: Smoke-Free Young America. Contact: Ms. Connie Reed, Assistant Public Education Director (207)729-3339 or (800)482-0113. Description: This program is aimed at five target groups: vocational and technical high school students, preschool children, early adolescents, health care professionals, and expectant parents. Currently this program package consists of the Breaking Free program for vocational and technical students and the Starting Free program for preschool children. For more information on these programs, see the detailed program descriptions in Part 1. 0459. AMERICANLUNG ASSOCIATION OF MAINE, 128 Sewall Street, Augusta, Maine 04330. Program Title: Because You Love Your Baby. Contact: Ms. Sharon Gleason, Program Assistant (207)622-6394. Description: This kit, designed to help health care providers counsel mothers-to-be on the dangers of smoking cigarettes, includes: 1) handbook for health care providers; 2) packet for mothers- to-be; 3) no smoking signs and posters; 4) flip chart illustrat- ing the reaction of the body to nicotine; 5) fact sheets on cigarette smoking and secondhand smoke; and 6) amagazine reprint of "It Might Have Been a Beautiful Baby." 0460. AMERICAN LUNG ASSOCIATION OF MAINE, 1 28 Sewall Street, Augusta, Maine 04330. Program Title: Freedom From Smoking Facilitators’ Training. Contact: Mr. Peter King, Assistant Executive Director (207)622-6394. Description: A two-day training program is offered biannually to health professionals and other interested persons who want to or- ganize and conduct stop smoking clinics in their community, hospital, or workplace. During the training, the concepts, philosophy, materials, and techniques incorporated into the Freedom From Smoking clinics are explored. Participants are given the chance to view audiovisuals that have been developed for the clinics and practice group dynamic skills necessary to conduct a program effectively. 0461. AMERICAN LUNG ASSOCIATION OF MAINE, 128 Sewall Street, Augusta, Maine 04330. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Mr. Peter King, Assistant Executive Director (207)622-6394. Description: The American Lung Association’s Freedom From Smoking self-help manuals are offered. For more information, see the detailed program description in Part 1. 0462. AMERICAN LUNG ASSOCIATION OF MAINE, 128 Sewall Street, Augusta, Malne 04330. Program Title: In Control. Contact: Ms. Sharon Gleason, Program Assistant (207)622-6394. Description: The American Lung Association's In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0463. AMERICAN LUNG ASSOCIATION OF MAINE, 1 28 Sewall Street, Augusta, Maine 04330. Program Title: School Resources. Contact: Ms. Karen Waldman, Program Associate (207)622-6394. Description: Avariety of smoking prevention education programs are avail- able to schools, communities, and other special interest groups. Informational resources include pamphlets, puzzles, fact sheets, and buttons. Specitic school programs offered are Octopuff in Kumquat, Lungs Are For Life, audiovisual resources for students in grades 5 through 12, “Death in the West," "Feminine Mistake,” “Hugh McCabe: The Coach’s Final Lesson,” and Biofeedback Smoking Education Project. For more information on these programs, see the descriptions in Part 1. 0464. THE BADVERTISING INSTITUTE, Post Office Box 644, Deer Isle, Maine 04627. Program Title: The Joy Of Smoking — A Brand New Look At The Same Old Hype. Contact: Ms. Bonnie Vierthaler, Artist and Director (207)348-9978. Description: The Joy Of Smoking is a spoof by artist Bonnie Vierthaler on glamorous cigarette advertisements. This witty series of col- lages tries to tell the truth behind cigarette advertising by jux- taposing cigarette advertisements with images from medical journals. The work has traveled to schools around the country so that children might learn to associate the health hazards of smoking with misleading cigarette advertising. The series is available for public exhibit. 0465. MAINE DEPARTMENT OF HUMAN SERVICES, DIVISION OF HEALTH PROMOTION AND EDUCATION, BUREAU OF HEALTH, State House Station 11, Augusta, Maine 04333. Program Title: Coalition On Smoke-Free Society. Contact: Mr. Randy Schwartz, Acting Director (207)289-5180. Description: The Bureau of Health provides staff support to the Coalition on Smoking or Health, which is composed of over 20 organiza- tions in the State of Maine. The goal of the coalition is a smoke-free society by the year 2000. The coalition sponsors legislation and educational activities related to that goal. 0466. MAINE DEPARTMENT OF HUMAN SERVICES, DIVISION OF HEALTH PROMOTION AND EDUCATION, BUREAU OF HEALTH, State House Station 11, Augusta, Maine 04333. Program Title: Planned Approach To Community Health. Contact: Mr. Randy Schwartz, Acting Director (207)289-5180. Description: The Community Health Promotion program is currently work- ing with the Centers for Disease Control's Division of Health Education to implement the Planned Approach to Community Health (PATCH) program in four communities in Maine. In several of the PATCH sites, smoking prevention and cessation programs are being developed. MARYLAND ALLEGANY COUNTY HEALTH DEPARTMENT, Willowbrook Road, Cumberland, Maryland 21502. 0467. Program Title: Quit And Win. Contact: Jane R. Miller, R.N., Health Educator (301)777-5600. Description: This is a smoking cessation incentive program that gives smokers an incentive to set a quit date and remain smoke-free for 1 month. Successful participants have a chance to win a variety of prizes. The program was designed and evaluated 248 by the Maryland Department of Health and Mental Hygiene. In a 1-year followup, 10 percent of contest participants in worksite programs and 6 percent of contest participants in community programs remained smoke-free. This program has been implemented by 16 local health departments since it was designed in 1984. 0468. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., ALLEGANY/GARRETT COUN- TIES UNIT OFFICE, 111 South George Street, Cumberland, Maryland 21502. Program Title: FreshStart. Contact: Ms. Helen Stallings, Program Coordinator (301)722-2145. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to the public free of charge. For more information, see the detailed program description in Part 1. 0469. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., CHESAPEAKE/POTOMAC AREA OFFICE, Bullding A, 1401 Route 3 North, Gambrills, Maryland 21054. Program Title: FreshStart. Contact: Ms. Pat Nolan, Program Coordinator (301)721-4304. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered to the public free of charge in Anne Arundel, Calvert, Charles, Prince Georges, and St. Mary’s Counties. For more information, see the detailed program description in Part 1. 0470. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., EASTERN SHORE AREA OFFICE, 104 West Chestnut Street, Post Office Box 163, Salisbury, Maryland 21801. Program Title: FreshStart. Contact: Ms. Laura Brittingham, Program Coordinator (301)749-1624. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to the public free of charge in Caroline, Dorchester, Kent, Queen Annes, Somerset, Talbot, Wicomico, and Worcester Counties. For more information, see the detailed program description in Part 1. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., FREDERICK COUNTY OFFICE, 11 West South Street, Frederick, Maryland 21701. 0471. Program Title: FreshStart. Contact: Ms. Mary Ann Ford, Program Coordinator (301)622-2357. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered to the public free of charge. For more information, see the detailed program description in Part 1. 249 0472. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., MONTGOMERY COUNTY OFFICE, 11323 Amherst Avenue, Silver Spring, Maryland 20902. Program Title: FreshStart. Contact: Ms. Christine Yankus-Eng, Program Coordinator (301)933-9350. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to the public free of charge. For more information, see the detailed program description in Part 1. 0473. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., NORTH CENTRAL MARYLAND AREA OFFICE, 200 East Joppa Road, Suite 300, Baltimore, Maryland 21204. Program Title: FreshStart. Contact: Mr. Christopher Heidelberg, Program Coordinator (301)821-7200. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered to the public free of charge in Baltimore, Carroll, Harford, and Howard Counties. For more information, see the detailed program description in Part 1. AMERICAN CANCER SOCIETY, MARYLAND DIVISION, INC., WASHINGTON COUNTY UNIT OFFICE, 1037 Haven Road, Hagerstown, Maryland 21740. 0474. Program Title: FreshStart. Contact: Ms. Mary Ann Ford, Program Coordinator (301)733-8272. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to the public free of charge. For more information, see the detailed program description in Part 1. 0475. AMERICAN HEART ASSOCIATION, MARYLAND AFFILIATE, 415 North Charles Street, Post Office Box 17025, Baltimore, Maryland 21203. Program Title: Save A Sweet Heart. Contact: Ms. Sandra L. Joy, Program Associate (301)685-7074. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 0476. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Sulte 705, Lutherville, Maryland 21093. Program Title: Freedom From Smoking. Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1100 or (800)492-7527. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0477. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1 100 or (800)492-7527. Description: The American Lung Association’s Freedom From Smoking For You And Your Baby program is offered. For more information, see the detailed program description in Part 1. 0478. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Sulte 705, Lutherville, Maryland 21093. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1100 or (800)492-7527. Description: The American Lung Association’s Freedom From Smoking For You And Your Family program is offered. For more information, see the detailed program description in Part 1. 0479. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Freedom From Smoking Self-Help Manuals. 250 Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1 100 or (800)492-7527. Description: Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking are available for $7. For more information, see the detailed program description in Part 1. 0480. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Growing Healthy. Contact: Ms. Anne V. Eder, Associate Program Director (301)494-1 100 or (800)492-7527. Description: This comprehensive health education curriculum for students in kindergarten through grade 7 is offered to area schools. For more information, see the detailed program description in Part 1. 0481. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Sulte 705, Lutherville, Maryland 21093. Program Title: I'll Never Smoke Campaign. Contact: Ms. Anne V. Eder, Associate Program Director (301)494-1 100 or (800)492-7527. Description: During the campaign, held once a year for 2 weeks, students between the ages of 9 and 13 make a commitment not to start smoking by signing a pledge form. Parents are asked to rein- force their child’s decision not to smoke by signing the reverse side of the pledge form. Signed forms are collected and returned to the American Lung Association of Maryland and entered in prize drawings. Individual winners are randomly selected and awarded prizes. Grand prize winning schools are also selected. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. 0482. Program Title: In Control. Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1100 or (800)492-7527. Description: The American Lung Association’s In Control smoking cessation program is offered. For more information, see the detailed program description in Part 1. 0483. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Sulte 705, Lutherville, Maryland 21093. Program Title: Lungs Are For Life. Contact: Ms. Anne V. Eder, Associate Program Director (301}494-1100 or (800)492-7527. Description: These self-contained lessons for students in kindergarten through grade 4 are easily integrated into existing curriculum. For more information, see the detailed program description in Part 1. 0484. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Marijuana: A Second Look. Contact: Ms. Anne V. Eder, Associate Program Director (301)494-1100 or (800)492-7527. Description: This is an educational program, designed for children aged 9 through 11, that emphasizes skills children can use to resist peer pressure to experiment with marijuana. For more information, see the detailed program description in Part 1. 0485. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Sulte 705, Lutherville, Maryland 21093. Program Title: Smoking And Pregnancy. Contact: Ms. Linda Frisch, Associate Director, Program Development (301)494-1100 or (800)492-7527. Description: The American Lung Association’s Smoking And Pregnancy program is offered. Fees for each package are as follows: Kit for Pregnant Women, free; Kit for Health Care Providers, $5; slideAape presentation, $30. For more information, see the detailed program description in Part 1. 0486. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Smoking Deserves A Smart Answer. 251 Contact: Ms. Anne V. Eder, Associate Program Director (301}494-1100 or (800)492-7527. Description: This smoking prevention program, designed for educators of students in grades 5 through 7, teaches adolescents to under- Stand and resist pressures to smoke and use smokeless tobacco. Designed as a seven-session program, this can be modified to fit into existing curricula. For more information, see the detailed program description in Part 1. 0487. AMERICAN LUNG ASSOCIATION OF MARYLAND, 1301 York Road, Suite 705, Lutherville, Maryland 21093. Program Title: Smoking Deserves A Smart Answer Videotape. Contact: Ms. Anne V. Eder, Associate Program Director (301)494-1100 or (800)492-7527, Description: An 11-minute videotape is available to reinforce the basic con- cepts of the Smoking Deserves A Smart Answer curriculum. The tape depicts adolescents in different situations in which they are offered cigarettes and successfully resist the pres- sures to smoke. Videotapes are available in VHS and Beta formats. BALTIMORE CITY HEALTH DEPARTMENT, BUREAU OF HEALTH EDUCATION AND PROMOTION, 303 East Fayette Street, Second Floor, Baltimore, Maryland 21202. 0488. Program Title: Quit And Win. Contact: Mr. Robert B. Mancke, Director (301)396-5637. Description: This is a smoking cessation incentive program that gives smokers an incentive to set a quit date and remain smoke-free for 1 month. Successful participants have a chance to win a variety of prizes. The program was designed and evaluated by the Maryland Department of Health and Mental Hygiene. In a 1-year fol- lowup, 10 percent of contest participants in worksite programs and 6 percent of contest participants in community programs remained smoke-free. This program has been implemented by 16 local health departments since it was designed in 1984. BALTIMORE CITY HEALTH DEPARTMENT, BUREAU OF HEALTH EDUCATION AND PROMOTION, 303 East Fayette Street, Eighth Floor, Baltimore, Maryland 21202. 0489. Program Title: Smoking Cessation Initiative. Contact: Ms. Lee Truelove, Program Administrator (301)396-5095. Description: This program is offered on request to residents of Baltimore, to employee trainers at worksites, and to Baltimore City Government employees. The program uses educational materials supplied by the American Lung Association, and it emphasizes behavior modification. _Instructor training to worksite representatives is provided. The program objective is to assist adults in their decision to stop smoking and to maintain a 33 percent quit rate after 1 year. BALTIMORE COUNTY DEPARTMENT OF HEALTH, DIVISION OF HEALTH EDUCATION AND INFORMATION, 401 Bosley Avenue, Towson, Maryland 21204. 0490. Program Title: Community Education. Contact: Mr. William L. Follett, Director (301)494-3078. Description: Literature on the health effects of smoking is provided to civic groups, school children, individual citizens, and county employees. The division has also produced two 30-minute television programs dealing with smoking for transmission over the county cable television facilities and has promoted the transmission of other programs on the subject. The health department has been a consultant to other county agencies and some private agencies in establishing smoking policies for that agency. The department also acts as a clearing-house in referring individuals to voluntary health agencies that offer smoking cessation programs. 0491. CARROLL COUNTY HEALTH DEPARTMENT, Post Office Box 854, Westminster, Maryland 21157. Program Title: Quit And Win. Contact: Ms. Barbara Rogers, Health Educator (301)876-2152. Description: This is a smoking cessation incentive program that gives smokers an incentive to set a quit date and remain smoke-free for 1 month. Successful participants have a chance to win a variety of prizes. The program was designed and evaluated by the Maryland Department of Health and Mental Hygiene. In a 1-year followup, 10 percent of contest participants in worksite programs and 6 percent of contest participants in community programs remained smoke-free. This program 252 has been implemented by 16 local health departments since it was designed in 1984. 0492. CHARLES COUNTY DEPARTMENT OF HEALTH, Post Office Box 640, La Plata, Maryland 20646. Program Title: Freedom From Smoking. Contact: Ms. Linda Leuthauser, Health Educator (301)934-9577. Description: The Charles County Health Department, working in conjunc- tion with the American Lung Association, offers the Freedom From Smoking program to smokers in the community. For more information, see the detailed program description in Part 1. 0493. FREDERICK COUNTY HEALTH DEPARTMENT, Winchester Hall, 12 East Church Street, Frederick, Maryland 21701. Program Title: Quit And Win. Contact: Ms. Suzanne Markowitz, Health Educator (301)694-1808. Description: This is a smoking cessation incentive program that gives smokers an incentive to set a quit date and remain smoke-free for 1 month. Successful participants have a chance to win a variety of prizes. The program was designed and evaluated by the Maryland Department of Health and Mental Hygiene. In a 1-year followup, 10 percent of contest participants in worksite programs and 6 percent of contest participants in community programs remained smoke-free. This program has been implemented by 16 local health departments since it was designed in 1984. 0494. HARFORD COUNTY HEALTH DEPARTMENT, 119 South Hays Street, Post Office Box 191, Bel Air, Maryland 21014-0191. Program Title: Smoking Cessation. Contact: Dr. Beverly Stump, Deputy Health Officer (301)879-8322 ext.259. Description: The program helps individuals prepare to quit smoking, then helps them identify, avoid, and break smoking triggers with a support network. This is followed by the most important phase of quitting and remaining a nonsmoker. The service is provided at health department clinics and selected worksite locations. HEALTH PROMOTION SERVICES, Franklin Square at White Marsh, 8114 Sandpiper Circle, Baltimore, Maryland 21236. 0495. Program Title: How To Quit Smoking. Contact: Ms. Monica Gennerella, Program Coordinator (301)529-3600. Description: This program consists of eight 1-hour sessions. During the first four sessions, the habit of smoking, the physical factors, and the steps to quitting are explored. Stress and other trig- gers related to smoking are discussed, along with hints for coping with the triggers when quitting. Weight control hints are also included. The last half of the course provides sup- port for the new ex-smokers. The focus is placed on remain- ing smokefree and living a healthier litestyle. This program is made available at the health center or in the workplace. HEALTH PROMOTION SERVICES, Frankiin Square at White Marsh, 8114 Sandpiper Circle, Baltimore, Maryland 21236. 0496. Program Title: Stop Smoking. Contact: Ms. Patricia G. Ford, Manager of Health Promotion (301)529-3600. Description: A service for developing a worksite smoking policy is offered. HOWARD COUNTY HEALTH DEPARTMENT, Post Office Box 476, Ellicott City, Maryland 21043. 0497. Program Title: Smoking And Pregnancy. Contact: Ms. Andrea Port, Health Educator (801)992-2333. Description: This is an ongoing program in prenatal clinics. The health department uses Pregnant Woman's Self Help Guide: Quit Smoking, developed by Richard Windsor, Ph.D., M.P.H. 0498. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 201 West Preston Street, Baltimore, Maryland 21201. Program Title: Project Smart and Training On Smoking. Contact: Ms. Joan Stine, Chief, Health Education Center (301)225-1362. 253 Description: The Maryland Department of Health and Mental Hygiene sponsors two smoking education programs. Project Smart is a program used in the middle school curriculum focusing on the prevention of alcohol, drug, and tobacco use. The second program, Training On Smoking, trains local health department nurses in advising patients to quit smoking. 0499. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 201 West Preston Street, Baltimore, Maryland 21201. Program Title: Quit And Win. Contact: Ms. Joan Stine, Chief, Health Education Center (310)225-1362. Description: Quit And Win is a smoking cessation program for those want- ing to quit smoking. ft offers both opportunity to, and incen- tive for, quitting. Based on the Minnesota Heart Health Program, Quit And Win asks smokers to quit for 1 month in order to be eligible to participate in arandom drawing of prizes. Prizes are awarded after the smoke-free status of those people whose names are drawn is verified. A telephone sur- vey at 6 months is utilized to evaluate the effectiveness of the program. 0500. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 201 West Preston Street, Baltimore, Maryland 21201 Program Title: Smoke-Free And Healthy. Contact: Ms. Joan Stine, Chief, Health Education Center (301)225-1362. Description: The Maryland Department of Health and Mental Hygiene enacted a stringent new smoking policy on October 1, 1987. Smoke-Free And Healthy is the umbrella title for an array of services being offered to department smokers who wish to use the new policy as an opportunity to quit smoking. These ser- vices include clinics, self-help materials, a videocassette rogram, and self-help tip sheets. While these services will ongoing, the results of the initial implementation will be evaluated at 6 months. MARYLAND DEPARTMENT OF HEALTH AND MENTAL HYGIENE, 201 West Preston Street, Baltimore, Maryland 21201. 0501. Program Title: Smoking Cessation In Pregnancy. Contact: Ms, Joan Stine, Chief, Health Education Center or Annelies Zachary, M.D., M.P.H. (301)225-1362 or 225-6721. Description: Maryland is one of three States participating in a Centers for Disease Control funded study designed to test the effects of an intervention with pregnant smokers. The interventions will be carefully targeted through the use of extensive State- specific information collected in focus groups. These inter- ventions will be designed to be effective and intensive while utilizing a minimum of resources. One of the goals of the study is to demonstrate that smoking cessation activities can be in- tegrated into the normal routine services of regular prenatal clinics and Women, Infants, and Children programs with ex- isting resources. Eval will be extensive. A large number of data items will be monitored. Behavioral change will be followed by self-report validated by urinary cotinine levels. 0502. SACRED HEART HOSPITAL, COMMUNITY WELLNESS PROGRAMS, CENTER FOR WELL- NESS, 915 Bishop Walsh Drive, Cumberland, Maryland 21502. Program Title: Smoke Stoppers. Contact: Sandi Geiger, Ed.D., Manager of Wellness (301)759-5020. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase Iil provides an ongoing support and maintenance system. 0503. WICOMICO COUNTY HEALTH DEPARTMENT, 300 West Carroll Street, Salisbury, Maryland 21801. Program Title: Quit And Win. Contact: Peggy Bagley, C.H.N., Program Coordinator (301)749-1244,. Description: This is a program developed by the Health Education Center of the Maryland Departrnent of Health and Mental Hygiene for seeking smokers willing to quit for a given time, usually a month, to be eligible to win prizes. The prizes are solicited from local businesses. In 1985 the Quit And Win program was sponsored and run by the Health Education Center in Wicomico, Somerset, Worcester, and Dorchester Counties. In 1987 when grant money was available Wicomico County secured funds to run their own Quit And Win programs. 0504. WICOMICO COUNTY HEALTH DEPARTMENT, 300 West Carroll Street, Salisbury, Maryland 21801. Program Title: Smoking And Pregnancy. Contact: Jeanette Brown, C.H.N., Program Coordinator (301)543-6961. Description: The Health Department Prenatal Clinic counsels pregnant women, using a package called Smoking And Pregnancy, developed by the American Lung Association. For more information, see the detailed program description in Part 1. MASSACHUSETTS 0505. AMERICAN CANCER SOCIETY, MAS- SACHUSETTS DIVISION, INC., 247 Common- wealth Avenue, Carhart Memorial Building, Boston, Massachusetts 02116. Program Title: Breaking Free. Contact: Ms. Kathy O’Connor, Director of Public Education (617)267-2650. Description: Breaking Free, a new smoking cessation program for high school students, is offered. For more information, see the detailed program description in Part 1. 0506. AMERICAN CANCER SOCIETY, MAS- SACHUSETTS DIVISION, INC., 247 Common- wealth Avenue, Carhart Memorial Building, Boston, Massachusetts 02116. Program Title: Early Start To Good Health. Contact: Ms. Kathy O'Connor, Director of Public Education (617)267-2650. Description: The American Cancer Society’s Early Start To Good Health program is offered to students in kindergarten through grade 3. For more information, see the detailed program description in Part 1. 0507. AMERICAN CANCER SOCIETY, MAS- SACHUSETTS DIVISION, INC., 247 Common- wealth Avenue, Carhart Memorial Building, Boston, Massachusetts 02116. Program Title: FreshStart. Contact: Ms. Karen Allen, Tobacco Education Coordinator (617)267-2650. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0508. AMERICAN CANCER SOCIETY, MAS- SACHUSETTS DIVISION, INC., 247 Common- wealth Avenue, Carhart Memorial Buliding, Boston, Massachusetts 02116. Program Title: Health Myself. Contact: Ms. Kathy O’Connor, Director of Public Education (617)267-2650. Description: The American Cancer Society's Health Myself program is of- fered to students in grades 7 through 9. For more information, see the detailed program description in Part 1. 0509. AMERICAN CANCER SOCIETY, MAS- SACHUSETTS DIVISION, INC., 247 Common- wealth Avenue, Carhart Memorial Bullding, Boston, Massachusetts 02116. Program Title: Health Network. Contact: Ms. Kathy O’Connor, Director of Public Education (617)267-2650. Description: The American Cancer Society's Health Network program is offered to students in grades 4 through 6. For more information, see the detailed program description in Part 1. 0510. AMERICAN HEART ASSOCIATION, MAS- SACHUSETTS AFFILIATE, 33 Fourth Avenue, Needham Heights, Massachusetts 02194. Program Title: Calling It Quits. Contact: information Services Coordinator (617)449-5931 ext.17. 255 Description: The American Heart Association's self-help smoking cessa- tion kit is available. For more information, see the detailed program description in Part 1. 0511. AMERICAN HEART ASSOCIATION, MAS- SACHUSETTS AFFILIATE, 33 Fourth Avenue, Needham Heights, Massachusetts 02194. Program Title: Coalition For A Smoke-Free Massachusetts By The Year 2000. Contact: Ms. Wendy Breen, Assistant Program Director (617)449-5931. Description: In collaboration with the American Cancer Society and the American Lung Association, the American Heart Association of Massachusetts is focusing prevention efforts on health care providers for this fiscal year. Program goals for providers in- clude making a personal commitment for smoking cessation; serving as a role model by advocating a smoke-free environment in health-care settings; and counseling patients. 0512. AMERICAN HEART ASSOCIATION, MAS- SACHUSETTS AFFILIATE, 33 Fourth Avenue, Needham Heights, Massachusetts 02194. Program Title: Let’s Talk About Smoking. Contact: Information Services Coordinator (617)449-5931 ext.17. Description: The American Heart Association's Let's Talk About Smoking program is offered. For more information, see the detailed program description in Part 1. AMERICAN HEART ASSOCIATION, MAS- SACHUSETTS AFFILIATE, 33 Fourth Avenue, Needham Helghts, Massachusetts 02194 0513. Program Title: Save A Sweet Heart. Contact: Mr. Keven McEllin, Program Director (617)449-5931 ext.25. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF CENTRAL MASSACHUSETTS, 35 Harvard Street, Worcester, Massachusetts 01609. 0514. Program Title: Freedom From Smoking Clinics. Contact: Ms. Emily B. Johnson, Program Director (617)756-5749. Description: The American Lung Association's Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0515. AMERICAN LUNG ASSOCIATION OF CENTRAL MASSACHUSETTS, 35 Harvard Street, Worcester, Massachusetts 01609. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Emily B. Johnson, Program Director (617)756-5749. Description: The American Lung Association's Freedom From Smoking For You And Your Baby program, for pregnant, pre- and postnatal women, is offered. For more information, see the detailed program description in Part 1. 0516. AMERICAN LUNG ASSOCIATION OF CENTRAL MASSACHUSETTS, 35 Harvard Street, Worcester, Massachusetts 01609. Program Title: Freedom From Smoking Manuals. Contact: Ms. Emily B. Johnson, Program Director (617)756-5749. Description: The American Lung Association's Freedom From Smoking self-help manuals, Freedom From Smoking In 20 Days, and A Lifetime Of Freedom From Smoking are available. For more information, see the detailed program description in Part 1. 0517. AMERICAN LUNG ASSOCIATION OF CENTRAL MASSACHUSETTS, 35 Harvard Street, Worcester, Massachusetts 01609. Program Title: Smoking Education For Students. Contact: Ms. Roberta Seidman, Program Associate (617)756-5749. Description: This informal smoking education program is conducted upon request. The group is shown the hazards of smoking and the underlying psychological reasons why people begin smoking. Factors involved in making that initial decision and the 256 difficulty in stopping are discussed as well as the rights of non- smokers. Brochures, pamphlets, and buttons are distributed; films and samples of lung tissue are shown. Although designed for students, the program can be adapted for any organization. 0518. AMERICAN LUNG ASSOCIATION OF ESSEX COUNTY, 239 Newburyport Turnpike, Topsfield, Massachusetts 01983. Program Title: Freedom From Smoking. Contact: Ms. Janet Sannella, Program Associate (617)887-6055. Description: The American Lung Association's Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0519. AMERICAN LUNG ASSOCIATION OF ESSEX COUNTY, 239 Newburyport Turnpike, Topsfield, Massachusetts 01983. Program Title: School Education. Contact: Ms. Susan Fallon, Program Coordinator (617)887-6055. Description: Various school health resources are available to ad- ministrators, curriculum specialists, health coordinators, and school nurses. Assistance is provided through an extensive audiovisual loan program, teacher training workshops, and background information on key health issues. Elementary and middle school resources include the Growing Healthy cur- riculum and the Lungs Are For Life mini-curriculum (both described in detail in Part 1), and various units on smoking ~ prevention. High school resources include 10 new audiovisuals related to smoking education with accompanying teaching guides. 0520. AMERICAN LUNG ASSOCIATION OF MAS- SACHUSETTS, 803 Summer Street, Boston, Massachusetts 02127. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Penny Richmond, Community Health Educator (617)269-9720. Description: The American Lung Association’s Biofeedback Smoking Education Project is offered to all area high schools. For more information, see the detailed program description in Part 1. 0521. AMERICAN LUNG ASSOCIATION OF MAS- SACHUSETTS, 803 Summer Street, Boston, Massachusetts 02127. Program Title: Freedom From Smoking At Work. Contact: Ms. Cynthia Ferguson, Program Manager (617)269-9720. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0522, AMERICAN LUNG ASSOCIATION OF MAS- SACHUSETTS, 803 Summer Street, Boston, Massachusetts 02127. Program Title: Freedom From Smoking Clinics. Contact: Ms. Cynthia Ferguson, Program Manager (617)269-9720. Description: The American Lung Association’s Freedom From Smoking clinics are offered 25 times each year to the general public. For more information, see the detailed program description in Part 1. 0523. AMERICAN LUNG ASSOCIATION OF MAS- SACHUSETTS, 803 Summer Street, Boston, Massachusetts 02127. Program Title: Freedom From Smoking Facilitators Training. Contact: Ms. Cynthia Ferguson, Program Manager (617)269-9720. Description: The American Lung Association’s Freedom From Smoking Facilitators Training program is offered four times each year. For more information, see the detailed program description in Part 1. 0524. AMERICAN LUNG ASSOCIATION OF MAS- SACHUSETTS, 803 Summer Street, Boston, Massachusetts 02127. Program Title: Marijuana: A Second Look. Contact: Ms. Penny Richmond, Community Health Educator (617)269-9720. 257 Description: The American Lung Association’s program, Marijuana: A Second Look, is offered to students in grades 4 to 6 in all area schools. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF WESTERN MASSACHUSETTS, 393 Maple Street, Springfield, Massachusetts 01105. 0525. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Gail Gramarossa, Program Coordinator (413)737-3506. Description: The American Lung Association’s Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. 0526. AMERICAN LUNG ASSOCIATION OF WESTERN MASSACHUSETTS, 393 Maple Street, Springfield, Massachusetts 01105. Program Title: Freedom From Smoking. Contact: Ms. Gail Gramarossa, Program Coordinator (413)737-3506. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0527. AMERICAN LUNG ASSOCIATION OF WESTERN MASSACHUSETTS, 393 Maple Street, Springfield, Massachusetts 01105. Program Title: School Education. Contact: Ms. Gail Gramarossa, Program Coordinator (413)737-3506. Description: A variety of school health education programs are offered to individual classes, to large groups, or to special interest groups such as the Key Club. Inservice education is also of- fered to teachers and school nurses. Objectives are to deliver accurate health information, to help students develop positive body images, to advocate positive health behavior, and to develop an awareness of health issues by helping students to develop their beliefs, values, and attitudes. The smoking-re- lated programs include Octopuff in Kumquat and Lungs Are For Life, described in detail in Part 1. Books, pamphlets, posters, films, teaching models of lungs showing the effects of smoking, and lung sections are avail- able for students in kindergarten through grade 12. Films and models are lent for a minimum of 3 weeks. THE CAMBRIDGE HOSPITAL, DEPARTMENT OF PSYCHIATRY, 1493 Cambridge Street, Cambridge, Massachusetts 02139. 0528. Program Title: Smoking Cessation — Behavioral Techniques. Contact: Deborah Hulihan, Psy.D., Program (617)498-1183. Director, Behavioral Medicine Description: This eight-session behavior modification group is geared toward reducing nicotine intake and addiction and reinforcing behaviors incompatible with smoking. The eight sessions in- clude a nicotine fading program, relaxation training, stress management, and relapse prevention, all enhanced by group support. The cost is $150; $50 may be paid at each of the first three sessions. All participants are evaluated individually. This initial screening is covered by Blue Cross/Blue Shield or other health insurance. Under individual circumstances, treat- ment may also be covered by health insurance. Individuals without a medically-based referral will be asked to pay in ad- vance. Financial investment enhances motivation. In addi- tion, the money normally spent on smoking will more than offset the costs. 0529. THE CAMBRIDGE HOSPITAL, DEPARTMENT OF PSYCHIATRY, 1493 Cambridge Street, Cambridge, Massachusetts 02139. Program Title: Smoking Cessation ~ Hypnosis. Contact: Deborah Hulihan, Psy.D., Director, Behavioral Medicine Program (617)498-1183. Description: The one-session hypnosis group is geared toward helping in- dividuals to quit smoking by increasing their personal motiva- tions for stopping. Addition focus is placed on enhancement of health consciousness and of one’s self-image as a non- smoker. Coping skills for relapse prevention are also taught. The cost is $45. Booster sessions will be available at a com- parable cost. All participants are evaluated individually. This initial screening is covered by Blue Cross/Blue Shield or other health insurance. Under some circumstances, treatment may also be covered by health insurance. Individuals without a medically-based referral will be asked to pay in advance. Financial investment enhances motivation. In addition, the money normally spent on smoking will more than offset the costs. 258 0530. FAULKNER HOSPITAL, 1153 Centre Street, Jamaica Plain, Massachusetts 02130. Program Title: Freedom From Smoking. Contact: Coordinator of Health Promotion Services (617)522-5800 ext. 1450. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description th Part 1. 0531. MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH, OFFICE OF NONSMOKING AND HEALTH, 150 Tremont Street, Boston, Massachusetts 02111. Program Title: Activities To Promote Nonsmoking. Contact: Gregory N. Connolly, D.M.D., M.P.H., Director (617)727-0732. Description: Working through the Women, Infants, and Children program and the State Office of Family Health Services, the Office of Nonsmoking and Health is distributing specially developed materials for pregnant smokers. This activity reaches 3,000 women through 250 physicians. The office is also working with the Massachusetts Lung Association to get other materials aimed at pregnant smokers into 1,000 obstetricians’ offices serving middle- and high-income women. In addition, the office supports public education programs, physician and dental counseling, and worksite counseling in the Neighbor- hood Health Centers in communities with high lung cancer rates. 0532. TOWN OF BROOKLINE HEALTH DEPARTMENT, 411 Plerce Street, Brookline, Massachusetts 02146. Program Title: Stop Smoking. Contact: Ms. Bettie Hirshom, Coordinator of Community Health Services (617)730-2336. Description: The department sponsors two monthly smoking cessation classes using hypnotherapy. The program targets all people who want to quit smoking. TOWN OF NORWOOD BOARD OF HEALTH, Norwood, Massachusetts 02062. 0533. Program Title: Multiple Risk Factor Reduction. Contact: Ms. Phyllis M. Boucher, Superintendent/Director (617)762-1240. Description: The Norwood Board of Health has adapted this program from the Massachusetts Department of Public Health. The program has been presented to town employees and to elementary and secondary school employees. Through an initial questionnaire, risk factors are identified and smokers are referred to the American Cancer Society and the Norfolk County-Newton Lung Association for smoking cessation programs. A followup questionnaire and testing are provided after 6 months. The objectives of the program are to promote decision making on a daily basis that will mitigate lifestyle risk factors, such as smoking. Evaluation has shown that while large numbers of people will not stop smoking, the number of cigarettes smoked each day often decreases. MICHIGAN 0534. AMERICAN CANCER SOCIETY, MICHIGAN DIVISION, INC., 1205 East Saginaw Street, Lansing, Michigan 48906. Program Title: The Dangers Of Smoking — The Benefits Of Quitting. Contact: Ms. Dorothy W. Cobb, Director of Public Education (517)371-2920. — Description: The program provides facts on the health consequences of smoking, describes and illustrates the immediate and tong- term benefits of quitting and provides helpful tips on smoking cessation methods. The program is presented free of charge and includes a trained speaker, a film, and audience participa- tion. Programs can be tailored to meet time allotments from 20 to 50 minutes. AMERICAN CANCER SOCIETY, MICHIGAN DIVISION, INC., 1205 East Saginaw Street, Lansing, Michigan 48906. 0535. Program Title: FreshStart. Contact: Ms. Dorothy W. Cobb, Director of Public Education (517)371-2920. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0536. AMERICAN CANCER SOCIETY, MICHIGAN DIVISION, INC., 1205 East Saginaw Street, Lansing, Michigan 48906. Program Title: Smoking Prevention Programs For Youth. 259 Contact: Ms. Dorothy W. Cobb, Director of Public Education (517)371-2920. Description: Programs begin in preschool and continue through high school. The most widely used smoking prevention programs of the Michigan American Cancer Society are An Early Start To Good Health, Health Network, Health Decisions, Health Myself, Starting Free: Good Air for Me, and Breaking Free. For more information about these programs, see the detailed program descriptions in Part 1. AMERICAN INSTITUTE FOR PREVENTIVE MEDICINE, 19111 West 10 Mile Road, Suite 101, Southfield, Michigan 48075. 0537. Program Title: Smokeless. Contact: Mr. Don R. Powell, Executive Director (313)352-7666. Description: The Smokeless system, developed by the American institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0538. AMERICAN LUNG ASSOCIATION OF GENESEE VALLEY, Post Office Box 529, Flint, Michigan 48501. Program Title: Antismoking Education. Contact: Ms. Sheryl Bennett, Program Manager (313)232-3177. Description: Education that promotes nonsmoking is provided for any school grade level or community group. Presentations are en- hanced with films, literature, and prepackaged educational materials for specific age groups. Presentations differ according to the group’s area of interest. AMERICAN LUNG ASSOCIATION OF GENESEE VALLEY, Post Office Box 529, Flint, Michigan 48501. 0539. Program Title: Freedom From Smoking Self-Help Booklets. Contact: Ms. Sheryl Bennett, Program Manager (313)232-3177. Description: : The American Lung Association Freedom From Smoking self- help manuals, Freedom From Smoking !n 20 Days, and A Lifetime Of Freedom From Smoking, are available. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF MICHIGAN, 403 Seymour Avenue, Lansing, Michigan 48833- 1179. 0540. Program Title: Freedom From Smoking Clinics. Contact: Ms. Karen Krzanowski, Program Director (517)484-4541,. Description: The American Lung Association’s Freedom From Smoking clinics are offered. Corpo are encouraged to sponsor on-site cessation clinics for employees. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF MICHIGAN, 403 Seymour Avenue, Lansing, Michigan 48933- 1179. 0541. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Karen Krzanowski, Program Director (517)484-4541. Description: The American Lung Association's Freedom From Smoking For You And Your Baby self-help program is offered. For more intormation, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF MICHIGAN, 403 Seymour Avenue, Lansing, Michigan 48933- 1179. 0542. 260 Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Karen Krzanowski, Program Director (517)484-4541. Description: The American Lung Association's Freedom From Smoking For You And Your Family self-help program is offered. For more information, see the detailed program description in ‘art 1. 0543. AMERICANLUNG ASSOCIATION OF MICHIGAN, 403 Seymour Avenue, Lansing, Michigan 48933- 1179. Program Title: in Control. Contact: Ms. Karen Krzanowski, Program Director (517)484-4541. Description: The American Lung Association's In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0544. AMERICAN LUNG ASSOCIATION OF SOUTHEAST MICHIGAN, 18860 West Ten Mile Road, Southfield, Michigan 48075. Program Title: Antismoking Education. Contact: Ms. Michelle Wegienek, Program Coordinator (313)559-5100. Description: Education that promotes nonsmoking is provided for any school grade level or community group. Presentations are en- hanced with films and literature, biofeedback equipment for demonstration purposes, and prepackaged educational materials for specific age groups. Presentations differ according to the group's area of interest. 0545. AMERICAN LUNG ASSOCIATION OF SOUTHEAST MICHIGAN, 18860 West Ten Mile Road, Southfield, Michigan 48075. Program Title: Cigarette Send Off. Contact: Ms. Michelle Wegienek, Program Coordinator (313)559-5100. Description: Held four or five times a year, the Send-Off is a comprehen- sive smoking withdrawal clinic combining hypnosis, behavior modification, presentations of the health effects of smoking, tips on how to quit, and dramatic film highlights of cigarettes’ immediate effects on the body. Participants receive a cas- sette tape for followup self-hypnosis, a variety of behavior modification materials, and A Lifetime Of Freedom From Smoking maintenance manual. 0546. AMERICAN LUNG ASSOCIATION OF SOUTHEAST MICHIGAN, 18860 West Ten Mile Road, Southfield, Michigan 48075. Program Title: Freedom From Smoking. Contact: Ms. Michelle Wegienek, Program Coordinator (313)559-5100. Description: The American Lung Association Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF SOUTHEAST MICHIGAN, 18860 West Ten Mile Road, Southfield, Michigan 48075. 0547. Program Title: The Smoking Phone (559-5111). Contact: Ms. Michelle Wegienek, Program Coordinator (313)559-5100 or (313)559-5111. Description: The Smoking Phone provides information on smoking cessa- tion, nonsmokers’ rights, clinics, the general health effects of smoking, and other smoking-related topics. After business hours, callers are greeted with a taped message urging par- ticipation in withdrawal techniques and upcoming programs. 0548. AMERICAN LUNG ASSOCIATION OF SOUTHEAST MICHIGAN, 18860 West Ten Mile Road, Southfield, Michigan 48075. Program Title: Tips And Truths On Tobacco. Contact: Ms. Michelle Wegienek, Program Coordinator (313)559-5100. Description: The distribution of a free information packet entitled Tips And Truths On Tobacco targets individuals who wish te quit on their own initiative. The packets contain information on the health effects of smoking, tips on how to quit, and notices of programs available in various areas. BLUE CARE NETWORK, 3624 South Westnedge, Kalamazoo, Michigan 49008. 0549. 261 Program Title: Smokeless. Contact: Ms. Sandy Donaldson, Program Coordinator (616)388-9515. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. BOTSFORD GENERAL HOSPITAL, HEALTH DEVELOPMENT NETWORK, 28050 Grand River Avenue, Farmington Hills, Michigan 48024. 0550. Program Title: Personalized Smoking Cessation. Contact: Ms. Margo Gorchow, Executive Director (313)471-8090. Description: Personalized Smoking Cessation is a comprehensive stop smoking program that incorporates various behavior modifica- tion techniques and the use of Nicorette gum to help the in- dividual stop smoking. Recognizing that people prefer to learn in a variety of ways and settings, the personalized stop smok- ing program was developed to reach individuals who prefer to learn in small groups or in an individual, one-to-one counsel- ing atmosphere. The program is designed to allow for more interactions between the learner and instructor. This ap- proach involves participants more actively, while addressing the individual’s particular needs, thereby increasing the likelihood of successful behavior change. The program is scheduled over 4 to 5 weeks. It includes three personal con- tacts and four telephone contacts. The first week includes a small group orientation session in which introductory materials are distributed and explained. Participants also are informed they need to obtain a prescription from their physician for Nicorette gum. Later sessions include instruction in the use of Nicorette gum and the various behavior modification tech- niques found in the program. Participants are followed up at 3 months, 6 months, and 1 year to offer support for maintain- ing their ex-smoker status, or to refer them back into the program if they have begun smoking again. BOTSFORD GENERAL HOSPITAL, HEALTH DEVELOPMENT NETWORK, 28050 Grand River Avenue, Farmington Hills, Michigan 48024. 0551. Program Title: Smokeless. Contact: Ms. Margo Gorchow, Executive Director (313)471-8090. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0552. CHELSEA COMMUNITY HOSPITAL, 775 South Maln Street, Chelsea, Michigan 48118. Program Title: Smokeless. Contact: Ms. Jean DuRussel-Weston, Program Coordinator (313)475-1311 ext.3945. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0553. DEPARTMENT OF HEALTH, Herman Klefer Health Complex, 1151 Taylor, Detroit, Michigan 48202. Program Title: Smoking Cessation. Contact: Dr. Stephen Blount, Program Contact (313)833-0710 ext.289. Description: As part of the Metropolitan Detroit Program To Reduce Avoidable Mortality From Cancer In The Black Population, a smoking cessation intervention has been established within a community service agency, the Franklin Wright Settlements, Inc. A self-care smoking cessation method has been chosen. All participants will receive a 21-day manual, the Step-by-Step Quit Kit of the University of Michigan School of Public Health. Also available to participants, upon request, will be an audiocassette of the manual recorded in either a male or a female voice. Total monetary cost of the program will be $1.75. Participants using the manual may elect to attend three group sessions during the 21 -day program. 0554. DICKINSON-IRON DISTRICT HEALTH DEPART- MENT, 601 Washington Avenue, Post Office Box 516, Stambaugh, Michigan 49964. Program Title: Freedom From Smoking Clinics. Contact: Naomi Haycock, R.N., Program Coordinator (906)265-9913. Description: The American Lung Association’s Freedom From Smoking clinics are offered to the general public on a quarterly basis. For more information, see the detailed program description in Part 1. 0555. EMMA L. BIXBY HOSPITAL, 818 Riverside Avenue, Adrian, Michigan 49221. Program Title: Freedom From Smoking Clinics. Contact: Ms. Barbara Litto, Director of Education (517)263-0711. Description: The American Lung Association’s smoking cessation clinic is held three times a year at Bixby Hospital, in January, May, and September. For more information, see the detailed program description in Part 1. 0556. GRATIOT COMMUNITY HOSPITAL, 300 Warwick Drive, Alma, Michigan 48801. Program Title: Smokeless. Contact: Ms. Virginia White-Linn, Program Coordinator (517)473-1101. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0557. JACKSON COUNTY HEALTH DEPARTMENT, 410 Erie Street, Jackson, Michigan 49202. Program Title: Freedom From Smoking. Contact: Ms. Robyn Grinzinger, Health Educator (517)788-4420. Description: The American Lung Association's cessation program is made available to department employees and their spouses. The sessions are held during work hours to attract more interest and desire to attend the program. For more information, see the detailed program description in Part 1. 0558. LIVINGSTON COUNTY HEALTH DEPARTMENT, 204 South Highlander Way, Howell, Michigan 48843. 262 Program Title: Freedom From Smoking Clinics. Contact: Ms. Janice L. Hoover, Adult Health Program Supervisor (517)546-9850. Description: The American Lung Association’s Freedom From Smoking clinics are offered to the community between two and four times a year. For more information, see the detailed program description in Part 1. 0559. MIDLAND COMMUNITY CANCER SERVICES, 1170 James Savage Road, Midland, Michigan 48640. Program Title: School Smoking Education. Contact: Ms. Susan Dusseau, Executive Director, and Kathleen Dolan, R.N. (517)835-4841, Description: Progressive informational programs on the health hazards of smoking are presented to students in grades 6, 7, and 9 in Midland County. The physical effects of smoking, chemical content of tobacco, and the advertising techniques employed by the tobacco industry are discussed. Separate films are util- ized for each class in addition to pamphlets and teaching models. 0560. MIDLAND COMMUNITY CANCER SERVICES, 1170 James Savage Road, Midland, Michigan 486.40. Program Title: Smoking Cessation. Contact: Ms. Susan Dusseau, Executive Director, and Kathleen Dolan, R.N. (517)835-4841. Description: The Smoking Cessation program assists the individual through either one-on-one session(s) or a group support ap- proach by a trained instructor. Heal education and behavior modification techniques are utilized. 0561. THE NATIONAL CENTER FOR HEALTH PROMO- TION, 3772 Plaza Drive, Suite 5, Ann Arbor, Michigan 48108. Program Title: How To Implement A Successful Worksite Smoking Policy. Contact: Program Coordinator (313)944-3329, 263 Description: How To implement A Successful Worksite Smoking Policy is @ practical manual that gives readers a concrete nine-step plan for successfully implementing a worksite smoking policy. Some of the steps included are assessing the present cor- porate environment, designing the smoking policy, implement- ing the plan, providing smoking cessation assistance, and tracking progress. This 102-page manual was developed by The National Center for Health Promotion and is available for $48. 0562. THE NATIONAL CENTER FOR HEALTH PROMO- TION, 3772 Plaza Drive, Suite 5, Ann Arbor, Michigan 48108. Program Title: Smoke Stoppers. Contact: Program Coordinator (313)944-3329,. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and maintenance system. 0563. OAKLAND COUNTY HEALTH DIVISION, Depart- ment of Institutional and Human Services, 1200 North Telegraph Road, Pontiac, Michigan 48053. Program Title: FreshStart. Contact: Mr. Martin Pawlicki, Public Heaith Educator (313)858-5088. Description: The American Cancer Society’s FreshStart program is offered monthly and is targeted mainly to local businesses. For more information, see the detailed program description in Part 1. 0564. PROVIDENCE HOSPITAL, Community Health Education Department, 16001 West Nine Mile Road, Post Office Box 2043, Southfield, Michigan 48037. Program Title: Smokeless. Contact: Pam Nelson, R.N., M.S.N., Coordinator (313)424-3068. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0565. SAINT JOHN HOSPITAL, Patient Education Center, 22101 Moross, Detroit, Michigan 48236. Program Title: Five-Day Plan. Contact: Mr. John H. Burrows, Program Coordinator (313)343-4000. Description: Offered twice a year, this 5-day clinic helps interested in- dividuals kick the habit. During these 90-minute sessions, a lecturer explains how cigarette smoking harms the body and illustrates his points with several fiims. Illustrations of disease states prepared by experts also are used. 0566. SAINT JOHN HOSPITAL, Patient Education Center, 22101 Moross, Detroit, Michigan 48236. Program Title: Individual Counseling Approach to Smoking. Contact: Ms. Camille C. Klimecki, Program Coordinator (313)343-3870. Description: The goal of this individual counseling approach to smoking cessation is to help individuals with their particular and unique needs in regard to quitting smoking. On the initial visit, the patient views two films on the health effects of smoking and techniques for quitting. Therapists work closely with the patient to develop a program of techniques specifically designed to help that individual quit smoking. Behavior modification and contracting techniques are often used. Coun- seling may include identification of the individual's motivation for quitting, an explanation of the reasons why quitting may be difficult, a description of the hazards of smoking and the benefits of quitting, development of an appropriate quitting strategy, an explanation of stimulus and response training and readjustment, and continued followup until smoking cessation is accomplished. Films, pre- and posttests, review sheets, and self-evaluation sheets may be used to augment the program. 0567. SAINT JOHN HOSPITAL, Patient Education Center, 22101 Moross, Detroit, Michigan 48236. Program Title: Want To Quit Smoking — It’s Up To You! Contact: ; Ms. Camille C. Klimecki, Program Coordinator (313)343-3870. Description: This week-long smoking cessation program is held on consecutive evenings for 2 to 2-1/2 hours. The program in- cludes lectures by physicians, Nationally produced films, and question-and-answer sessions. Topics covered include the health hazards of smoking, reasons for initiation and main- tenance of the smoking habit, and tips for quitting. Brochures, pamphlets, posters, buttons, slides, films, and visual diagrams are used to illustrate the program. 0568. ST. JOSEPH MERCY HOSPITAL, 900 Woodward Avenue, Pontiac, Michigan 48053. Program Title: Smokeless. Contact: Ms. Joan Sheridan, Program Coordinator, Office of Health Promotion (313)858-3155. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0569. ST. JOSEPH’S HEALTH EDUCATION CENTER, 215 North Avenue, Mt. Clemens, Michigan 48043. Program Title: Smokeless. Contact: Ms. Eileen Eckert, Director (313)263-2880. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0570. ST. LUKE’S HOSPITAL, 700 Cooper Avenue, Saginaw, Michigan 48602. Program Title: Smokeless. Contact: Ava Lewis, R.N., B.S.N., Program Coordinator (517}771-6163. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0571. ST. MARY’S HEALTH CONNECTION, 830 South Jefferson Avenue, Saginaw, Michigan 48601. Program Title: Freedom From Smoking. Contact: Ms. Laura Foy, Coordinator, Health Promotion Program (517)776-8400. Description: The Health Connection is currently using the American Lung Association’s Freedom From Smoking program in health promotion to the community. For more information, see the detailed program description in Part 1. 0572. SHIAWASSEE COUNTY HEALTH DEPART- MENT, 110 East Mack Street, Corunna, Michigan 48817. Program Title: Freedom From Smoking. Contact: Ms. Mikelle Whitt, Public Health Educator (517)743-2355. Description: The American Lung Association's cessation program is of- fered three or four times a year to the general public. For more information, see the detailed program description in Part 1. 0573. WASHTENAW COUNTY HEALTH DEPART- MENT, 4101 Washtenaw Road, Post Office Box 8645, Ann Arbor, Michigan 48107-8645. Program Title: Breathe Easy Packet And Manual. Contact: Ms. Michelle Scranton, Worksite Wellness Coordinator (313)971-3993. Description: The manual and packet are the same as those provided in the Breathe Easy Seminar. The cost of the packet is $5 plus postage and the cost of the manual is $3 plus postage. 0574. WASHTENAW COUNTY HEALTH DEPART- MENT, 4101 Washtenaw Road, Post Office Box 8645, Ann Arbor, Michigan 48107-8645. Program Title: Breathe Easy Seminar. 265 Contact: Ms. Michelle Scranton, Worksite Wellness Coordinator (313)971-3993. Description: This seminar provides the basis for individual worksites to develop their own smoking policies. It is completed in one 1/2- day session. The format includes both lecture and small group discussions and provides specific steps to take in answering the questions: when, where, how, and by whom. A manual and packet are provided for each participant. Pre- viously available only locally, the seminar is now being offered throughout Michigan. 0575. WASHTENAW COUNTY HEALTH DEPART- MENT, 4101 Washtenaw Road, Post Office Box 8645, Ann Arbor, Michigan 48107-8645. Program Title: Marketing Smoking Cessation To And Through Physicians. Contact: Ms. Beverly Chethik, Chief, Community Health Bureau and Ms. Vicki Nighswander, Health Educator (313)971-4582 and 971-3993. Description: Through a Michigan Department of Public Health grant, a self- help packet of tools has been developed for health providers to counsel pregnant patients who smoke in cessation techni- ques. Along with research on available techniques, input from both local health care providers and patients was solicited in the development of the tools. The cost of a packet is $2 plus postage. 0576. WESTERN MICHIGAN ASSOCIATED DISTRICT HEALTH DEPARTMENT, District #5, 314 State Street, Post Office Drawer 72, Hart, Michigan 49420. Program Title: Freedom From Smoking. Contact: Ms. Linda VanGills, Health Education Coordinator (616)873-2193. Description: This program is offered twice a year to the general public in the following Counties: Lake, Newaygo, Oceana, Manistee, Mason, and Mecosta. The service is also offered to worksites. For more information, see the detailed program description in Part 1. MINNESOTA 0577. ABBOTT NORTHWESTERN HOSPITAL, 800 East 28th Street, Minneapolis, Minnesota 55407. Program Title: Phase II Quit Smoking Program. Contact: Mr. Howard Epstein, Program Coordinator (612)863-4302. Description: The Phase I! Quit Smoking Program focuses not only on help- ing smokers to quit, but also on helping them not to relapse. The program incorporates elements of a chemical depend- ency model and works to help participants develop a different self-concept. Phase Il meets twice a week for 3 weeks. Ab- bott Northwestern Hospital also provides one-to-one consult- ation with psychologists from the Behavioral Medicine Clinic. 0578. AMERICAN HEART ASSOCIATION, MINNESOTA AFFILIATE, INC., 4701 West 77th Street, Minneapolls, Minnesota 55435. Program Title: Calling It Quits. Contact: Ms. Roz Johnson, Director of Community Programs (612)835-3300. Description: The American Heart Association’s Calling It Quits program is offered. For more information, see the detailed program description in Part 1. 0579. AMERICANHEART ASSOCIATION, MINNESOTA AFFILIATE, INC., 4701 West 77th Street, Minneapolis, Minnesota 55435. Program Title: In Control. Contact: Ms. Roz Johnson, Director of Community Programs (612)835-3300. Description: The American Heart Association offers the American Lung Association's In Control videocassette smoking cessation program. For more information, see the detailed program description in Part 1. 0580. AMERICANHEART ASSOCIATION, MINNESOTA AFFILIATE, INC., 4701 West 77th Street, Minneapolis, Minnesota 55435. Program Title: Save A Sweet Heart. 266 Contact: Ms. Roz Johnson, Director of Community Programs (612)835-3300. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 0581. AMERICAN LUNG ASSOCIATION OF MIN- NESOTA AND MINNESOTA DEPARTMENT OF EDUCATION, 614 Portland Avenue, St. Paul, Minnesota 55102. Program Title: Tobacco Free Schools In Minnesota. Contact: Ms. Holly Loeffler, Program Coordinator (612)227-8014. Description: After an extensive period of coordination and planning, the American Lung Association of Minnesota and the Tobacco Use Prevention Office of the Department of Education have initiated a program entitled Tobacco Free Schools in Min- nesota. Workshops have been held around the State and a resource manual has been developed for schools and school districts. The program targets schools and addresses tobac- co policies that affect the students, staff, and community mem- bers who use school facilities. The goal is to encourage school districts to adjust their policies to prohibit smoking. 0582. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Because You Love Your Baby. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association’s Freedom From Smoking For You And Your Baby kit is offered for a minimal cost. For more information, see the detailed program description in Part 1. 0583. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Freedom From Smoking Clinics. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association’s Freedom From Smoking cessation clinics are offered. A fee of $50 is charged to all participants in order to cover material costs and facilitators’ salaries. Clinics are offered throughout Ramsey County on an ongoing basis. For more information, see the detailed program description in Part 1. 0584. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Freedom From Smoking For You And Your Baby. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association’s 10-day self-help program for pregnant women is offered. The cost for manual and relaxation tape is $5 each or $7 for both. For more information, see the detailed program description in Part 1. 0585. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Freedom From Smoking For You And Your Family. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association’s Freedom From Smoking For You And Your Family self-help program is offered at acost to participants of $4.95. For more information, see the detailed program description in Part 1. 0586. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Freedom From Smoking In 20 Days. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association's Freedom From Smoking self-help manuals, Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking are available. Single 267 manuals cost $5; the cost for the set is $7. For more information, see the detailed program description in Part 1. 0587. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: In Control. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association's In Control smoking cessa- tion program is offered. The materials may be purchased for $59.95 or borrowed for $30. For more information, see the detailed program description in Part 1. 0588. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Smokers’ Support Group. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: Former smokers, ex-smokers still struggling with their habit, and smokers wanting to quit ara invited to attend. For more information, call the American Lung Association of Ramsey County. 0589. AMERICAN LUNG ASSOCIATION OF RAMSEY COUNTY, 614 Portland Avenue, St. Paul, Minnesota 55102-2287. Program Title: Smoking And Pregnancy Kit For Health Care Providers. Contact: Sue Olmstead, M.P.H., Director, Smoking or Health Education (612)224-4901. Description: The American Lung Association's Smoking And Pregnancy Kit is distributed to local physicians at a cost of $7 a kit. For more information, see the detailed program description in Part 1. 0590. AMERICAN LUNG ASSOCIATION, HENNEPIN COUNTY, 1829 Portland Avenue, Minneapolis, Minnesota 55404. Program Title: Freedom From Smoking Clinics. Contact: Ms. Penny Gottier, Program Coordinator (612)871-7332. Description: The American Lung Association Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0591. AMERICAN LUNG ASSOCIATION, HENNEPIN COUNTY, 1829 Portland Avenue, Minneapoiis, Minnesota 55404. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Penny Gottier, Program Coordinator (612)871-7332. Description: ; The American Lung Association Freedom From Smoking self- help program, consisting of two manuals on cessation and maintenance, is offered. For more information, see the detailed program description in Part 1. 0592. AMERICAN LUNG ASSOCIATION, HENNEPIN COUNTY, 1829 Portland Avenue, Minneapolils, Minnesota 55404. Program Title: In Control. Contact: Ms. Penny Gottier, Program Coordinator (612)871-7332. Description: The American Lung Association's In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0593. BEMIDJI CLINIC, 1233 34th Street Northwest, Bemidji, Minnesota 56601. Program Title: FreshStart. Contact: Ms. Ann Daley, Program Coordinator (218)751-1280 ext.212. Description: This hospital offers eight 2-hour sessions based on the American Cancer Society cessation model. In addition, clinic patients are invited on an individual basis to view an audiovisual program on cessation methods, after which a counselor helps them to set goals and provides a point of con- tact for followup. For more information, see the detailed program description in Part 1. 268 0594. FAIRMONT MEDICAL CLINIC, P.A., AMERICAN LUNG ASSOCIATION OF MINNESOTA, 800 Clinic Circle, Post Office Box 800, Fairmont, Minnesota 56031. Program Title: Freedom From Smoking. Contact: Ms. Susan M. Hanson, Program Coordinator (507)238-4263. Description: The American Lung Association's Freedom From Smoking clinic is offered in the fall and spring of each year. For more information, see the detailed program description in Part 1. 0595. GROUP HEALTH, INC., Health Education Depart- ment, 2829 University Avenue, Southeast, Minneapolis, Minnesota 55414. Program Title: Unsmoke. Contact: Program Coordinator (612)623-8536. Description: The Unsmoke class serves the HMO’s 200,000 members and staff at 14 medical and dental centers in the Twin Cities Metropolitan area. This 7-week class is designed to provide smokers with support and skills to enable them to quit smok- ing gradually, comfortably, and successfully. The class is taught by former smokers and teaches smokers to: 1) iden- tify their own smoking triggers; 2) set realistic and attainable goals for themselves; 3) cut-down on their smoking gradually and comfortably; and 4) develop skills to stop smoking and prevent a relapse. A Quit Smoking Resource list is available to Group Health, Inc. members and staff with information on smoking cessation classes and support groups in the metropolitan area where they can attend and receive a dis- count on the class fee. A variety of patient education literature is available at the medical center sites. ISANTI-MILLE LACS COMMUNITY HEALTH SER- VICES, 221 Northwest Second Avenue, Cambridge, Minnesota 55008. 0596. Program Title: © Nonsmoking And Health Promotion Project. Contact: Ms. Karen Nelson, Program Coordinator (612)689-5149. Description: This project is working toward three major goals: promoting nonsmoking environments in local businesses, reducing or preventing smoking among District 911 students, and expand- ing local D-Day efforts. Businesses are provided with techni- cal assistance, on-site presentations, educational materials, and cessation programs. Awards are continually given to employers that implement a smoke-free policy. The project health educator helped the middle schools in Dis- trict 911 choose a smoking prevention curriculum, the Min- nesota Smoking Prevention Plan developed by the University of Minnesota, to be used in grade 7. In addition, all fourth- grade students in District 911 received instruction from the Smoke-free Generation curriculum for 2 or 3 days, and all stu- dents and their teachers were given T-shirts with a nonsmoking message. A technical advisory committee was established consisting of representatives from local businesses, schools, clergy, and health facilities. Committee members were charged with promoting D-Day activities. Businesses were visited by atask force member who distributed brochures and decals for store windows. Members encourage participation in smoking ces- sation programs and this Community Health Services agency sponsors FreshStart classes several times a year. 0597. MANKATO HEART HEALTH PROGRAM, 101 North Second Street, Suite 103, Mankato, Minnesota 56001. Program Title: Quit And Win. Contact: Mr. Richard Swanson, Program Coordinator (507)625-8874. Description: Quit And Win is a self-help program to stop smoking. It helps the smoker understand the habit and identify the problems that will be hardest to overcome. It also teaches specific techni- ques for tackling these problems that can threaten success in quitting. With the Quit And Win method, smokers learn how to handle tempting situations or how to avoid them. It also an- ticipates relapse situations and helps the participant prepare for them. The fee for the Quit And Win manual is $5. 0598. MAYO CLINIC, Patlent and Health Education Section, Rochester, Minnesota 55901. Program Title: Smoking Cessation. Contact: Ms. Dorothy Ann Dale, Assistant Director (507)284-8140. Description: Smoking Cessation is a 90-minute, entry-level program providing an overview of smoking behavior and covering the basic concepts of smoking cessation. It is designed to assist smokers in examining their thoughts about the decision to stop smoking, to provide information about the health effects of smoking, and to help the smoker develop a plan for quitting. 269 0599. MAYO CLINIC, Rochester, Minnesota 55905. Program Title: Smoking Cessation Center. Contact: Richard D. Hurt, M.D., Director (507)286-1930, Description:. The Center provides smoking cessation services to Mayo Clinic patients. It is staffed by physicians, a psychologist, and smoking cessation counselors providing a range of services. There is a smoking cessation consultation service that evaluates and counsels smokers referred by their physicians. The level | intervention program provides five sessions of 2 hours each, with the first hour being educational in format and the second hour oriented to group therapy. The following are educational topics covered in the sessions: 1) overview of the medical consequences of smoking and concept of nicotine de- pendence; 2) development of nonsmoking and coping skills; 3) diet and exercise; 4) overview of stress management methods; and 5) maintenance of the nonsmoking status and relapse prevention. Th services are provided for outpatients and patients hospitalized at Mayo-affiliated hospitals. Continued relapse prevention is provided for each patient by a system of computer-prompted individual evaluation and patient contact, which will occur approximately 14 times during the 12 months after the initial treatment. The Center is developing a nicotine-dependence question- naire to assist staff in determining the degree of the patient’s nicotine dependence. There are plans for the development of more intensive treatment, to include inpatient treatment for patients with severe nicotine dependence. 0600. MINNEAPOLIS HEALTH DEPARTMENT, Public Health Center, 250 South Fourth Street, Minneapolis, Minnesota 55415-1372. Program Title: FreshStart. Contact: Mr. Al Olson, Supervisor, Health Education (612)348-2304. Description: The program's objective is to help people stop smoking using the American Cancer Society's FreshStart program. For more information, see the detailed program description in Part 1. 0601. MINNESOTA DEPARTMENT OF HEALTH, 717 Southeast Delaware Street, Post Office Box 9441, Minneapolis, Minnesota 55440. Program Title: The Minnesota NonSmoking Initiative. Contact: Ms. Kathy Harty, Manager for NonSmoking and Health (612)623-5500. Description: By legislative mandate, the Minnesota Department of Health has initiated, and is promoting, a wide variety of high-quality tobacco-use prevention programs, including community and Statewide special projects grants, Statewide surveys, tobac- co-use prevention programs in schools, extensive market re- search, and most recently, campaigns on television, radio, and billboards. Together these programs are called the Min- nesota NonSmoking Initiative. These programs represent a multifaceted, Statewide effort to market a tobacco-free life- style to Minnesotans. By November 1985, eight special projects grants, each for a 2-year period, had been awarded across the State for non- smoking projects. In spring 1986, a Statewide survey on the smoking habits of students in grade 9 was completed. The health department is currently collaborating with the Univer- sity of Minnesota and Wisconsin's Departments of Public In- struction and of Health and Social Services on a National Cancer Institute grant to evaluate school activities in Min- nesota in relation to those in Wisconsin over the next 5 years. During the 1985-86 school year, 75 percent of the 433 school districts in Minnesota applied for and received funds allocated by the legislature to develop tobacco-use prevention programs. For the 1986-87 school year, the percentage was 91. Pursuant to the use of mass media in promoting a tobacco- free lifestyle, extensive market research and several mass media campaigns have been conducted by the Minnesota Department of Health. In May and June 1986, the Department conducted its first mass media project with a 6-week television campaign promoting a smoke-free lifestyle for children ages 8 through 18. in March 1987, the Department became cospon- sor of the Minnesota High School Hockey Tournament with a tobacco use prevention campaign aimed at youth and young adults. More recently, the Minnesota Department of Health con- tracted jointly with the Minnesota Institute of Public Health and Campbell-Mithun Advertising to design and initiate two varied tobacco-free lifestyle campaigns emphasizing the social un- desirability of tobacco use. The campaigns, initiated in June 1987, were aimed at adolescents, preadolescents, and young women. Also, the Department conducted the first in a series of Statewide telephone surveys to gather data related to tobacco use. 0602. NORTHFIELD HOSPITAL, 801 West First Street, Northfield, Minnesota 55057. Program Title: Freedom From Smoking. Contact: Maxine Lamm, R.N., Education Director (507)645-6661. Description: A physician lectures on the physical effects of smoking, why people smoke, and what triggers smoking behavior. Using a breath ecolyzer machine, participants record the carbon monoxide level in their bodies. After 2 days of abstention, carbon monoxide is again measured to show its decrease. Participants are urged to exercise to minimize weight gain and to avoid social situations that trigger and influence smoking behavior. At the last meeting, successfu! control is celebrated. It any participants feel it necessary to remain in contact, a Smokers Anonymous group is formed and meets weekly as needed. The program costs $35. 0603. OLMSTED COUNTY HEALTH DEPARTMENT, 1650 Fourth Street S.E., Rochester, Minnesota 55904. Program Title: Smoking Cessation/Education. Contact: Ms. Joyce Stromberg, Program Coordinator (507)285-8343. Description: Staff offer smoking cessation to county employees through behavior modification classes and hypnotherapy sessions. In addition, education and cessation classes are offered in the county high schools. Students meet for 1 hour during the school day for 10 weeks. They learn why and how they can be successful in quitting and how not to succumb to pressure to start smoking again. 0604. PRIMARY CARE CLINIC, THE HEALTH CENTER FOR WOMEN, 258 East University Avenue, St. Paul, Minnesota 55101. Program Title: Smoking Cessation Clinic. Contact: Susan Schwartz, M.D., Medical Director (612)221-8854. Description: Pamphlets from the American Lung Association, the National Cancer Institute, and the Minnesota Department of Health are distributed to members who request information. Persons in- terested in quitting smoking are referred to a cessation clinic held at Ramsey Clinic. 0605. RAMSEY COUNTY PUBLIC HEALTH DEPART- MENT, ST. PAUL DIVISION, 555 Cedar Street, St. Paul, Minnesota. Program Title: Freedom From Smoking Clinics. Contact: Ms. Peg Torgerson, Program Coordinator (612)292-7238. Description: The American Lung Association’s Freedom From Smoking clinics are offered to city employees. For more intormation, see the detailed program description in Part 1. 0606. REACH MAXIMUM HEALTH, ROCHESTER METHODIST HOSPITAL, 201 West Center Street, Rochester, Minnesota 55902. Program Title: Smokers’ Clinic. Contact: Ms. Doris Toddie, Program Coordinator (507)286-7006. Description: Smokers’ Clinic is designed to provide information through for- mal presentations, insight through group d iscussion, and sup- port through audiovisual materials and literature. The first hour of each Smoker's Clinic session begins with a formal presentation by resource people such as physicians, psychiatrists, dietitians, other health care professionals, and ex-smokers, The topics addressed in this part of the session include: an introduction and discussion of the Smokers’ Clinic philosophy; smoking and health; how smoking affects your lungs and cardiovascular system and how smoking affects your ears, nose, and throat; psychological aspects of smok- ing and quitting; a panel discussion of ex-smokers; nutrition and weight control while quitting smoking; and an experimen- tal withdrawal session. The second hour of each session is spent in small group discussion under the direction of ex- smokers who volunteer to act as group leaders. 0607. RIVERSIDE MEDICAL CENTER, A Joint Venture of St. Mary's and Fairview Riverside Hospitals, Riverside at 25th Avenue South, Minneapolis, Minnesota 55454, Program Title: Smokeless. Contact: Mr. William Salzer, Program Coordinator (612)337-4680. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multitaceted smoking cessation program. Parti learn systematic techni- ques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0608. WASHINGTON COUNTY DEPARTMENT OF PUBLIC HEA!.TH, 14900 61st Street North, Post Office Box 6, Stillwater, Minnesota 55082-0006. Program Title: Freedom From Smoking. Contact: Suz-Ann Stenso-Velo, M.P.H., Health Educator (612)779-5445. Description: The American Lung Association’s Freedom From Smoking clinics are conducted about fourtimes a year for general public participation. The department also conducts on-site clinics at requesting worksites. In addition to the clinic approach, a self- help approach is offered that covers similar information, but lacks the group support. For more information, see the detailed program description in Part 1. 0609. WINONA COUNTY COMMUNITY HEALTH SER- VICES, Courthouse, 171 West Third Street, Winona, Minnesota 55987. Program Title: Community Nonsmoking And Health Project. Contact: Ms. Lynn S. Theurer, Administrator (507}454-2836. Description: The project targets children and adolescents at risk for smok- ing and smokeless tobacco use and young adult women who smoke. The project aims to increase public knowledge and awareness of tobacco and to promote a tobacco-free lifestyle. Community education on the health risks of smoking is being implemented in the schools, Park and Recreation Department activities, 4-H Clubs, Girl Scouts, Boy Scouts, YMCA, and YWCA. There is also an education program on the effects of smokeless tobacco for Little League players. A community education program for young adult women is being imple- mented at Winona State University, St. Mary's College, St. Teresa’s College, and Winona Area Technical Institute. Also, smoking pregnant women in the Women, Infants, and Children program are counseled on the risks of smoking. MISSISSIPPI 0610. AMERICAN HEART ASSOCIATION, MISSISSIPPI AFFILIATE, 4830 East McWillle Circle, Post Office Box 16808, Jackson, Mississippi 39236. Program Title: Heart At Work. Contact: Ms. Sally Walton, Program Director (601)981-4721. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 0611. AMERICAN HEART ASSOCIATION, MISSISSIPPI AFFILIATE, 4830 East McWillie Circle, Post Office Box 16808, Jackson, Mississippl 39236. Program Title: Heart Health Education For The Young. Contact: Ms. Sally Walton, Program Director (601)981-4721. Description: The American Heart Association’s Heart Health Education For The Young program is offered. For more information, see the detailed program description in Part 1. 0612. MISSISSIPPI LUNG ASSOCIATION, 353 North Mart Plaza, Post Office Box 9865, Jackson, Mississippi 39206. Program Title: Smoking Or Health. Contact: Mr. Jedson M. Allred, Jr., Executive Director (601)362-5453. Description: The Mississippi Lung Association supports the work for a Smoke-Free Society by the Year 2000 by implementing and expanding the American Lung Association’s Smoke-Free Family and Tobacco-Free Young America Project activities. Other activities include smoking cessation programs, marijuana education, nonsmoker protection, school health education, and support for legislation to regulate smoking in public places. 0613. MISSISSIPPI STATE DEPARTMENT OF HEALTH, 2423 North State Street, Post Office Box 1700, Jackson, Mississippi 39215-1700. Program Title: Health Department Activities. Contact: Alton B. Cobb, M.D., M.P.H., State Health Officer (601)354-6612. Description: Initial activities regarding smoking and health implemented by the Mississippi State Department of Health since 1986 include gathering data from two Smoke Surveys. The object of these surveys was to gather data reflecting public sentiment about laws regulating smoking in public places. Both surveys showed that residents polled strongly favored some regulation of smoking in public places. Even smokers themselves sup- ported regulation of smoking in public places or a total ban of smoking in public places. The contact persons for both sur- veys are F.E. Thompson, Jr., M.D., M.P.H., Chief, Bureau of Preventive Health Services; Bruce Brackin, M.P.H., Epidemiologist; and Ms. Ellen Shea Jones, Director, Health Promotion and Education. The Department of Health has also included smoking cessa- tion clinics in its activities. One smoking cessation clinic was held in February 1987 for central office employees. In addi- tion, the Office of Health Promotion and Education has cited as a goal scheduling a smoking cessation clinic in each of the nine district health offices. The contact persons for these two programs are, respectively, Ms. Jan Walker, Director, Staff Development (601)960-7634 and Ms. Ellen Shea Jones, Director, Health Promotion and Education (601)960-7725. 0614. REGION ONE MENTAL HEALTH CENTER, Post Office Box 1046, Clarksdale, Mississippi 38614. Program Title: Heaith Education — Prevention: Alcohol/Drugs/Tobacco. Contact: John Farris, M.Ed., Coordinator (601)627-7267. Description: Minority junior high school students in a four-County rural area are exposed to information about tobacco use and drug abuse, and are assisted in establishing both the intra- and in- terpersonal skills necessary to make informed decisions about behavior related to these substances. The aim is to decrease the use of these substances in the target audience. The program also aims at increasing the number of students par- ticipating in establishing alternative programs related to tobac- co use and drug abuse, and improving the interagency affiliation and communication among community resources. Specially trained faculty present the educational material in a classroom setting. The program uses pre- and posttest results and multiple baseline assessments to evaluate effectiveness. MISSOURI 0615. AMERICAN CANCER SOCIETY, MISSOURI DIVISION, INC., Post Office Box 1066, Jefferson City, Missouri 65102. Program Title: FreshStart. Contact: Ms. Cindi Keele, Director of Public Education (314)893-4800. Description: The Missouri Division of the American Cancer Society offers smoking cessation and education programs to the public ona request basis in worksites, health care organizations, com- munity youth groups, and to children in schools. The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0616. AMERICAN CANCER SOCIETY, MISSOURI DIVISION, INC., Post Office Box 1066, Jefferson City, Missouri 65102. Program Title: Tobacco Use Education For Youth And Adults. Contact: Ms. Cindi Keele, Director of Public Education (314)893-4800. Description: The American Cancer Society’s programs that focus on prevention are available free. For more information, see the detailed program description in Part 1. 0617. AMERICAN LUNG ASSOCIATION OF EASTERN MISSOURI, 1118 Hampton Avenue, St. Louis, Missouri 63139. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Diane L. Lee, Program Director (314)645-5505. Description: The American Lung Association’s Freedom From Smoking materials are used. For more information, see the detailed program description in Part 1. 0618. AMERICAN LUNG ASSOCIATION OF EASTERN MISSOURI, 1118 Hampton Avenue, St. Louis, Missouri 63139. Program Title: Speakers’ Bureau On Smoking And Health. Contact: Ms. Diane L. Lee, Program Director (314)645-5505. Description: At the request of businesses, social groups, civic clubs, and others, the bureau provides volunteer speakers on the topic of smoking and health. The primary objective is to educate the general public about the hazards associated with cigarette smoking and secondhand smoke, The secondary objective 273 is to encourage smokers to quit. Other topics are smoking and pregnancy, State, Federal and local legislative efforts to protect the rights of nonsmokers, and marijuana and the lungs. Supplemental materials such as audiovisuals, brochures, posters, and buttons are available. 0619. AMERICAN LUNG ASSOCIATION OF WESTERN MISSOURI, 1835 South Stewart Street, Springfleld, Missouri 65804. Program Title: Freedom From Smoking. Contact: Ms. Shirley A. Fulda, Program Director (816)842-5242. Description: The American Lung Association's Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0620. AMERICAN LUNG ASSOCIATION OF WESTERN MISSOURI, 1835 South Stewart Street, Springfield, Missouri 65804. Program Title: Freedom From Smoking In The Workplace. Contact: Ms. Shirley A. Fulda, Program Director (816)842-5242, Description: The Freedom From Smoking clinics are adapted by the American Lung Association's director to meet the specific needs of the individual workplace. The director is also con- sulted in the planning and is directly involved in the implemen- tation of the program. For more information, see the detailed program description in Part 1. 0621. AMERICAN LUNG ASSOCIATION OF WESTERN MISSOURI, 1835 South Stewart Street, Springfield, Missour! 65804. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Shirley A. Fulda, Program Director (816)842-5242. Description: Materials developed by the American Lung Association are sold on request. AMERICAN LUNG ASSOCIATION OF WESTERN MISSOURI, 1835 South Stewart Street, Springfield, Missouri 65804. 0622. Program Title: Students Teach Students. Contact: Ms. Shirley A. Fulda, Program Director (816)842-5242. Description: Health occupations students in area vocational schools are specially trained in information techniques developed by the American Lung Association. T teach elementary school children the hazards of nicotine, marijuana, and smokeless tobacco use. For more information, see the detailed program description in Part 1. 0623. AUDRAIN MEDICAL CENTER, 620 East Monroe, Mexico, Missouri 65265. Program Title: Freedom From Smoking. Contact: Cindy Feutz, R.N., B.S.N., Patient Educator (314)581-1760. Description: Audrain Medical Center offers the American Lung Association's Freedom From Smoking clinics. For more information, see the detailed program description in Part 1. 0624. MISSOURI DEPARTMENT OF HEALTH, 1730 East Elm Street, Post Office Box 570, Jefferson City, Missouri 65102. Program Title: Employer-Assisted Smoking Elimination. Contact: Ms. Patricia Hansen, Health Educator (314)751-6077. Description: The American Lung Association of Eastern Missouri's Employer-Assisted Smoking Elimination (EASE) program, a comprehensive smoking education and cessation program designed specifically forthe workplace, is offered to public and private worksites. The EASE program encourages participa- tion of all employees, both smokers and nonsmokers, and en- courages recruitment into smoking education programs and self-help, video, and group smoking cessation programs through the use of an employee steering committee. Techni- cal assistance in implementing the EASE program is available through the Office of Health Promotion. 0625. MISSOURI DEPARTMENT OF HEALTH, 1730 East Elm Street, Post Office Box 570, Jefferson City, Missouri 65102. Program Title: Freedom From Smoking Self-Help Manuals. 274 Contact: Ms. Patricia Hansen, Health Educator (314)751-6077. Description: The American Lung Association’s self-help smoking cessation and maintenance manuals are available to State employees and local health departments. For more information, see the detailed program description in Part 1. 0626. MISSOURI DEPARTMENT OF HEALTH, 1730 East Elm-Street, Post Office Box 570, Jefferson City, Missouri 65102. Program Title: Public Information. Contact: Ms. Patricia Hansen, Health Educator (314)751-6077. Description: The Office of Health Promotion provides free literature and materials regarding the hazards of cigarette smoking, secondhand smoke, and other issues related to smoking and health. Literature is also available on smoking legislation, workplace smoking policies, and smoking cessation. 0627. MISSOURI DEPARTMENT OF HEALTH, OFFICE OF HEALTH PROMOTION, Post Office Box 570, Jefferson City, Missouri 65102. Program Title: Smoking Cessation During Pregnancy Research And Demonstration Project. Contact: Ms. Nancy Miller, Chief, Office of Health Promotion (314)751-6077. Description: Missouri is one of three States funded by the Centers for Dis- ease Control for a 2-year research and demonstration project evaluating the effectiveness of a smoking cessation interven- tion among pregnant women in a public prenatal clinic setting. State-of-the-art smoking cessation techniques coupled with information derived from focus groups will be used to develop an intervention to be delivered by prenatal clinic staff. The ef- fectiveness of this intervention will be measured by patient quit rates; biochemical testing will be used to verify reported quits. A practitioner's manual will be developed, and the smoking cessation intervention is expected to be replicated in other prenatal clinic settings. 0628. MISSOURI REHABILITATION CENTER, 600 North Main Street, Mt. Vernon, Missour! 65712. Program Title: FreshStart. Contact: Ms. Jane Nelson, Director of Pulmonary Rehabilitation (417)466-3611 ext.427. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0629. MISSOURI REHABILITATION CENTER, 600 North Main Street, Mt. Vernon, Missouri 65712. Program Title: Pulmonary Rehabilitation Patient Education. Contact: Ms. Jane Nelson, Director of Pulmonary Rehabilitation (417)466-3611 ext.427. Description: This information program for patients with minor to severe pul- monary disorders includes exercise sessions, discussions of the hazards of smoking, and tips on how to quit. Materials from the American Cancer Society and the American Lung Association are used. MONTANA 0630. AMERICAN CANCER SOCIETY, MONTANA DIVISION, INC., 313 North 32nd Street, Suite 1, Billings, Montana 59101. Program Title: FreshStart. Contact: Mr. Ric Liggett, Program Director (406)252-7111. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0631. AMERICAN CANCER SOCIETY, MONTANA DIVISION, INC., 313 North 32nd Street, Suite 1, Billings, Montana 59101. Program Title: Great American Smokeout. Contact: Mr. Ric Liggett, Program Director (406)252-7111. Description: On the third Thursday of November, Montanans are asked to voluntarily give up their smoking habit for a full day. Included in the promotion are national television public service announcements featuring “Dallas” star Larry Hagman, locally produced spots, newspapers, and corporate newsletters. For more information, see the detailed program description in Part 1. 0632. AMERICAN CANCER SOCIETY, MONTANA DIVISION, INC., 313 North 32nd Street, Sulte 1, Billings, Montana 59101. Program Title: Statewide Health Seminars. Contact: Mr. Ric Liggett, Program Director (406)252-7111. Description: The American Cancer Society has nationally produced videos and training materials for public education involving the use of tobacco products, lung cancer, and oral cancer resulting from the use of chewing tobacco. There are currently 58 local volunteer units across Montana with a firm commitmentto help their neighbors educate themselves in the fight against cancer. 0633. AMERICAN HEART ASSOCIATION, MONTANA AFFILIATE, 510 First Avenue North #4, Great Falls, Montana 59401. Program Title: Activities To Promote Nonsmoking. Contact: Ms. Ellie Hilpert, Program Director (406)452-1401 or (800)447-9442. Description: The association has education materials, including posters, pamphlets, films, and videos, available upon request for the general public, schools, and civic organizations. Other ac- tivities include support of clean air legislation and smoke-free schools, banning billboard advertising and free tobacco samples, and preparing policy for medical facilities. 0634. AMERICANLUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Death In The West. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: The audiovisual tape is available in various Beta and VHS for- mats. A teaching guide and other relevant materials are avail- able with the audiovisual. The materials focus on the effects of smoking and target junior high students through adults. 0635. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Freedom From Smoking Clinics. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0636. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Freedom From Smoking In The Workplace. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: This program assists both employers and employees in as- sessing workplace problems and needs prior to initiating on- site Freedom From Smoking clinics for interested personnel. For more information, see the detailed program description in Part 1. 0637. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: In Control. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: The American Lung Association’s In Control smoking cessa- tion program is offered. For more information, see the detailed program description in Part 1. 0638. AMERICANLUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Smokescreen. 276 Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: Smokescreeen consists of six programs designed for Apple II computers that involve the individual learner in an engrossing smoking education experience. The programs are targeted at persons age 7 through adult. 0639. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Smoking And Pregnancy. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: The American Lung Association’s Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 0640. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Smoking Deserves A Smart Answer. Contact: Ms. AnnaB. Jones, Program Consultant (406)442-6556. Description: This packet of attractive classroom materials is planned to provide junior high students with appealing methods of com- bating peer pressure to smoke. For more information, see the detailed program description in Part 1. 0641. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Tip Of The Hat. Contact: Ms. Anna B. Jones, Program Consultant (406)442-6556. Description: This program honors businesses and groups offering smoke- free atmospheres. Individuals are encouraged to seek and make nominations. Those commended are sent certificates and featured in local newspapers. 0642. AMERICAN LUNG ASSOCIATION OF MONTANA, 825 Helena Avenue, Helena, Montana 59601. Program Title: Tobacco Free Class Of 2000. Contact: Mr. Earl W. Thomas, Program Consultant (406)442-6556. Description: The American Lung Association of Montana is adopting the kindergarten class of 1987, eventually the graduating Class of 2000. Programs, buttons, and banners will be aimed at this class, with followup each year reinforcing their freedom from tobacco. A Tobacco Free School program is being offered simultaneously. 0643. MONTANA DEACONESS MEDICAL CENTER, Department of Education, 1101 26th Street South, Great Falls, Montana 59405. Program Title: Freedom From Smoking. Contact: Ms. Esther Lantz, Program Coordinator (406)791-5507. Description: The American Lung Association's cessation program is offered. For more information, see the detailed program description in Part 1. 0644. MOUNTAINVIEW CLINIC, Box 469, White Sulphur Springs, Montana 59645. Program Title: FreshStart. Contact: Audrey East, L.P.N., Program Coordinator (406)547-3384. Description: The American Cancer Society's FreshStart program is offered to all County residents. For more information, see the detailed program description in Part 1. NEBRASKA 0645. AMERICAN CANCER SOCIETY, NEBRASKA 0647. AMERICAN HEART ASSOCIATION, NEBRASKA DIVISION, INC., 8502 West Center Road, Omaha, AFFILIATE, 3624 Farnam Street, Omaha, Nebraska 681 24-5255. Nebraska 68131. Program Title: Program Title: FreshStart. Heart Rx. Contact: Contact: Mr. Daniel E. Wherry, Chairman (402)474-1791. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0646. AMERICAN HEART ASSOCIATION, NEBRASKA AFFILIATE, 3624 Farnam Street, Omaha, Nebraska 68131. Program Title: Heart At Work. Contact: Ms. Patricia Shea, Program Specialist (402)346-0771. Description: This wellness education program helos employers sponsor health promotion activities in their workplace. For more infor- mation, see the detailed program description in Part 1. 277 Ms. Gayle Cluck, Program Director (402)346-0771. Description: This patient education program is available to health care providers. For more information, see the detailed program description in Part 1. 0648. AMERICAN HEART ASSOCIATION, NEBRASKA AFFILIATE, 3624 Farnam Street, Omaha, Nebraska 68131. Program Title: Putting Your Heart Into The Curriculum. Contact: Ms. Gayle Cluck, Program Director (402)346-0771. Description: Smoking education is included in each of four health curricula for students in kindergarten through grade 12. For more in- formation, see the detailed program description in Part 1. 0649. AMERICAN HEART ASSOCIATION, NEBRASKA AFFILIATE, 3624 Farnam Street, Omaha, Nebras- ka 68131. Program Title: Save A Sweet Heart. Contact: Ms. Gayle Cluck, Program Director (402)346-0771. Description: This 10-week program targets junior and senior high school students. Conducted by students, this awareness program culminates on February 14, Save A Sweet Heart Day. For more information, see the detailed program description in Part 1. 0650. AMERICAN LUNG ASSOCIATION OF NEBRASKA, 8901 Indian Hilis Drive, Suite 107, Omaha, Nebraska 68114-4093. Program Title: Biofeedback Tobacco Education Project. Contact: Ms. Arlene Weingart, Program Associate (402)393-2222. Description: The American Lung Association of Nebraska provides the necessary biofeedback equipment for schools to conduct a five-lasson program about smoking designed for students in grades 7 through 12. This program is based on the American Lung Association's Biofeedback Smoking Education Program. For more information, see the detailed program description in Part 1. 0651. AMERICAN LUNG ASSOCIATION OF NEBRASKA, 8901 Indian Hills Drive, Suite 107, Omaha, Nebraska 68114-4093. Program Title: Freedom From Smoking. Contact: Ms. Pegg Noyes, Program Director (402)393-2222. Description: The American Lung Association’s Freedom From Smoking clinics and self-help programs are offered. For more information, see the detailed program descriptions in Part 1. AMERICAN LUNG ASSOCIATION OF NEBRASKA, 8901 Indian Hills Drive, Suite 107, Omaha, Nebraska 68114-4093. 0652. Program Title: Octopuff In Kumquat. 278 Contact: Ms. Arlene Weingart, Program Associate (402)393-2222. Description: The American Lung Association's Octopuff In Kumquat pre- school smoking education program is offered. For more information, see the detailed program description in Part 1. 0653. AMERICAN LUNG ASSOCIATION OF NEBRASKA, 8901 Indian Hills Drive, Suite 107, Omaha, Nebraska 68114-4093. Program Title: Students Teach Students. Contact: Ms. Arlene Weingart, Program Associate (402)393-2222. Description: The American Lung Association’s Students Teach Students program is offered to area schools. For more information, see the detailed program description in Part 1. 0654. NEBRASKA STATE DEPARTMENT OF HEALTH, 301 Centennial Mali South, Post Office Box 95007, Lincoln, Nebraska 68509-5007. Program Title: Health Department Activities. Contact: Ms. Edye Wiebers, Program Coordinator (402)471-2101. Description: A tobacco education program has been developed that ex- plores peer, farnily, and advertising pressures to smoke and provides students with ways to say no. Field testing on 1,600 youngsters showed a positive effect on what students know about tobacco and their attitudes toward using it. Workshops, funded by a grant from the Nebraska Department of Health, were held across the State in 1987 to present the program to teachers. Finally, in conjunction with the State Employee Wellness Program located within the health department, the Risk Reduction Program has been encouraging and assisting State agencies and departments in limiting or banning smoking in their work areas. 0655. UNIVERSITY OF NEBRASKA, LINCOLN, UNIVERSITY HEALTH CENTER, Community Health Department, 15th and U Streets, Room 12, Lincoln, Nebraska 68588-0618. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Mr. Joseph Anderson, Jr., Program Coordinator (402)472-7477. Description: The Seventh-Day Adventists’ Breathe-Free Plan To Stop Smoking is offered. For more information, see the detailed program description in Part 1. NEVADA 0656. AMERICAN CANCER SOCIETY, NEVADA 0659. AMERICAN HEART ASSOCIATION, NEVADA DIVISION, INC., 1325 East Harmon, Las Vegas, AFFILIATE, 3355 Spring Mountain Road, Suite Nevada 89119. 23, Las Vegas, Nevada 89102. Program Title: Program Title: FreshStart. Heart At Work. Contact: Contact: Mr. Al Levitt, Program Coordinator (702)798-6877. Description: The American Cancer Society’s FreshStart program is offered at no cost. For more information, see the detailed program description in Part 1. 0657. AMERICAN CANCER SOCIETY, NORTHERN NEVADA DIVISION, INC., 120 South Wells Avenue, Reno, Nevada 89502. Program Title: FreshStart. Contact: Mrs. Dee Schafer-Kruper, Program Administrator (702)329-0609. Description: The American Cancer Society's FreshStart program is offered at no cost. For more information, see the detailed program description in Part 1. 0658. AMERICAN HEART ASSOCIATION, NEVADA AFFILIATE, 3355 Spring Mountain Road, Suite 23, Las Vegas, Nevada 89102. Program Title: Fourth Grade Smoking. Contact: Mr. R. Sky McClain, Program and Communications Director (702)367-6490. Description: This program is implemented in area grace schools. It focuses on the dangers of tobacco use and the health risks involved. It prepares the student to make informed decisions on the use of tobacco products. 279 Mr. R. Sky McClain, Program and Communications Director (702)367-6490. Description: The American Heart Association’s employee wellness program is offered. For more information, see the detailed program description in Part 1. 0660. AMERICAN HEART ASSOCIATION, NEVADA AFFILIATE, 3355 Spring Mountain Road, Suite 23, Las Vegas, Nevada 89102. Program Title: Heart Rx. Contact: Mr. R. Sky McClain, Program and Communications Director (702)367-6490. Description: The American Heart Association’s information dissemination program for health care providers is provided. For more information, see the detailed program description in Part 1. 0661. AMERICAN HEART ASSOCIATION, NEVADA AFFILIATE, 3355 Spring Mountain Road, Suite 23, Las Vegas, Nevada 89102. Program Title: Save A Sweet Heart. Contact: Mr. R. Sky McClain, Program and Communications Director (702)367-6490. Description: The American Heart Association's Save A Sweet Heart program is offered to area schools. For more information, see the detailed program description in Part 1. 0662. AMERICAN HEART ASSOCIATION, NEVADA AFFILIATE, 3355 Spring Mountain Road, Suite 23, Las Vegas, Nevada 89102. Program Title: Treasure Chest. Contact: Mr. R. Sky McClain, Program and Communications Director (702}367-6490. Description: This program involves children in preschools and kindergar- ten in an informational curriculum regarding the anatomy of the heart and nutritional care needed for future years. This hands-on program presents basic health concepts for children through enjoyable small group and individual activities. 0663. AMERICAN HEART ASSOCIATION, NORTHERN NEVADA DIVISION, 1135 Terminal Way, Suite 105, Reno, Nevada 89502. Program Title: Fourth Grade Smoking. Contact: Ms. Christy Jefferson, Division Director (702)322-7064. Description: This program is implemented in area grade schools. k focuses on the dangers of tobacco use and the health risks involved. It prepares the student to make informed decisions on the use of tobacco products. 0664. AMERICAN HEART ASSOCIATION, NORTHERN NEVADA DIVISION, 1135 Terminal Way, Suite 105, Reno, Nevada 89502. Program Title: Heart At Work. Contact: Ms. Christy Jefferson, Division Director (702)322-7064. Description: The American Heart Association’s employee wellness program is offered. For more information, see the detailed program description in Part 1. 0665. AMERICAN HEART ASSOCIATION, NORTHERN NEVADA DIVISION, 1135 Terminal Way, Suite 105, Reno, Nevada 89502. Program Title: Heart Rx. Contact: Ms. Christy Jefferson, Division Director (702)322-7064. 280 Description: The American Heart Association's information dissemination program fo; health care providers is implemented. For more information, see the detailed program description in Part 1. 0666. AMERICAN HEART ASSOCIATION, NORTHERN NEVADA DIVISION, 1135 Terminal Way, Suite 105, Reno, Nevada 89502. Program Title: Save A Sweet Heart. Contact: Ms. Christy Jefferson, Division Director (702)322-7064. Description: The American Heart Association's Save A Sweet Heart program is offered to area schools. For more information, see the detailed program description in Part 1. 0667. AMERICAN HEART ASSOCIATION, NORTHERN NEVADA DIVISION, 1135 Terminal Way, Suite 105, Reno, Nevada 89502. Program Title: Treasure Chest. Contact: Ms. Christy Jefferson, Division Director (702)322-7064. Description: This program involves children in preschools and kindergar- ten in an informational curriculum regarding the anatomy of the heart and nutritional care needed for future years. This hands-on program presents basic health concepts for children through enjoyable small group and individual activities. 0668. AMERICAN HEART ASSOCIATION, SOUTHERN NEVADA DIVISION, 3355 Spring Mountain Road, Sulte 64, Las Vegas, Nevada 89102. Program Title: Fourth Grade Smoking. Contact: Ms. Vicky Congdon, Division Director (702)367-1366. Description: This program is implemented in area grade schools. It focuses on the dangers of tobacco use and the health risks involved. It prepares the student to make informed decisions on the use of tobacco products. 0669. AMERICAN HEART ASSOCIATION, SOUTHERN NEVADA DIVISION, 3355 Spring Mountain Road, Suite 64, Las Vegas, Nevada 89102. Program Title: Heart At Work. Contact: Ms. Vicky Congdon, Division Director (702)367-1366. Description: The American Heart Association’s employee weliness program is offered. For more information, see the detailed program description in Part 1. 0670. AMERICAN HEART ASSOCIATION, SOUTHERN NEVADA DIVISION, 3355 Spring Mountain Road, Suite 64, Las Vegas, Nevada 89102. Program Title: Heart Rx. Contact: Ms. Vicky Congdon, Division Director (702)367-1366. Description: The American Heart Association’s information dissemination program for health care providers is implemented. For more information, see the detailed program description in Part 1. 0671. AMERICAN HEART ASSOCIATION, SOUTHERN NEVADA DIVISION, 3355 Spring Mountain Road, Suite 64, Las Vegas, Nevada 89102. Program Title: Save A Sweet Heart. Contact: Ms. Vicky Congdon, Division Director (702)367-1366. Description: The American Heart Association's Save A Sweet Heart program is offered to area schools. For more information, see the detailed program description in Part 1. 0672. AMERICAN HEART ASSOCIATION, SOUTHERN NEVADA DIVISION, 3355 Spring Mountain Road, Suite 64, Las Vegas, Nevada 89102. Program Title: Treasure Chest. Contact: Ms. Vicky Congdon, Division Director (702)367-1366. 281 Description: This program involves children in preschools and kindergar- ten in an informational curriculum regarding the anatomy of the heart and nutritional care needed for future years. This hands-on program presents basic health concepts for children through enjoyable small group and individual activities. 0673. AMERICAN LUNG ASSOCIATION OF NEVADA, Post Office Box 7056, Reno, Nevada 89510. Program Title: Freedom From Smoking. Contact: Ms. Jolene Stewart, Program Coordinator (702)323-5864. Description: Smoking cessation materials from the Freedom From Smok- ing program are distributed. For more information, see the detailed program description in Part 1. 0674. AMERICAN LUNG ASSOCIATION OF NEVADA, Post Office Box 7056, Reno, Nevada 89510. Program Title: Freedom From Smoking Clinic Leaders Training. Contact: Ms. Jolene Stewart, Program Coordinator (702)323-5864. Description: The American Lung Association encourages staff, volunteers, and paid leaders to attend a workshop and use the manual to train others. Once trained in an American Lung Association workshop, a person can serve as the clinic coordinator, responsible for organization, promotion, administration, recruitment, selection, and training of clinic leaders. For more information, see the detailed program description in Part 1. 0675. AMERICAN LUNG ASSOCIATION OF NEVADA, Post Office Box 7056, Reno, Nevada 89510. Program Title: Smoking And Pregnancy. Contact: Ms. Jolene Stewart, Program Coordinator (702)323-5864. Description: The American Lung Association's Smoking and Pregnancy program is offered. For more information, see the detailed program description in Part 1. NEW HAMPSHIRE 0676. AMERICAN CANCER SOCIETY, NEW HAMPSHIRE DIVISION, INC., 686 Mast Road, Manchester, New Hampshire 03102. Program Title: FreshStart. Contact: Ms. Margaret Murphy, Public Education Director (603)669-3270. Description: The American Cancer Saciety’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0677. AMERICAN HEART ASSOCIATION, NEW HAMPSHIRE AFFILIATE, 309 Pine Street, Manchester, New Hampshire 03103. Program Title: Smoking Education. Contact: Ms. Molly Mayo, Executive Director (603)669-5833 or (800}442-1600. Description: Grants are awarded annually for eligible Heart Health Educa- tion In The Young projects operated by schools, colleges, and youth organizations. A free audiovisual loan library contains films about the health and social hazards of smoking. Literature published by the American Heart Association is available free of charge. A volunteer speakers’ bureau is also maintained. 0678. AMERICAN LUNG ASSOCIATION OF NEW HAMPSHIRE, 456 Beech Street, Post Office Box 1014, Manchester, New Hampshire 03105. Program Title: Smoking Education Program. Contact: Ms. Joan Stevens, Program Coordinator (603)669-2411. Description: The program utilizes the American Lung Association's Biofeedback Smoking Education Project. For more information, see the detailed program description in Part 1. 0679. STATE OF NEW HAMPSHIRE DEPARTMENT OF HEALTH AND HUMAN SERVICES, Bureau of Health Promotion, Health and Welfare Bullding, 6 Hazen Drive, Concord, New Hampshire 03301- 6527. Program Title: Health Department Activities. Contact: Kay Zaso, R.N., M.P.A., Chief, Bureau of Health Promotion (603)271-4551. Description: The Bureau of Health Promotion provides smoking prevention education efforts in almost all of its health promotion program initiatives. The Bureau oversees compliance with N.H. Law RSA 155:45, an Act restricting smoking in enclosed public places, and to this end, the Bureau distributes, upon request to both the public and private sector, information packets con- taining facts on the effects of smoking, secondhand smoke is- sues, sample smoking policies, and guidelines for developing policies. Workshops and keynote addresses dealing with smoking and health are included in the annual Statewide multiday, multitrack health promotion conference. The Bureau also serves as a clearinghouse for materials and information on smoking issues and maintains a lending library for print, audiovisual, and computer software materials for use by health and human service professionals and educators Statewide. In addition, it funds demonstration projects in the State, including smoking cessation and prevention education projects in the schools. NEW JERSEY 0680. AMERICAN CANCER SOCIETY, 120 Findern Avenue, Bridgewater, New Jersey 08807. Program Title: FreshStart. Contact: Program Coordinator (609)725-4664. Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0681. AMERICAN CANCER SOCIETY, Post Office Box 601, 2303 Woodbridge Avenue, Edison, New Jersey 08818. 282 Program Title: FreshStart. Contact: Program Coordinator (201)985-9566. Description: The American Cancer Society's FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0682. AMERICAN CANCER SOCIETY, 110 East High Street, Glassboro, New Jersey 08028. Program Title: FreshStart. Contact: Ms. Annette Hess, Executive Director (609)881 -6677. Description: The American Cancer Society's FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0683. AMERICAN CANCER SOCIETY, 22 Mercer Street, Hackensack, New Jersey 07601. Program Title: FreshStart. Contact: Program Coordinator (201)343-2222. Description: For more information about the American Cancer Society’s FreshStart program, see the detailed program description in Part 1. 0684. AMERICAN CANCER SOCIETY, 410 White Horse Pike, Haddon Heights, New Jersey 08035. Program Title: FreshStart. Contact: Program Coordinator (609)546-1600. Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0685. AMERICAN CANCER SOCIETY, 1 Kings High- way, Middletown, New Jersey 07748. 283 Program Title: FreshStart. Contact: Ms. Maureen Miner, Director of Health Education (201)280-2323. Description: The American Cancer Society's FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0686. AMERICAN CANCER SOCIETY, 120 Washington Street, Morristown, New Jersey 07960. Program Title: FreshStart. Contact: Program Coordinator (201)538-5336. Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0687. AMERICAN CANCER SOCIETY, 101 Shore Road, Northfields, New Jersey 08225. Program Title: FreshStart. Contact: Program Coordinator (609)645-7272. Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0688. AMERICAN CANCER SOCIETY, Post Office Box 116, Mount Holly, New Jersey 08060. Program Title: FreshStart. Contact: Ms. Barbara DiFrank, Program Director (609)267-8444. Description: The American Cancer Society's FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 7. 0689. AMERICAN CANCER SOCIETY, 652 Whitehead Road, Trenton, New Jersey 08648. Program Title: FreshStart. Contact: Program Coordinator (609)394-5000. Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0690. AMERICAN CANCER SOCIETY, Orchard Road and Landis Avenue, Vineland, New Jersey 08360. Program Title: FreshStart. Contact: Ms. Joan McAllister, Program Coordinator (609)692-1364. Description: The American Cancer Society's FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0691. AMERICAN CANCER SOCIETY, 4 Brown Avenue, Woodstown, New Jersey 08098. Program Title: FreshStart. Contact: Mr. Wiley Brannan, Program Coordinator (609)299-2211, Description: The American Cancer Society’s FreshStart program is avail- able for $25. For more information, see the detailed program description in Part 1. 0692. AMERICAN CANCER SOCIETY, MONMOUTH UNIT, 1540 Route 38, Suite 303, Wall, New Jersey 07719. Program Title: FreshStart. Contact: Ms. Maureen Miner, Director of Health Education (201)280-2323. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0693. AMERICAN CANCER SOCIETY, NEW JERSEY DIVISION, INC., CN 2201, 2600 Route 1, North Brunswick, New Jersey 08902. 284 Program Title: FreshStart. Contact: Ms. Shirley Greene, Public Education Director (201)297-8000. Description: The American Cancer Society’s FreshStart program is offered for $25. For more information, see the detailed program description in Part 1. 0694. AMERICAN CANCER SOCIETY, NEW JERSEY DIVISION, INC., CN 2201, 2600 Route 1, North Brunswick, New Jersey 08902. Program Title: School Education Programs. Contact: Ms. Shirley Greene, Public Education Director (201)297-8000. Description: An education kit is available to each school for the following: preschool- Starting Free; kindergarten to grade 3— Early Start To Good Health; grades 4 to 6 — Health Myself; grades 7 to 9 — Health Network. For more information, see the detailed program descriptions in Part 1. 0695. AMERICAN CANCER SOCIETY, NEW JERSEY DIVISION, INC., CN 2201, 2600 Route 1, North Brunswick, New Jersey 08902. Program Title: Why Quit Quiz. Contact: Ms. Shirley Greene, Public Education Director (201)297-8000. Description: The Why Quit Quiz is a 1-hour, one-session program led by a physician or trained speaker who outlines the dynamics of cigarette addiction and points out the dangers of smoking. This self-pretest, film and discussion format fosters a fun, interactive education program. 0696. AMERICAN HEART ASSOCIATION, NEW JERSEY AFFILIATE, Post Office Box 1900, North Brunswick, New Jersey 08902. Program Title: Heart At Work. Contact: Mr. Kevin Sorge, Vice President, Programs (201)821-2610. Description: The American Heart Association's Heart At Work worksite health promotion program is offered. The fee is $30 for the Heart At Work kit. For more information, see the detailed... program description in Part 1. 0697. AMERICAN HEART ASSOCIATION, NEW JERSEY AFFILIATE, Post Office Box 1900, North Brunswick, New Jersey 08902. Program Title: Heart Rx. Contact: Mr. Kevin Sorge, Vice President of Programs (201)821-2610. Description: The American Heart Association’s Heart Rx program for health care providers is offered for $30. For more information, see the detailed program description in Part 1. 0698. AMERICAN HEART ASSOCIATION, NEW JERSEY AFFILIATE, Post Offlce Box 1900, North Brunswick, New Jersey 08902. Program Title: Save A Sweetheart. Contact: Mr. Kevin Sorge, Vice President of Programs (201)821-2610. Description: This program involves a series of activities to promote non- smoking among students. For more information, see the program description in Part 1. 0699. AMERICAN HEART ASSOCIATION, NEW JERSEY AFFILIATE, Post Office Box 1900, North Brunswick, New Jersey 08902. Program Title: School-Based Cardiovascular Education Curricula. Contact: Mr. Kevin Sorge, Vice President, Programs (201)821-2610. Description: This in-school program is offered to students in grades 1 through 12. Special attention is given to the effects of smok- ing on the cardiovascular system. : 0700. AMERICAN LUNG ASSOCIATION, 14-25 Plaza Road, Falr Lawn, New Jersey 07410. Program Title: Freedom From Smoking. Contact: Ms. Jackie Quigley, Program Director (201)791-6600. 285 Description: For more information about the American Lung Association's Freedom From Smoking program, see the detailed program description in Part 1. 0701. AMERICAN LUNG ASSOCIATION, 10 West Main Street, Mays Landing, New Jersey 08330. Program Title: Freedom From Smoking In 20 Days. Contact: Ms. Helen Dougherty, Program Director (609)625-0101. Description: This Freedom From Smoking self-help program, including special seminars on asthma education, cardiac obstructive pulmonary disease, and smoking and pregnancy, is offered. For more information, see the detailed program description in Part 1. 0702. AMERICAN LUNG ASSOCIATION OF MID-NEW JERSEY, 29 Emmons Drive, Post Office Box 2006, Princeton, New Jersey 08543-2006. Program Title: Freedom From Smoking Clinics. Contact: Ms. Karren Stanton-Newman, Program Consultant (609)452-2112. Description: The American Lung Association's Freedom From Smoking Clinics are available in the five-county area at a cost of $35. For more information, see the detailed program description in Part 1, 0703. AMERICAN LUNG ASSOCIATION OF NEW JERSEY, 1600 Route 22 East, Union, New Jersey 07083. Program Title: Freedom From Smoking. Contact: Ms. Kathy Adelsheim, Program Director (201)687-9340. Description: This program, aimed at current smokers in the community and the workplace, is offered at two clinics in each county each year. For more information, see the detailed program descrip- tion in Part 1. AMERICAN LUNG ASSOCIATION OF NEW JERSEY, 1600 Route 22 East, Union, New Jersey 07083. 0704, Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Kathy Adelsheim, Program Director (201)687-9340. Description: This is a self-help program assisted by a broad media and public relations push. kh is a 10-day stop smoking program designed to help pregnant women quit on their own. For more information, see the detailed program description in Part 1. 0705. AMERICAN LUNG ASSOCIATION OF NEW JERSEY, 1600 Route 22 East, Union, New Jersey 07083. Program Title: In Control. Contact: Ms. Kathy Adelsheim, Program Director (201)687-9340. Description: The In Control videocassette smoking cessation program is offered. For more information, see the detailed program description in Part 1. 0706. AMERICAN LUNG ASSOCIATION OF NEW JERSEY, 1600 Route 22 East, Union, New Jersey 07083. Program Title: Self-Help Materials. Contact: Ms. Kathy Adelsheim, Program Director (201)687-9340. Description: Various self-help manuals and materials, such as Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking, are provided at minimal cost. Also, a new self-help manual is available entitled, Freedom From Smoking For You And Your Family. For more information, see the detailed program description in Part 1. 0707. ATLANTIC CITY HEALTH DEPARTMENT, 35 South Illinois Avenue, Atlantic City, New Jersey 08401. Program Title: Freedom From Smoking. Contact: Ms. Patricia McGovern, Health Educator (609)347-5676. Description: The American Lung Association's Freedom From Smoking 286 program is available without charge. Individualized education and support are also provided. For more information, see the detailed program description in Part 1. 0708. ATLANTIC CITY MEDICAL CENTER, 1925 Pacific Avenue, Atlantic City, New Jersey 08401. Program Title: FreshStart. Contact: Mr. Jay A. Zimmer,* Assistant Vice President for Medical Education (609)441-8094. Description: The American Cancer Society's FreshStart program is offered for $20. For more information, see the detailed program description in Part 1. 0709. BAYONNE HOSPITAL, 29 East 29th Street, Bayonne, New Jersey 07002. Program Title: Freedom From Smoking Clinics. Contact: Ms. Kathleen C. Wendowski, Assistant Administrator (201)858-5287. Description: The American Lung Association’s Freedom From Smoking clinics are offered for $30. For more information, see the detailed program description in Part 1. 0710. BAYSHORE COMMUNITY HOSPITAL, 727 North Beers Street, Holmdel, New Jersey 07733. Program Title: Smokeless. Contact: Ms. Janet Hostrup, Director, Consumer Education (201)739-5919. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup ser- vices are provided. 0711. BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES, 327 Ridgewood Avenue, Paramus, New Jersey 07652-4895. Program Title: Learn Not To Smoke. Contact: Ms. Joyce Lisbin, Health Educator (201)599-6110. Description: Through viewing the film, "Octopuff in Kumaquat," preschoolers and primary school children are taught why smoking is not healthy. Utilizing the film, "Kids on Smoking,” and the filmstrip, "Tobacco: The Followers Habit,” elementary and junior high students learn the hazards of cigarette smoking. Individual decision making is emphasized. The health education program is provided by the Bergen County Department of Health Services in cooperation with local Boards of Health in contracting communities. 0712. BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES, 327 Ridgewood Avenue, Paramus, New Jersay, 07652-4895. : Program Title: Quit Smoking Program. Contact: Mr. Albert J. Ferrara, Jr., Coordinator (201)599-6110. Description: The Quit Smoking Program is based on behavior modification and offers each participant individualized attention combined with the structure and support of a group experience. Smokers meet twice weekly for eight smoking-cessation ses- sions. Participants focus on why they smoke, explore heal- thier alternatives to their smoking dependency, and learn how to cope with the urges to return to smoking. Stress reduction and weight control while quitting are discussed, A film and pamphlets also provide information. After 1 year, a followup evaluation is conducted. The program is limited to 20 Participants and a fee of $30 is charged. 0713. BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES, 327 Ridgewood Avenue, Paramus, New Jersey, 07652-4895. Program Title: Secondhand Smoke. Contact: Ms. Joyce Lisbin, Health Educator (210)599-61 10. Description: Research, combined with public pressure, has resulted in laws to protect nonsmokers from the health hazards of secondhand smoke. New health laws, their benefits, and the facts about secondhand smoke are discussed in this program for students in grades 7 through 12 and adults. 0714. BERGEN COUNTY DEPARTMENT OF HEALTH SERVICES, 327 Ridgewood Avenue, Paramus, Now Jersey 07652-4895. 287 Program Title: Smoking: Why and How to Quit. Contact: Ms. Joyce Lisbin, Health Educator (201)599-6110. Description: An up-to-date film, featuring Frank Field, explores the facts about smoking, followed by a discussion on quitting techni- ques. This program is for students in grades 9 through 12 and adults. 0715. BETH ISRAEL HOSPITAL, 70 Parker Avenue, Passalc, New Jersey 07055. Program Title: Freedom From Smoking Clinics. Contact: Ms. Mary O'Connor-Root, Director, Services (201)365-5220. Community Health Description: The American Lung Association's Freedom From Smoking clinics are offered for $35. For more information, see the detailed program description in Part 1. 0716. BETTER LIVING CENTER, Seventh-Day Adventist Church, Route 202 and Tempe Wick Road, Morristown, New Jersey 07960. Program Title: Five Day Plan. Contact: Program Coordinator (201)539-2250. Description: The Seventh-Day Adventists’ Five Day Plan is offered for $50. For more information, see the detailed program description in Part 1. 0717. CAPE MAY COUNTY DEPARTMENT OF HEALTH, Crest Haven Complex on Parkway, Cape May Court House, New Jersey 08210-3067. Program Title: Freedom From Smoking. Contact: Mr. Andrew W. Melchiorre, Senior Field Representative (609)465-1225, Description: The American Lung Association's Freedom From Smoking program is offered once or twice a year for the general public using the Kick The Habit kit. For more information, see the detailed program description in Part 1. 0718. CARRIER FOUNDATION, Belle Mead, New Jersey 08502. Program Title: Smokeless. Contact: Mr. William Dundon, Director, Educational Services (201)874-4000. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate cravings that may develop. Cessation booklets and followup services are provided. 0719. CHEST AND LUNG ASSOCIATION OF SOUTHERN NEW JERSEY, 21 South Washington Street, Hammonton, New Jersey 08037. Program Title: Smoking Cessation. Contact: Program Coordinator (609)561-8700. Description: Two free clinics are offered to all Gloucester County residents. Each clinic consists of five sessions. Sessions focus on be- havior modification, group reinforcement, and hypnosis. Forthcoming clinics will be held at Gateway Regional High School and Glassboro State College. The charge for these workshops is $40. 0720. CHILTON MEMORIAL HOSPITAL, Pompton Plains, New Jersey 07444. Program Title: Smoke Cessation. Contact: Ms. Sandra Gigante, Smoke Cessation Coordinator (201)831-5070. Description: A 7-week smoke cessation program is offered for $50. The goal is a smoke-free environment within 2 years. This will be a continuing program for as long as needed. 0721. CHRISTHOSPITAL, 176 Palisade Avenuo, Jersey City, New Jersey 07306. Program Title: Freedom From Smoking Clinics. Contact: Program Coordinator (201)795-8030. 288 Description: The American Lung Association’s Freedom From Smoking clinics are offered for $55. For more information, see the detailed program description in Part 1. 0722. CITY OF LINDEN BOARD OF HEALTH, City Hall, Linden, New Jersey 07036. Program Title: Smokeless Tobacco. Contact: Ms. Lorraine H. Kowalski, Health Educator (210)352-5694 ext.51. Description: This education program for teenagers is offered in all health classes grades 6 through 12. The program uses audiovisual materials including films, slides, articles, and reports to inform students about the dangers of smokeless tobacco. The cur- riculum covers the history and physiology of use, physical reactions, and health hazards associated with use as well as labeling and advertising restrictions on tobacco products. 0723. CITY OF LINDEN BOARD OF HEALTH, City Hall, Linden, New Jersey 07036. Program Title: Smoking Cessation. Contact: Ms. Lorraine H. Kowalski, Health Educator (210)352-5694 ext.51. Description: Focusing on mothers in health clinics, this program includes audiovisual presentations, counseling, and distribution of materials. 0724. CITY OF LINDEN BOARD OF HEALTH, City Hall, Linden, New Jersey 07036. Program Title: Smoking For Kids. Contact: Ms. Lorraine H. Kowalski, Health Educator (210)352-5694 ext.51. Description: This program is offered to students in preschool through grade 3. Two films, handouts, stories, demonstration with Smokey Sue, and discussion sessions inform children of health hazards associated with smoking. 0725. CITY OF PATERSON, DEPARTMENT OF HUMAN RESOURCES, Division of Health, 176 Broadway, Paterson, New Jersey 07505. Program Title: Freedom From Smoking. Contact: Ms. Jeanmarie Fasulo, Health Educator (201)881-3987. Description: This comprehensive four-session smoking cessation program, adapted from the American Lung Association’s Freedom From Smoking program, is available to the general public. For more information, see the detailed program description in Part 1. 0726. CITY OF TRENTON, DEPARTMENT OF HEALTH AND HUMAN SERVICES, Division of Health, Trenton, New Jersey 08608. Program Tite: Little Lungs, No Smoking Please. Contact: Carol Ann Notte, R.N., B.S.N., Coordinator (609)989-3263. Description: The smoking cessation program is an 8-week behavior modification program being offered at least eight times each year to women of child-bearing age and fathers. Participants learn the hazards of smoking and the effect that secondhand smoke has on their children. The serious complications that pregnant smokers face are also discussed in detail. Par- ticipants become aware of their smoking behavior, what stimuli encourage smoking, and what reward smoking current- ly offers them. They learn to substitute alternative behaviors for smoking. A self-help version of the program is also available to those who can not attend sessions. 0727. CLARA MAAS MEDICAL CENTER, Community Health Resource Center, 1 Franklin Avenue, Belleville, New Jersey 07109. Program Title: FreshStart. Contact: Ms. Monique Davis, Health Educator (201)450-2119. Description: Scheduling information for the American Cancer Society’s FreshStart program is published in local newspapers prior to the program start date. For more information, see the detailed program description in Part 1. 0728. CUMBERLAND COUNTY HEALTH DEPART- MENT, Room 200, 790 East Commerce Street, Bridgeton, New Jersey 08302. Program Title: Smoking Cessation. Contact: Ms. Mary Ann Cooney, Health Educator (609)451-8000 ext.374. 289 Description: The health educator currently conducts cessation programs for community groups, agencies, and local industry. 0729. DELAWARE-RURITAN LUNG ASSOCIATION, 29 Emmons Drive, Princeton, New Jersey 08543- 2006. Program Title: Smoking Cessation. Contact: Ms. Karren Stanton-Newman, Program Consultant (609)452-2112. Description: Cessation programs are offered for $50, in conjunction with other organizations and corporations. 0730. EAST ORANGE GENERAL HOSPITAL, 300 Central Avenue, East Orange, New Jersey 07019. Program Title: FreshStart. Contact: Mr. T. Cahill, Vice President (201)266-4413. Description: The American Cancer Society’s FreshStart cessation program is offered. In addition, a program developed by one of the hospital's addiction specialists will be offered. For more information, see the detailed program description in Part 1. 0731. FRANKLIN TOWNSHIP HEALTH DEPARTMENT, 935 Hamllton Street, Somerset, New Jersey 08873. Program Title: Smoking Cessation Through Hypnosis. Contact: A. Mayer, R.N., Program Coordinator (201)873-2500 ext.250. Description: A 1-hour, 4-week course on how to quit smoking through hypnosis is offered for $25. 0732. FREEHOLD AREA HOSPITAL, West Main Street, Freehold, New Jersey 07728. Program Title: Smoke Enders. Contact: Ms. Maryann Murtha, Director, Weliness Center (201)780-6050. Description: The program is offered for $149. 0733. FROST VALLEY YMCA, 298 Claremont Avenue, Montclair, New Jersey, 07042. Program Title: Wellness Resource Guide For Counselors At A Resident Camp Setting. Contact: Project Director (201)744-3488. Description: A manual, designed to assist camp administrators, program staff, and counselors in programming weliness activities for campers, has been developed and is available for distribution. Also available are support materials including a slide/cassette introduction to wellness and an administrator's guide. The material focuses on nutrition, physical fitness, stress manage- ment, human relations, safety, and abuse of tobacco, alcohol, and drugs. 0734. GLOUCESTER COUNTY HEALTH DEPART- MENT, Carpenter Street and Allens Lane, Woodbury, New Jersey 08096. Program Title: Freedom From Smoking. Contact: Ms. Jennifer Austin, Health Educator (609)853-3424. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0735. GLOUCESTER COUNTY HEALTH DEPART- MENT, Carpenter Street and Allens Lane, Woodbury, New Jersey 08096. Program Title: FreshStart. Contact: Ms. Jennifer Austin, Health Educator (609)853-3424. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 0736. HACKENSACK HEALTH DEPARTMENT, 215 State Street, Hackensack, New Jersey 07602. Program Title: FreshStart. 290 Contact: Program Coordinator, Bergen County Unit (201)}343-2222. Description: This American Cancer Society program is offered free to par- ticipants and organizations that sponsor the program or for a fee of $25 for the four group sessions. For more information, see the detailed program description in Part 1. 0737. HACKETTSTOWN COMMUNITY HOSPITAL, 651 Wiliow Grove Street, Hackettstown, New Jersey 07840. Program Title: Smoking Cessation. Contact: Program Coordinator, Community Education Department (201)852-5100. Descrlption: This is a 5-day plan for smoking cessation offered several times a year for a fee of $50. 0738. HAMILTON HOSPITAL, Whitehorse-Hamilton Square Road, Hamilton, New Jersey 08690. Program Title: Freedom From Smoking. Contact: Lucille A. Rosso, R.N., 8.S.N., Health Educator (609)586-7900 ext.6860. Description: The American Lung Association’s Freedom From Smoking program is offered for $50. For more information, see the detailed program description in Part 1. 0739. HAZLET/ABERDEEN HEALTH DEPARTMENT, 319 Middle Road, Hazlet, New Jersey 07730. Program Title: FreshStart. Contact: Ms. Deborah K. Shields, Health Educator (201)264-1700 or 747-7180. Description: The American Cancer Society’s FreshStart program is offered for $20. For more information, see the detailed program description in Part 1. 0740. HEALTH INSURANCE PLAN OF NEW JERSEY, 165 Old Marlton Pike, Medford, New Jersey 08055. Program Title: Smoke No More. Contact: Ms. Jean E. Gorman, Coordinator, Health Education (800)367-0248. Description: The program represents a positive approach to quitting through habit replacement, group support, and other proven methods. 0741. HELENE FULD MEDICAL CENTER, 750 Brunswick Avenue, Trenton, New Jersey 08638. Program Title: Little Lungs, No Smoking Please. Contact: Mrs. Susan Bell, Community Health Education (609)394-6062. Description: This 8-week program, designed by the American Lung Association, is for individuals who are around small children. tt teaches methods on how to stop smoking gradually while in- corporating nutrition, exercise, and relaxation into the program. 0742. HOBOKEN HEALTH DEPARTMENT, Health Center, Hoboken, New Jersey 07030. Program Title: Smoking Cessation And Information. Contact: Ms. Patricia Mitten, Health Officer (201)420-2365. Description: Individual counseling for smoking cessation is offered to stu- dents and adults. Special lectures are available for pregnant women. 0743. HOLY NAME HOSPITAL, 718 Teaneck Road, Teaneck, New Jersey 07666. Program Title: Cigarrest. Contact: Ms. Deborah VandeVelde, Patient Education Coordinator (201)833-3327. Description: This six-session program incorporates group support and be- havior modification techniques. The sessions are led by a trained facilitator and are offered free of charge. 0744. HUNTERDON MEDICAL CENTER, Route 31, Flemington, New Jersey 08822. 291 Program Title: Smokeless. Contact: Ms. Carolyn Swithers, Coordinator (201)788-6158. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge tc smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0745. JERSEY SHORE WELLNESS CENTER, 2020 Route 33, Neptune, New Jersey 07753. Program Title: Smoking Cessation. Contact: Mr. Dennis Peloso or Ms. Cynthia Horvath, Membership Coordinators (201)776-4480. Description: Behavior modification, nicotine fading, substitutes for smok- ing, weight control, and maintenance methods are used. The program is offered for $150. 0746. JOHN F. KENNEDY MEDICAL CENTER, Depart- ment of Preventive Medicine and Nutrition, The Robert Wood Johnson, Jr. Lifestyle Institute, 2050 Oak Tree Road, Edison, New Jersey 08817. Program Title: Smoking Cessation. Contact: Nicholas Partenope, M.D., Director (201)548-7055. Description: The Department of Preventive Medicine and Nutrition com- bines the latest scientific knowledge in behavior modification, nutrition, motivation, individual counseling, patient education, drugs, and hypnosis to design a personalized smoking cessa- tion program. The cost of the program ranges from $180 to $220. 0747. MEMORIAL HOSPITAL OF BURLINGTON COUNTY, 175 Madison Avenue, Mount Holly, New Jersey 08060. Program Title: Freedom From Smoking. Contact: James D. Brandt, M.D., Program Coordinator (609)261-7035. Description: The American Lung Association’s Freedom From Smoking program is offered for $40. For more information, see the detailed program description in Part 1. 0748. MERCER MEDICAL CENTER, 446 Bellevue Avenue, Trenton, New Jersey 08607. Program Title: Nonsmoking Course. Contact: Mr. Roy Helfrick, Respiratory Therapist (609)394-4000. Description: The Nonsmoking Course is offered, in conjunction with the American Lung Association, for $40. 0749. MILLVILLE HOSPITAL, High Street and Harrison Avenue, Millville, New Jersey 08332. Program Title: Smoke Stoppers. Contact: Ms. Janice Shumate, Coordinator (609)825-3500 ext.202. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase I provides the techniques, guidance, support, and structure for cessa- tion: and Phase HI provides an ongoing support and maintenance system. 0750. MONTCLAIR YMCA, 25 Park Street, Montclair, New Jersey 07042. Program Title: Green Seminar. Contact: Program Coordinator (201)783-8863. Description: This hypnosis cessation program is offered for $30. MORRISTOWN MEMORIAL HOSPITAL, 100 Madison Avenue, Morristown, New Jersey 07960. 0751. Program Title: Smokeless. Contact: Kathleen Baker, R.N., M.S., Director, Health Education Services (201)540-5451. 292 Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0752. NEW JERSEY DEPARTMENT OF HEALTH, CN 360, Trenton, New Jersey 08625-0360. Program Title: Heatth Department Activities. Contact: Ms. Janice Marshall, Program Coordinator (609)588-7470. Description: The Department of Health offers several activities related to smoking education and cessation. Under a program entitled Self-Help Quit Tips, department employees receive individual consultations with a professional staff member and self-help literature to take home. Followup services are available by telephone. This is an ongoing program. The American Can- cer Society's FreshStart program is also offered periodically to employees. For more information on the FreshStart program, see the detailed program description in Part 1. Finally, in conjunction with the University of Medicine and Den- tistry of New Jersey, program staff will participate in a com- munity intervention research project. This project will develop and test a community-based intervention protocol that can be disseminated Nationwide to reduce smoking prevalence. The Community Intervention Trial (COMMIT) design has eleven pairs of communities matched in size, demographics, and location. The objective of this project will be to demonstrate and analyze the effects of community-wide intervention efforts to reduce cigarette smoking. In addition to these programs and projects, the department is also compiling a directory of smoking cessation programs sponsored by health maintenance organizations, hospitals, and local health departments to use as a referral resource. 0753. NEWCOMB MEDICAL CENTER, 65 South State Street, Vineland, New Jersey 08360. Program Title: FreshStart. Contact: Program Coordinator (609)691-9000. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 0754. NEWTONMEMORIAL HOSPITAL, DEPARTMENT OF EDUCATION, 175 High Street, Newton, New Jersey 07860. Program Title: Freedom From Smoking. Contact: Rosamond Dee Lockwood, R.N., Director, Health Education (201)383-2121. Description: The education department has sponsored the American Lung Association's Freedom From Smoking program for several years. The program is conducted twice each year, in the spring and fall. The program is advertised in the local newspaper, on local radio, and by flyers to industry. Lifestyle films that focus on stress management, nutrition, and weight control are incorcorated into the program. For more informa- tion, see the detailed program description in Part 1. 0755. NORTHWEST LUNG ASSOCIATION, 300 Main Street, Orange, New Jersey 07050. Program Title: Freedom From Smoking. Contact: Program Coordinator (201)791-6600. Description: The American Lung Association's Freedom From Smoking program is offered for $50. For more information, see the detailed program description in Part 1. 0756. OCEAN COUNTY HEALTH DEPARTMENT, Sunset Avenue, CN 2191, Toms River, New Jersey 08754. Program Title: Smoking Cessation. Contact: Lora Resignato, R.N., Hypertension Program Coordinator (201)341-9700. Description: The focus of the program is survival techniques. It prepares the participant to identify why and how he or she smokes and to become aware of how to quit before he or she actually quits. The program provides participants with techniques that will enable them to become smoke-free. The fee is $25. 0757. OVERLOOK HOSPITAL, 99 Beauvoir Avenue at Sylvan Road, Summit, New Jersey 07901. Program Title: Smokeless. 293 Contact: Connie Frank, R.N., M.A., Coordinator, Department of Health Education (201)522-2836. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup services are provided. 0758. PASCACK VALLEY HOSPITAL, 150 Red Hook Road, Westwood, New Jersey 07675. Program Title: Smoking Cessation. Contact: Mr. John Frey, Director of Planning and Marketing (201)358-3180. Description: Smoking cessation programs are scheduled at a cost of $30 per participant. 0759. PASSAIC DIVISION OF HEALTH, 330 Passaic Street, Passaic, New Jersey 07050. Program Title: Give Yourself Life! Contact: Charlene Stokamer, M.P.H., Health Educator (201)365-5618. Description: The program runs for 5 weeks with an ongoing support group that continues for a year. 0760. RIVERVIEW MEDICAL CENTER, One Riverview Plaza, Red Bank, New Jersey 07701. Program Title: Smoke Stoppers. Contact: Ms. Marian Wattenbarger, Health Educator (201)530-2417. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and maintenance system. 0761. RIVERVIEW MEDICAL CENTER, One Riverview Plaza, Red Bank, New Jersey 07701. Program Title: Smoking: The Big Decision. Contact: Ms. Marian Wattenbarger, Health Educator (201)530-2417. Description: A presentation for preadolescents and adolescents concern- ing the decision to smoke and the financial, social, and health costs of smoking. The presentation can be tailored to the time and needs of the schoo! or group and can also cover secondhand smoke and smokeless tobacco. 0762. ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL, Robert Wood Johnson Place, New Brunswick, New Jersey 08901. Program Title: Freedom From Smoking Clinics. Contact: Mr. Robert Rudders, Respiratory Therapy Department (201)937-8681. Description: The Freedom from Smoking clinics are sponsored by Robert Wood Johnson University Hospital and the American Lung Association of Mid-New Jersey several times ayear. For more information, see the detailed program description in Part 1. 0763. ROCKAWAY TOWNSHIP DEPARTMENT OF HEALTH, 65 Mt. Hope Road, Rockaway, New Jersey 07866. Program Title: Many Ways To Stop Smoking. Contact: Miriam Zaid, M.P.H., Health Educator (201)627-7200 ext.347. Description: Many Ways to Stop Smoking offers three programs to the Township's municipal employees and residents. These programs are: 1) Do It Yourself: one-to-one counseling; 2) Stop Smoking Clinic: six evening sessions over a period of 4 weeks; and 3) Staying Off: clinics and counseling for ex- smokers. 0764. RUTGERS COMMUNITY HEALTH PLAN, Prin- ceton Health Center, 4250 U.S. Highway #1, North, Monmouth Junction, New Jersey 08852. Program Title: Wellness Works Smoking Cessation. 294 Contact: Ms. Leslee Oliu, Administrative Supervisor (201)329-6626. Description: The smoking cessation program developed through Wellness Works at RCHP guides participants through the stages of be- coming anonsmoker. After discussing and preparing for pos- sible withdrawal effects, participants will set a quit date to stop smoking, and explore effective strategies to cope with crav- ings during this period. Instruction on stress management and weight control is offered. The RCHP became a smoke-free work environment in November 1987. As part of its wellness services, the organization provides information and assis- tance to other organizations that are interested in instituting such a policy. 0765. SAINT BARNABAS MEDICAL CENTER, Old Short Hills Road, Livingston, New Jersey 07039. Program Title: Smokeless. Contact: Mr. Richard Hallinan, Director of Training (201)533-5154. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0766. SAINT CLARE’S HOSPITAL, Pocono Road, Denvitle, New Jersey 07834. Program Title: Feelin’ Good. Contact: Program Coordinator, Community Relations Department (201)625-6000. Description: This smoking cessation workshop is offered for $30. 0767. SAINT JOSEPH’S HOSPITAL AND MEDICAL CENTER, 703 Main Street, Paterson, New Jersey 07503. Program Title: Wellness Works! Contact: Jennifer J. Jackson, M.S., Wellness Coordinator (201)779-2511. Description: The smoking cessation class is a 6-hour intensive course that concentrates on behavior modification and a wellness life- style. Development of an individualized plan, nutrition, and physical fitness information are stressed. 0768. SEVENTH-DAY ADVENTIST CHURCH, South Evergreen and Barber Avenues, Woodbury, New Jersey 08096. Program Title: Five Day Plan. Contact: Ms. Pear! Haas, Coordinator of Health Council (609)881-6677 Description: The Seventh-Day Adventists’ Five Day Plan is offered for $40. For more information, see the detailed program description in Part 1. 0769. SHORE MEMORIAL HOSPITAL WELLNESS PROGRAM, Somers Point, New Jersey 08244. Program Title: FreshStart. Contact: Program Coordinator, Wellness Department (609)653-4500. Description: The American Cancer Society's FreshStart program is offered for $25. For more information, see the detailed program description in Part 1. 0770. SOUTHERN OCEAN COUNTY HOSPITAL, 140 West Bay Avenue, Manahawkin, New Jersey 08050. Program Title: Freedom From Smoking. Contact: Ms. Carol Willox, Community Education Coordinator (609)597-6011 ext.203 or 209. Description: The American Lung Assocation’s Freedom From Smoking program is offered for $35. For more information, see the detailed program description in Part 1. 0771. THE MEDICAL CENTER OF OCEAN COUNTY, 2121 Edgewater Place, Point Pleasant, New Jersey 08742. 295 Program Title: Smokeless. Contact: Ms. Kathy Gunnell, Health Education Department Assistant (201)892-1100 ext.2825. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup services are provided. 0772. THE MEDICAL CENTER OF OCEAN COUNTY, 2121 Edgewater Place, Point Pleasant, New Jersey 08742, Program Title: Smoking Or Heatth, Contact: Ms. Kathy Gunnell, Health Education Department Assistant (201}892-1100 ext.2825. Description: A stop-smoking lecture is given to adult organizations, at which time the common rationalizations that smokers fre- quently use are discussed. The smoking or health segment deals with the changes that take place in the respiratory sys- tem of the smoker as well as potential dangers to the lungs, heart, and brain. 0773. THE MEDICAL CENTER OF OCEAN COUNTY, 2121 Edgewater Place, Point Pleasant, New Jersey 08742. Program Title: The Choice Is Yours. Contact: Ms. Kathy Gunnell, Health Education Department Assistant (201)892-1100 ext.2825. Description: The Choice Is Yours is a 20-minute presentation given to preadolescents and adolescents concerning decisions they will be making in the near future. Smoking and its hazards are discussed at this time. 0774. THE RESPIRATORY HEALTH ASSOCIATION, 55 Paramus Road, Paramus, New Jersey 07652. Program Title: Smoking Education And Cessation For The School Community. Contact: Ms. Martha Lizza, Health Educator (201)843-4111. Description: Presentations to promote nonsmoking incorporate ap- propriate strategies for various age levels. Programs include films, games, and demonstrations in flexible sessions for 30 to 100 students. Specific approaches for different grades in- clude, for grades 4 through 6 — presenting the "Why People Smoke" film, Smoker's Roulette, and The Billboard Smoking Machine; for grades 7 and 8 — incorporating the "Second Hand Smoke" film, role playing regarding exposure to passive smoke and peer pressure to smoke, and emphasis on fitness and athletics in relation to smoking; and for all ages, using professional athletes when possible as speakers. 0775. TOWNSHIP OF MIDDLETOWN, DEPARTMENT OF HEALTH, Johnson-Glll Annex, 1 King’s Highway, Middletown, New Jersey 07748-2594. Program Title: Smoking and Health Information. Contact: Ms. Kathryn S. Meier, Health Educator (201)615-2000. Description: The Middletown Township Department of Health acts as a clearinghouse for information on local smoking cessation programs and on programs that discourage youth from developing the habit. 0776. TOWNSHIP OF PARSIPPANY-TROY HILLS HEALTH DEPARTMENT, 1001 Parsippany Boulevard, Parsippany, New Jersey 07054. Program Title: Smoking Cessation. Contact: Mr. Max Schubert, Health Officer (201)263-7160. Description: A 6-week smoking cessation program was held in the Township of Parsippany-Troy Hills for municipal employees. Approximately 23 employees participated; each was given a copy of the American Lung Association's manual, Freedom From Smoking In 20 Days. Weekly sessions were held during working hours, and guest speakers from the American Lung Association and from St. Clare's Mental Health Hospital spoke to participants regarding the hazards of smoking. Also, the fol- lowing films were shown: “Death in the West,” "Smoking: How to Stop,” and "Why Quit Quiz." For more information on these films and the American Lung Association programs, see the detailed program descriptions in Part 1. TOWNSHIP OF SOUTH ORANGE VILLAGE, BOARD OF HEALTH, Village Hali, South Orange, New Jersey 07079. 0777. 296 Program Title: FreshStart. Contact: Ms. Kathleen DeHay, Health Officer (201)762-6000. Description: The American Cancer Society's FreshStart program is being offered to the general public upon request. For more informa- tion, see the detailed program description in Part 1. 0778. UNDERWOOD MEMORIAL HOSPITAL, Broad and Red Bank Avenues, Woodbury, New Jersey 08096. Program Title: Freedom From Smoking Clinics. Contact: Ms. Domenica Grant, Staff Development Coordinator (609)845-0100 ext.2905. Description: The American Lung Association's Freedom From Smoking clinics are offered for $35. For more information, see the detailed program description in Part 1. 0779. UNION HOSPITAL, 1000 Galloping Hill Road, Union, New Jersey 07083. Program Title: Freedom From Smoking. Contact: Kay Ford, R.N., B.A., C.D.E., Patient Education Specialist (201)687-1900 ext.3134. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0780. VETERAN'S ADMINISTRATION MEDICAL CEN- TER, Lyons, New Jersey 07939. Program Title: Smoking Cessation. Contact: Zeke Mayberry, Ph.D., Program Director, Outpatient Section (201)647-0180 ext. 44488. Description: The program is a 6-week session held during working hours at no cost to participants. The program is conducted on an as-needed basis according to the number of registrants. WALLKILL VALLEY HOSPITAL AND HEALTH CENTERS, 20 Walnut Street, Sussex, New Jersey 07461. 0781. Program Title: FreshStart. Contact: Ms. Eileen Katz, Community Health Coordinator (201)875-4121. Description: The American Cancer Society’s FreshStart program is offered as needed at the Health Center in Franklin. For more infor- mation, see the detailed program description in Part 1. 0782. WARREN COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH NURSING AGENCY, 151 West Washington Avenue, Washington, New Jersey 07882. Program Title: Freedom From Smoking. Contact: Donna Rue, R.N., M.P.H., Health Educator (201)689-6000. Description: The American Lung Association's Freedom From Smoking group support program is offered to Warren County residents as requested. Several self-help programs are also available including In Control. For more information, see the detailed program description in Part 1. 0783. WARREN COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH NURSING AGENCY, 151 West Washington Avenue, Washington, New Jersey 07882. Program Title: FreshStart. Contact: Donna Rue, R.N., M.P.H., Health Educator (201)689-6000. Description: The American Cancer Society's FreshStart program is offered to Warren County residents as requested. Several self-help programs are also offered including the | Quit Kit. For more information, see the detailed program description in Part 1. 0784. WARREN COUNTY HEALTH DEPARTMENT, PUBLIC HEALTH NURSING AGENCY, 151 West Washington Avenue, Washington, New Jersey 07882. Program Title: Is There A Safe Tobacco? Contact: Donna Rue, R.N., M.P.H., Health Educator (201)689-6000. 297 Description: The program informs participants of the health risks of tobac- co use in its various forms and examines the pressures to smoke both from peers and the tobacco industry. Handouts, resources, and referrals for cessation of tobacco use are provided. 0785. WARREN HOSPITAL, 185 Roseberry Street, Phillipsburg, New Jersey 08865. Program Title: Smokeless. Contact: Ms. Patricia A. Mathews, Coordinator (201)859-6777. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup ser- vices are provided. 0786. WAYNE TOWNSHIP HEALTH DEPARTMENT, 475 Valley Road, Wayne, New Jersey 07470. Program Title: FreshStart. Contact: Ms. Denise A. DePalma, Health Educator (201)694-1800 ext.242. Description: The American Cancer Society’s FreshStarnt program is of- fered. A month after the completion of FreshStart, a refresher class is offered. For more information, see the detailed program description in Part 1. 0787. WESTHUDSON HOSPITAL, 206 Bergen Avenue, Kearny, New Jersey 07032. Program Title: SCRAP Stop Smoking. Contact: Jean Devlin, R.N., M.S., Employee and Community Health Coordinator (201)955-7077. Description: SCRAP Stop Smoking is sponsored by the American Heart Association. ht is an 8-week behavior modification program with followup for 1 year. WEST JERSEY WEIGHT MANAGEMENT AND NUTRITION SERVICES, GARDEN STATE COM- MUNITY MEDICAL CENTER, One Brick Road, Suite 304, Mariton, New Jersey 08053. 0788. Program Title: Stop Smoking Without Weight Gain. Contact: Mary Lou Bialon, M.S., R.D., General Manager (609)596-3397. Description: This is a new approach to the problem of stopping smoking. Smokers are believed to be inherently motivated to quit smok- ing. Providing solutions to the problems that make people re- start smoking is the key to stopping smoking. This approach is called Restart Prevention because it addresses the problems that cause people to restart. Restart Prevention has four components: weight control, withdrawal symptom control, habit control, and stress control. 0789. WOMEN’S HEALTH CONNECTION OF KIMBALL MEDICAL CENTER, 19 West County Line Road, Jackson, New Jersey 08527. Program Titie: Freedom From Smoking. Contact: Sharyn Cartnick, R.N., B.S.N. and Deborah Cox, R.N.,B.S.N., Community Health Education Coordinators (609)370-9667 and 370-7466. Description: The American Lung Association's Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 0790. ZURBRUGG MEMORIAL HOSPITAL, Rancocas Valley Division, Sunset Road, Willingboro, New Jersey 08046. Program Title: Smoke Stoppers. Contact: Reba Scharf, R.N., Program Coordinator (609)835-2900 ext.2118. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase III provides an ongoing support and maintenance system. NEW MEXICO 0791. AMERICAN HEART ASSOCIATION, NEW MEXICO AFFILIATE, 629 Truman, N.E., Albuquerque, New Mexico 87110. Program Title: Heart At Work. Contact: Ms. Holly Mueller, Program Coordinator (505)268-3711. Description: The Heart At Work program is arranged at worksites in the community. American Heart Association literature on smok- ing cessation is available. For more information, see the detailed program description in Part 1. 0792. AMERICAN LUNG ASSOCIATION OF NEW MEXICO, 216 Truman, N.E., Albuquerque, New Mexico 87108. Program Title: Freedom From Smoking Clinics. Contact: Ms. Beverly Besedick, Program Director (505)265-0732. 298 Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 0793. AMERICAN LUNG ASSOCIATION OF NEW MEXICO, 216 Truman, N.E., Albuquerque, New Mexico 87108. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Beverly Besedick, Program Director (505)265-0732. Description: The American Lung Association’s Freedom From Smoking self-help series is offered free of charge. For more informa- tion, see the detailed program description in Part 1. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OF- FICE, 530 North Church Street, Las Cruces, New Mexico 88001. 0794. Program Title: Great American Smokeout. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-6617. Description: The Public Health Department, in conjunction with the local American Cancer Society, collaborates with interested local worksites, groups, and agencies to promote a day-long quit smoking campaign each November. Written materials are distributed at a mall and on the local university campus. Con- tests are conducted among worksites to determine the percentage of smokers who quit for a day. 0795. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OFFICE, 530 North Church Street, Las Cruces, New Mexico, 88001. Program Titie: Group Smoking Cessation Clinics. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-6617. Description: Smoking cessation clinics are offered four times a year at the health department and at other sites, as requested. The American Cancer Society's FreshStart program is used. In addition, other supplemental materials are utilized focusing on the habit of smoking, physical factors, stress, weight control, self-esteem, and developing a healthier lifestyle. Followup is coordinated through the Heaith Services Division Smoking Prevention Program. For more information on FreshStart, see the detailed program description in Part 1. 0796. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OFFICE, 530 North Church Street, Las Cruces, New Mexico 88001. Program Title: Health Education And Promotion. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-6617. Description: Presentations to community groups, institutions, worksites, schools, service organizations, and individuals are provided on demand. These sessions range from 30 minutes to 2 hours in length. The focus is tobacco products and their effects on the human body. Also, the advertising approach of the tobac- co industry is explored. The purpose of the presentation is to provide education and enlist support to help achieve a smoke- free environment. 299 0797. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OFFICE, 530 North Church Street, Las Cruces, New Mexico 88001. Program Title: Self-Help Kits. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-6617. Description: Upon request, a packet of self-help material, entitled Self-Help Kit — No Smoking is distributed to smokers who want to quit and to various physicians’ offices. The packet contains a questionnaire, tips on quitting, 24-hour craving record, list of smoking cessation clinics, and other pamphlets. 0798. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OFFICE, 530 North Church Street, Las Cruces, New Mexico 88001. Program Title: Smoke-Free Environment. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-661 7. Description: Upon request, assistance is provided in drawing up a formal, written smoking policy that emphasizes nonsmoking as the norm for worksites, public buildings, and other locations. En- forcement, posting of signs, assistance for smokers who want to quit, designated areas, air purification, initial planning, and surveys of communication are among the topics discussed. 0799. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, DONA ANA PUBLIC HEALTH OFFICE, 530 North Church Street, Las Cruces, New Mexico 88001. Program Title: Worksite Facilitator Training. Contact: Jean Jewell, R.N., Adult Health Nurse (505)526-661 7. Description: Training sessions are conducted on worksites to prepare par- ticipants to lead smoking cessation groups. Each session consists of a 4-hour mock group role playing, and instruction in using audiovisual materials, various commercially produced written materials, lecture, and discussion. Participants should lead a group within 6 months. Continuing education units are provided for nurses. 0800. NEW MEXICO HEALTH AND ENVIRONMENT DEPARTMENT, HOBBS HEALTH OFFICE, 316 West Scharbauer, Hobbs, New Mexico 88240. Program Title: Cancer Screening. Contact: Lorna Graben, R.N., Family Nurse Practitioner (505)392-1041. Description: The Cancer Screening program targets high-risk persons in southeastern New Mexico for individual counseling and refer- ral to smoking cessation programs. Also, information on smoking is presented to students in grades 11 and 12 and at worksites. NEW YORK 0801. AMERICAN CANCER SOCIETY, LONG ISLAND DIVISION, INC., 145 Pidgeon Hill Road, Huntington Station, New York 11746-4585. Program Title: FreshStart. Contract: Ellyn Troisi, M.P.H., Public Education Director (516)385-9100 ext.316. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0802. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., Brooklyn Area, 185 Montague Street, Brooklyn, New York 11201. Program Title: FreshStart. Contact: Mr. Lou Hoyos, Program Coordinator (718)237-7850. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0803. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., Staten Island Unit, 58 New Dorp Plaza, Staten Island, New York 10306. Program Title: FreshStart. Contact: Ms. Joy Speziale, Program Coordinator (718)987-8871. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered at Doctors Hospital and Christ Lutheran Church. For more information, see the detailed program description in Part 1. 0804. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., Harlem Unit, 656 West 181st Street, New York, New York 10033. Program Title: FreshStart. Contact: Mr. Louis Perez, Program Administrator (212)928-8800. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered at Harlem Hospital. For more information, see the detailed program description in Part 1. 0805. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., Manhattan Unit, 19 West 56th Street, New York, New York 10019. Program Title: FreshStart. Contact: Ms. June Walzer, Coordinator (212)586-8700. Description: The American Gancer Society offers the FreshStart smoking cessation clinic at various locations within Manhattan. For more information, see the detailed program description in Part 1. 0806. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., Bronx Unit, 656 West 181st Street, New York, New York 10033. Program Title: FreshStart. Contact: Stop Smoking Coo’ ator (212)928-8800. Description: The American Cancer Society offers the FreshStart smoking cessation clinic at various locations in the Bronx. For more in- formation, see the detailed program description in Part 1. 0807. AMERICAN CANCER SOCIETY, NEW YORK CITY DIVISION, INC., 19 West 56th Street, New York, New York 10019. Program Title: Stop Smoking Programs. Contact: Ms. June Walzer, Coordinator (212)586-8700. Description: The American Cancer Society offers a group stop smoking program at area hospitals and YMCAs. The program is conducted 2 afternoons a week for $25 to $35. 0808. AMERICAN CANCER SOCIETY, WESTCHESTER DIVISION, INC., 30 Glenn Street, White Plains, New York 10603. Program Title: FreshStart. Contact: Ms. Monica Garrigan, Director, Public Education (914)949-4800. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered to the public and to private organizations. There is a small commitment fee refundable to participants who attend all four classes. For more information, see the detailed program description in Part 1. 0809. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. Program Title: Chain Groups. Contact: Mr. Jack Stiggins, Program Coordinator (716)442-4260. Description: Smokers and recovered smokers band together to help each other achieve their goals to be free from smoking. No fees are required. 0810. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. 301 Program Title: Freedom From Smoking Recovery Clinics. Contact: Mr. Jack Stiggins, Program Coordinator (716)442-4260. Description: With assistance from qualified, recovered smokers, par- ticipants take the necessary steps to become nonsmokers. Group support makes stopping easier. Clinic sessions in- clude education as to the nature of the smoking addiction, recovery techniques, medical consultants, and feelings shared with others. Clinics are offered year round and in different locations. 0811. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. Program Title: Freedom Line. Contact: Mr. Jack Stiggins, Program Coordinator (716)442-4260. Description: Produced in association with the University of Rochester, this recorded nonsmoking message, available 24 hours a day, may be utilized as a daily maintenance tool or to fight the crav- ing to smoke. For additional help or information, counselors are available. 0812. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. Program Title: Pot Shots. Contact: Mr. Jack Stiggins, Program Coordinator (716)442-4260. Description: Pot Shots is aimed at educating 12- to 18-year-old youths. A rock group will play at school or community dances as role models demonstrating that one can rock and roll without being high. During the performance a continuous slide show called Pot Shots flashes with minicommercials that state smoking is harmful, that you can have fun without dope, and describe how to avoid letting your lungs go to pot. Don't Let Your Lungs Go To Pot buttons are distributed and marijuana fact sheets are available. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. 0813. Program Title: Relapse Workshops. Contact: Mr. Jack Stiggins, Program Coordinator (716)442-4260. Description: Meetings are held periodically to help prevent smokers from returning to smoking. Counselors aid participants in coping with their smoking addiction by exploring the dynamics of relapse, how to avoid and recover from relapse, and the benefits of being a nonsmoker. 0814. AMERICAN LUNG ASSOCIATION, FINGER LAKES REGION, INC., 1595 Elmwood Avenue, Rochester, New York 14620. Program Title: Self-Help Manuals. Contact: Mr, Jack Stiggins, Program Coordinator (716)442-4260. Description: A self-help manual provides smokers with a 20-day plan to conquer smoking addiction 1 day at a time, and a second manual helps smokers to stay off cigarettes. 0815. AMERICAN LUNG ASSOCIATION OF BROOK- LYN, 165 Cadman Plaza East, Brooklyn, New York 11201. Program Title: Freedom From Smoking At Work. Contact: Mr. Khadijah Odeh, Program Manager (718)624-8531. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program descriptions in Part 1. 0816. AMERICAN LUNG ASSOCIATION OF BROOK- LYN, 165 Cadman Plaza East, Brooklyn, New York 11201. Program Title: Freedom From Smoking Clinic. Contact: Mr. Khadijah Odeh, Program Manager (718)624-8531. Description: This Freedom From Smoking Clinic, offered to businesses, is the standardized program offered by the American Lung As- sociation Nationwide. The cost is $40 for each participant. For more information, see the detailed program description in Part 1. 0817. AMERICAN LUNG ASSOCIATION OF CENTRAL NEW YORK, INC., 2013 East Genesee Street, Post Office Box 6409, Syracuse, New York 13217. Program Title: Freedom From Smoking Clinics. Contact: Ms. Susan S. Flewelling, Director of Smoking Cessation Programs (315)422-6142. Description: The American Lung Association's established cessation program is offered. A fee of $50 is charged to all participants in order to cover material costs and facilitator's salary. Al- though the program is offered predominantly. in Onondaga County, it is also held in Cortland, Jefferson, Lewis, St. Lawrence, and Tompkins Counties. For more information, see the detailed program description in Part 1. 0818. AMERICAN LUNG ASSOCIATION OF MID-NEW YORK, INC., 23 South Street, Utica, New York 13501. Program Title: Freedom From Smoking. Contact: Ms. Martha S. Cline, Program Director (315)735-9225. Description: The Freedom Fram Smoking program is offered. For more information, see the detailed program description in Part 1. 0819. AMERICAN LUNG ASSOCIATION OF MID-NEW YORK, INC., 147 Henry Street, Oneonta, New York 13820. Program Title: Freedom From Smoking By Radio. Contact: . Ms. Martha K. Hoffman, Program Associate (607)432-8934. Description: This program is based on the self-help manuals for smoking cessation developed by the American Lung Asscv-iation: Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking. Twenty segments, 5 minutes each, are aired several times a day, Monday through Friday for 4 weeks. Promotional scripts are used leading up to the 20 days, and six followup scripts are to be aired after the 20 days. The broadcast is supported by print media ads and distribu- tion of the self-help manuals through the mail and pick-up locations. 0820. AMERICAN LUNG ASSOCIATION OF MID-NEW YORK, INC., 23 South Street, Utica, New York 13501. Program Title: Smoking And You: Does It Compute? Contact: Ms. Martha S. Cline, Program Director (315)735-9225. Description: This educational computer program helps teach children in grade 3 smoking and health terms, immediate and long-term effects of smoking, common perceptions and attitudes about smoking, and responses to peer pressure about smoking. The floppy disk is accompanied by a teacher’s manual. 0821. AMERICAN LUNG ASSOCIATION OF MID-NEW YORK, INC., 50 Prospect Avenue, Gloversville, New York 12078. Program Title: Tobacco Education. Contact: Ms. Valerie R. Bochenek, Program Associate (518)773-8998. Description: A monthly program is held for clients of Women, Infants, and Children’s (WIC) Programs of Fulton County, New York. The purpose is to educate WIC clients about the health effects of smoking and to offer them support in smoking cessation. In- itiaily, a training session for WIC staff will be held. Each month, programs with WIC clients at each center begin. Movies, speakers, group discussions, and one-on-one coun- seling are used. 0822. AMERICAN LUNG ASSOCIATION OF NASSAU/ SUFFOLK, 210 Marcus Boulevard, Hauppauge, New York 11788. Program Title: Cigarette Breakaway Hypnosis Program. Contact: Ms. Madelon Goldberg, Program Coordinator (516)231-LUNG. Description: This special one-session seminar, which lasts for 2-1/2 hours, combines the most successful cessation methods: hypnosis, short-term coping techniques, long-term lifestyle modifica- tions, relaxation techniques, sharing experiences, and a main- tenance program. AMERICAN LUNG ASSOCIATION OF NASSAU/ SUFFOLK, 210 Marcus Boulevard, Hauppauge, New York 11788. 0823. 303 Program Title: Freedom From Smoking Self-Help. Contact: Ms. Madelon Goldberg, Program Coordinator (516)231-LUNG. Description: The program is presented in the form of two self-help manuals: Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking. Other formats available include: Freedom From Smoking For You And Your Family and Freedom From Smoking For You And Your Baby. For more information, see the detailed program descriptions in Part 1. 0824. AMERICAN LUNG ASSOCIATION OF NASSAU/ SUFFOLK, 210 Marcus Boulevard, Hauppauge, New York 11788. Program Title: Smoking And Pregnancy. Contact: Ms. Madelon Goldberg, Program Coordinator (516)231-LUNG. Description: The American Lung Association’s Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 0825. AMERICAN LUNG ASSOCIATION OF NASSAU/ SUFFOLK, 210 Marcus Boulevard, Hauppauge, New York 11788. Program Title: Stop Smoking Workshop. Contact: Ms. Madelon Goldberg, Program Coordinator (516)231-LUNG. Description: This program, presented in cooperation with area hospitals, libraries, and worksites, is based on the American Lung Association’s Freedom From Smoking clinic program. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF NEW YORK STATE, 8 Mountain View Avenue, Albany, New York 12205. 0826. Program Title: Freedom From Smoking At Work. Contact: Mr. Tim LaPier, Smoking or Health Specialist (518)459-4197. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 0827. AMERICAN LUNG ASSOCIATION OF NEW YORK STATE, 8 Mountain View Avenue, Albany, New York 12205. Program Title: Freedom From Smoking Clinics. Contact: Mr. Tim LaPier, Smoking or Health Specialist (518)459-4197, Description: The American Lung Association’s Freedom From Smoking clinics are available to the general public at a cost of $45. For more information, see the detailed program description in Part 1. 0828. AMERICAN LUNG ASSOCIATION OF NEW YORK STATE, 8 Mountain View Avenue, Albany, New York 12205. Program Title: Freedom From Smoking Self-Help. Contact: Mr. Tim LaPier, Smoking or Health Specialist (518)459-4197. Description: This self-help program is presented in the form of two manuals. For more information, see the detailed program description in Part 1. 0829. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Freedom From Smoking Clinics. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: The Freedom From Smoking clinics are offered. The cost is $40 for each participant. For more information, see the detailed program description in Part 1. 0830. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Freedom From Smoking Self-Help Manuals. 304 Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: The two Freedom From Smoking (FFS) self-help manuals, FFS In 20 Days and A Lifetime Of FFS, are available to par- ticipants at a cost of $7 each. For more information, see the detailed program description in Part 1. 0831. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Growing Healthy In New York City. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: The Growing Healthy program is part of a revised comprehen- sive health curriculum for students in kindergarten through grade 6. Each grade covers a different subject or system. Smoking is covered in most grade levels with the greatest concentration in grades 3 to 6. 0832. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Hugh McCabe: The Coach's Final Lesson. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: This American Lung Association film is offered to area schools and adult audiences. For more information, see the detailed program description in Part 1. 0833. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Information Distribution Program. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: General information is distributed about smoking. Films, literature, posters, stickers, and buttons are available. Information is targeted at children, teens, and adults. 0834. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Marijuana: A Second Look. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: Marijuana: A Second Look is an educational program in- tended to influence children not to smoke marijuana. For more information, see the detailed program description in Part 1. 0835. AMERICAN LUNG ASSOCIATION OF QUEENS, 112-25 Queens Boulevard, Forest Hills, New York 11375. Program Title: Smoking And Pregnancy. Contact: Esther Friedman, M.S., Coordinator, Smoking or Health Programs (718)263-5656. Description: The American Lung Association's Smoking And Pregnancy program is offered. The complete program cost is $7. For more information, see the detailed program description in Part 1. 0836. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Answer Back. Contact: Ms. Constance M. Schweitzer, Director of School Health (716)886-4655. Description: Junior and senior high school students are trained to be peer counselors within their schools. The curriculum includes physiology of the respiratory system, how to say no, under- standing the media's influence in the area of cigarette adver- tising, and the opportunity for role playing typical adolescent situations. A kick-off assembly is offered along with peer counselor training, educational materials are distributed to all teachers and students. An answer Back fundraiser offsets the cost of the program. 305 0837. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Freedom From Smoking Clinics. Contact: Ms. Jenna Cain, Coordinator (716)886-4655. Description: The Freedom From Smoking clinics are offered to the com- munity through adult education programs, hospitals, and YMCAs. The fee for the program is $50. For more informa- tion, see the detailed program description in Part 1. 0838. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Freedom From Smoking In The Workplace. Contact: Mr. Marty Kirchner, Program Coordinator {716)886-4655. Description: This program is a comprehensive approach to the problems of cigarette smoking in the work environment. Association staff work with the company to develop a program tailored to the company’s needs. The program components consist of policy development, employee awareness and education, and in-house cessation programs. There is afee for this program. 0839. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Freedom From Smoking Manuals. Contact: Barbara R. Edelman, R.N., Coordinator (716)886-4655. Description: A self-help approach to quitting smoking is presented in two manuals that are available to the general community for a fee. For more information, see the detailed program description in Part 1. 0840. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Second Hand Smoke And Rights Of The Nonsmoker. Contact: Barbara R. Edelman, R.N., Coordinator (716)886-4655. Description: In an effort to increase the knowledge of nonsmokers about the hazards of secondhand smoke, this organization has in- itiated a public education campaign and provides support for the New York Clean Air Act and any other pertinent county or State bills. Nonsmoking individuals troubled by secondhand smoke are given support, and related literature is distributed. 0841. AMERICAN LUNG ASSOCIATION OF WESTERN NEW YORK, 766 Ellicott Street, Buffalo, New York 14203. Program Title: Superspeller Smoking Prevention Program. Contact: Ms. Nanci M. Stickevers, Schoo! Heaith Program Coordinator (716)886-4655. Description: Prevention programs are available for elementary school children, concentrating on the second to sixth grade levels. The program has four phases including information about smoking, marijuana, and smokeless tobacco and demonstra- tion of a carboximeter. A variety of films and literature are used for the assembly, with additional literature available for parents. 0842. BROOME COUNTY HEALTH DEPARTMENT, One Wall Street, Binghamton, New York 13901. Program Title: Freedom From Smoking. Contact: Carol Ferrell, Ph.D., Director, Employee Wellness Program (607)772-2855. Description: The American Lung Association’s Freedom From Smoking program is offered to Broome County employees, although the course is open to all Broome County residents. The Employee Wellness Program is able to subsidize the cost of the course through grant funds for cardiovascular risk reduction. For more information, see the detailed program description in Part 1. 0843. CHINATOWN HEALTH CLINIC, 89 Baxter Street, New York, New York 10013. Program Title: Community Education Program. Contact: Cynthia M. Chong, M.D., Medica! Director (212)732-9545. Description: Information regarding cigarette smoking is integrated into all aspects of primary care to ameliorate the risk associated with cardiovascular, pulmonary, and peripheral vascular diseases, intrauterine growth retardation, peptic ulcer disease, chronic active hepatitis, and hepatoma. In addition to patient counsel- ing, community efforts include Chinese language radio broad- casts and newspaper articles and presentations to community agencies. 0844. CLINTON COUNTY DEPARTMENT OF HEALTH, Post Office Box 769, Plattsburgh, New York 12901. Program Title: Community Based Smoking Prevention And Cessation. Contact: Mr. John V. Andrus, Director of Public Health (518)565-3250. Description: This program includes prevention and cessation programs, Clinical programs for pregnant women, and comprehensive local coalition activities. 0845. COMMUNITY GENERAL HOSPITAL, HEALTH EDUCATION DEPARTMENT, Broad Road, Syracuse, New York 13215. Program Title: Quit Smoking Program. Contact: Ms. Helen R. Barrett, Director, Health Education (315)492-5152. Description: The smoking cessation program consists of eight sessions, usually held on Mondays and Wednesdays from 4:00 p.m. to 5:30 p.m. This program is taught by registered nurses and a physician. Topics include analysis of smoking behavior, physiology of addiction, health implications, stress management, exercise, and weight control. 0846. CROUSE-IRVING MEMORIAL HOSPITAL, 736 Irving Avenue, Syracuse, New York 13210. Program Title: Breathing Basics. Contact: Ms. Lisa Lambiase-Stolakis, Wellness Manager, Health Promotion Services (315)470-7573. Description: Breathing Basics is an educational tool that teachers can use with students in grades 4 to 6 to reinforce the students’ cur- rent knowledge of the respiratory system. The goal of the program is to give students a better understanding of how their respiratory system functions and of hazards of smoking. This in turn will help them make informed decisions regarding smoking. Breathing Basics includes preprogram materials for each student, a 30-minute videotape, and a teacher's manual with suggested followup activities designed to reinforce learning. 0847. CROUSE-IRVING MEMORIAL HOSPITAL, 736 Irving Avenue, Syracuse, New York 13210. Program Title: Smokeless. Contact: Ms. Lisa Lambiase-Stolakis, Wellness Manager, Health Promotion Services (315)470-7573. Description: - The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0848. ERIE COUNTY DEPARTMENT OF HEALTH, Rath Bullding, Room 833, 95 Franklin Street, Buffalo, New York 14202. Program Title: Community Education Program. Contact: Dr. Eugene Sillman, Medical Director (716)846-7714. Description: The department of health developed a media campaign in- voiving local businesses, food wholesalers, and supermarket chains. The campaign focuses on school children in grades 4 to 6. The department also developed a 27-piece exhibit, 14- page pamphlet, and self-administered quiz on the health ef- fects of tobacco use. An automatic slide presentation is in operation at the department 8 hours a day and is available for use at other public offices and schools. The department ac- tively disseminates information on cigarette smoking, cessation programs, and a fact sheet on smokeless tobacco. 0849. ERIE COUNTY DEPARTMENT OF HEALTH, Rath Building, Room 833, 95 Franklin Street, Buffalo, New York 14202. Program Title: Stop Smoking Clinics. Contact: Dr. Eugene Sillman, Medica! Director (716)846-7714. 307 Description: The department of health offers a smoking cessation clinic for employees in conjunction with the American Lung Associa- tion. They also work with the American Cancer Society to conduct smoking cessation clinics for the general public. 0850. GASP (GROUP AGAINST SMOKING POLLU- TION) OF NEW YORK, 7 Maxine Avenue, Plainview, New York 11803. Program Title: Smoking And Your Health. Contact: Ms. Rhoda Nichter, President (516)938-0080. Description: Since October 1979, this series of 30-minute public affairs radio programs has been broadcast every Tuesday at 4:30 p.m. and repeated every Sunday at 4:00 p.m. on WHPC-FM (90.3). The program is hosted by the president of GASP of New York. It is an educational program designed to explore the smoking problem as it relates to the lives of both smokers and nonsmokers. The series includes interviews with doctors, dentists, legislators, smokers, ex-smokers, nonsmokers, nutritionists, a fire marshal, students, teachers, and a laryn- gectomy, plus a series of programs specifically on smoking cessation. Subjects covered in the programs broadcast to date include the rights of nonsmokers, smoking cessation, youth and smoking, women and smoking, government and smoking, and sex and smoking. Listeners are invited to write to GASP for further information. This program continues to update listeners with information on current legistation (proposed and passed) and new findings regarding the hazards of tobacco smoke to smokers and nonsmokers of all ages. 0851. GASP (GROUP AGAINST SMOKING POLLU- TION) OF NEW YORK, 7 Maxine Avenue, Plainview, New York 11803. Program Title: Smoking Prevention. Contact: Ms. Rhoda Nichter, President (516)938-0080. Description: Junior high or senior high schoo! students are trained to work in teams to develop suitable presentations for grades 4,5, and 6. The older students try to influence the younger students not to start smoking or to quit if they have already started and to educate nonsmoking students as to the hazards of secondhand smoke and their right to clean indoor air. Junior and senior high school students attend 6 to 10 training ses- sions that help them to plan and conduct the program and to organize other activities that may be appropriate for ac- complishing the program objectives. Subjects covered in the Students’ presentations include why young people start to smoke; the physical effects of smoking; why smokers continue to smoke; how to quit smoking; how the nonsmoker is affected by secondhand smoke; laws, ordinances, and school rules restricting smoking; and the economics of smoking. Students may also develop and present programs for their peers in the secondary schools. 0852. THE LEONARD HOSPITAL, 74 New Turnpike Road, Troy, New York 12182. Program Title: Smokeless. Contact: Ms. Gail Hanlon, Director of Staff Development (518)235-0310 ext.289. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0853. LONGWOOD HIGH SCHOOL, Longwood Road, Middle Island, New York 11953. Program Title: Longwood Action On Alcohol/Drug Abuse, Smoking And Health. Contact: Mr. Francis P. Massey, Director (516)345-2158. Description: This program of ten 40-minute sessions is aimed at high school students. Sessions cover identifying oneself as a smoker, the physiological aspects of smoking, regaining decision-making skills, and alternatives to alcohol and drug abuse. Students are encouraged to adopt a new lifestyle by breaking free from smoking and to exercise contro! over their physical fitness. In addition, the program has been extended to students in grade 5 with Team Force, specially trained high school students teaching elementary students to choose not to smoke. This program is partially sponsored by the American Lung Association. 0854. MADISON COUNTY DEPARTMENT OF HEALTH, County Office Building, Wampsville, New York 13163. Program Title: Community Based Smoking Prevention And Cessation. Contact: Agatha Slater, R.N., Director, Public Health Nurses (315)366-2369. Description: This program includes prevention and cessation programs, clinical programs for pregnant women, and comprehensive local coalition activities. 0855. MADISON COUNTY PUBLIC HEALTH NURSING SERVICE, Post Office Box B, Morrisville, New York 13408. Program Title: Smoking Prevention And Cessation. Contact: ‘ Ms. Maureen N. Fox, Program Coordinator (315)684-7133. Description: Programs are aimed at college-age through middle-aged women, especially pregnant women and women with children, and also at children in grades 4 through 6. The American Can- - cer Society and American Lung Association smoking cessa- tion clinics are offered in addition to educational programs in schools and health clinics throughout the County. 0856. MATERNITY, INFANT CARE, FAMILY PLANNING PROJECTS, MEDICAL AND HEALTH RE- SEARCH ASSOCIATION OF NEW YORK CITY, INC., 225 Broadway, New York, New York 10007. Program Title: A Smoke-Free Pregnancy. Contact: Ms. Jean Tyler, Director, Health Education (212)267-0900. Description: This program aims to improve pregnancy outcomes by reduc- ing smoking among the Maternity, Infant Care, Family Plan- ning Project prenatal population. The program works toward this goal in the following ways: 1) establishing strong attitudes for nonsmoking among staff; 2) providing a smoke-free clinic environment; 3) educating patients on effects of smoking during pregnancy: and 4) providing interested patients with as- sistance in quitting or significantly reducing their smoking during and after pregnancy. 0857. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: A Clean Act! Contact: Ms. Carole Snyder, Program Director (212)889-3370. Description: A Clean Act! is a comprehensive lung health and smoking prevention curriculum developed by the New York Lung As- sociation for use in grades 1 through 12. The units emphasize activities that demonstrate the impact of cigarettes on critical body functions, as well as the development of skills to deal with pressure to smoke. The curricula were designed so that teachers, with minimal training, can conduct the units. To facilitate the implementation, a teacher’s fact sheet and’ guidelines are provided. Each unit also contains a list of learn- ing objectives and materials needed to conduct the lesson. Guidance is provided to ensure effectiveness in fostering expected cognitive and behavioral learning outcomes. 0858. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: Biofeedback Smoking Education Project. Contact: Mr. Steve Rifkind, Manager, Smoking Education Programs (212)889-3370, Description: The American Lung Association's Biofeedback Smoking Education Project is offered. This program can be conducted in either the classroom or auditorium. For more information, see the detailed program description in Part 1. 0859. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: Freedom From Smoking Self-Help. Contact: Mr. Steve Rifkind, Manager, Smoking Education Programs (212)889-3370. Description: A structured smoking cessation program on videocassette and a two-volume self-help manual are available to individuals who prefer to quit smoking on their own. Freedom From Smoking For You And Your Family, a 20-day step-by-step program, emphasizing behavior modification exercises is also available. For more information, see the detailed program description in Part 1. 0860. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: Kick-The-Habit Clinic. Contact: Mr. Steve Rifkind, Manager, Smoking Education Programs (212)889-3370. Description: The six-session clinic is founded upon peer support and be- havior modification techniques. Participants determine the reasons and situations or moods that trigger an urge to smoke. A trained facilitator helps participants develop a plan of action and specific coping strategies to maintain a smoke-free life- style. Diet, weight control, stress management, and other topics of special interest to participants are described. 309 Continued peer support to graduates of the program is available through monthly meetings of a Smoke-Free Club. 0861. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: Marijuana: A Second Look. Contact: Mr. Steve Rifkind, Manager, Smoking Education Programs (212)889-3370. Description: Marijuana: A Second Look is an educational program in- tended to influence children not to smoke marijuana. For more information, see the detailed program description in Part 1. 0862. NEW YORK LUNG ASSOCIATION, 432 Park Avenue South, New York, New York 10016. Program Title: Smoking And Pregnancy. Contact: Mr. Steve Rifkind, Manager, Smoking Education Programs (212)889-3370. Description: The American Lung Association's Smoking And Pregnancy program is available. Freedom From Smoking For You And Your Baby, a 10-day quit smoking program, is also available. For more information, see the detailed program description in Part 1. 0863. NEW YORK UNIVERSITY MEDICAL CENTER, COOPERATIVE CARE CENTER, 530 First Avenue, New York, New York 10016. Program Title: Smokeless. Contact: Eileen DiFrisco, R.N., M.A., Coordinator, Outpatient Education (212)340-7007. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0864. ONONDAGA COUNTY HEALTH DEPARTMENT, 421 Montgomery Street, Post Office Box 1325, Syracuse, New York 13201. Program Title: Community Health Nursing. Contact: Ms. Rose DeJoseph, Director of Maternal and Child Health Services (315)425-3294. Description: Patient and family education includes a discussion of the harmful effects of smoking to the mother, fetus, and newborn. In homes where there is a newborn, the mother and family are cautioned against having the infant in a smoke-filled room. Adults are encouraged not to smoke in the home. Informa- tional pamphlets are available and referral to community smoking cessation programs is provided. Public health nur- ses discuss smoking and health with parents of young children attending the well-child clinics. 0865. ONONDAGA COUNTY HEALTH DEPARTMENT, 421 Montgomery Street, Post Office Box 1325, Syracuse, New York 13201. Program Title: Patient Education. Contact: Mr. Mim Seidel, Coordinator (315)425-3304. Description: Within the Women, Infants, and Children program, patients who smoke are informed of the health risks associated with smoking. Informational pamphlets and brochures are made available and information about community smoking cessa- tion programs is provided. 0866. ONONDAGA COUNTY HEALTH DEPARTMENT, 421 Montgomery Street, Post Office Box 1325, Syracuse, New York 13201. Program Title: Prevention Of Low Birthweight Program. Contact: Cara Steiner, P.H.N., Coordinator (315)425-2000. Description: Women who enter prenatal care through satellite clinics are educated in ways to prevent low birthweight, including avoidance of alcohol, cigarettes, and drugs. Patients who smoke receive at least one 10- to 15-minute educational ses- sion provided by a health educator. This session includes in- formation on health risks associated with smoking, individual smoking risk assessment, tips on how to quit smoking, and referral to community resources for smoking cessation. The health educator utilizes a film, flip-charts, and pamphlets in the one-to-one patient education session. RENSSELAERVILLE INSTITUTE, Rensselaer- ville, New York 12147. 0867. 310 Program Title: Planned Approach To Community Health (P.A.T.C.H.). Contact: Dr. Patricia Hanson, Health Projects Director (518)797-3783. Description: Ongoing comprehensive smoking cessation is offered four times yearly. The program is targeted at rural adult smokers. The American Lung Association and American Cancer Society formats are both used. 0868. ROCKLAND COUNTY DEPARTMENT OF HEALTH, The Dr. Robert L. Yeager Health Cen- ter, Pomona, New York 10970. Program Title: Biofeedback Smoking Education Program. Contact: Ms. Sandra King, Senior Public Health Educator (914)354-0200 ext.2500. Description: This program, based on the American Lung Association’s Biofeedback Smoking Education Project, is offered to area schools. For more information, see the detailed program description in Part 1. 0869. SAINT FRANCIS HOSPITAL, Port Washington Boulevard, Roslyn, New York 11576. Program Title: | Quit Club. Contact: Ms. Rhoda Nichter, Course Director, and Ms. Lynn Walsh, Coordinator (516)938-0080 and 627-6200 ext.1508. Description: The | Quit Club offers reinforcement and support to alumni of the St. Francis Hospital Stop-Smoking Clinics via monthly meetings. Alumni receive a mailed notice of the meeting, which usually includes pertinent newspaper or magazine ar- ticles to reinforce staying abstinent. The | Quit Club also helps anyone who resumed smoking to make a new commitment to quit without going through another clinic. 0870. SAINT FRANCIS HOSPITAL, Port Washington Boulevard, Roslyn, New York 11576. Program Title: Step Smoking Clinic. Contact: Ms. Rhoda Nichter, Course Director, and Ms. Lynn Walsh, Coordinator (516)938-0080 and 627-6200 ext.1508. Description: Smokers who want to quit are invited to a free 2-hour orienta- tion meeting of the Stop Smoking Clinic. This not-for-profit Clinic, established for more than 12 years, has an 85- to 100- percent success rate during the course of the program. A recent survey indicated a 74.8 percent success rate after 1 year. The clinic provides seven sessions including 5 consecu- tive days for around-the-clock reinforcement during initial withdrawal, and monthly meetings for support after the initial intensive program to provide continuity and to help ensure long-term success. A pulmonary function test, films, talks by health professionals, personal assistance, and special attention to weight control are included in the program. 0871. SAINT FRANCIS HOSPITAL, Port Washington Boulevard, Roslyn, New York 11576. Program Title: Worksite Stop-Smoking Clinic. Contact: Ms. Rhoda Nichter, Course Director, and Ms. Lynn Walsh, Coordinator (516)938-0080 and 627-6200 ext.1508. Description: St. Francis Hospital conducts its highly successful Stop Smoking Clinic at corporate worksites during lunch or after work. The clinic provides seven sessions including 5 con- secutive days for round-the-clock reinforcement during initial withdrawal, monthly meetings for support after initial intensive program, on-site pulmonary function screening test, group sessions, films, special attention to weight control, behavior modification, and personal assistance. Benefits of a smoke- free workplace to the employer include reduced costs due to decreases in absenteeism, fire risk, air conditioning costs, in- surance premiums and payouts, accidents, maintenance and housekeeping costs, and time wasting. The employer provides a minimum of 10 participants and a meeting room. 0872. SAINT LAWRENCE COUNTY PUBLIC HEALTH NURSING SERVICE, Post Office Box 5157, Potsdam, New York 13676. Program Title: SMART - Self-Monitoring Modules For Awareness Of Risk- Reduction Techniques. Contact: Susanne Osterberg, R.N., Program Coordinator (315)265-3730. Description: Ongoing programs include special modules on smoking, weight control, stress reduction, and diet. Role models such as school teachers and health care administrators in rural upstate communities serve as teachers. Evaluation includes attendance, knowledge, testing, and followup. 0873. SAINT MARY’S HOSPITAL, 427 Guy Park Avenue, Amsterdam, New York 12010. 311 Program Title: Smokeless. Contact: Sister Rita Jean DuBrey, Certified Instructor, Wellness Institute (518)842-1900. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 0874. SCHUYLER COUNTY HOME HEALTH AGENCY, 105 Ninth Street, Watkins Glen, New York 14891. Program Title: Community Based Smoking Prevention And Cessation. Contact: Cherie Trabert, R.N., M.S., Director of Patient Services (607)535-2704. Description: This program includes prevention and cessation programs, clinical programs for pregnant women, and comprehensive local coalition activities. 0875. SEVENTH-DAY ADVENTIST COMMUNITY HEALTH SERVICES, Post Office Box 1029, Manhasset, New York 11030. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Ms. Juanita Kretschmar, Director (516)627-2210. Description: Both the Five-Day Plan and its successor, the Breathe-Free Plan To Stop Smoking, are available. For more information on the Breathe-Free Plan To Stop Smoking, see the detailed program description in Part 1. 0876. STOP SMOKING CENTER OF ROCHESTER, INC., Mt. Hope Professional Bullding, 1351 Mt. Hope Avenue, Sulte 102, Rochester, New York 14620. Program Title: Cigarette Dependency Treatment. Contact: Mr. Anthony R. Klein, Executive Director (716)442-2489. Description: After completing a screening and pretherapy visit designed to increase the smoker's awareness of personal smoking behaviors a 5-day detoxification treatment begins withdrawal from the chemical influence of cigarettes. The therapy in- cludes an intense psychoeducational program developed to elevate motivation and help the smoker adapt to replacement behaviors. The educational process includes counseling by a psychologist and medical testing under the direction of a pul- monary physician. A 12-month maintenance followup, con- ducted by a psychologist, is a major part of the methodology to provide additional reinforcement and support to promote continued abstinence. 0877. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES, 225 Rabro Drive East, Hauppauge, New York 11788. Program Title: Today’s Smoke. Contact: Mr. David Bekofsky, Director and Ms. Nancy Koehler, Program Coordinator (516)348-2708 and 348-2844. Description: The department has developed a smoking prevention program, offered to students in grades 5 and 6 throughout the County. The program includes three lesson plans taught by classroom teachers and one biofeedback lesson taught by staff of the Office of Health Education and Public Information. To increase the students’ awareness of the immediate physiological effects of smoking, a smoker is recruited and tested in the classroom before and after smoking for com- parisons on carbon monoxide level, pulse rate, blood pres- sure, skin temperature, and hand tremors. Objectives of the program also include increasing students’ awareness of the reasons why people decide whether or not to smoke, promot- ing the development of nonsmoking behavior and attitudes among young children, and helping students recognize advertising propaganda. 0878. TOMPKINS COMMUNITY HOSPITAL, 101 Dates Drive, ithaca, New York 14850-1383. Program Title: Smoke Stoppers. Contact: Ms. Alma S. Coats, Program Coordinator (607)274-4421. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase lil provides an ongoing support and maintenance system. NORTH CAROLINA 0879. AMERICAN CANCER SOCIETY, NORTH CAROLINA DIVISION, INC., 11 South Boylan Avenue, Suite 221, Raleigh, North Carolina 27611-7624. Program Title: FreshStart. Contact: Ms. Betsy Mitchell, Director of Public Education (919)834-8463. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 0880. AMERICAN CANCER SOCIETY, NORTH CAROLINA DIVISION, INC., 11 South Boylan Avenue, Sulte 221, Raleigh, North Carolina 27611-7624. Program Title: Taking Control. 312 Contact: Ms. Betsy Mitchell, Director of Public Education (919)834-8463. Description: This program is composed of two series: Young Adults and Teens, and Adults. The Young Adults and Teens program casts a science-fiction eye backwards in time to explain how individual responsibilities and choices in the 1980s came to take control. ft explains the basic steps to good health that may help reduce cancer risk. The purpose of Taking Control for Adults is to provide an in- troduction to a healthy, enjoyable lifestyle that reduces one's risk of developing cancer. The program gives an overview of five protective factors against cancer and five preventive fac- tors as well. There are slides, videos, flip charts, and other materials available. 0881. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Title: Calling It Quits. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: This self-help smoking cessation packet contains two book- lets, How To Quit and The Good Life. A slideAape presenta- tion is also available. For more information, see the detailed program description in Part 1. 0882. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Titie: Heart At Work. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453, Description: The American Heart Association's Heart At Work program is offered to area schools. For more information, see the detailed program description in Part 1. 0883. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Title: Heart Rx. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: The American Heart Association’s Heart Rx program is offered to area health care providers. For more information, see the detailed program description in Part 1. 0884. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514, Program Title: Heartbeat Journal Packet. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: This heart health education newspaper series has been 313 developed to teach heart health to students in grades 4 through 6. Each packet contains materials for six students. 0885. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Title: In Control. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: The home video, developed by the American Lung Associa- tion, is available for use with the Heart Rx program or any worksite cessation program. For more information, see the detailed program description in Part 1. 0886. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Title: Putting Your Heart Into The Curriculum. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: This program is a resource package of educational materials and activities for students in kindergarten through high school. The three modules were developed to address risk factor areas and designed for integration into an existing school health educator program. 0887. AMERICAN HEART ASSOCIATION, NORTH CAROLINA AFFILIATE, 300 Silver Cedar Court, Post Office Box 2636, Chapel Hill, North Carolina 27514. Program Title: Save A Sweet Heart. Contact: Mr. Pat Mitchell, Director of Programs (919)968-4453. Description: The American Heart Association's Save A Sweet Heart program is offered to area schools. For more information, see the detailed program description in Part 1. 0888. ANSON COUNTY HEALTH DEPARTMENT, Post Offlce Box 473, Wadesboro, North Carolina 28170. Program Title: Dangers Of Smokeless Tobacco. Contact: Ms. Fannie Ingram, Health Educator (704)694-5188. Description: A brief lecture is presented to senior citizens participating in the nutritional mealsite programs. The presentation em- phasizes the health hazards of smokeless tobacco and its ef- fects on the body. Mr. Gross Mouth, a model of teeth, tongue, and oral cavity that accurately shows the effects of the dead- ly habit, will be on display. Pamphlets and brochures on the subject of smokeless tobacco are distributed. The par- ticipants are able to recognize the health hazards resulting from the use of smokeless tobacco, describe the chewing and dipping procedure, and identify the danger signs of cancer of the mouth. 0889. DURHAM COUNTY HEALTH DEPARTMENT, HEALTH EDUCATION DIVISION, 414 East Main Street, Durham, North Carolina 27701. Program Title: FreshStart. Contact: Kathleen R. Heise, M.P.H., Health Promotion Coordinator (919)688-9375. Description: The American Cancer Society’s FreshStart program is designed to help participants stop smoking by providing them with all of the essential information and strategies needed to direct their own efforts at stopping. For more information, see the detailed program description in Part 1. 0990. GUILFORD COUNTY DEPARTMENT OF PUBLIC HEALTH, 301 North Eugene Street, Post Office Box 3508, Greensboro, North Carolina 27401. Program Title: Freedom From Smoking. Contact: Ms. Tracy Enright, Program Director (919)373-3568. Description: Smoking cessation programs are offered to county employees using the American Lung Association’s Freedom From Smok- ing clinic format, self-help manuals, or video programs. For more information, see the detailed program description in Part 1. 0991. HAYWOOD COUNTY HEALTH DEPARTMENT, 2216 Asheville Road, Waynesville, North Carolina 28786. 314 Program Title: Drug And Alcohol Education. Contact: Lynne C. Ward, R.H.Ed., Health Educator (704)452-6675. Description: information on smokeless tobacco and cigarettes is included in this program that is regularly offered to grades 4 through 8. The program includes a basic review of drug classifications and effects, laws, and decision making skills. Many audiovisual aids are, used, including flipcharts on drug clas- sifications, drug placebo display, and graphic pictures of oral and lung cancer caused by smoking and smokeless tobacco. 0992. HAYWOOD COUNTY HEALTH DEPARTMENT, 2216 Asheviile Road, Waynesville, North Carolina 28786. Program Title: Drug And Drug Abuse Update. Contact: Lynne C. Ward, R.H.Ed., Health Educator (704)452-6675. Description: This program, which includes information on smokeless tobacco and cigarettes, is offered regularly to high schoo! stu- dents and also to adults. The program is designed to refresh students’ memory on drug classifications and the effects and health risks of drug use. Emphasis is placed on new informa- tion about existing drugs, and new drugs and their effects are described. Special emphasis is placed on recognizing the signs that may indicate addiction and what may be done to ob- tain help. Audiovisual aids are used and take-home materials are supplied. 0993. IREDELL COUNTY HEALTH DEPARTMENT, Post Office Box 1268, Statesville, North Carolina 28677. Program Title: Drugs, Alcohol, And Tobacco. Contact: Ms. Paula G. Troutman, Health Educator (704)843-7291. Description: The portion of the Drugs, Alcohol, and Tobacco program deal- ing with tobacco comprises two 1-hour sessions. The program is available to County employees, local industry, and other groups. The objective of the program is to increase awareness of the short- and long-term effects of smoking on the individual and significant others. It is a general program, taught lecture style with transparencies, discussing why people smoke, financial costs of smoking, smokeless tobac- co, and secondhand smoke. Participants receive printed educational materials and a reference list of area smoking cessation programs. 0994. NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, Post Office Box 2091, Raleigh, North Carolina 27602-2091. Program Title: Preconceptional Health. Contact: Ms. Margie Rose, Head, Family Planning Branch (919)733-4871. Description: This is a health promotion program focusing on young women attending Family Planning clinics. The purpose is to identify risks before pregnancy occurs. Women who smoke are coun- seled and referred to smoking cessation programs in the community. 0995. NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, Post Office Box 2091, Raleigh, North Carolina 27602-2091. Program Title: Prenatal Care Program. Contact: Dr. James Rhyne, Head, Maternal and Child Health Branch (919)733-7791. Description: In the Prenatal Care Program, pregnant women who smoke are counseled on the risk they are taking and encouraged to reduce or quit smoking. Women who decide to quit smoking are referred to smoking cessation programs that are available in the community. 0996. NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, Post Office Box 2091, Raleigh, North Carolina 27602-2091. Program Title: Chronic Diseases. Contact: Mr. Amin Khalil, Head, Health Education Branch (919)733-7081. Description: in the Chronic Diseases Program, counseling and information on the risks of smoking and tobacco use are provided to smokers who seek chronic disease screening services as well as to patients with a diagnosed chronic illness. 315 A community educational program on the prevention of can- cer has been developed for use by local health departments. Information on smoking and smokeless tobacco as risk fac- tors in cancer is provided. 0997. NORTH CAROLINA DEPARTMENT OF HUMAN RESOURCES, DIVISION OF HEALTH SERVICES, Post Office Box 2091, Raleigh, North Carolina 27602-2091. Program Title: Statewide Health Promotion Program. Contact: Ms. Meredith Cosby, Head, Health Promotion Branch (919)733-7081. Description: During 1986 the Statewide Health Promotion Program was operational in 29 counties in North Carolina. Most of these projects provided information on smoking as a risk factor in the program's effort to reduce the risks of the leading causes of adult morbidity and mortality in the funded counties. Each county applying for funds determines the problem and target population that will be addressed through a needs assess- ment. The program, which so far has operated with Federal funds, is being expanded to fund every local health department through a new State appropriation. 0998. ONSLOW COUNTY HEALTH DEPARTMENT, 612 College Street, Jacksonville, North Carolina 28540. Program Title: FreshStart. Contact: Peggie L. Garner, R.H.Ed., Public Health Educator (919)347-6021. Description: The American Cancer Society’s FreshStart program is provided to the public on request. For more information, see the detailed program description in Part 1. 0989. PARK RIDGE HOSPITAL, Naples Road, Fletcher, North Carolina 28752. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Mr. Phillip Collins, Program Coordinator (704)684-8501. Description: The Seventh-Day Adventists’ Breathe-Free Plan To Stop Smoking is offered. For more information, see the detailed program description in Part 1. 1000. RANDOLPH COUNTY HEALTH DEPARTMENT, lra McDowell Governmental Center, 2222 South Fayetteville Street, Asheboro, North Carolina 27203. Program Title: Hypnotherapy Smoking Cessation Clinic. Contact: Ms. MiMi Cooper, Director of Health Education (919)629-2131 ext.3249. Description: The hypnotherapy smoking cessation clinic is lead by Dr. Richard Lovelace, an area psychologist with 25 years’ ex- perience in hypnotherapy. The program consists of questions and answers concerning hypnotherapy, positive thinking and language training, hypnotherapy inductions, and training for home use. The clinics are sponsored locally in conjunction with the American Lung Association and are available to any interested persons at the cost of $35. 1001. SAMPSON COUNTY HEALTH DEPARTMENT, Rowan Road, Clinton, North Carolina 28328. Program Title: FreshStart. Contact: Ms. Carolyn King, Health Educator (919)592-1131. Description: The American Cancer Society’s FreshStart program is offered to the general public. For more information, see the detailed program description in Part 1. NORTH DAKOTA 1002. AMERICAN HEART ASSOCIATION, NORTH DAKOTA AFFILIATE, 1005 12th Avenue, S.E., Post Office Box 1287, Jamestown, North Dakota 58401-1287. Program Title: Save A Sweet Heart. Contact: Ms. Barb Sand, Program Director (701)252-5122. Description: This is a program implemented by students to increase the awareness of the effects of smoking. For more information, see the detailed program description in Part 1. 1003. AMERICAN LUNG ASSOCIATION OF NORTH DAKOTA, 212 North Second Street, Post Office Box 5004, Bismarck, North Dakota 58502. Program Title: CLASP. Contact: Ms. Marcie Andre, Program Coordinator (701)223-5613. Description: CLASP kits represent modified versions of the original program created by the Stanford Heart Disease Program. Kits are designed to teach junior high students to identify and deal with pressures from peers and advertising. The program helps to make students aware of not only the long-term, but also the short-term effects of smoking. Students are involved in experiments, role playing, and discussions, all led by high school team leaders. CLASP kits contain all necessary materials. Also provided are guidelines for team leader training and how to conduct each session and analyze the results. There is no charge for this program. 1004. NORTH DAKOTA STATE DEPARTMENT OF HEALTH, State Capitol Building, Bismarck, North Dakota 58505. Program Title: Public Education. Contact: Stephen L. McDonough, M.D., Chief, Preventive Health Section (701)224-2493. Description: The North Dakota State Department of Health Consolidated Laboratories completed a comprehensive study on the health risks of tobacco use by North Dakota citizens. The study couples mortality data with tobacco use prevalence informa- tion to estimate the tobacco-attributable mortality and economic losses. The report also includes a history of tobac- co use in the State, the economic impact of use, and a list of recommendations to achieve a tobacco-free State. 1005. NORTH DAKOTA STATE DEPARTMENT OF HEALTH, State Capitol Building, Bismarck, North Dakota 58505. Program Title: Smoking Cessation. Contact: Stephen L. McDonough, M.D., Chief, Preventive Health Section (701)224-2493. Description: A resource guide listing, by County, all trained smoking ces- sation programs and leaders has been compiled and will be distributed to health care providers, libraries, and interested people across the State. 1006. NORTH DAKOTA STATE DEPARTMENT OF HEALTH, State Capitol Bullding, Bismarck, North Dakota 58505. Program Title: Tobacco Education. Contact: Stephen L. McDonough, M.D., Chief, Preventive Health Section (701)224-2493. Description: In an effort to educate students on the hazards of tobacco use, a resource guide was developed and distributed. The guide lists all available educational resources, including prevention programs and curricula, audiovisuals, and general literature such as pamphlets, books, posters, and magazines. 1007. NORTH DAKOTA STATE DEPARTMENT OF HEALTH, State Capitol Bullding, Bismarck, North Dakota 58505. Program Title: Tobacco Free North Dakota. Contact: Stephen L. McDonough, M.D., President, Tobacco Free North Dakota Coalition (701)224-2493, Description: The program has been in operation since December 1985, focusing on all North Dakota children and adolescents. North Dakota adults who are already tobacco users are also tar- geted. The Coalition has published the Tobacco Free North Dakota Resource Guide, which lists all educational materials available to schools regarding tobacco use. In addition, the Coalition has sponsored expansion of smoking prevention curricula through peer-pressure resistance, A directory of smoking cessation leaders was published in the fail of 1987. Seminars were held with businesses for estab- lishing worksite smoking policies. Many North Dakota schools are establishing smoke-free school districts and most North Dakota hospitals will have smoke-free facilities by 1988. OHIO 1008. AKRON GENERAL MEDICAL CENTER, Lovelife Wellness Corporation, 400 Wabash Avenue, Akron, Ohlo 44307. Program Title: Smokeless. Contact: Ms. Katherine Reilly, Health Educator (216)384-6000. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup ser- vices are provided. 1009. AMERICAN CANCER SOCIETY, OHIO DIVISION, INC., 5555 Frantz Road, Dublin, Ohio 43017. Program Title: FreshStart. Contact: Ms. Margaret Titterington, Director of Public Education (614)889-9565 or (800)686-4357 within Ohio. Description: The American Cancer Society's FreshStart program is offered throughout the State at no cost. For more information, see the detailed program description in Part 1. 1010. AMERICAN HEART ASSOCIATION, OHIO AF- FILIATE, 6161 Busch Boulevard, Suite 327, Columbus, Ohlo 43229. Program Title: Heart At Work. Contact: Mr. Bill Leinweber, Director of Community Programs (614)436-0958. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1011. AMERICAN HEART ASSOCIATION, OHIO AF- FILIATE, 6161 Busch Boulevard, Suite 327, Columbus, Ohlo 43229. Program Title: Heart Rx. Contact: Mr. Bill Leinweber, Director of Community Programs (614)436-0958. Description: The American Heart Association's Heart Rx program is of- fered. For more information, see the detailed program description in Part 1. 1012, AMERICAN HEART ASSOCIATION, OHIO AF- FILIATE, INC., 6161 Busch Boulevard, Sulte 327, Columbus, Ohlo 43229. Program Title: Save A Sweet Heart. Contact: Mr. Bill Leinweber, Director of Community Programs (614)436-0958. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1013. AMERICAN HEART ASSOCIATION, CENTRAL OHIO HEART CHAPTER, 200 East Rich Street, Post Office Box 739, Columbus, Ohio 43216. Program Title: Heart At Work. Contact: Program Coordinator (614)228-6327. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1014. AMERICAN HEART ASSOCIATION, CENTRAL OHIO HEART CHAPTER, 200 East Rich Street, Post Office Box 739, Columbus, Ohio 43216. Program Title: Heart Rx. Contact: Program Coordinator (614)228-6327. Description: The American Heart Association’s Heart Rx program is offered. For more information, see the detailed program description in Part 1. 318 1015. AMERICAN HEART ASSOCIATION, CENTRAL OHIO HEART CHAPTER, 200 East Rich Street, Post Office Box 739, Columbus, Ohio 43216. Program Title: Save A Sweet Heart. Contact: Program Coordinator (614)228-6327. Description: The American Heart Association's Save A Sweet Heart program is offered. ‘For more information, see the detailed program description in Part 1. 1016. AMERICAN HEART ASSOCIATION, MIAMI VALLEY HEART CHAPTER, 124 North Jefferson Street, Dayton, Ohio 45402. Program Title: Heart At Work. Contact: Program Coordinator (513)224-3571. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1017. AMERICAN HEART ASSOCIATION, MIAMI VALLEY HEART CHAPTER, 124 North Jefferson Street, Dayton, Ohio 45402. Program Title: Heart Rx. Contact: Program Coordinator (513)224-3571. Description: The American Heart Association's Heart Rx program is offered. For more information, see the detailed program description in Part 1. 1018. AMERICAN HEART ASSOCIATION, MIAMI VALLEY HEART CHAPTER, 124 North Jefferson Street, Dayton, Ohio 45402. Program Title: Save A Sweet Heart. Contact: Program Coordinator (513)224-3571. Description: The American Heart Association’s Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1019. AMERICAN HEART ASSOCIATION, NORTH- EAST OHIO AFFILIATE, 1689 East 115th Street, Cleveland, Ohio 44106. Program Title: Heart At Work. Contact: Program Coordinator (216)791-7500. Description: The American Heart Association's Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1020. AMERICAN HEART ASSOCIATION, NORTH- EAST OHIO AFFILIATE, 1689 East 115th Street, Cleveland, Ohlo 44106. Program Title: Heart Rx. Contact: Program Coordinator (216)791-7500. Description: The American Heart Association’s Heart Ax program is offered. For more information, see the detailed program description in Part 1. 1021. AMERICAN HEART ASSOCIATION, NORTH- EAST OHIO AFFILIATE, INC., 1689 East 115th Street, Cleveland, Ohlo 44106. Program Title: Save A Sweet Heart. Contact: Program Coordinator (216)791-7500. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1022. AMERICAN HEART ASSOCIATION, SOUTH- WESTERN OHIO CHAPTER, 2936 Vernon Place, Cincinnati, Ohio 45219. Program Title: Heart At Work. 319 Contact: Program Coordinator (513)281-4048, Description: The American Heart Association's Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1023. AMERICAN HEART ASSOCIATION, SOUTH- WESTERN OHIO CHAPTER, 2936 Vernon Place, Cincinnati, Ohio 45219. Program Title: Heart Rx. Contact: Program Coordinator (513)281-4048. Description: The American Heart Association’s Heart Rx program is offered. For more information, see the detailed program description in Part 1. 1024. AMERICAN HEART ASSOCIATION, SOUTH- WESTERN OHIO CHAPTER, 2936 Vernon Place, Cincinnati, Ohio 45219. Program Title: Save A Sweet Heart. Contact: Program Coordinator (513)281-4048, Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1025. AMERICAN HEART ASSOCIATION OF AKRON DISTRICT AREA, 1236 Weathervane, Suite 300C, Akron, Ohio 44313. Program Title: Heart At Work. Contact: Program Coordinator (216)867-9987. Description: The American Heart Association's Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1026. AMERICAN HEART ASSOCIATION OF AKRON DISTRICT AREA, 1236 Weathervane, Suite 300C, Akron, Ohio 44313. Program Title: Heart Rx. Contact: Program Coordinator (216)867-9987. Description: The American Heart Association’s Heart Rx program is offered. For more information, see the detailed program description in Part 1. 1027. AMERICAN HEART ASSOCIATION OF AKRON DISTRICT AREA, 1236 Weathervane, Sulte 300C, Akron, Ohio 44313. Program Title: Save A Sweet Heart. Contact: Program Coordinator (216)867-9987. Description: The American Heart Association’s Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1028. AMERICAN HEART ASSOCIATION OF EAST CENTRAL OHIO AREA, 1327 Market Avenue, North, Canton, Ohio 44714. Program Title: Heart At Work. Contact: Program Coordinator (216)536-2871. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1029. AMERICAN HEART ASSOCIATION OF EAST CENTRAL OHIO AREA, 1327 Market Avenue, North, Canton, Ohlo 44714. Program Title: Heart Rx. Contact: Program Coordinator (216)536-2871. Description: The American Heart Association’s Heart Rx program is offered. For more information, see the detailed program description in Part 1. 320 1030. AMERICAN HEART ASSOCIATION OF EAST CENTRAL OHIO AREA, 1327 Market Avenue, North, Canton, Ohlo 44714. Program Title: Save A Sweet Haart. Contact: Program Coordinator (216)536-2871. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1031. AMERICAN HEART ASSOCIATION OF EASTERN OHIO AREA, 4822 Market Street, Youngstown, Ohio 44512. Program Title: Heart At Work. Contact: Program Coordinator (216)782-2288. Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1032. AMERICAN HEART ASSOCIATION OF EASTERN OHIO AREA, 4822 Market Street, Youngstown, Ohio 44512. Program Title: Heart Rx. Contact: Program Coordinator (216)782-2288. Description: The American Heart Association’s Heart Rx program is offered. For more information, see the detailed program description in Part 1. 1033. AMERICAN HEART ASSOCIATION OF EASTERN OHIO AREA, 4822 Market Street, Youngstown, Ohlo 44512. Program Title: Save A Sweet Heart. Contact: Program Coordinator (216)782-2288. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1034. AMERICAN HEART ASSOCIATION OF NORTHWESTERN OHIO AREA, 215 Community Services Building, 1 Stranahan Square, Toledo, Ohlo 43604. Program Title: Heart At Work. Contact: Program Coordinator (419)244-3769, Description: The American Heart Association’s Heart At Work program is offered. For more information, see the detailed program description in Part 1. 1035. AMERICAN HEART ASSOCIATION OF NORTHWESTERN OHIO AREA, 215 Community Services Building, 1 Stranahan Square, Toledo, Ohlo 43604. Program Title: Heart Rx. Contact: Program Coordinator (419)244-3769. Description: The American Heart Association's Heart Rx program is offered. For more information, see the detailed program description in Part 1. 1036. AMERICAN HEART ASSOCIATION OF NORTHWESTERN OHIO AREA, 215 Community Services Buliding, 1 Stranahan Square, Toledo, Ohio 43604. Program Title: Save A Sweet Heart. Contact: Program Coordinator (419)244-3769. Description: The American Heart Association’s Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1037. AMERICAN LUNG ASSOCIATION OF NORTH- ERN OHIO, 4614 Prospect Avenue, Suite 307, Cleveland, Ohio 44103. 321 Program Title: Freedom From Smoking Clinics. Contact: Mr. James Corcoran, Program Administrator (216)361-8000. Description: The American Lung Association's Freedom From Smoking clinics are offered on-site at area organizations. For more information, see the detailed program description in Part 1. 1038. AMERICAN LUNG ASSOCIATION OF NORTH- ERN OHIO, 4614 Prospect Avenue, Suite 307, Cleveland, Ohio 44103. Program Title: Freedom From Smoking Instructor Training. Contact: Mr. James Corcoran, Program Administrator (216)361-8000. Description: The American Lung Association of Northern Ohio, through the American Lung Association National Corps of Clinic Leader Trainers, will teach individuals how to conduct Freedom From Smoking programs at a worksite or in a community setting. The National program, described in Part 1, is used as a basis for this training. 1039. AMERICAN LUNG ASSOCIATION OF NORTH- ERN OHIO, 4614 Prospect Avenue, Suite 307, Cleveland, Ohio 44103. Program Title: Smoking Policy Information. Contact: Mr. James Corcoran, Program Administrator (216)361-8000. Description: The American Lung Association of Northern Ohio is able to provide two manuals, Creating Your Company Policy and Taking Executive Action, to help organizations attempting to create a smoking policy in the workplace. 1040. AMERICAN LUNG ASSOCIATION OF NORTH- ERN OHIO, 4614 Prospect Avenue, Suite 307, Cleveland, Ohio 44103. Program Title: Teen Targeted Anti-Smoking Program. Contact: Ms. Pat Westfall, School and Lung Health Coordinator (216)361-8000. Description: This program offers school administrators an alternative to suspending high school students for smoking. By testing their own bodies’ responses on the electronic equipment, students experience the health hazards of just one cigarette. The stu- dents participate in the cessation portion of the program. The goals of the program are: 1) to keep the students in the class- room; 2) to provide a unique learning experience; and 3) to provide an opportunity for students to quit smoking. 1041. AMERICAN LUNG ASSOCIATION OF NORTHWESTERN OHIO, 520 Madison Avenue, Sulte 225, Toledo, Ohio 43604. Program Title: Freedom From Smoking Clinics. Contact: Ms. Sarah W. Russell, Program Administrator (419)255-2378. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF 1042. NORTHWESTERN OHIO, 520 Madison Avenue, Sulte 225, Toledo, Ohio 43604. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Sarah W. Russell, Program Administrator (419)255-2378. Description: This program is presented in the form of two self-help manuals: Freedom From Smoking In 20 Days and A Lifetime Ot Freedom From Smoking. For more information, see the detailed program descriptions in Part 1. 1043. AMERICAN LUNG ASSOCIATION OF NORTHWESTERN OHIO, 520 Madison Avenue, Sulte 225, Toledo, Ohlo 43604. Program Title: Freedom From Smoking Self-Help Starter Session. Contact: Ms. Sarah W. Russell, Program Administrator (419)255-2378. Description: One 3-hour program introduces the participant to the major concepts of the Freedom From Smoking cessation program. Materials include audiovisual back-up, a set of FFS self-help manuals, and additional support items. AMERICAN LUNG ASSOCIATION OF NORTHWESTERN OHIO, 520 Madison Avenue, Sulte 225, Toledo, Ohio 43604. 1044. 322 Program Title: Freedom From Smoking Self-Help Starter Session Plus. Contact: Ms. Sarah W. Russell, Program Administrator (419)255-2378. Description: Three 1-hour programs are held during each 2-week period. Participants receive a packet of Starter Session materials before the first session, and all use the Freedom From Smok- ing In20 Days manual to quit during the program. Audiovisual back-up, a Former Smokers Panel, and some group support are provided in this program. 1045. AMERICAN LUNG ASSOCIATION OF NORTHWESTERN OHIO, 520 Madison Avenue, Suite 225, Toledo, Ohio 43604. Program Title: In Control. Contact: Ms. Sarah W. Russell, Program Administrator (419)255-2378. Description: The In Control program includes a videocassette, a 20-minute audiocassette, and a workbook. The videocassette may be purchased or borrowed. For more information, see the detailed program description in Part 1. 1046. AMERICAN LUNG ASSOCIATION OF SOUTH- WESTERN OHIO, 2330 Victory Parkway, Cincinnati, Ohio 45206-2885. Program Title: Freedom From Smoking. Contact: Ms. Paula Monahan, Associate Director (513)751-3650. Description: The American Lung Association’s Freedom From Smoking program is offered monthly at area Group Health Associates’ offices. For more information, see the detailed program description in Part 1. 1047. AMERICAN LUNG ASSOCIATION OF SOUTH- WESTERN OHIO, 2330 Victory Parkway, Cincinnati, Ohlo 45206-2885. Program Title: Freedom From Smoking In 20 Days. Contact: Ms. Paula Monahan, Associate Director (513)751-3650. Description: Acolorful guide through the quitting process is used as a self- help approach to smoking cessation. A relaxation tape is also available. For more information, see the detailed program description in Part 1. 1048. AMERICAN LUNG ASSOCIATION OF SOUTH- WESTERN OHIO, 2330 Victory Parkway, Cincinnatl, Ohio 45206-2885. Program Title: In Control. Contact: Ms. Paula Monahan, Associate Director (513)751-3650. Description: In Control is a video program that can be used alone or in a group. For more information, see the detailed program description in Part 1. 1048. AMERICAN LUNG ASSOCIATION OF SOUTH- WESTERN OHIO, 2330 Victory Parkway, Cincin- nati, Ohio 45206-2885. Program Title: Smoking Cessation Through Hypnosis. Contact: Ms. Paula Monahan, Associate Director (513)751-3650. Description: Hypnosis is a nonmedical means to achieve smoking cessa- tion in a group setting. A clinical hypnotist provides the hyp- notic suggestion to counter the usual traumas associated with breaking the habit, such as weight gain and anxiety. Hypnosis is a deep relaxation with concentration focused on one objec- tive to heighten consciousness. Sessions are held monthly at Quality Inn Central, Norwood. 1050. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal! Drive, N.W., Canton, Ohio 44709. Program Title: Biofeedback Smoking Education Project. Contact: Mr. Mike Rogers, Program Director (216)456-8275, Description: The American Lung Association’s Biofeedback Smoking Education Project is offered to area high schools. For more information, see the detailed program description in Part 1. 1051. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal Drive, N.W., Canton, Ohio 44709. Program Title: Freedom From Smoking. 323 Contact: Mr. Mike Rogers, Program Director (216)456-8275. Description: The American Lung Association's Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 1052. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal Drive, N.W., Canton, Ohlo 44709. Program Title: Freedom From Smoking At Work. Contact: Ms. Fran R. Parsons, Director of Public Relations (216)456-8275. Description: The American Lung Association's Freedom From Smoking At Work program is offered to local businesses. For more information, see the detailed program description in Part 1. 1053. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal Drive, N.W., Canton, Ohlo 44709. Program Title: Hypnosis Stop Smoking Clinics. Contact: Mr. Mike Rogers, Program Director (216)456-8275. Description: The sessions are conducted by a clinical hypnotist who per- suades smokers to become nonsmokers in their own minds. The participants remain fully awake, but achieve a state of awareness through concentration and muscle relaxation. During this stage, smokers take control of their habit and focus thoughts toward a nonsmoking lifestyle. Self-hypnosis is also taug it so that nonsmokers can reinforce new lifestyles at ome. 1054. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal Drive, N.W., Canton, Ohlo 44709. Program Title: STOMPS. Contact: Mr. Mike Rogers, Program Director (216)456-8275. Description: Staff of the American Lung Association teach high school students about respiratory health and the hazards of smoking. Upon completion of the 20-hour course, the participants are commissioned as student instructors. They make presenta- tions to children in the lower grades about peer pressure and the negative aspects of cigarette smoking. 1055. AMERICAN LUNG ASSOCIATION OF STARK- WAYNE, 1300 Christmas Seal Drive, N.W., Can- ton, Ohio 44709. Program Title: Suspension Alternatives To Students’ Smoking. Contact: Mr. Mike Rogers, Program Director (216)456-8275. Description: Suspension Alternatives To Students’ Smoking (SASS) is a smoking intervention program developed by the American Lung Association of Stark-Wayne for the Stark County schools. This program will provide Stark County school administrators with an alternative to suspension, if a student is in violation of school policy regarding tobacco use. The intent of this program is to increase the awareness of the health factors in- volved in tobacco use, and to decrease the incidence of tobacco use among Stark County students. SASS will include the use of biofeedback equipment that will demonstrate the immediate effect of one cigarette on the body. Behavior modification techniques will be used to aid the stu- dent in his or her quest to become tobacco free. Evaluations and followup will be conducted at the end of the clinic, every 3, 6, and 9 months, and after 1 year. 1056. AMERICAN LUNG ASSOCIATION OF OHIO, NORTH CENTRAL BRANCH, 111 East Chestnut Street, Post Office Box 613, Mt. Vernon, Ohio 43050. Program Title: Biomonitoring Smoking Education Project. Contact: Ms. Jeanne Kenney, Branch Director (614)392-9366, Description: This program, based on the American Lung Association's Biofeedback Smoking Education Project, is offered to area schools. For more information, see the detailed program description in Part 1. 1057. AMERICAN LUNG ASSOCIATION OF OHIO, NORTH CENTRAL BRANCH, 111 East Chestnut Street, Post Office Box 613, Mt. Vernon, Ohio 43050. Program Title: Freadom From Smoking. Contact: Ms. Emily J. Packard, Branch Director (614)392-9366. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 1058. AMERICAN LUNG ASSOCIATION OF OHIO, NORTH CENTRAL BRANCH, 111 East Chestnut Street, Post Office Box 613, Mt. Vernon, Ohio 43050. Program Title: In Control. Contact: Ms. Jeanne Kenney, Branch Director (614)392-9366. DescrIption: The In Control videocassette program is offered and can be used at home or at a worksite. For more information, see the detailed program description in Part 1. 1059. AMERICAN LUNG ASSOCIATION OF OHIO, NORTH CENTRAL BRANCH, 111 East Chestnut Street, Post Office Box 613, Mt. Vernon, Ohio 43050. Program Title: Self-Help Manuals. Contact: Ms. Emily J. Packard, Program Consultant (614)392-9366. Deseription: This program is presented in the form of two self-help manuals: Freedom From Smoking In 20 Days and A Lifetime Ot Freedom From Smoking. A variety of audiovisuals are used to reinforce the nonsmoking message. For more infor- mation, see the detailed program descriptions in Part 1. 1060. AMERICAN LUNG ASSOCIATION OF OHIO, NORTH CENTRAL BRANCH, 111 East Chestnut Street, Post Office Box 613, Mt. Vernon, Ohio 43050, Program Title: Self-Hypnosis Smoking Cessation. Contact: Ms. Jeanne Kenney, Branch Director (614)392-9366. Description: A clinical psychologist persuades smokers to quit by achiev- ing a state of awareness. Through concentration and deep muscle relaxation, a suggestion directed at quitting smoking is repeated. During this stage, smokers take control of their habit and focus thoughts toward becoming a nonsmoker. A cassette tape for use at home further reinforces the new life- style. 1061. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: Freedom From Smoking Clinics. Contact: Ms. Charlotte Kleeman, Certified Freedom Leader (419)228-3335. From Smoking Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1062. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Nancy Nedilsky, Director (419)224-8561. Description: This self-help program is designed to assist a pregnant woman in quitting smoking in 10 days. For more information, see the detailed program description in Part 1. 1063. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Nancy Nedilsky, Director (419)224-8561. Description: As a new component to the American Lung Assaciation’s Smoke-Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 1064. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Nancy Nedilsky, Director (419)228-3335. Description: The American Lung Association’s self-help manuals, Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking, are available at a minimal cost. For more information, see the detailed program description in Part 1. 325 1065. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: In Control. Contact: Ms. Nancy Nedilsky, Director (419)224-8561. Description: The In Control program includes a videocassette, a 20-minute audiocassette, and a workbook. The videocassette may be purchased or borrowed. For more information, see the detailed program description in Part 1. 1066. AMERICAN LUNG ASSOCIATION OF OHIO, WESTERN BRANCH, 855 West Market Street, Post Office Box 870, Lima, Ohio 45802. Program Title: Self-Help Plus. Contact: Ms. Charlotte Kleeman, Certified Freedom From Smoking Leader (419)228-3335. Description: Self-Help Pius is offered in three 1-hour sessions during a 2- week period. Participants receive a packet of Starter Session materials before the first session, and all use the Freedom From Smoking In 20 Days manual to quit during the program. Audiovisual back-up, a Former Smokers Panel, and some group support are also provided in this program. 1067. CITY OF CLEVELAND DEPARTMENT OF PUBLIC HEALTH AND HUMAN RESOURCES, 1925 St. Clair Avenue, Cleveland, Ohio 44114. Program Title: Freedom From Smoking. Contact: Mr. Walter H. Scott, Preventive Health Counselor (216)664-2324. Description: The American Lung Association’s Freedom From Smoking program is offered to county and Federal employees and the public community. For more information, see the detailed program description in Part 1. 1068. CITY OF CLEVELAND DEPARTMENT OF PUBLIC HEALTH AND HUMAN RESOURCES, 1925 St. Clair Avenue, Cleveland, Ohlo 44114. Program Title: Smoking Education. Contact: Mr. Walker H. Scott, Preventive Health Counselor (216)664-2324,. Description: Through cooperation with the American Cancer Society, American Lung Association and American Heart Association, tobacco use education programs are presented to school children in kindergarten through grade 12. For students in kindergarten through grade 3, the program focuses on the ills of tobacco use. For those in grades 4 through 6, programs focus on the effects of tobacco on the human body, and for grades 7 though 12, smoking education and a focus on value clarification is presented. Smoking education will also be provided to three target groups: 1) 2,000 individuals aged 18 to 25; 2) 45 hearing- impaired persons; and 3) 30 disabled veteran minorities. 1069. CLINTON MEMORIAL HOSPITAL, 610 West Main Street, Wilmington, Ohio 45177. Program Title: Smokeless. Contact: Ms. Cynthia Crosthwaite, HealtthSense Manager (513)382-6611. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup services are provided. 1070. COLUMBIANA COUNTY HEALTH DEPART- MENT, Post Office Box 396, Lisbon, Ohio 44432- 0396. Program Title: BREAK-OUT: Break Out Of The Use Of Tobacco. Contact: Barbara Stamp, R.N., Director of Nursing (216)424-9511 ext.222. Description: The focus of the project is to discourage the use of both smokeless and smoking tobacco among delinquent youth at the Louis Tobin Attention Center. The children range from age 8 to 18 and are considered at risk. The overall goal is to help teenagers acquire knowledge and understanding about how their own health practices and lifestyles influence their chan- ces of future debilitation and chronic disease. The Columbiana County Health Department will present a class once a week ontobacco and attitude adjustment. To support the education- al component of this project, the Juvenile Court Judge has re- quired that no tobacco be used in the presence of any court employee at any time. The niediral advisor of the health department is available for advice, guidance, and program preparation. 326 1071. GALLIA COUNTY HEALTH DEPARTMENT, County Courthouse, Locust Street, Gallipolis, Ohio 45631. Program Title: Desmond, The Dragon. Contact: Barbara C. Ephrig, R.N., Program Coordinator (614)446-4612 ext.292. Description: The Desmond, The Dragon program is presented to all kinder- garten through grade 6 County students. The County Health Educator introduces the topic of tobacco prevention and uses pretest questions in assembly situations. The live drama, "Desmond, The Dragon,” is then presented. The drama is fol- lowed by a review of the content, posttest questions, and practice in how to say no to tobacco. 1072. GALLIA COUNTY HEALTH DEPARTMENT, County Courthouse, Locust Street, Gallipolis, Ohlo 45631. Program Title: FreshStart. Contact: Barbara C. Ephrig, R.N., Program Coordinator (614)446-4612 ext.292. Description: The American Cancer Society's FreshStart program is offered to the general public. For more information, see the detailed program description in Part 1. 1073. GALLIA COUNTY HEALTH DEPARTMENT, County Courthouse, Locust Street, Gallipolis, Ohio 45631. Program Title: Peer Pressure. Contact: Barbara C. Ephrig, R.N., Program Coordinator (614)446-4612 ext.292. Description: The Peer Pressure program is presented to teenage students annually. Peer pressure is discussed with examples of peer- pressure situations. Ways to say no are discussed, with specific examples of responses. The objective is to teach stu- dents to recognize peer pressure as it applies to tobacco use. 1074. GALLIA COUNTY HEALTH DEPARTMENT, County Courthouse, Locust Street, Gallipolis, Ohio 45631. Program Title: Smoking Is Yucky. Contact: Barbara C. Ephrig, R.N., Program Coordinator (614)446-4612 ext.292. Description: This program is presented to preschoolers annually. It con- sists of four 10- to 15-minute sessions. The program em- phasizes the ill effects of smoking on the lungs and the heart. The students practice how to say no to tobacco and are shown pictures of role models who do not smoke. Puppets, pictures, sports equipment, posters, and medical equipment are among the displays used. 1075. GRANT MEDICAL CENTER, 111 South Grant Avenue, Columbus, Ohio 43215. Program Title: Smokeless. Contact: Grant Fitness Center (614)461-3880. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup services are provided. 1076. GREENE COUNTY COMBINED HEALTH DIS- TRICT, 360 Wilson Drive, Post Office Box 250, Xenla, Ohlo 45385. Program Title: Grade School Tobacco Project. Contact: Ms. Barbara Wagner, Development Officer (513)376-9411. Description: The program targets students in grades 3 and 4 in six disad- vantaged areas of the County. The program objective is to reduce the acceptance and adoption of tobacco use among the students. Topics covered include preassessment of stu- dent knowledge, attitude and behavior toward tobacco use, a general introduction, a discussion about the visual aspects of tobacco use, the social aspects of tobacco use, and how to cope with peer pressure and behavior role models. 1077. GROUP HEALTH ASSOCIATES, INC., 2915 Clifton Avenue, Cincinnati, Ohio 45220. Program Title: Freedom From Smoking. Contact: Mr. Randy O'Neill, Program Coordinator (513)872-2044, 327 Description: The American Lung Association’s Freedom From Smoking cessation program is offered. For more information, see the program description in Part 1. 1078. HAMILTON DEPARTMENT OF HEALTH, 20 High Street at Monument, Hamilton, Ohio 45011. Program Title: FreshStart. Contact: Priscilla Seymour, R.N., B.S.N., Nursing Administrator (513)868-5978. Description: The American Cancer Society’s FreshStart program is offered to local industry, as requested. For more information, see the detailed program description in Part 1. 1079. HEALTH MAINTENANCE PLAN, 2555 South Dixie, Dayton, Ohio 45409. Program Title: Freedom From Smoking. Contact: Ms. Joanne C. Zahora, Health Education Specialist (513)296-4000. Description: A health professional from the health plan conducts the American Lung Association's smoking cessation workshop. For more information, see the detailed program description in Part 1. 1080. KETTERING CENTER FOR HEALTH PROMO- TION, Kettering Medical Center, 3535 Southern Boulevard, Kettering, Ohlo 45429. Program Title: Stop Smoking Clinic. Contact: Mr. Larry W. Wilson, Director (513)296-7245. Description: A series of in-depth sessions is offered to those needing professional help to stop smoking. Pretesting and orientation costs $26; the program fee is $50. Clinics are offered to businesses as requested. 1081. OHIO DEPARTMENT OF HEALTH, Division of Chronic Diseases, Post Office Box 118, Columbus, Ohio, 43266-0118. Program Title: Ohio Education Program On Smoking And Health. Contact: Ms. Ellen M. Capwell or Ms. Darlene P. Kreiser, Program Coordinators (614)466-2144. Description: The Ohio Education Program On Smoking And Health serves as a resource center for lay and professional information on tobacco. Literature and educational materials are available upon request. Publications recently developed include the Stamp Out Snuff activity coloring book for school children. A quarterly newsletter, Smoking vs. Health, has a circulation of approximately 350. It includes a summary of new information on tobacco; description of resources; updates on tobacco-re- lated activities of National, State, and local agencies and or- ganizations; and updates on legislation. Ten films on tobacco are currently available on free loan to Ohio residents. Staff provide consultations and make presentations to State and local professionals in community health and education. Staff also consult with employers and employees concerning the development and implementation of workplace nonsmoking policies. They conduct conferences and workshops, provide exhibits, distribute public service announcements, and survey schools, health departments, and businesses. Staff coor- dinate a Statewide annual tobacco versus health poster con- test for students in grade 7 as an awareness activity. The program is also funding and monitoring nine local tobacco prevention projects aimed at preventing youth from using tobacco. The program emphasizes coordination and cooperation of official agencies, voluntary organizations, professional associations, and educational institutions in ad- dressing the tobacco issues. Staff participate in interagency groups and coalitions for this purpose. 1082. OHIO DEPARTMENT OF HEALTH, Division of Chronic Diseases, Post Office Box 118, Columbus, Ohio 43266-0118. Program Title: Ohio Tobacco Prevention Project. Contact: Ms. Ellen M. Capwell or Ms. Darlene P. Kreiser, Program Coordinators (614)466-2144. Description: The Ohio Tobacco Prevention Project is aimed at young Ohioans. Selected sites, including local health departments, voluntary health agencies, and community youth groups, are awarded 1-year contracts to develop, implement, and evaluate tobacco prevention programs and reinforcement ac- tivities. The overall objectives of the program are: 1) to es- tablish educational programs and initiatives aimed at the prevention of habitual smoking among youth at high risk from becoming adult smokers; and 2) to increase public awareness of the addictive and harmful effects of smokeless tobacco use in geographic areas of high smokeless tobacco use. Programs and supportive services designed to prevent tobac- co use have been conducted from preschool through the senior high levels. 1083. THE CENTER FOR HEALTH PROMOTION AT RIVERSIDE HOSPITAL, 1600 North Superior Street, Toledo, Ohio 43604. Program Title: Smokeless. Contact: Ms. Ann Murray, Program Coordinator (419)729-6035. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cesation booklets and followup services are provided. 1084. WILLIAMS COUNTY DISTRICT BOARD OF HEALTH, 310 Lincoln, Post Office Box 146, Montpelier, Ohlo 43543-0146. Program Title: Heatthy Me, Tobacco Free. Contact: Jean Wise, R.N., Health Educator and Ms. Mindy Schaffner, Health Commissioner (419)485-3141. Description: The County Health Department provides local middie school teachers with audiovisual aids and an educational curriculum on the hazards of tobacco use for use in their classrooms. Also, exhibits featuring Mr. Gross Mouth are planned for each school along with poster contests. OKLAHOMA 1085. AMERICAN HEART ASSOCIATION, OKLAHOMA AFFILIATE, 2915 Classen Boulevard, Suite 220, Post Office Box 11376, Oklahoma City, Oklahoma 73136. Program Title: Heart At Work. Contact: Mr, John Hanley, Associate Executive Director (405)52 1 -9838. Description: . For more information on the American Heart Association’s Heart At Work program, see the detailed program description in Part 1. 1086. AMERICAN HEART ASSOCIATION, OKLAHOMA AFFILIATE, 2915 Classen Boulevard, Suite 220, Post Office Box 11376, Oklahoma City, Oklahoma 73136. Program Title: Putting Your Heart Into The Curriculum. Contact: Mr. John Hanley, Associate Executive Director (405)521-9838. Description: For more information on this American Heart Association program, see the detailed program description in Part 1. 1087. AMERICAN HEART ASSOCIATION, OKLAHOMA AFFILIATE, 2915 Classen Boulevard, Sulte 220, Post Office Box 11376, Oklahoma City, Oklahoma 73136. Program Title: Save A Sweet Heart. Contact: Mr. John Hanley, Associate Executive Director (405)521-9838. Description: The American Heart Association's Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1088. AMERICAN LUNG ASSOCIATION OF GREEN COUNTY, OKLAHOMA, 2805 East Skelly Drive, Sulte 806, Tulsa, Oklahoma 74105. Program Title: Freedom From Smoking Clinic. Contact: Ms. Pam Hollman, Program Director (918)747-3441. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1089. AMERICAN LUNG ASSOCIATION OF GREEN COUNTY, OKLAHOMA, 2805 East Skelly Drive, Sulte 806, Tulsa, Oklahoma 74105. Program Title: Freedom From Smoking in 20 Days. 329 Contact: Ms. Pam Hollman, Program Director (918)747-3441, Description: The American Lung Association’s self-help manual is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF GREEN COUNTY, OKLAHOMA, 2805 East Skelly Drive, Sulte 806, Tulsa, Oklahoma 74105. 1090. Program Title: In Control. Contact: Ms. Pam Hollman, Program Director (918)747-3441. Description: The American Lung Association’s In Control videocassette program is offered. For more information, see the detailed program description in Part 1. 1081. AMERICAN LUNG ASSOCIATION OF GREEN COUNTY, OKLAHOMA, 2805 East Skelly Drive, Sulte 806, Tulsa, Oklahoma 74105, Program Title: Smoking Control Through Hypnosis. Contact: Ms. Pam Hollman, Program Director (918)747-3441. Description: The goal of this nonmedical group hypnosis program is to create a state of increased sensitivity to positive suggestion that helps minimize difficult withdrawal from cigarettes. A local hypnotist conducts the one-session program in Tulsa month- ly and in area towns semiannually. Pamphlets and instruction in self-hypnosis are also made available. 1092. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Cold Turkey Day. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471, Description: Cold Turkey Day is a Statewide event in which smokers are encouraged to lay down their cigarettes for at least that 1 day. The belief is that 1 day's success will provide incentive for another until habit mastery is accomplished. 1093. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Freedom From Smoking At Work. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 1094. AMERICAN LUNG ASSOCIATION OF OK- . LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Tle: Freedom From Smoking For You And Your Baby. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: This 32-page manual is a self-help program designed to as- sist a pregnant woman in quitting smoking in 10 days. For more information, see the detailed program description in Part 1. 1095. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Freedom From Smoking Clinic. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1096. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 52303, Oklahoma City, Oklahoma 73152. Program Title: Freedom From Smoking Self-Help Manuals. Contact: ; Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s self-help programis offered. For more information, see the detailed program descriptions in Part 1. 1097. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: In Control. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s In Control videocassette program is offered. For more information, see the detailed program description in Part 1. 1098. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Lungs Are For Life. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s Lungs Are For Life modules are offered to area schools. For more information, see the detailed program description in Part 1. 1099. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Smoking And Pregnancy. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The American Lung Association’s Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1100. AMERICAN LUNG ASSOCIATION OF OK- LAHOMA, Post Office Box 53303, Oklahoma City, Oklahoma 73152. Program Title: Smoking Cessation Through Hypnosis. Contact: Mr. John G. Rogers, Executive Vice President (405)524-8471. Description: The nonmedical group hypnosis program is designed to aid in withdrawal from cigarettes. Participants are instructed in the techniques of self-hypnosis to achieve maximum and long- lasting benefits. Sessions are offered monthly in Oklahoma City and in rotation at locations around the State. 1101. OKLAHOMA STATE DEPARTMENT OF HEALTH, 1000 Northeast Tenth, Post Office Box §3551, Oklahoma City, Oklahoma 73152. Program Title: FreshStart. Contact: Mr. Richard M. Gunn, Chief, Health Education and Information (405)271-5601. Description: The American Cancer Society's FreshStart program is offered in conjunction with the State employee health and wellness promotion activities available through the Oklahoma Office of Personnel Management. Health risk assessment, evaluation, and referral are included in the total package. For more information, see the detailed program description in Part 1. 1102. STILLWATER MEDICAL CENTER, Box 2408, Stillwater, Oklahoma 74076. Program Title: How To Quit Smoking. Contact: Bobbi Bryson, R.N., B.S.N., Director of Education (405)372-1480. Description: This program leads participants through the three steps to quitting smoking: 1) getting ready to quit; 2) quitting; and 3) remaining an ex-smoker. Participants analyze why they smoke and discover what kind of smoker they are. They tar- get a quitting day, learn techniques for lessening weight gain, tension, and withdrawal pangs, and build exercise and a healthy diet into a new life. 1103. TULSA CITY—COUNTY HEALTH DEPARTMENT, 4616 East 15th Street, Tu Isa, Oklahoma 74112. Program Title: Smoking And Health. Contact: Ralph R. Wooley, M.D., M.P.H., Director (918)744-1000, Description: The program is offered, on request, to students in grades 4 and 5. The program lasts 1 hour. The presentation begins with a discussion on the importance of the children’s feelings of self-worth. The children are asked to listen to the informa- tion given, thinking only of their bodies, and not anyone else’s, in order to avoid any overpowering fear of the potential loss of family members who smoke. Factual information is given through slides and 16mm films, appropriate for each grade level, depicting the damage to human tissue because of smok- ing. I'll Never Start and | Will Stop Club member cards are dis- tributed. The cards are given to help the children become conscious of the importance of never starting and to assist them in helping their parents to stop smoking. OREGON 1104. AMERICAN CANCER SOCIETY, OREGON Program Title: DIVISION, INC., 0330 Southwest Curry Street, Breathing Easy. Portland, Oregon 97201. Contact: Program Title: Ms. Cathy H. Rowland, Public Education Director Breaking Free. (503)295-6422. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: The American Cancer Society’s smoking cessation program for high school students is offered. For more information, see the detailed program description in Part 1. 1105. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. 331 Description: This videocassette program was designed for children aged 10to 14. The program, which features an imaginary television network and teacher's guide, is loaned at no cost. 1106. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: Cancer Response System. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422 or (800)ACS-2345. Description: Volunteers answer smoking-related questions and provide tips on quitting. 1107. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: FreshStart. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: The American Cancer Society's FreshStart cessation program is offered at no cost to individuals and up to $25 to organizations. For more information, see the detailed program description in Part 1. 1108. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: FreshStart: Computer Software. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: The American Cancer Society’s FreshStart cessation program is available on PC compatible software. This inter- active program includes a customized printout with specific quit strategies and self-help instructions. This program is lent to the public at no cost. 1109. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: FreshStart: 21 Days To Stop Smoking. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: This self-help program includes: a 159-page paperback at a cost of $3.95; an audiocassette at a cost of $7.95; and a VHS format videocassette at a cost of $29.95. These items may be ordered at local bookstores or by calling (800)446-3500, operator 866. 332 1110. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: The Gnome. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: This smoking prevention kit was designed for students in grades 2 to 3. Children learn the health effects of tobacco use as well as polite ways to tell a smoker how they feel or to leave a room when someone is smoking. This package includes a puppet, script, activities, and posters. There is no charge for this program. 1111. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: Know Smoke. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: Know Smoke is a computer software program designed for teenagers 12 to 18 years of age. This program provides general facts and personalized information regarding an individual’s smoking habit. This program is lent free to schools and other organizations. 1112. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: Quitter’s Guide. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: This 7-day plan to stop smoking, compiled into a booklet by the American Cancer Society, is distributed to the public at no cost. For more information, see the detailed program description in Part 1. 1113. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portiand, Oregon 97201. Program Title: Speakers’ Bureau. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422, Description: Speakers and films on lung cancer, smoking, and the benefits of quitting are available to employee groups and other or- ganizations at no cost. 1114. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: Starting Free: Good Air For Me. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422, Description: The American Cancer Society’s preschool smoking preven- tion program is available. For more information, see the detailed program description in Part 1. 1115. AMERICAN CANCER SOCIETY, OREGON DIVISION, INC., 0330 Southwest Curry Street, Portland, Oregon 97201. Program Title: Tobacco Free Teens. Contact: Ms. Cathy H. Rowland, Public Education Director (503)295-6422. Description: In conjunction with the American Lung Association of Oregon, this eight-session program is offered to teenagers. Teachers and other adults are trained to conduct the program at their own locations. There is no charge for this program. 1116. AMERICAN HEART ASSOCIATION, OREGON AFFILIATE, 2121 Southwest Broadway, Portland, Oregon 97201-3146. Program Title: Save A Sweet Heart. Contact: Mr. G. Anthony Starbird, Affiliate Executive Director (503)336-2575 or (800)452-9445, Description: The American Heart Association's Save A Sweet Heart Program is offered. For more information, see the detailed program description in Part 1. 1117. AMERICAN HEART ASSOCIATION, OREGON AFFILIATE, 2121 Southwest Broadway, Portland, Oregon 97201-3146. 333 Program Title: Tobacco Free Young America. Contact: Mr. G. Anthony Starbird, Affiliate Executive Director (503)226-2575 or (800)452-9445, Description: The American Heart Association’s Tobacco Free Young America campaign is promoted. For more information, see the detailed program description in Part 1. 1118. AMERICAN LUNG ASSOCIATION OF OREGON, 319 Southwest Washington, Suite 520, Portland, Oregon 97204. Program Title: Freedom From Smoking. Contact: Jeanette Bader, M.S.W., Northern Region Director (503)224-5145, Description: The American Lung Association's Freedom From Smoking Program is offered. For more information, see the detailed program description in Part 1. 1119. AMERICAN LUNG ASSOCIATION OF OREGON, 319 Southwest Washington, Sulte 520, Portland, Oregon 97204, Program Title: Freedom From Smoking For You And Your Family. Contact: Jeanette Bader, M.S.W., Northern Region Director (503)224-5145. Description: Anewcomponentto the American Lung Association’s Smoke- Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 1120. AMERICAN LUNG ASSOCIATION OF OREGON, 319 Southwest Washington, Suite 520, Portland, Oregon 97204. Program Title: In Control. Contact: Jeanette Bader, M.S.W., Northern Region Director (503)224-5145. Description: The In Control videocassette program may be purchased or borrowed. For more information, see the detailed program description in Part 1. 1121. AMERICAN LUNG ASSOCIATION OF OREGON, 319 Southwest Washington, Suite 520, Portland, Oregon 97204. Program Title: Smoke-Free Line. Contact: Jeanette Bader, M.S.W., Northern Region Director (503)224-5145. Description: Smoke-Free Line is a 24-hour toll-free hotline for people in Oregon who are trying to stop smoking. The caller receives a recorded message that changes daily. Monday through Friday, a caller can stay on the line and talk to a counselor. The objective is to provide additional, ongoing support to people who are quitting smoking. One-week, 3-month, 6- month, and 1-year followup calls are made to those who have asked for counseling help, with their permission. 1122. GOODSAMARITAN HOSPITAL, Health Care Cen- ter, 3600 Northwest Samaritan Drive, Room 4- S26, Post Office Box 1068, Corvallis, Oregon 97339. Program Title: Stop Smoking. Contact: Ms. Janie Krieg, Hospital Coordinator and Linda R. Bryson, M.S., Smoking Consultant (503)757-5121 and 758-5139. Description: This six-session class meets twice weekly for 3 weeks. Month- ly support meetings continue for 1 year. The cost of the program is $50 and the class text, Are You Ready To Quit Smoking?, is available for $9.95. 1123. OREGON CONFERENCE OF SEVENTH-DAY ADVENTISTS, 13400 Southeast 97th Avenue, Clackamas, Oregon 97015. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Mr. Frank W. Baker, Director, Health Services (503)652-2225. Description: For a complete cutline of the Breathe-Free Plan To Stop Smoking, see the detkiled program description in Part 1. 1124. SAINT VINCENT HOSPITAL AND MEDICAL CENTER, Health and Lifestyle Center, 1885 Northwest 185th Avenue, Aloha, Oregon 97008. Program Title: Stop Smoking. Contact: Ms. Gail Harris, Health and Lifestyle Center Coordinator (503)645-4864. Description: The Health and Lifestyle Center has been offering their Stop Smoking program since 1982. The 8-week program meets twice a week for the first 4 weeks and once a week for the last 4 weeks. Participants quit smoking on the fifth class. The first four classes prepare the participants for quit day and the remaining classes reinforce the new behavior of being a non- smoker. Participants are also given a manual to follow throughout the class. Followup is conducted with participants for one year after they complete the program. PENNSYLVANIA 1125. AMERICANCANCER SOCIETY, PENNSYLVANIA 1126. AMERICAN CANCER SOCIETY, PENNSYLVANIA DIVISION, INC., Route 422 and Sipe Avenue, DIVISION, INC., Route 422 and Sipe Avenue, Hershey, Pennsylvania 17033-0897. Hershey, Pennsylvania 17033-0897. Program Title: Program Title: Breaking Free. FreshStart. Contact: Contact: Ms. Sharon H. McCool, Public Education Director (717)533-6144. Description: This cessation program for teenagers is available. For more information, see the detailed program description in Part 1. 334 Ms. Sharon H. McCool, Public Education Director (717)533-6144. Description: The American Cancer Society's FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 1127. AMERICAN CANCER SOCIETY, PENNSYLVANTA DIVISION, INC., Route 422 and Sipe Avenue, Hershey, Pennsylvania 17033-0897. Program Title: Starting Free: Good Air For Me. Contact: Ms. Sharon H. McCool, Public Education Director (717)533-6144, Description: Smoking prevention program packages for preschool children are offered. For more information, see the detailed program description in Part 1. 1128. AMERICAN CANCER SOCIETY, PHILADELPHIA DIVISION, INC., 1422 Chestnut Street, Philadelphia, Pennsylvania 19102. Program Title: FreshStart. Contact: Stephen Gambrescia, M.Ed., Coordinator (215)665-2959. Description: The American Cancer Society’s FreshStart pregram is offered. For more information, see the detailed program description in Part 1. 1129. AMERICAN CANCER SOCIETY, PHILADELPHIA DIVISION, INC., 1422 Chestnut Street, Philadelphia, Pennsylvania 19102. Program Title: FreshStart: 21 Days To Stop Smoking. Contact: Stephen Gambrescia, M.Ed., Coordinator (215)665-2959. Description: This new audio and videocassette program, based on the FreshStart program, allows quitters to chose where they quit and offers group support in the privacy of their own homes. 1130. AMERICAN CANCER SOCIETY, PHILADELPHIA DIVISION, INC., 1422 Chestnut Street, Philadelphia, Pennsyivania 19102. Program Title: Quitter’s Guide. Contact: Stephen Gambrescia, M.Ed., Coordinator (215)665-2959. Description: This self-help pamphlet is available upon request. For more information, see the detailed program description in Part 1. 335 1131. AMERICAN HEART ASSOCIATION, PENNSYL- VANIA AFFILIATE, 3700 Vartan Way, Harrisburg, Pennsylvania 17110. Program Title: Calling It Quits. Contact: Ms. B. Linda Greaver, Program Director (717)657-3383. Description: The Calling It Quits brochure, developed by the American Heart Association, is available free of charge. For more information, see the detailed program description in Part 1. 1132. AMERICAN HEART ASSOCIATION, PENNSYL- VANIA AFFILIATE, 3700 Vartan Way, Harrisburg, Pennsylvania 17110. Program Title: School Health Education. Contact: Ms. 8. Linda Greaver, Program Director (717)657-3383. Description: Smoking education programs are directed toward all school- aged children. The program includes Heart Health Education Of The Young, A Resource Guide, for teachers of kindergar- ten through grade 12, and Save A Sweet Heart, for high school Students. For more information, see the detailed program descriptions in Part 1. 1133. AMERICAN LUNG ASSOCIATION OF BERKS COUNTY, 611 Walnut Street, Post Office Box 137, Reading, Pennsylvania, 19603. Program Title: Freedom From Smoking. Contact: Ms. Deb Hannah, Program Associate (215)373-0253. Description: Freedom From Smoking programs include public and worksite clinics, consultation on policies for business, self-help manuals, and videotapes. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF BUCKS COUNTY, 272 Titus Avenue, Post Office Box 251, Warrington, Pennsylvania 18976. 1134, Program Title: Freedom From Smoking. Contact: Ms. Lynne Manley, Program Director (215)343-6420. Description: Freedom From Smoking cessation clinics and self-help manuals are available. Clinics are conducted at various sites, including workplaces and community-oriented locations. Freedom From Smoking In 20 Days and A Lifetime Of Freedom From Smoking are the two cessation and main- tenance manuals designed for use by the individuals on their own. For more information, see the detailed program descriptions in Part 1. 1135. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Breathing Easy. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: This program consists of a 30-minute 16mm color film and an accompanying teacher's guide for junior high school teachers. 1136. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Freedom From Smoking Clinics. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: The American Lung Association's Freedom From Smoking clinics are offered to the general public and to private organiza- tions. For more information, see the detailed program description in Part 1. 1137. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Freedom From Smoking For You And Your Baby. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: This 32-page manual is a self-help program designed to as- sist a pregnant woman in quitting smoking in 10 days. For more information, see the detailed program description in Part 1. 336 1138. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Freedom From Smoking For You And Your Family. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: Anewcomponentofthe American Lung Association’s Smoke- Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 1138. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: The self-help program is presented in the form of two manuals: the first manual helps a person stop smoking and the second manual helps a person stay off cigarettes. For more information, see the detailed program description in Part 1. 1140. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Hugh McCabe: The Coach’s Final Lesson. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: The American Lung Association has made "Hugh McCabe: The Coach's Final Lesson,” available for use in the com- munity. For more information, see the detailed program description in Part 1. 1141. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: In Control. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: The American Lung Association’s In Control videocassette smoking cessation program is available. The videocassette may be purchased or borrowed at no cost. For more information, see the detailed program description in Part 1. 1142. AMERICAN LUNG ASSOCIATION OF CENTRAL PENNSYLVANIA, 123 Forster Street, Post Office Box 1632, Harrisburg, Pennsylvania 17105-1632. Program Title: Marijuana: A Second Look. Contact: Ms. Kim McKeown, Program Director (717)234-5991. Description: The American Lung Association’s Marijuana: A Second Look program is available to schools and community groups. For more information, see the detailed program description in Part 1. 1143. AMERICAN LUNG ASSOCIATION OF DELAWARE/CHESTER COUNTIES, Post Office Box 1329, West Chester, Pennsylvania 19380. Program Title: Freedom From Smoking. Contact: Mr. John Garbin, Program Director (215)692-4233. Description: Corporations are encouraged to allow employee group smok- ing cessation clinics at their worksites. For more information, see the detailed program description in Part 1. 1144. AMERICAN LUNG ASSOCIATION OF LAN- CASTER COUNTY, 630 Janet Avenue, Lancaster, Pennsylvania 17601. Program Title: Freedom From Smoking. Contact: Susan J. Sink, R.N., B.S.N., Program Director (717)397-5203. Description: Group cessation clinics based on the American Lung Association's Freedom From Smoking manuals and clinic guide 2: offered through area hospital programs or directly to area companies. Consultation to companies interested in smoking control policies is provided. For more information, see the detailed program description in Part 1. 337 1145. AMERICAN LUNG ASSOCIATION OF LAN- CASTER COUNTY, 630 Janet Avenue, Lancaster, Pennsylvania 17601. Program Title: Freedom From Smoking For You And Your Baby. Contact: Susan J. Sink, R.N., B.S.N., Program Director (717)397-5203. Description: A special self-help cessation program for pregnant smokers is offered. For more information, see the detailed program description in Part 1. 1146. AMERICAN LUNG ASSOCIATION OF LAN- CASTER COUNTY, 630 Janet Avenue, Lancaster, Pennsylvania 17601. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Susan J. Sink, R.N., B.S.N.. Program Director (717)397-5203. Description: The American Lung Association's Freedom From Smoking self-help manuals are offered. For more information, see the detailed program description in Part 1. 1147. AMERICAN LUNG ASSOCIATION OF LAN- CASTER COUNTY, 630 Janet Avenue, Lancaster, Pennsylvania 17601. Program Title: School Health Education. Contact: Susan J. Sink, R.N., B.S.N., Program Director (717)397-5203. Description: Various curriculum programs designed to prevent children from beginning to smoke and emphasizing general good health are offered. AMERICAN LUNG ASSOCIATION OF LEHIGH VALLEY, Valley Federal Building, 2nd Floor, Club Avenue and Union Boulevard, Bethlehem, Pennsylvania 18018. 1148. Program Title: Freedom From Smoking Clinics. Contact: Mr. John R. Williams, Executive Director (215)867-4100. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1149. AMERICAN LUNG ASSOCIATION OF NORTH- EAST PENNSYLVANIA, Post Office Box 115, Scranton, Pennsylvania 18504. Program Title: Freedom From Smoking Clinics. Contact: Mr. Raymond Bechtel, Executive Director (717)346-1784 or (717)343-0987. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1150. AMERICAN LUNG ASSOCIATION OF NORTHWEST PENNSYLVANIA, 352 West Eighth Street, Erie, Pennsylvania 16502. Program Title: Freedom From Smoking Clinics. Contact: Joy Greco, R.N., Program Director (814)454-0109. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1151. AMERICAN LUNG ASSOCIATION OF PHILADEL- PHIA AND MONTGOMERY COUNTY, 1100 East Hector Street, Third Floor East, Sulte 360, Conshohocken, Pennsylvania 19428, Program Title: Freedom From Smoking. Contact: Ms. Amy Lupinski, Program Manager (215)735-2200. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF PHILADEL- PHIA AND MONTGOMERY COUNTY, 1100 East Hector Street, Third Floor East, Suite 360, Conshohocken, Pennsylvania 19428. 1152. Prograrn Title: School Health Education. 338 Contact: Ms. Amy Lupinski, Program Manager (215}735-2200. Description: Various curriculum programs designed to prevent children from beginning to smoke and emphasizing general good health are offered. 1153. AMERICAN LUNG ASSOCIATION OF SOUTH AL- LEGHENIES, 124 North Center Avenue, Post Office Box 247, Somerset, Pennsylvania 15501. Program Title: Freedom From Smoking Clinics. Contact: Ms. Mary Barrons, Executive Director (814)445-5747 or (814)536-7245. Description: The American Lung Association’s Freedom From Smoking Clinics are offered. For more information, see the detailed program description in Part 1. 1154. AMERICAN LUNG ASSOCIATION OF SOUTH CENTRAL PENNSYLVANIA, 488 West Market Street, Box 1125, York, Pennsylvania 17405, Program Title: Freedom From Smoking. Contact: Ms. Lisa M. Marriott, Director of Programs (717)845-3639. Description: The seven-session Freedom From Smoking clinic was designed by the American Lung Association to help smokers join with others to quit their habit. This program is offered to both the community and to local worksites. A minimum of 20 Participants is required. For more information, see the detailed program description in Part 1. 1155. AMERICAN LUNG ASSOCIATION OF SOUTH CENTRAL PENNSYLVANIA, 488 West Market Street, Box 1125, York, Pennsylvania 17405. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Ms. Lisa M. Marriott, Director of Programs (717)845-3639 . Description: The Freedom From Smoking self-help manuals are com- prehensive quit-smoking guides developed by the American Lung Association. For more information, see the detailed program description in Part 1. 1156. AMERICAN LUNG ASSOCIATION OF SOUTH CENTRAL PENNSYLVANIA, 488 West Market Street, Box 1125, York, Pennsylvania 17405. Program Title: In Control. Contact: Ms. Lisa M. Marriott, Director of Programs (717)845-3639. Description: In Control, the American Lung Association’s home video program, is available. For more information, see the detailed program description in Part 1. 1157. AMERICAN LUNG ASSOCIATION OF SOUTH CENTRAL PENNSYLVANIA, 488 West Market Street, Box 1125, York, Pennsylvania 17405. Program Title: Smoking And Pregnancy. Contact: Ms. Lisa M. Marriott, Director of Programs (717)845-3639. Description: The Smoking And Pregnancy program designed by the American Lung Association and the Freedom From Smoking For You And Your Baby package are available. For more in- formation, see the detailed program descriptions in Part 1. 1158. AMERICAN LUNG ASSOCIATION OF WESTERN PENNSYLVANIA, 2851 Bedford Avenue, Pittsburgh, Pennsylvania 15219. Program Title: A Lifetime Of Freedom From Smoking. Contact: Ms. Julie Carlin, Program Associate (412)621-0400. Description: This self-help followup manual is available for a minimal cost. For more information, see the detailed program description in Part 1. 1159. AMERICAN LUNG ASSOCIATION OF WESTERN PENNSYLVANIA, 2851 Bedford Avenue, Pittsburgh, Pennsylvania 15219. Program Title: Freedom From Smoking Clinics. Contact: Ms. Julie Carlin, Program Associate (412)621-0400. Description: ; The American Lung Association's Freedom From Smoking 339 clinics are offered to the community and to private organiza- tions. For more information, see the detailed program description in Part 1. 1160. AMERICAN LUNG ASSOCIATION OF WESTERN PENNSYLVANIA, 2851 Bedford Avenue, Pittsburgh, Pennsylvania 15219. Program Title: Freedom From Smoking In 20 Days. Contact: Ms. Julie Carlin, Program Associate (412)621-0400. Description: This self-help manual is available at minimal cost. For more information, see the detailed program description in Part 1. 1161. AMERICAN LUNG ASSOCIATION OF WESTERN PENNSYLVANIA, 2851 Bedford Avenue, Pittsburgh, Pennsylvania 15219. Program Title: In Control. Contact: Ms. Julie Carlin, Program Associate (412)621-0400. Description: The American Lung Association’s In Control smoking cessa- tion videocassette is available for loan or purchase. For more information, see the detailed program description in Part 1. 1162. AMERICAN LUNG ASSOCIATION OF WESTERN PENNSYLVANIA, 2851 Bedford Avenue, Pittsburgh, Pennsylvania 15219. Program Title: 21-Day Personal Smoking Reduction Program. Contact: Ms. Julie Carlin, Program Associate (412)621-0400. Description: The 21-day program is an exclusive, copyrighted program developed by the American Lung Association of Western Pen- nsylvania, formerly the Christmas Seal League. It features a reduction schedule tailored to each smoker's habit. A unique system of progress report cards is used throughout and even after completion of this program. The program has been re- quested by over 150,000 peopie locally and is being followed as part of a study being conducted by Carnegie-Mellon Univer- sity funded by a grant from the National Institutes of Health. The 21-Day Personal Smoking Reduction Program, complete with a Quitter’s Handbook, daily guide, personalized schedule, and progress report cards, is offered for free. 1163. BEHAVIORAL MEDICINE GROUP, INC., 355 Flowers Mili Road, Post Office Box L103, Langhorne, Pennsylvania 19047. Program Title: Stop Smoking Without Weight Gain. Contact: Program Coordinator (215)752-7111, DescrIption: In this approach to smoking cessation, smokers are believed to be inherently motivated to quit. Relapses in quitting do not indicate a lack of motivation, but the persistence of physical and psychological factors that makes quitting difficult. In an approach called Restart Prevention, these problems are ad- dressed in the foliowing four areas: weight control, withdrawal symptom control, habit control, and stress control. 1164. CHESTER COUNTY HEALTH DEPARTMENT, 326 North Walnut Street, West Chester, Pennsylvania 19380. Program Title: Babies Don't Thrive In Smoke-Filled Wombs. Contact: Ms. Susan Pizzi, Public Health Educator (215)431-6259. Description: This is one of the ten 30-minute programs delivered in the educational segment of the department’s prenatal service. The public health educator teaches, through a group process, the effects that smoking has on both the baby and mother during pregnancy as well as after delivery. Pamphlets from the American Lung Association, the U.S. Department of Health and Human Services, and the Developmental Dis- abilities Planning Council and a 6-minute slide program are also used to reinforce the teaching. Quit Smoking Kits have been developed and are used during the one-on-one counsel- ing sessions by both the public health educator and the public health nurse. 1165. ERIE COUNTY DEPARTMENT OF HEALTH, 606 West Second Street, Erie, Pennsy!vania 16507. Program Title: Health Risk Reduction Project. Contact: Ms. Janet Vogt, Public Health Educator (814)454-5811 ext.374. Description: The Northwest Pennsylvania Coalition on Smoking and Health is affiliated with the Erie County Department of Health. Recent activities and accomplishments include: 1) distribu- tion of a smoke-free kit to restaurants interested in smoke-free dining; 2) support for and promotion of the Growing Healthy comprehensive school health curriculum; 3) survey of schools to determine the status of smoking education and policies on 340 smoking for students and school employees; and 4) distribu- tion of a Model Policy For Smoking In The Workplace packet to local employers and technical assistance and advice to companies interested in developing a policy. 1166. PENNSYLVANIA DEPARTMENT OF HEALTH, Post Office Box 90, Harrisburg, Pennsylvania 17108. Program Title: Self-Help Smoking Cessation. Contact: Ms. Teresa V. Brown, Cancer Program Administrator (717)787-5251. Description: This program was designed to assist smoking mothers of pre- school children attending clinics to stop smoking. It is a cost- effective smoking cessation program that can be used by health care professionals with minimal training and little dis- ruption of clinic activities. The contractor, the Fox Chase Can- cer Center, will provide training, educational materials, and evaluation instruments to clinic sites. The program will con- tinue at the Department of Health until December 31, 1989. "Quitting Times: A Magazine For Women Who Smoke” and client tip sheets are integra! parts of the intervention. 1167. PENNSYLVANIA STATE UNIVERSITY, 1 White Building, University Park, Pennsylvania 16802. Program Title: Youth Helping Youth: A Behavioral Approach To Self-Control Of Smoking. Contact: Dr. Richard St. Pierre, Program Director (814)863-0435. Description: This program trains instructors who then train selected senior high school students to conduct a smoking cessation clinic within their school setting. Training sessions are held over a 2-week period and cover the following topics: an overview of smoking and health issues, self-control of smoking behavior, strategies and methods to increase motivation, and structure and format of clinic sessions. The cessation clinics are also conducted over a 2-week period with two weekly sessions and two optional maintenance sessions in the following 2 weeks. 1168. STUDIES ON SMOKING, INC., 125 High Street, Edinboro, Pennsylvania 16412. Program Title: SOS Stop Smoking Clinics. Contact: G. H. Miller, M.D., Director (814)734-5538. Description: The primary objective of the clinic is to attain a cure rate of 65- 75 percent at the completion of the 1-year program: The'SOS: Stop Smoking Clinics make use of lectures, films, and group and individualized counseling. The materials come from the extensive research of Studies on Smoking, the latest research on smoking and health, information and materials provided by the National health associations, and State and local smoking and health groups. The clinics have been held in Erie County, Pennsylvania, and in the State of Indiana for the Cummins En- gine Company. The clinics consist of 25 sessions over a 12- month period with a concentration of 15 sessions during the first 10 weeks. Participants are continually checked with a device that measures their carbon monoxide exhalations to determine whether they have started smoking again. In- dividualized counseling is used to maintain permanent smok- ing cessation for those having difficulties. At the end of the year each participant is checked to see that smoking cessation has been maintained. The SOS Stop Smoking Clinics include clinics for the general public, special clinics for business and industry, and personal- ized clinics for long-term smoking cessation. Recently, well- ness programs have been initiated for companies that want all smokers to become permanent former smokers in a 2- to 5- year period. This program will enable them to have a smoke- free environment before the year 2000. . 1168. UNIVERSITY OF PITTSBURGH, 5K01 Forbes Quadrangle, Pittsburgh, Pennsylvania 15260. Program Title: Maximizing Adolescent Potentiais. Contact: Carl |. Fertman, Ph.D., Executive Director (412)648-7196. Description: Maximizing Adolescent Potentials (MAPS) program focuses on the prevention of smoking, drug, and alcohol problems among youth. Programs that promote nonsmoking have been developed using concepts of enhancing coping skills and social support networks to assist children and adolescents in dealing with their concerns about smoking. All programs are school based. Teacher training is also available. 1170. WELLNESS CENTER, St. Joseph Hospital, 250 College Avenue, Lancaster, Pennsylvania 17604. Program Title: Freedom From Smoking. Contact: Ms. Romaine Sneath, Director (717)291-8148. Description: The instructor is a respiratory: therapist trained by the American Lung Association to present the Freedom From Smoking program. For more information, see the detailed program description in Part 1. PUERTO RICO 1171. ASOCIACION PUERTORIQUENA DEL 1172. MAYAGUEZ PUBLIC HEALTH UNIT, PUERTO CORAZON, Cabo Alverio 554, Hato Rey, Puerto RICO DEPARTMENT OF HEALTH, Western Rico 00918. Health Region, Box 400, Mayaguez, Puerto Rico 00709. Program Title: . Call It Quits. Program Title: Educational Program Service. Contact: Mildred A. Merced, M.Ed., Program Director (809)751-6595. Description: The American Heart Association’s Heart At Work and Heart Rx programs are available. For more information, see the detailed program description in Part 1. In addition, the As- sociation is making available for distribution to corporations and workplaces a public awareness brochure, Area de Aire Limpio, Gracias Por no Fumar (Clear Air Area, Thank You For Not Smoking). 341 Contact: Ms. Ada T. Capo de Colley, Medical Director (809)832-2162 or (809)832-5053. Description: Patients are advised of the hazards of smoking in individual education in the clinics and in group lectures to prenatal patients (mostly new mothers) and diabetics. Consuitation is based on a general knowledge of the hazards of smoking, such as the many forms of cancer, premature babies, low weight babies, coronary heart disease, premature aging, premature changes of the skin, oral decay, sinusitis, and shortened life. Each professional has acquired this informa- tion during the training for his or her profession by reading journals or attending continuing medical education courses. RHODE ISLAND 1173. AMERICAN CANCER SOCIETY, RHODE ISLAND Program Title: DIVISION, INC., 400 Main Street, Pawtucket, FreshStart. Rhode Island 02860-2996. Contact: Program Title: Alan J. Ventetuolo, M.Ed., Director of Public Education Breaking Free. Contact: Alan J. Ventetuolo, M.Ed., Director of Public Education (401)722-8480. Description: This smoking prevention/cessation program is available to area schools. For more information, see the detailed program description in Part 1. 1174. AMERICAN CANCER SOCIETY, RHODE ISLAND DIVISION, INC., 400 Main Street, Pawtucket, Rhode Island 02860-2996. Program Title: Check ft Out. Contact: Alan J. Ventetuolo, M.Ed., Director of Public Education (401)722-8480. Description: This smokeless tobacco prevention/cessation program utilizes audiovisual and accompanying educational literature. 1175. AMERICAN CANCER SOCIETY, RHODE ISLAND DIVISION, INC., 400 Main Street, Pawtucket, Rhode Island 02860-2996. Program Title: Dangers Of Smoking And Benefits Of Quitting. Contact: Alan J. Ventetuolo, M.Ed., Director of Public Education (401)722-8480. Description: This educational program addresses physical, psychological, and social problems associated with tobacco use. The im- mediate and long-term benefits of quitting smoking are dis- cussed as well as the hazardous health effects of passive smoking. Speakers, audiovisual aids, and supporting educational literature are used. 1176. AMERICAN CANCER SOCIETY, RHODE ISLAND DIVISION, INC., 400 Main Street, Pawtucket, Rhode Island 02860-2996. (401)722-8480. Description: The American Cancer Society's FreshStart smoking cessation clinic is offered. For more information, see the detailed program description in Part 1. 1177. AMERICAN CANCER SOCIETY, RHODE ISLAND DIVISION, INC., 400 Main Street, Pawtucket, Rhode Island 02860-2996. Program Title: Health Myself. Contact: Alan J. Ventetuolo, M.Ed., Director of Public Education (401)722-8480. Description: The American Cancer Society’s Health Myself program is offered to area schools. For more information, see the detailed program description in Part 1. 1178. AMERICAN CANCER SOCIETY, RHODE ISLAND DIVISION, INC., 400 Main Street, Pawtucket, Rhode Island 02860-2996. Program Title: Starting Free: Good Air For Me. Contact: Alan J. Ventetuclo, M.Ed., Director of Public Education (401)722-8480. Description: This smoking prevention program is offered to area schools. For more information, see the detailed program description in Part 1. 1179. BLUE CROSS AND BLUE SHIELD OF RHODE IS- LAND, 444 Westminster Mall, Providence, Rhode Island 02901. Program Title: In Control. Contact: Ms. Lois Gardner, Manager, Corporate Training and Development (401)272-8500. Description: A six-session program conducted by the In Control Stop Smoking Center of Cranston, Rhode Island, has been offered to all employees. The program combines a variety of techni- ques. In addition, Blue Cross and Blue Shield offers a stress management program to all employees. This four-session program includes information and activities on stress reduction, nutrition, fitness, and lifestyles. 1180. IN CONTROL STOP SMOKING CENTER, 1013 Reservoir Avenue, Cranston, Rhode Isiand 02910. Program Title: Stop Smoking Program. Contact: Ms. Gail Weisberg, Program Coordinator (401)943-6690. Description: The program consists of six 1-hour sessions (one on a Tues- day and then Monday through Friday the following week). The course includes behavior modification; Dynamic Mind Recon- ditioning, a cassette system to use at home; psychology of ad- diction; stress handling; weight control as it applies to quitting smoking; physical changes; misconceptions people have; and the biochemistry. The Center’s program is done on-site in in- dustry, insurance companies, and hospitals throughout the United States and Canada. Companies either have the Center’s staff come to their companies or are trained to per- form the program. One hundred and fifty companies are presently using this system. 1181. RHODE ISLAND GROUP HEALTH ASSOCIA- TION, 530 North Main Street, Providence, Rhode Island 02904. Program Title: Agreement to Quit. Contact: Ms. Patricia O. Blenkiron, Manager, Health Education and Health Programs (401)732-0300. Description: A contract is signed with the clinical provider by Rhode Island Group Health Association members ready to quit. They are sent information by mail and followed up by telephone for 1 month. 1182. RAHODE ISLAND GROUP HEALTH ASSOCIA- TION, 530 North Main Street, Providence, Rhode Island 02904. Program Title: Quit Smoking Workshop. Contact: Ms. Patricia O. Blenkiron, Manager, Health Education and Health Programs (401)732-0300. Description: Smokers who wish to quit meet for 6 weeks to learn about the hazards of smoking and to provide each other with group sup- port while quitting. A positive approach emphasizing the benefits of quitting is used. Other topics discussed include an individual's reasons for smoking and for quitting, the anticipated withdrawal symptoms and how to handle them, relaxation and exercise techniques, and how not to gain weight while quitting smoking. In addition to the six sessions, there are optional monthly followup sessions to check on progress and provide support and reinforcement. 1183. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Biofeedback Smoking Education Project. Contact: Mr, Claude LaBrosse, Program Coordinator (401)421-6487. Description: The American Lung Association’s Biofeedback Smoking Education Project is offered. For more information, see the detailed program description in Part 1. 1184. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Freedom From Smoking At Work. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. Description: Trained staff help companies: develop a comprehensive ap- proach to reducing smoking at the workplace. For more information, see the detailed program description in Part 1. 1185. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Freedom From Smoking Clinics. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1186. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Freedom From Smoking Self-Help. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. Description: The American Lung Association's Freedom From Smoking self-help program is offered. For more information, see the detailed program description in Part 1. 1187. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: In Control. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. Description: The American Lung Association’s In Control video program is offered. For more information, see the detailed program description in Part 1. 1188. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Lungs Are For Life. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421 -6487. Description: The American Lung Association's Lungs Are For Life program is used. For more information, see the detailed program description in Part 1. 1189. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Marijuana: A Second Look. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. 344 Description: The American Lung Association’s Marijuana: A Second Look is offered for youth. For more information, see the detailed program description in Part 1. 1190. RHODE ISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Octopuff In Kumquat. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421 -6487, Description: The American Lung Association's "Octopuff In Kumquat" film and materials are available. For more information, see the detailed program description in Part 1. 1191. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Smokers In Transition. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487. Description: Smokers In Transition is a followup maintenance group for people who have stopped smoking and are in transition to a nonsmoking lifestyle. Groups meet regularly at various locations in the State. 1192. RHODEISLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Smoking And Pregnancy. Contact: Mr. Claude LaBrosse, Program Coordinator (401}421-6487, Description: The American Lung Association's Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1193. RHODE!SLAND LUNG ASSOCIATION, 10 Abbott Park Place, Providence, Rhode Island 02903. Program Title: Tobacco-Free Young America Project. Contact: Mr. Claude LaBrosse, Program Coordinator (401)421-6487, Description: For more information about the Tobacco-Free Young America Project, see the detailed program description in Part 1. 1194. RHODE ISLAND STATE DEPARTMENT OF HEALTH, Office of Health Promotion, 75 Davis Street, Room 103, Providence, Rhode island 02908. Program Title: High School Smoking Education. Contact: . Ms. Amy L. Savastano, Program Coordinator (401)277-6957. Description: The Smoking Education program improves health knowledge and provides a positive role model for a healthful behavior change. The program consists of two classroom visits to cover the topics of physical hazards, pregnancy and smoking, smokeless tobacco, secondhand smoke, advertising, and laws conceming smoking. Materials used include a film, an Ecolyzer-carbon monoxide tester, posters, Squeezey lung demonstration, and pre- and posttesis. 1195. RHODE ISLAND STATE DEPARTMENT OF HEALTH, Office of Health Promotion, 103 Can- non Bullding, 75 Davis Street »Providence, Rhode Isiand 02908, Program Title: High School Smoking Survey. Contact: . Robert M. Cabral, Ph.D., Program Coordinator (401)277-6957. Description: The High Schoal Smoking Survey is a standardized question- naire designed to measure attitudes, knowledge, and be- havior regarding cigarette smoking. Students are questioned on family smoking behaviors, beliefs about the harmful effects of smoking, extent of usage, age of onset, and reasons they would quit. All information regarding the survey and results is confidential. Participating schools receive data analyses on their own students along with comparative summaries repre- senting all schools in the survey. Survey results provide infor- mation to school administrators for developing smoking policies, curricula, and other activities related to health education. The data also allow for trend analysis over time. 1196. AHODE ISLAND STATE DEPARTMENT OF HEALTH, Office of Health Promotion, 103 Can- non Buliding, 75 Davis Street, Providence, Rhode island 02908. Program Title: Youth Council On Smoking. Contact: Ms. Amy L. Benevides, Program Coordinator (401)277-6957. Description: The Youth Council on Smoking is a cross-age teaching program that trains high school students to discuss the hazards of smoking with elementary school children. The high school training consists of four sessions. The elementary school visits consist of two sessions in 2 consecutive weeks that include an explanation of physical and emotional hazards of smoking and a preparation of children for decision making regarding cigarettes. The materiais used include films, posters, and Squeezey lungs. SOUTH CAROLINA 1197. AMERICAN CANCER SOCIETY, SOUTH CAROLINA DIVISION, INC., 2214 Devine Street, Columbia, South Carolina 29205. Program Title: FreshStart. Contact: Ne, Cindy Cot Cothran, Senior Vice President for Education Description: The American Cancer Society's FreshStart program is offered the of charge to all participants. For more information, see © detailed program description in Part 1. 1198. AMERICAN HEART ASSOCIATION, SOUTH CAROLINA AFFILIATE, 400 Percival Road, Post Office Box 6604, Columbia, South Carolina 29260. Program Title: In Control. Contact: Ms. Mary Beth Schuitz, Program Associate (803)738-9540. Description: The American Lung Association's in Control videocassette program is available to the general public. For more information, see the detailed program description in Part 1. 1199. BRUCE HOSPITAL SYSTEM, The Fitness Forum Health and Wellness Center, 121 East Cedar Street, Florence, South Carolina, 29501. Program Title: Smokeless. Contact: Ms. Robin D. Hutchinson, Community Relations Director and Karen Kemper, M.S.P.H. (803)661-3785 and (803)661-3875. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 1200. CATAWBA PUBLIC HEALTH DISTRICT, Post Of- fice Box 817, Lancaster, South Carolina 29720. Program Title: Freedom From Smoking. Contact: Jacque Linderman, R.N., C.D.E., Program Coordinator (803)286-9948. Description: The American Lung Association's Freedom From Smoking program is offered to the general public, on an as requested basis. For more information, see the detailed program description in Part 1. 1201. CATAWBA PUBLIC HEALTH DISTRICT, Post Of- fice Box 817, Lancaster, South Carolina 29720. Program Title: FreshStart. Contact: Jacque Linderman, R.N., C.D.E., Program Coordinator (803)286-9948. Description: The American Cancer Society’s FreshStart program is offered to city employees and health department patients. For more information, see the detailed program description in Part 1. 1202. CATAWBA PUBLIC HEALTH DISTRICT, Post Of- fice Box 817, Lancaster, South Carolina 29720. Program Title: Smoker Chart Tag. Contact: Joyce B. Brown, R.N., P.N.S., Program Coordinator (803)286-9948. Description: The charts of all health department patients who smoke are tagged with red smoker labels. This is done to alert all staff members to deliver reinforcement for smoking cessation. 1203. CATAWBA PUBLIC HEALTH DISTRICT, Post Of- fice Box 817, Lancaster, South Carolina 29720. Program Title: Smoking And Pregnancy Prenatal Class. Contact: ‘ Ms. Deedy Smith, Health Educator (803)324-7521. Description: This class is taught to prenatal patients once a quarter. Patients are taught the ill effects smoking has on their own bodies as well as on their babies. The ways one can be hooked on cigarettes, approaches to quitting, and coping skills for withdrawal symptoms are discussed. For those who seek additional help, referrals are made to the FreshStart program. 1204. SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, 2600 Bull Street, Columbia, South Carolina 29201. Program Title: Cardiovascular Disease Prevention — Community-Based Intervention. Contact: Ms. Maria Whitehead, Project Director (803)734-4790. Description: The purpose of the grant is to implement and evaluate a com- munity-based cardiovascular disease risk reduction program with the hope that the model developed can be replicated with even fewer resources and disseminated in South Carolina and elsewhere. Program implementation will begin shortly in Florence using community resources and directed by a coordinating commit- tee of Florence leaders. One of the behaviors targeted for in- tervention is smoking. Since Florence is in the center of South Carolina's tobacco belt, as well as stroke and heart disease belt, the manner and enthusiasm with which smoking cessa- tion is pursued within this community will be very interesting to observe. 1205. SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, Office of Health Education, 2600 Bull Straat, Columbia, South Carolina 29201. Program Title: Carolina Healthstyle. Contact: Ms. Dorothy Maysey, Health Education Consultant (803)734-4650. Description: Carolina Healthstyle is the name given to the State employee wellness program. Carolina Healthstyle staff have been work- ing with the various wellness committees to develop smoking cessation programs and agency smoking policies. A number of agencies have provided programs to their staff and developed their own smoking policies. Carolina Healthstyle has been evaluated by administering a lengthy questionnaire that includes a variety of health knowledge, behavior, and behavioral intent questions. It has been administered to a random sample of State employees in the Columbia area. Analysis has been done on smoking from the first two administrations of the questionnaire: smoking did not decrease, but the number of cigarettes smoked by smokers did decrease. 1206. SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, 2600 Bull Street, Columbia, South Carolina 29201. Program Title: Preconception Intervention Project. Contact: Ms. Marion Clark, Health Educator Ill (803)536-9060. Description: Family planning patients are risk assessed when they come for services. They are given written materials on their risk be- haviors and steps to make changes. If they are interested in change, they are counseled by a social worker (Upper Savan- nah) or referred to a class in the community (Edisto). 1207. SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, 2600 Bull Street, Columbia, South Carolina, 29201. Program Title: Prenatal Smoking Cessation. Contact: Ms. Kelli Schroeder, Health Educator Ill, East Midlands Health District (803)734-8959. Description: When prenatals come to the Health Department for care and are identified as smokers, the health educator provides coun- seling and instruction on how to use the Richard Windsor booklet, Prenatal Smoking Cessation. Followup is done by the nursing staff. The purchase of the Windsor booklets was funded by a March of Dimes grant. 1208. SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL, Office of Health Education, 2600 Bull Street, Columbia, South Carolina 29201. Program Title: Prenatal Smoking. Contact: Ms. Sara Jo Moore, Health Educator III, Appalachia | Health District (803)225-3731. Description: Prenatals, upon entry into prenatal care, are assessed as to smoking behavior and number of cigarettes smoked. Those who smoke are targeted for specific interventions that include behavioral contracting and followup discussions at each visit. Incentives to stop smoking and cues to action are included. 1209. YORK COUNTY HEALTH DEPARTMENT, Post Office Box 3057 CRS, Rock Hill, South Carolina 29730. Program Title: FreshStart. Contact: Ms. Deedy Smith, Health Eclucator (803)324-7521. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. SOUTH DAKOTA 1210. AMERICAN CANCER SOCIETY, SOUTH DAKOTA DIVISION, INC., 1025 North Minnesota Avenues, Hillcrest Plaza, Sioux Falls, South Dakota 57104. Program Title: Smoke/Tobacco-Free Young America. Contact: Ms. Olive Rissky, Education Chairman (605)996-7286. Description: This is an ongoing public education program aimed at voca- tional educational students aged 17 to 21, to discourage teenage students from beginning to smoke or to encourage them to quit if they have already begun. Smokeless tobacco is also addressed as a health hazard. 1211. AMERICAN CANCER SOCIETY, SOUTH DAKOTA DIVISION, INC., 1025 North Minnesota Avenue, Hilicrest Plaza, Sioux Falls, South Dakota 57104. Program Title: FreshStart. Contact: Ms. Olive Rissky, Education Chairman (605)996-7286. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 1212. BLACK HILLS HEALTH AND EDUCATION CEN- TER, Post Office Box 1, Hermosa, South Dakota 57744, Program Title: Weliness Program. Contact: Mr. Klaus Irrgang, Program Coordinator (605)255-4101. Description: A residential 12-day lifestyle program with special attention given to persons who want to give up smoking, the program focuses on the whole person, including the physical, mental, social, and spiritual aspects. The benefits experienced far ex- ceed quitting smoking: nutritional habits are altered, exercise tolerance is increased, an individual exercise prescription is given, and better stress management techniques are learned. Followup is also provided. 1213. RAPID CITY REGIONAL HOSPITAL INC., 353 Fairmont Boulevard, Rapid City, South Dakota 57701. Program Title: Smokeless. Contact: Ms. Mardi Beaumont, Coordinator (605)341-1905. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 348 1214. RAPID CITY REGIONAL HOSPITAL, INC., 353 Fairmont Boulevard, Rapid City, South Dakota 57701. Program Title: Stay Well/How To Quit Smoking. Contact: Ms. Mardi Beaumont, Coordinator (605)341-1905. Description: Stay Well/How to Quit Smoking is a 7-week program using be- havior modification techniques. 1215. SOUTH DAKOTA DEPARTMENT OF HEALTH, Joe Foss Building, 523 East Capitol, Pierre, South Dakota 57501-3182. Program Title: Tobacco Initiatives. Contact: Lynne Post, M.P.H., Director, Health Education/Promotion (605)773-3361. Description: The South Dakota Department of Health, in its efforts at tobac- co program development, is a member of HEALTHNET, a Statewide coalition focused toward Smoke-Free Society by the Year 2000. The Department also acts as a resource to the community, businesses, State government, and others regarding smoke-free policy development and other issues regarding tobacco programs, such as implementation, cessa- tion, and evaluation. In fiscal year 1988, the Department will be developing a new Health Promotion Unit that will have, as part of its program agenda, a specific tobacco initiative section. 1216. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Straet, Sioux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking At Work. Contact: Mr. Robert Roby, Field Consultant (603)336-7222. Description: The American Lung Association's Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 1217. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sioux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking Clinics. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: Smoking cessation programs are available at 29 sites throughout South Dakota, using the American Lung Association's tested program. For more information, see the detailed program description in Part 1. 1218. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking Clinic Leader Training. Contact: Mr. Robert Roby, Field Consultant (603)336-7222. Description: The American Lung Association encourages staff, volunteers, and paid leaders to attend a 1-1/2-day training program for those interested in becoming clinic leaders. By the end of the training program for clinic leaders, participants will be able to: 1) clarify the role of smoking cessation clinics within the total Freedom From Smoking (FFS) program; 2) describe the theoretical/philosophical basis for the methodology used in conducting the FFS clinic; 3) identify techniques for helping in- dividuals select the smoking cessation program best suited to their needs; and 4) practice solving problems related to the behavior of FFS clinic participants. 1219. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking For You And Your Baby. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: This 32-page manual is a self-help program designed to as- sist a pregnant woman in quitting smoking in 10 days. For more information, see the detailed program description in Part 1. 1220. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sioux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking For You And Your Family. Contact: Mr. Robert Roby, Field Consultant (603)336-7222. 349 Description: As a new component to the American Lung Association's Smoke-Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 1221. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: Freedom From Smoking Self-Help Manuals. Contact: Mr. Robert Roby, Field Consultant (603)336-7222. Description: This set of two colorful guides to the quitting process includes a step-by-step approach to quitting and a guide to reinforcing and maintaining the participant's decision to quit. For more information, see the detailed program description in Part 1. 1222. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099, Program Title: Health Fairs. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: The South Dakota Lung Association participates in over 30 health fairs each year, featuring special exhibits and computer programs that lead participants through a self-test, using the Smokescreen program, and others. 1223. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: in Control. Contact: Mr. Robert Roby, Field Consultant (603)336-7222. Description: The In Control videocassette program is offered. For more information, see the detailed program description in Part 1. 1224. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sioux Falls, South Dakota 57102- 1099, Program Title: Marijuana: A Second Look. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: The American Lung Association's Marijuana: A Second Look program is offered. For more information, see the detailed program description in Part 1. 1225. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: Recess And Time Out. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: This is a children’s health newspaper, distributed four times a year to all children in South Dakota in grades 3 through 6. Fea- ture articles emphasize good health and wise health choices. 1226. SOUTH DAKOTA LUNG ASSOCIATION, 208 East 13th Street, Sloux Falls, South Dakota 57102- 1099. Program Title: Smokescreen. Contact: Mr. Robert Roby, Field Consultant (603)366-7222. Description: The South Dakota Lung Association has computerized smok- ing education programs for students in grades 7 through 12, developed by the American Lung Association of Minnesota and the Minnesota Educational Computing Consortium. Smokescreen is comprehensive. There are six programs on one disk and graphics are used. Students can compute the exact cost of smoking, discover each brand’s carbon monoxide content, and learn about marijuana. Smokescreen can be used in the classroom, smoking cessation clinics, patient education classes, and at health fairs. Equipment re- quired is an Apple computer (11.11 + 11¢), disk drive, and color or black-and-white monitor. TENNESSEE 1227. AMERICAN CANCER SOCIETY, TENNESSEE DIVISION, INC., 1315 Eighth Avenue South, Nashville, Tennessee 37203. Program Title: Why Quit Quiz. Contact: Mr. Jim Carrigan, Director of Public Education (615)255-1ACS. Description: The American Cancer Society’s Why Quit Quiz is used. For more information, see the detailed program description in Part 1, 1228. AMERICAN CANCER SOCIETY, TENNESSEE DIVISION, INC., 1315 Elghth Avenue South, Nashville, Tennessee 37203. Program Title: FreshStart. Contact: Mr. Jim Carrigan, Director of Public Education (615)255-1ACS. Description: The American Cancer Society’s FreshStart program is 350 available as requested. For more information, see the detailed program description in Part 1. 1229. AMERICAN LUNG ASSOCIATION OF TEN- NESSEE, 1717 West End Avenue, Suite 201, Post Office Box 399, Nashville, Tennessee 37202. Program Title: Freedom From Smoking Manuals. Contact: Mr. William F. Busse, Executive Director (615)329-1151. Description: The program is presented in the form of two manuals: Freedom From Smoking In 20 Days, helps a person stop smoking and the second, A Lifetime Of Freedom From Smok- ing, helps a person stay off cigarettes. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF TEN- NESSEE, 1717 West End Avenue, Suite 201, Post Office Box 399, Nashville, Tennessee 37202. 1230. Program Title: Smoking And Pregnancy. Contact: Mr. William F. Busse, Executive Director (615)329-1151, Description: The American Lung Association's Srnoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1231. AMERICAN LUNG ASSOCIATION OF TEN- NESSEE, 1717 West End Avenue, Suite 201, Post Office Box 399, Nashville, Tennessee 37202. Program Title: Freedom From Smoking Clinics. Contact: Mr. William F. Busse, Executive Director (615)329-1151. Description: The American Lung Association’s group cessation clinics are offered. Community-based programs are held periodically in each region or they may be available through a local health care facility or at a worksite. For more information, see the detailed program description in Part 1. 1232. AMERICAN LUNG ASSOCIATION OF TEN- NESSEE, 1717 West End Avenue, Suite 201 , Post Office Box 399, Nashville, Tennessee 37202. Program Title: Freedom From Smoking At Work. Contact: Mr. William F. Busse, Executive Director (615)329-1151. Description: The American Lung Association’s worksite cessation and policy development program is offered. For more information, see the detailed program description in Part 1. 1233. AMERICAN LUNG ASSOCIATION OF TEN- NESSEE, 1717 West End Avenue, Suite 201, Post Office Box 399, Nashville, Tennessea 37202. Program Title: Smoking Prevention. Contact: Mr. William F. Busse, Executive Director (615)329-1151. Description: The American Lung Association of Tennessee disseminates to the schools and other community organizations facts relevant to the dangers of starting to smoke and urges children to maintain good health habits. The Association promotes, in elementary schools, the Growing Healthy comprehensive health curriculum, which emphasizes the need for good health habits and increases the knowledge of the harm that can come 361 to a person who smokes. For more information, see the detailed program description in Part 1. The Association also assists in promoting Jegislation to curb smoking in public places. 1234. CARTER-UNICOI-JOHNSON HEALTH DISTRICT, TENNESSEE DEPARTMENT OF HEALTH AND ENVIRONMENT, Post Office Box 788, Holston and G Street, Elizabethton, Tennessee 37643. Program Title: Tobacco Use Prevention Program. Contact: Mr. Terry Henson, School Health Educator (615)543-2521. Description: The Tobacco Use Prevention Program is a week-long, 5-hour program presented to all grade-5 students in the Carter Coun- ty School System. Students learn the risks and effects of tobacco use, including the correlation between tobacco use and cardiorespiratory diseases and cancers. The program in- cludes student workbooks — Using Tobacco, Is It For Me; a variety of audiovisual aids such as books, pamphlets, slides, posters, films, anatomical models, and laboratory smokers; role playing, games and demonstrations, lectures, group dis- cussions, and question and answer sessions. Surveys given before the program and at the end of the school year assess changes in students’ attitudes and behavior. 1235. CHATTANOOGA-HAMILTON COUNTY HEALTH DEPARTMENT, 921 East Third Street, Chattanooga, Tennessee 37403-2165. Program Title: Freedom From Smoking. Contact: William D. Ulmer, M.A., Chairman, Health Promotion and Wellness. (615)757-2065. Description: The American Lung Association's Freedom From Smoking program is offered a minimum of three times per year to the general community and employees of area businesses. For more information, see the detailed program description in Part 1. 1236. CHATTANOOGA-HAMILTON COUNTY HEALTH DEPARTMENT, 921 East Third Street, Chattanooga, Tennessee 37403-2165. Program Title: Living Smokelessly. Contact: William D. Ulmer, M.A., Chairman, Health Promotion and Wellness (615)757-2065. Description: A minimum of three 1-hour programs is presented quarterly to college students, high school students, community/civic groups, and high-risk minority groups. The program consists of general presentations and focuses on awareness, the dis- tribution of educational materials, and the identification of area resources and referrals. 1237. CHATTANOOGA-HAMILTON COUNTY HEALTH DEPARTMENT, 921 East Third Street, Chattanooga, Tennessee 37403-2165. Program Title: Smokeless Tobacco. Contact: William D. Ulmer, M.A., Chairman, Health Promotion and Wellness (615)757-2065. Description: For the Tennessee Department of Health and Environment, the Chattanooga-Hamilton County health department provides a program on smokeless tobacco to students in grades 5 and 6 in the town of Sale Creek. The program begins with a pretest questionnaire on smoking, tobacco products and new State and National tobacco laws. A 1-hour lecture is given for 4 consecutive days. The materials used include word search worksheets, posters, and pamphlets, voluntary posters, and homeroom door decorating inspired by a contest. This program receives local media coverage. 1238. CLARKSVILLE-MONTGOMERY COUNTY HEALTH DEPARTMENT, Box 1026, Clarksville, Tennessee 37040. Program Title: Smoking Cessation. Contact: Ms. Elaine Horn, Health Promotion (615)645-9016. Description: The Smoking Cessation Program is offered three times year- ly and when requested. The program is available to hospital employees, prenatals, industries, and any interested groups from the community. The program’s objectives are immediate cessation or reduction in smoking and maintenance of cessa- tion. Lectures, films, pamphlets, worksheets, displays, and homework assignments are all utilized. 1239. EAST TENNESSEE REGIONAL HEALTH OFFICE, Post Office Box 59019, Knoxville, Tennessee 3795-9019. Program Title: Smoking Cessation Courses. 352 Contact: Ms. Kay Burtnett, Health Promotion Coordinator and Ms. Teresa Garren, School Health Educator (615)546-9221. Description: High school students who smoke, dip, or chew tobacco products on school grounds are offered smoking cessation courses as an alternative to detention. The students attend five classes either before or after school taught by the School Health Educator. 1240. EASTTENNESSEE REGIONAL HEALTH OFFICE, Post Office Box 59019, Knoxville, Tennessee 3795-9019. Program Title: Smokeless Tobacco Education. Contact: Ms. Kay Burtnett, Health Promotion Coordinator and Ms. Teresa Garren, School Health Educator (615)546-9221. Description: There are three lessons on the dangers of smokeless tobac- co products presented to students in grades 6 through 8. The program provides education for both intervention and cessation. 1241. FIRST TENNESSEE REGIONAL HEALTH OF- FICE, 1233 Southwest Avenue Extension, Johnson City, Tennessee 37605-2966. Program Title: Freedom From Smoking Clinics. Contact: Ms. Lesa L. Dotson, Director, Health Promotion (615)929-5900. Description: The American Lung Association's Freedom From Smoking clinics are made available to worksites and the community upon request. For more information, see the detailed program description in Part 1. 1242. FIRST TENNESSEE REGIONAL HEALTH OF- FICE, 1233 Southwest Avenue Extension, Johnson City, Tennessee 37605-2966. Program Title: Smoking Policy Survey. Contact: Ms. Dallas Jones, Public Health Educator Ill (615)928-7125. Description: A telephone survey is being conducted by health educators at the Washington County Health Department. The goal is to contact all area businesses and industries to ascertain worksite policies on smoking and to gauge interest in provid- ing smoking cessation programming. Surveys will be tabu- lated upon completion and a report submitted to the Medical Director of the Washington County Health Department and the Health Promotion Director of the First Tennessee Regional Health Office. 1243. FIRST TENNESSEE REGIONAL HEALTH OF- FICE, 1233 Southwest Avenue Extension, Johnson City, Tennessee 37601-6519. Program Title: Using Tobacco: Is it For Me? Contact: Ms. Terry Henson, Public Health Educator il, Carter County and Ms. Tina Wilson, Public Health Educator Il, Hawkins County (615)543-2521 and (615)272-7641. Description: A teaching unit is offered 1 hour each day for 5 days to all grade-5 students in the Carter County, Rogersville City, and Hawkins County school systems. The main focus of this program is to diminish the problem of adolescent tobacco use through preventive educational Strategies and techniques that will help increase knowledge and awareness of the risk fac- tors. The program specifically addresses the health effects of tobacco usage and the decision-making process. Tobacco products that are discussed include cigarettes, cigars, pipe tobacco, chewing tobacco, and snuff. The overall gcal of this Program is to enable the student to make responsible, informed decisions regarding his or her own health. 1244. HCA REGIONAL HOSPITAL OF JACKSON, 49 Old Hickory Boulevard East, Jackson, Tennessee 38305. Program Title: HCA Smoking Cessation Program. Contact: Ms. Deborah Mills, Director of Education (901)668-2100. Description: The HCA Smoking Cessation Program utilizes a systematic series of copyrighted procedures that effectively neutralize the desire for tobacco. It is a total lifestyle approach to smoking cessation that consists of behavior modification, stress management, coping skills, and weight control. It addresses cigarette smoking from psychological, physiological, sociological, and behavioral perspectives. 1245. HOLSTON VALLEY HOSPITAL AND MEDICAL CENTER, Post Office Box 238, Kingsport, Tennessee 37662. 353 Program Title: The Effects Of Smoking On The Respiratory System. Contact: Ms. Penny Hensley, Respiratory Nurse (615)246-3322. Description: At the request of his or her physician, an inpatient views a synchronized slide-tape presentation on the hazards of smok- Ing, the reasons why people choose to smoke, and the ways in which a person can kick the habit. The smoker is encouraged to kick the nicotine habit in order to become a healthier person. Along with the slide-tape presentation, the program contains a pre- and posttest, a list of objectives, a fact sheet, and a glossary. Although this module was designed for use as a patient education program, it may also be used with community groups interested in a short-term stop-smoking program. 1246. HOLSTON VALLEY HOSPITAL AND MEDICAL CENTER, Post Office Box 238, West Ravine Street, Kingsport, Tennessee 37662. Program Title: Stop Smoking Program. Contact: Mr. Marty Runyan, Health Educator, Department of Education (615)229-7779. Description: Six structured educational sessions conducted by a group leader expedite the cessation process by providing under- Standing of the hazards of smoking and of the reasons why a particular individual chooses to smoke. Once these factors are understood, a methodology of quitting is taught, and a spirit of group support emerges. At the completion of the program, participants are able to list three diseases that have a direct relationship to cigarette smoking, evaluate personal baseline pulmonary functions, and identify resources that provide ongoing support for those who have stopped smok- ing. The program uses various pamphlets and materials sup- plied by the American Cancer Society, the American Heart Association, and the American Lung Association. In addition, two films about smoking are shown. A followup evaluation is made to determine the percentage of participants who have stopped smoking or have reduced the number of cigarettes that they smoke. 1247. NORTHWEST REGIONAL OFFICE, TENNESSEE DEPARTMENT OF HEALTH AND ENVIRON- MENT, Post Office Box 190, 1010 Mount Zion Road, Union City, Tennessee 38261. Program Title: Clearing The Air. Contact: Sammie S. Walker, R.N., Health Promotion Coordinator (901)885-7700. Description: A workshop in strategies and resources for smoking cessa- tion is offered to health care providers and representatives from local industry interested in health promotion and smok- ing cessation. 1248. NORTHWEST REGIONAL OFFICE, TENNESSEE DEPARTMENT OF HEALTH AND EDUCATION, Post Office Box 190, 1010 Mount Zion Road, Union City, Tennessee 38261. Program Title: Smoking Prevention Program. Contact: Sammie S. Walker, R.N., Health Promotion Coordinator (901)855-7700. Description: For the Tennessee Department of Health and Environment, the Northwest Regional Office provides a smoking prevention program to students in grades 5 through 8 in Carroll County. The program consists of a 15-minute lecture on smokeless tobacco and a 40-minute videotape on smokeless tobacco. In addition, a questionnaire is given on usage of smokeless tobacco to be used as baseline data for health education. 1249. SOUTH CENTRAL REGION, TENNESSEE DEPARTMENT OF HEALTH AND ENVIRON- MENT, Health Promotion Section, 100 Ninth Avenue North, Nashville, Tennessee 37219-5405. Program Title: Smokeless Tobacco. Contact: Ms. Mary Lee Johnson, Health Promotion Coordinator (615)741.7300. Description: In the South Central Region, there are two counties that main- tain a smokeless tobacco program. Lewis County Elementary School gives this program to the grade 4 and 5 classes, while the schools in Marshall County provide it only to the grade 5 students. For both counties the program is the same. It begins with a pretest to assess the students’ knowledge of smokeless tobacco and then there are weekly 1-hour classes for the 6 subsequent weeks. Visual aids such as Mr. Gross Mouth, Smokey Sue, and a videotape called Smokeless Tobacco: The Real Truth are used. The program also con- sists of a lecture on self-esteem and a final posttest to deter- mine how much the students have learned about smokeless tobacco. 1250. SOUTHEAST REGIONAL OFFICE, TENNESSEE DEPARTMENT OF HEALTH AND ENVIRON- MENT, 2501 Miine Avenue, Chattanooga, Tennessee 37406-3399. Program Title: Freedom From Smoking. 354 Contact: Sharlinda S. Turner, M.D., Director (615)624-9921. Description: The American Lung Association’s Freedom From Smoking Program is offered to the general community, upon demand, in all 10 of the counties the Regional Office serves. its availability is advertised in news releases and worksite well- ness programs. For more information, see the detailed program description in Part 1. 1251. TENNESSEE DEPARTMENT OF HEALTH AND ENVIRONMENT, Health Promotion Section, 100 Ninth Avenue North, Nashville, Tennessee 37219-5405. Program Title: Activities To Prornote Nonsmoking. Contact: Ms. Connie Pearson, Worksite Wellness Director (615)741-7366. Description: The State of Tennessee continues to place emphasis on reducing the use of tobacco products through its school health, health promotion, prenatal, and adult wellness programs. In December 1986, a Statewide educational cam- paign designed to increase the public's awareness of the risks associated with the use of smokeless tobacco was launched. In March 1987, summary data of the Teen Wellness Check Research Project revealed that a higher percentage of teen males in Tennessee used smokeless tobacco (23 percent) than smoked (19 percent). Timely school health projects, plac- ing emphasis on the use of smokeless tobacco, had already begun in 5 of Tennessee’s 13 public health regions. The Health Promotion Section continues to offer smoking cessa- tion classes in several regional health offices in conjunction with its Adult Wellness Program. 1252. TENNESSEE DEPARTMENT OF HEALTH AND ENVIRONMENT, Health Promotion Section, 100 Ninth Avenue North, Nashville, Tennessee 37219-5405. Program Title: intensified Nutrition Education For Women, Infants, And Children Prenatals. Contact: Ms. Moiselle Peay, Nutrition Education Coordinator (615)741-7218. Description: The Tennessee Department of Health and Environment program, Women, infants, and Children (WIC) has imple- mented a pilot nutrition education project designed to deter- mine the effect of intensified versus standard current Tennessee WIC nutrition education on WIC prenatal clients in four Tennessee counties. One desired resutt of this program is an increase in the percentage of women in the test groups who quit smoking and/or decrease smoking. Currently 43 per- cent of the women in the four counties in east Tennessee smoke. To make counseling as consistent as possible and to provide general topical guidelines, five instructional modules were developed for this project in conjunction with east Ten- nessee nutritionists. One of these modules instructs on the effects of smoking on unborn babies and the need for smok- ing cessation. Counselors will provide smoking cessation counseling using the American Lung Association (ALA) smok- ing cessation package, ALA flip chart, and Your Health is in Your Hands, a health department flyer. 1253. UPPER CUMBERLAND REGIONAL OFFICE, TENNESSEE DEPARTMENT OF HEALTH AND ENVIRONMENT, Health Promotion Section, 100 Ninth Avenue North, Nashville, Tennessee 37219-5405. Program Title: Smokeless Tobacco. Contact: Ms. Nina Whitfield, Health Promotion (615)528-7531. Description: The Upper Cumberland Region sponsors a Smokeless Tobacco program for grade-6 students at Fox Elementary School in Red Boiling Springs (Macon County). The program begins with a pretest and two lectures about smokeless tobac- co and its effects. The lectures are supported by handouts, discussions on the consequences of using tobacco, a posttest, and the following films: “Don't Take The Risk," "The Haunted Mouth," and "Check It Out." 1254. TENNESSEE DEPARTMENT OF HEALTH AND ENVIRONMENT, Health Promotion Section, 100 Ninth Avenue North, Nashville, Tennessee 37219-5405. Program Title: Smoking Cessation Classes. Contact: Ms. Beverly Bitterman, Acting Director, Employee Health Service (615)741-7366. Description: The Employee Health Service (EHS) offers smoking cessa- tion classes four times a year to State employees. State employees are permitted, according to the Department of Per- sonnel, to use work time to attend class twice a week for 3 weeks. Each class lasts 2 hours. The EHS uses a group structure and followup classes are available upon request. Class participants choose when and how often they want to return for motivation. Course content includes a variety of Strategies modified from the American Lung Association’s Guide For Clinic Leaders — Freedom From Smoking. The EHS program differs because of the inclusion of a com- puterized health risk appraisal, which is a graphic display cal- culating the effect that cigarette smoking and other health risk behaviors have on overall health age. Other strategies used in the EHS program include the use of films, nutritionists, and fitness specialists as guest speakers, and everyone’s favorite treat — all the ice water with lemon they can drink. A heavy emphasis is placed on the use of behavioral change contracts. These written commitments that identify outcome behavior are secured during the first meeting but may be changed at any time. TEXAS 1255. AMERICAN CANCER SOCIETY, TEXAS DIVISION, INC., 2433 Ridgepoint Drive-A, Post Office Box 9863, Austin, Texas 78766. Program Title: FreshStart. Contact: Mr. James Morgan, Associate Vice President for Programs (512)928-2262. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 355 1256. AMERICAN CANCER SOCIETY, TEXAS DIVISION, INC., 2433 Ridgepoint Drive-A, Post Office Box 9863, Austin, Texas 78766. Program Title: School Smoking Prevention. Contact: Mr. James Morgan, Associate Vice President for Programs (512)928-2262. Description: Smoking prevention programs are sponsored for preschool through high school students. Free kits are provided to the schools and each year in November the Great American Smokeout is held. 1257. AMERICAN HEART ASSOCIATION, Post Office Box 15186, Austin, Texas 78761. Program Title: In Control. Contact: Ms. Amy Martin, Program Assistant (512)836-7220. Description: The American Lung Association videocassette, In Control, is available for loan or purchase through this American Heart Association office. For more information, see the detailed program description in Part 1. 1258. AMERICAN HEART ASSOCIATION, Post Office Box 15186, Austin, Texas 78761. Program Title: Save A Sweet Heart. Contact: Ms. Amy Martin, Program Assistant (512)836-7220. Description: The Save A Sweet Heart program of the American Heart Association is offered free to junior and senior high school stu- dents and is run by the students themselves. For more information, see the detailed program description in Part 1. 1259. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central I, 7616 LBJ Freeway, Suite 100, Dallas, Texas 75251. Program Title: Freedom From Smoking. Contact: Ms. Janis Reich, Program Director (214)239-LUNG. Description: The American Lung Association’s Freedom From Smoking program is used as well as the In Control videocassette. For more information, see the detailed program descriptions in Part 1. 1260. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central I, 7616 LBJ Freeway, Suite 100, Dallas, Texas 75251. Program Title: Freedom From Smoking At Work And Public Places. Contact: Ms. Janis Reich, Program Director (214)239-LUNG. Description: Literature, audiovisuals, and consultation are available for employers, employees, and concerned citizens wanting to develop policies to create smoke-free environments in the workplace or in public places. 1261. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central |, 7616 LBJ Freeway, Sulte 100, Dallas, Texas 75251. Program Title: Lungs Are For Life. Contact: Ms. Janis Reich, Program Director (214)239-LUNG. Description: This program is composed of four health curriculum modules for students in kindergarten and grades 1 through 4. For more information, see the detailed program description in Part 1. 1262. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central I, 7616 LBJ Freeway, Sulte 100, Dallas, Texas 75251. Program Title: Marijuana: A Second Look. Contact: Ms. Janis Reich, Program Director (214)239-LUNG. Description: The American Lung Association’s Marijuana: A Second Look education program is offered. For more information, see the detailed program description in Part 1. 1263. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central I, 7616 LBJ Freeway, Suite 100, Dallas, Texas 75251. Program Title: Smoking And Pregnancy. Contact: Ms. Carolyn Rousseau, Program Associate (214)239-LUNG. Description: The American Lung Association's Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1264. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central !, 7616 LBJ Freeway, Suite 100, Dallas, Texas 75251. 356 Program Title: Smoking Deserves A Smart Answer. Contact: Ms. Janis Reich, Program Director {214)239-LUNG. Description: The American Lung Association’s Smoking Deserves A Smart Answer program is offered. For more information, see the detailed program description in Part 1. 1265. AMERICAN LUNG ASSOCIATION, DALLAS AREA, Park Central |, 7616 LBJ Freeway, Suite 100, Dallas, Texas 75251. Program Title: Students Teaching About Risks Smoking. Contact: Ms. Carolyn Rousseau, Program Associate (214)239-LUNG. Description: Students Teachings About Risks Smoking (STARS) is a peer- teaching program in which Association staff or volunteers train high school students to teach students in grades 5 and 6 about the health hazards of smoking. 1266. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Suite G-100, Austin, Texas 78731-1698. Program Title: Death In The West. Contact: Ms. Jana Jahns, Program Administrator (800)252-LUNG. Description: "Death In The West" is a documentary distributed in connec- tion with the California Nonsmokers’ Rights Foundation. it contrasts the advertising images with the reality of American cowboys dying from cigarette-related diseases. The 5-day curriculum plan is suitable for elementary and junior high students. 1267. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Sulte G-100, Austin, Texas 78731-1698, Program Title: Freedom From Smoking. Contact: Ms. Jana Jahns, Program Administrator (800)252-LUNG. Description: ; The American Lung Association’s Freedom From Smoking 357 clinics are offered. For mora information, see the detailed program description in Part 1. 1268. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Suite G-1 00, Austin, Texas 78731-1698. Program Title: Marijuana: A Second Look. Contact: Ms. Jana Jahns, Program Administrator (800)252-LUNG. Description: The American Lung Association's Marijuana: A Second Look program is offered. For more information, see the detailed program description in Part 1. 1269. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Suite G-100, Austin, Texas 78731-1698. Program Title: Second-Hand Smoke. Contact: Ms. Jana Jahns, Program Administrator (800)252-LUNG. Description: This 5-day curriculum for upper elementary, junior, and senior high students supplements the viewing of the Second-Hand Smoke videotape. The curriculum is designed to allow stu- dents to explore the impact of tobacco advertising, the need to protect nonsmokers, and the skills necessary to deal individually with secondhand smoke exposure. 1270. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Sulte G-100, Austin, Texas 78731-1698, Program Title: Smoking And Pregnancy. Contact: Ms. Jana Jahns, Program Adrninistrator (800)252-LUNG., Description: The American Lung Association’s Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1271. AMERICAN LUNG ASSOCIATION OF TEXAS, 3520 Executive Center Drive, Suite G-100, Austin, Texas 78731-1698. Program Title: Smoking Deserves A Smart Answer. Contact: Ms. Jana Jahns, Program Administrator (800)252-LUNG. Description: The American Lung Association's Smoking Deserves A Smart Answer program is offered. For more information, see the detailed program description in Part 1. 1272. AMERICAN LUNG ASSOCIATION, SAN JACINTO AREA, 777 Post Oak Boulevard, Sulte 222, Houston, Texas 77056. Program Title: Freedom From Smoking At Work. Contact: Ms. Ross Bannister, Program Administrator — Smoking or Health (713)963-9935. Description: The American Lung Association’s Freedom From Smoking At Work program is offered. For more information, see the detailed program description in Part 1. 1273. AMERICAN LUNG ASSOCIATION, SAN JACINTO AREA, 777 Post Oak Boulevard, Suite 222, Houston, Texas 77056. Program Title: Freedom From Smoking Clinics. Contact: Mr. Ross Bannister, Program Administrator (713)963-9935. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1274. AMERICAN LUNG ASSOCIATION, SAN JACINTO AREA, 777 Post Oak Boulevard, Suite 222, Houston, Texas 77056. Program Title: Freedom From Smoking For You And Your Baby. Contact: Mr. Ross Bannister, Program Administrator (713)963-9935. Description: This 32-page manual is a self-help program designed to as- sist a pregnant woman in quitting smoking in 10 days. For more information, see the detailed program description in Part 1. 358 1275. AMERICAN LUNG ASSOCIATION, SAN JACINTO AREA, 777 Post Oak Boulevard, Suite 222, Houston, Texas 77056. Program Title: Freedom From Smoking Manuals. Contact: Mr. Ross Bannister, Program Administrator (713)963-9935. Description: This program includes two manuals that enable a motivated smoker to successfully quit smoking. For more information, see the detailed program description in Part 1. 1276. CITY OF HOUSTON HEALTH AND HUMAN SER- VICES, 1115 North MacGregor, Houston, Texas 77030-1797. Program Title: FreshStart. Contact: Inez C. Manning, Dr.N., Health Educator Coordinator (713)794-9158. Description: The American Cancer Society's FreshStart program is offered to Health and Human Services employees, as requested. For more information, see the detailed program description in Part 1. 1277. GRAYSON COUNTY HEALTH DEPARTMENT, 515 North Walnut, Sherman, Texas 75090. Program Title: The Wellness Program. Contact: Ms. Carol Fulenwider, Program Coordinator (214)465-2878. Description: The Wellness Program is a multifaceted adult health effort. Three full- time employees provide daily services. The Well- ness Clinic includes a questionnaire that identifies smokers and thus provides a foundation for counseling and referral. Counseling is supported by printed material from the American Cancer Society, the National Cancer Institute, the American Lung Association, the Texas Department of Health, and others. The referrals are made to local programs and to the participant's personal physician. Wellness Outreach/Health Promotion activities are frequently planned to meet special community needs. Past efforts have included Stop Smoking classes at the Health Department. Now classes are cosponsored with local colleges, community education programs, the American Cancer Society, the American Lung Association, and others. 1278. HUGULEY MEMORIAL HOSPITAL, 11801 South Freeway, Post Office Box 6337, Fort Worth, Texas 76115. Program Title: Breathe-Free Plan To Stop Smoking. Contact: Manager of Health Education (817)551-1771. Description: The program is offered as part of the hospital’s Help Yourself To Life community health education seminar series. For more information about the Seventh-Day Adventist Breathe-Free fh To Stop Smoking, see the detailed program description in Part 1. 1279. LAREDO-WEBB COUNTY HEALTH DEPART- MENT, Post Office Box 2337, Laredo, Texas 78044-2337. Program Title: Buena Vida Lifestyle Program. Contact: Carmen Seibert, M.A., Chief, Health Promotion Director (512)723-2402. Description: The Laredo-Webb County Health Department began planning a health promotion program for the prevention of chronic dis- eases during the late 1970s. To deal with smoking, the depart- ment continually maintains a media campaign geared toward educating the public of the dangers of smoking and smoking cessation techniques. Smoking cessation clinics are also of- fered at various sites throughout the city. The FreshStart program of the American Cancer Society is used as a founda- tion. These clinics last 3 weeks and meet three times a week for a total of nine sessions. They are offered on a monthly basis. For more information, see the detailed program description in Part 1. 1280. METHODIST HOSPITAL, SID W. RICHARDSON INSTITUTE FOR PREVENTIVE MEDICINE, 6565 Fanin M.S. S400, Houston, Texas 77030. Program Title: Stop Smoking. Contact: Dr. William Myerson, Program Coordinator (713)790-6450. Description: The program is designed to help participants gradually stop smoking with a minimum of withdrawal symptoms and without weight gain. The goal of the program is complete smoking abstinence for a lifetime. The program uses nonaversive be- havior modification techniques. During the withdrawal phase, Nicorette gum (a prescription substitute) is available to help alleviate the discomfort associated with tobacco withdrawal. 359 An ecolyzer is used to analyze carbon monoxide levels. Fol- lowing the initial withdrawal phase, the program focuses on long-term success by teaching participants techniques to avoid relapses. Classes are 1 1/2 hours long and meet week- ly for 8 weeks. Lifetime followup sessions are available at no charge. 1281. PRESBYTERIAN HOSPITAL OF DALLAS, FIN- LEY EWING CARDIOVASCULAR AND FITNESS CENTER, 5721 Phoenix Drive, Dallas, Texas 75231. Program Title: Smokeless. Contact: Ms. Teresa Weber, Program Coordinator (214)696-7074. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup ser- vices are provided. 1282. TEXAS DEPARTMENT OF HEALTH, OFFICE OF SMOKING AND HEALTH, 1100 West 49th Street, Austin, Texas 78756-3199. Program Title: Tobacco Information Clearinghouse. Contact: Ron Todd, M.S.Ed., Coordinator (512)458-7111 or (800)345-8647. Description: The department's objectives are: 1) to help prevent young people from using tobacco products; 2) to assist smokers who want to quit; and 3) to promote clean indoor air in Texas. The Tobacco Information Clearinghouse of the Office of Smoking and Health was established to coordinate these information and education activities. The Tobacco Information Clearing- house has three objectives: first, to establish a Statewide clearinghouse for tobacco information: second, to provide technical assistance to worksites and communities in the development of smoking policies, programs, and ordinances; and, third, to carry out a series of promotional initiatives to publicize the availability of programs, information, and sup- port. To achieve these goals, the Directory of Smoking Resources and Contacts in Texas was published in 1986. In addition, staff are trained to respond to requests for informa- tion, to research and maintain the directory of the current programs, and to handle referrals to cessation and interven- tion programs. Training for cessation facilitators is also provided. The department has developed an information pack- age for establishing local ordinances that restrict smoking in public places and for implementing worksite smoking policies. Development is under way for health fair and professional meeting exhibits, a tobacco information guide for teachers of grades 5 and 6, and extensive contact with community or- ganizations to enlist their support. An information package on smokeless tobacco for dentists and articles for the public in related newsletters and other publications will be circulated. UTAH 1283. AMERICAN CANCER SOCIETY, UTAH DIVISION, 610 East South Temple Street, Salt Lake City, Utah 84102. Program Title: FreshStart. Contact: Ms. Clara Glasker, Program Coordinator (801)322-0431. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 1284. AMERICAN LUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Double Plus Program. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: This modification of the Freedom From Smoking self-help method provides for a group of individuals to organize a group effort to quit. Preparation, clarification, motivation, and the buddy system are added through group meetings. Prior to this, individuals go through their own Freedom From Smoking In 20 Days program. 1285. AMERICANLUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Freedom From Smoking Clinics. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: The American Lung Association’s Freedom From Smoking clinics are offered. Corporations are encouraged to allow group smoking cessation clinics at their worksites for employees. For more information, see the detailed program description in Part 1. 1286. AMERICAN LUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. 360 Program Title: Freedom From Smoking For You And Your Baby. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: The American Lung Association self-help manual is offered to pregnant women. For more information, see the detailed program description in Part 1. 1287. AMERICAN LUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Freedom From Smoking For You And Your Family. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: As a new component to the American Lung Association's Smoke-Free Family campaign, this 54-page manual assists smokers in kicking the habit. For more information, see the detailed program description in Part 1. 1288. AMERICANLUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Freedom From Smoking in 20 Days. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: The American Lung Association’s Freedom From Smoking In 20 Days self-help manual is offered. For more information, see the detailed program description in Part 1. 1289. AMERICANLUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Hypnosis Cessation Clinics. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: This is a group hypnosis program conducted in one 2-hour session. During the first hour, smoking habits, previous at- tempts at quitting, and reasons for quitting are discussed. During the second hour, the hypnotist helps reinforce positive images of a nonsmoker that assist the smoker in kicking the habit. A cassette tape is given so that individuals are provided with a daily followup. 1280. AMERICAN LUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Lungs Are For Life. Contact: Mr. Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: The American Lung Assocation’s Lungs Are For Life program is offered. For more information, see the detailed program description in Part 1. 1291. AMERICANLUNG ASSOCIATION OF UTAH, 1930 South 1100 East, Salt Lake City, Utah 84106. Program Title: Marijuana: A Second Look. Contact: Mr, Ed Grudzinski, Smoking Program Coordinator (801)484-4456. Description: The American Lung Association's Marijuana: A Second Look program is offered. For more information, see the detailed program description in Part 1. 1292. UTAH DEPARTMENT OF HEALTH, DIVISION OF COMMUNITY HEALTH SERVICES, 288 North 1460 West, Post Office Box 16660, Salt Lake City, Utah 84116-0660. Program Title: Tobacco-Free Utah. Contact: Ms. Christine Chalkley, Coordinator (801)538-6120. Description: The Surgeon General has issued a challenge for a Smoke- Free Society by the Year 2000. Considering this goal, recent legislation was passed in Utah to raise the cigarette excise tax from 12 cents a pack to 23 cents a pack. A portion of the revenue is now being dispersed to local health departments to pursue the goal of Tobacco-Free Utah. During Fiscal Year 1988, the Tobacco-Free program staff will: 1) offer smoking and smokeless tobacco cessation programs to junior and senior high school students; 2) provide tobacco education in- service training to teachers attending kindergarten through 361 grade 12 workshops; 3) collect tobacco use prevalence data among adolescent and adults; 4) provide smoking cessation services to pregnant women attending Women, Infant, and Children clinics; 5) promote and enforce the Utah Indoor Clean Air Act in conjunction with environmental health personnel: and, 6) coordinate with local school districts to develop a long- term plan for tobacco-free schools. 1293. UTAH DEPARTMENT OF HEALTH, DIVISION OF COMMUNITY HEALTH SERVICES, 288 North 1460 West, Post Office Box 16660, Salt Lake City, Utah 84116-0660. Program Title: Tobacco Risk Reduction Program. Contact: Ms. Christine Chalkley, Coordinator (801)538-6120. Description: As part of a mandatory Statewide kindergarten through grade 12 tobacco, alcohol, and drug program, teachers are provided information and teaching strategies on the traditional long- term consequences of smoking and, most important, the im- mediate consequences that are believed to be highly salient to young people. In addition, skills relevant to decision making and resisting peer pressure are emphasized. 12984. UTAH DEPARTMENT OF HEALTH, DIVISION OF COMMUNITY HEALTH SERVICES, 288 North 1460 West, Post Office Box 16660, Salt Lake City, Utah 84116-0660. Program Title: Utah Coalition On Smoking And Health. Contact: Ms. Christine Chalkley, Coordinator (801)538-6120. Description: The Utah Coalition on Smoking and Health (UCSH) is an or- ganization of Utahns interested in the promotion of tobacco education. Established in 1984 to foster the development of effective public smoking policies in Utah and to provide cur- rent information to the public concerning the adverse health affects and economic impact of tobacco use, the UCSH has been instrumental in successfully advocating the passage of such legislation as requiring warning labels on smokeless tobacco products sold in Utah, prohibiting the sale of clove cigarettes in Utah, and strengthening the Utah Clean Indoor Air Act, which requires public and private workplaces to provide for the “heaith, safety, welfare, comfort, and environ- ment of nonsmokers.” UTAH DEPARTMENT OF HEALTH, DIVISION OF COMMUNITY HEALTH SERVICES, 288 North 1460 West, Post Office Box 16660, Salt Lake City, Utah 84116-0660. 1295. Program Title: Utah Clean Indoor Air Act. Contact: Ms. Christine Chalkley, Coordinator (801)538-6120. Description: With the passage of a strengthened version of the Utah Clean Indoor Air Act, which restricts smoking in public places, the Tobacco Risk Reduction Program staff has been providing Smoking Policy Packets to businesses Statewide. The educational materials include a copy of the law, rules and regulations, sample smoking policies, smoking cessation resources, and numerous workplace smoking articles. In ad- dition, staff offers policy development consuitation upon re- quest and publishes a yearly Smoking OR Health newsletter for Utah businesses. VERMONT 1296. AMERICAN CANCER SOCIETY, VERMONT DIVISION, INC., 13 Loomis Street, Drawer C, Montpelier, Vermont 05602. Program Title: FreshStart. Contact: Ms. Nancy Zorn, Program Director (802)223-2348. Description: The American Cancer Society's FreshStart program is offered periodically throughout the year. For more information, see the detailed program description in Part 1. 1297. AMERICAN HEART ASSOCIATION, VERMONT AFFILIATE, 1929 Shelburne Road, Post Office Box 130, Shelburne, Vermont 05482. Program Title: Heart At Work. Contact: Mr. James Gears, Program Director (802)985-8048. Description: Heart At Work is a health awareness program designed to educate and promote the adoption of heart healthy behaviors. For more information, see the detailed program description in Part 1. 1298. AMERICAN HEART ASSOCIATION, VERMONT AFFILIATE, 1929 Shelburne Road, Post Office Box 130, Shelburne, Vermont 05482. Program Title: Heart Health Education For The Young. Contact: Mr. James Gears, Program Director (802)985-8048. Description: The Heart Health Education For The Young program 362 designed to educate students about cardiovascular disease and its prevention through adoption of a healthy lifestyle. For more information, see the detailed program description in Part 1. 1299. AMERICAN HEART ASSOCIATION, VERMONT AFFILIATE, 1929 Shelburne Road, Post Office Box 130, Shelburne, Vermont 05482. Program Title: Public Health Education. Contact: Mr. James Gears, Program Director (802)985-8048. Description: The American Heart Association's Public Health Education program consists of numerous materials designed to educate the public on cardiovascular disease and risk factors modifica- tions. In the area of smoking, materials such as films, pamphlets, and posters are available to educate as well as assist individuals in smoking cessation. 1300. VERMONT DEPARTMENT OF HEALTH, 1193 North Avenue, Post Office Box 70, Burlington, Vermont 05402. Program Title: Heart Healthy Vermonter. Contact: Ms. Deborah Owen Dameron, Health Promotion Specialist (802)863-7611. Description: The Heart Healthy Vermonter program is a community-based effort to reduce the rate of heart disease by focusing on the three major risk factors of smoking, high blood pressure, and high serum cholesterol. The goals of the smoking component are to reduce the incidence of smoking among Vermonters, to reduce the number of public places and worksites that do not have smoking policies, and to create an atmosphere in Ver- mont that encourages nonsmoking as the normal behavior. The strategies used to achieve these goais include an annual Quit And Win Contest, assisting employers with the implemen- tation of smoking policies, and Surveying restaurants to deter- mine what percentage of them have no-smoking sections. Also, educational pamphiets and materials are sent to physicians to encourage them to counsel their patients to quit smoking. All Heart Healthy Vermonter projects offer at least one group smoking cessation class each year and offer individuals self-help materials to help them quit smoking. 1301. VERMONT LUNG ASSOCIATION, WINSTON L. PROUTY CENTER, 30 Farrell Street, South Burlington, Vermont 05403. Program Title: Biofeedback Smoking Education Program. Contact: Ms. Janet R. Francis, Program Director (802)863-6817. Description: The Biofeedback Smoking Education Program utilizes four pieces of electronic equipment to demonstrate the immediate harmtul health effects of smoking. For more information, see the detailed program description in Part 1. 1302. VERMONT LUNG ASSOCIATION, WINSTON L. PROUTY CENTER, 30 Farrell Street, South Burlington, Vermont 05403. Program Title: Freedom From Smoking. Contact: Ms. Janet R. Francis, Program Director (802)863-6817. Description: The Freedom From Smoking program is offered at this loca- tion on an ongoing basis and is open to the public. For more information, see the detailed program description in Part 1. 1303. VERMONT LUNG ASSOCIATION, WINSTON L. PROUTY CENTER, 30 Farrell Street, South Burlington, Vermont 05403. Program Title: Freedom From Smoking Clinics. Contact: Ms. Janet R. Francis, Program Director (802)863-6817. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For mora information, see the detailed program description in Part 1. 1304. THE WELLNESS CENTER, NORTH COUNTRY HOSPITAL, Prouty Drive, Newport, Vermont 05855. Program Title: FreshStart. Contact: Ms. Merrilyn Barry, Manager (802)334-5566. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 1305. THE WELLNESS CENTER, NORTH COUNTRY HOSPITAL, Prouty Drive, Newport, Vermont 05855. Program Title: Heart Healthy Vermonter. Contact: Ms. Merrityn Barry, Manager (802)334-5566. Description: Through this project loca! restaurants are encouraged to provide nonsmoking sections and worksites are encouraged to develop smoking policies. Talks are given in local elemen- tary schools and high schools that encourage children not to Start smoking and help them resist the peer pressure. A Quit And Win contest is held annually for both adults and teens. Support groups for new nonsmokers are organized when there is a need. VIRGIN ISLANDS 1306. AMERICAN LUNG ASSOCIATION OF THE VIR- GIN ISLANDS, Post Office Box 974, St. Thomas, Virgin Isiands 00801. Program Title: Freedom From Smoking In 20 Days. Contact: Ms. May Amritt Villa, Secretary (809)776-5998. Description: ; The American Lung Association's Freedom From Smoking In 20 Days self-help manual is offered. For more information, see the detailed program description in Part 1. 1307. AMERICAN LUNG ASSOCIATION OF THE VIR- GIN ISLANDS, Post Office Box 974, St. Thomas, Virgin islands 00801. Program Title: In Control. Contact: Ms. May Amrit Villa, Secretary (809)776-5998. Description: The American Lung Association's in Control videocassette program is offered. For more information, see the detailed program description in Part 1. 1308. AMERICAN LUNG ASSOCIATION OF THE VIR- GIN ISLANDS, Post Office Box 974, St. Thomas, Virgin Islands 00801. Program Title: Quit Smoking Clinics. Contact: Ms. May Amrit Villa, Secretary (809)776-5998. Description: Participants work with members to learn skills and strategies to enable them to quit smoking without gaining weight, to main- tain abstinence, and more. A minimal fee is charged to all par- ticipants in order to cover material costs and instructor's salary. The American Lung Association also carries public ser- vice announcements regarding prevention and secondhand smoke and meets with schools and other groups as requested. VIRGINIA 1309. ALEXANDRIA HOSPITAL, 4320 Seminary Road, 1311. ALLEGHANY COUNTY —- COVINGTON HEALTH Alexandria, Virginia 22304. DEPARTMENT, 321 Beech Street, Post Office Box 747, Covington, Virginia 24426. Pa fo Title: Program Title: , Freedom From Smoking Clinics. Contact: Contact: Ms. Jacqueline Baird, Director, The Wellness Center (703)379-3494. Description: This is a behavior modification program that decreases the participant’s desire to smoke and teaches positive substitution. 1310. ALLEGHANY COUNTY - COVINGTON HEALTH DEPARTMENT, 321 Beech Street, Post Office Box 747, Covington, Virginia 24426. Program Title: Dangers Of Smoking. Contact: Ms. Karen Metzler, Health Educator (703)962-2173. Description: This 1-hour program is offered on request. The objective is to educate school-age children on the dangers of smoking. Videos ("Live or Die" of Perennial Education, "Hugh McCabe: The Coach's Final Lesson” of the American Lung Association) and discussion comprise the program. Evaluation involves surveying the number of students smoking at the time of presentation to the number smoking at a later date. 364 Ms. Karen Metzler, Health Educator (703)962-2173. Description: The American Lung Association's Freedom From Smoking clinics are offered to businesses and other organizations upon request. For more information, see the detailed program description in Part 1. 1312. ALLEGHANY COUNTY — COVINGTON HEALTH DEPARTMENT, 321 Beech Street, Post Office Box 747, Covington, Virginia 24426. Program Title: Smoking Cessation Methods. Contact: Ms. Karen Metzler, Health Educator (703}962-2173. Description: This 30-minute to 1-hour program is offered on request to busi- nesses and other organizations. The objectives of the program are to educate persons interested in quitting smok- ing as to the various self-help and group programs available for smoking cessation and to assist persons in choosing an appropriate method. Various self-help and group programs are described and participants have the opportunity to examine materials and ask questions. 1313. AMERICAN CANCER SOCIETY, VIRGINIA DIVISION, INC., 4240 Park Place, Post Office Box 1547, Glen Alien, Virginia 23060. Program Title: FreshStart. Contact: Mr. Jim Poppell, Executive Vice President (804)270-01 42 or (800)552-7996. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 1314. AMERICAN HEART ASSOCIATION, VIRGINIA AFFILIATE, 4217 Park Place Court, Glen Allen, Virginia 23060-3315. Program Title: Heart At Work. Contact: Ms. Joan Miller, Director of Work Site Programs (804)747-8334. Description: The American Heart Association's Heart At Work program is available to worksites at no cost. Supplemental materials for distribution are available at a nominal fee. For more informa- tion, see the detailed program description in Part 1. 1315. AMERICAN HEART ASSOCIATION, VIRGINIA AFFILIATE, 4217 Park Place Court, Glen Allen, Virginia 23060-3315. Program Title: Heart Rx. Contact: Ms. Joan Miller, Director of Work Site Programs (804)747-8334. Description: The American Heart Association's Heart Rx program is avail- able to physicians and other health care providers in Virginia for $30. Supplemental materials are available at a nominal fee. For more information, see the detailed program description in Part 1. 1316. AMERICAN LUNG ASSOCIATION OF NORTH- ERN VIRGINIA, 9735 Main Street, Fairfax, Virginia 22031. Program Title: Alternative To Suspension Smoking Program. 365 Contact: Ms. Toni Brown, Associate Managing Director (703)591-1431. Description: Instead of being automatically suspended from school for 3 days, high school students caught smoking in unauthorized areas of the school attend three after-school sessions offer- ing information on the health consequences of smoking. The goal of the program is to create among these students a greater awareness of the consequences of smoking that may serve later as a motivating factor to caase smoking. Discus- sions about their attitudes concerning smoking, development of the smoking habit, and methods to quit smoking also are conducted. Films, self-tests, specimens of human lung tissue, demonstrations, and lectures are included in the program. The program is led by teachers who have been trained by the Staff of the American Lung Association of Northern Virginia and is available to all schools in Arlington, Fairfax, Fauquier, King George, Loudoun, Prince William, and Stafford Counties as well as the cities of Alexandria and Fredericksburg. Evaluation is limited to pre- and postknowledge tests. 1317. AMERICAN LUNG ASSOCIATION OF NORTH- ERN VIRGINIA, 9735 Main Street, Fairfax, Virginia 22031. Program Title: In-School Presentations. Contact: Ms. Toni Brown, Associate Managing Director (703)591-4131. Description: A wide range of materials and programs is offered for use in the schools, in an effort to educate students about the hazards of and alternatives to smoking. Different programs have been created for kindergarten through grades 3, 4 through 5, 6 through 8, 7 through 12 and 9 through 12, based on popular films about smoking. In-service training for teachers and other school professionals is also available. Printed materials and audiovisual materials are available free of charge either for distrioution or on a loan basis as appropriate. 1318. AMERICAN LUNG ASSOCIATION OF NORTH- ERN VIRGINIA, 9735 Main Street, Fairfax, Virginia 22031. Program Title: Smoking At The Workplace Program. Contact: Ms. Toni Brown, Associate Managing Director {703)591-4131. Description: American Lung Association of Northern Virginia (ALANV) of- fers a wide range of services to help companies create a heal- thier, more productive work environment. After specific needs and characteristics of the company are assessed, ALANV provides consultation in smoking policy development, management update presentations, employee awareness programs, and worksite stop-smoking clinics. Literature is available on the health effects of secondhand smoke, the economic impact of smoking at the workplace, management guidelines for smoking policy development, and employee guidelines for establishing smoke-free areas in the workplace. 1319. AMERICAN LUNG ASSOCIATION OF NORTH- ERN VIRGINIA, 9735 Main Street, Fairfax, Virginia 22031. Program Title: Speakers’ Bureau. Contact: Ms. Toni Brown, Associate Managing Director (703)591-4131. Description: One of four presentations available on request concerns the effects of cigarette smoking on the lungs and how to quit smok- ing. The program is intended to teach the hazards of smok- ing. A staff member or a volunteer conducts the session. Brochures and films or other audiovisual materials are used. 1320. AMERICAN LUNG ASSOCIATION OF NORTH- ERN VIRGINIA, 9735 Main Street, Fairfax, Virginia 22031. Program Title: Stop Smoking Clinic. Contact: Ms. Toni Brown, Associate Managing Director (703)591-4131. Description: Each session of the Stop Smoking Clinic provides both educa- tion and group interaction in an effort to help the participants stop smoking cigarettes. The educational aspects are presented through lectures, films, and demonstrations. Small group sessions offer participants the opportunity to discuss and resolve their cigarette smoking problems with the expec- tation that quitting will be easier with group support. Success- ful graduates and other ex-smokers offer their experiences and guidance through these small group discussions. Each clinic covers a 2-week period with two sessions held each week. Success rates are evaluated at the program’s end and again at 1 year. 1321. AMERICAN LUNG ASSOCIATION OF VIRGINIA, RICHMOND REGION, Post Office Box 7065, Richmond, Virginia 23221. Program Title: No Butts About It: Smoking Cessation For Teens. 366 Contact: Ms. Sarah K. Stacy, Director of Program (804)355-3295. Description: This six-session program is based on the successful behavior modification techniques used in the American Lung Association’s Freedom From Smoking Clinic. The program is designed to relate to teenagers on their level and to help them realize that it is easier to quit smoking now than it will be in 10 or 20 years. The target audience is high school students. The objectives of the program are to increase the knowledge base of adolescents with regard to smoking initiation and con- tinuance and to teach adolescents specific skills that will help them stop smoking. The program also includes a session on the influence of tobacco advertising on young people. An evaluation component is included. Teachers and other staff members can be trained to conduct the program by associa- tion staff members. There is no charge for the training or the program. 1322. CENTRAL VIRGINIA HEALTH DISTRICT, LYNCHBURG HEALTH DEPARTMENT, 1900 Thomson Drive, Post Office Box 6056, Lynchburg, Virginia 24505-6056. Program Title: Be A Winner. Contact: Joanna H. Harris, M.D., Director (804)528-6777. Description: Be A Winner is a stop smoking program for pregnant women who are eligible for health department services. i was developed as a joint venture between the Lynchburg Health Department and the American Lung Association of Virginia. The 8-week program recognizes a particular need to motivate the participants to quit smoking as it raises participants’ aware- ness of effects of smoking during and after pregnancy. Key components of the Be A Winner program include providing child care and transportation for the participants, as well as attendance and quitting rewards. 1323. EASTERN HENRICO COUNTY HEALTH DEPARTMENT, 3810 Nine-Mile Road, Richmond, Virginia 23223. Program Title: Freedom From Smoking. Contact: Edith Mooney, R.N., Public Health Nurse (804)222-4213, Description: The American Lung Association's Freedom From Smoking program is offered annually. For more information, see the detailed program description in Part 1. 1324. JOHNSTON-WILLIS HOSPITAL, 1401 Johnston- Willls Drive, Richmond, Virginia 23235. Program Title: Smoking Cessation. Contact: Vivian Biggers, R.N., M.S.N., Director of Educational Resources (804)320-2900 ext. 171. Description: Individualized patient and family instruction on smoking ces- sation is provided. Patients directed by their physicians to stop smoking are visited by a staff nurse for assessment and instruction. A film is shown and a pamphlet offering tips on smoking cessation is provided. Instruction is individualized and may include the effects of smoking on the patient’s health, recognition and modification of habits that stimulate the desire for cigarettes, suggestions for alternative activities, family and social support, and direction to community stop-smoking clinics. A community smoking cessation program, the American Lung Association’s Freedom From Smoking program, is held twice a year. 1325. MOUNT ROGERS HEALTH DISTRICT, Post Office Box 348, Marion, Virginia 24354, Program Title: Worksite Wellness Project. Contact: Mr. Jim Meadows, Health Educator (703)783-81 88. Description: The American Cancer Society's FreshStart program is offered both to employees at the worksite in industries, agencies, and school systems and to interested civic groups. Other activities include dissemination of literature and audiovisual aids. For more information, see the detailed program description in Part 1. 1326. RADFORD COMMUNITY HOSPITAL, 8th and Randolph Streets, Radford, Virginia 24141. Program Title: Smokeless. Contact: Lynda Hartson, R.N., Health Educator (703)731-2644. Description: The Smokeless system, developed by the American Institute for Preventive Medicine, is a highly structured, multifaceted smoking cessation program. Participants learn systematic techniques to prevent the urge to smoke and to eliminate crav- ings that may develop. Cessation booklets and followup services are provided. 367 1327. ROANOKE COUNTY/VINTON HEALTH DEPART- MENT, Post Office Box 307, Vinton, Virginia 24179. Program Title: Smokeless Tobacco: Is It Really Safe? Contact: Linda Huffman, R.N. (703)983-7804. Description: This 20-minute presentation is available to health classes in junior and senior high schools and on request to any other groups. The objective of the program is to increase awareness of the manipulation of advertising and the harmful effects of using smokeless tobacco, stressing that it is not a safe alter- native to smoking. Audiovisual and handout materials reinforce the program’s objectives. 1328. SOUTHSIDE HEALTH DISTRICT, HALIFAX COUNTY HEALTH DEPARTMENT, South Baston, Virginia 24592. Program Title: Freedom From Smoking Clinic. Contact: Mr. Seymour Barnes, District Health Educator (804}572-2986. Description: The Health Department is collaborating with the American Lung Association of Virginia and the Halifax/South Boston Community Hospital to offer the American Lung Association's Freedom From Smoking clinic. For more information, see the detailed program description in Part 1. 1329. VIRGINIA DEPARTMENT OF HEALTH, James Madison Bullding, 109 Governor Street, Richmond, Virginia 23219. Program Title: Heart Health Education For The Young. Contact: Ms. Judy Turner, Curriculum Specialist (703)998-2160. Description: The American Heart Association's Heart Health Education For The Young program was set up on a school-by-school basis in Alexandria. For more information, see the detailed program description in Part 1. 1330. VIRGINIA DEPARTMENT OF HEALTH, James Madison Bullding, 109 Governor Street, Richmond, Virginia 23219. Program Title: Students Teaching Students. Contact: Sister Catherine Dever, Assistar:t Diractor (804)787-7373. Description: The Virginia Department of Health offers the American Lung Association’s Students Teaching Students smoking preven- tion program in conjunction with the Eastern Shore Rural Health System, Inc. For more information, see the detailed program description in Part 1. 1331. VIRGINIA DEPARTMENT OF HEALTH, AL- LEGHANY HEALTH DISTRICT AND SOUTH- WEST REGIONAL OFFICE, James Madison Building, 109 Governor Street, Richmond, Virginia 23219, Program Title: Adolescent Smoking Awareness Frograin. Contact: Nancy Harvey, R.N., M.S.N., Nurse Practitioner B, and Carolyn Green, M.Ed., Regional Health Educator (703)982-7411. Description: This program is targeted at students in schools that have in- stituted a no smoking policy. It demonstrates to adolescents the immediate physiological impact of smoking just one cigarette. Adolescents who smoke learn to monitor their pulse rate, test for hard steadiness, and monitor their skin tempera- ture to show the effects of their habit. Nonsmoking as well as smoking adolescents participate in a class discussion that focuses on the physiological effects of smoke and decision- making skills to maintain or achieve a nonsmoking lifestyle. 1332. VIRGINIA STATE DEPARTMENT OF HEALTH, HAMPTON HEALTH DEPARTMENT, James Madison Bulliding, 109 Governor Street, Richmond, Virginia 23219. Program Title: Looking Ahead. Contact: Linda Erdman, R.N., Maternal and Child Health Coordinator (804)728-0700. Description: A four-session program on pregnancy and infant mortality risks is conducted. The program emphasizes the effects of smoking during pregnancy and a smoking cessation program is conducted for interested smokers. 1333. VIRGINIA DEPARTMENT OF HEALTH, ROANOKE VALLEY COUNCIL OF COMMUNITY SERVICES, James Madison Building, 109 Governor Street, Richmond, Virginia 23219. Program Title: Alive And Weil -- Risk Reduction. Contact: Mr. Fraser Nelson, Director of Community Health Education (703)985-0131. Description: As part of a larger program to stimulate collaborative use of available community resource in health promotion, the Alive And Well program is a week-long celebration of health and wellness that includes a program on coping with secondhand smoke and pulmonary function screenings. WASHINGTON 1334. AMERICAN CANCER SOCIETY, WASHINGTON DIVISION, INC., 2120 First Avenue North, Seattle, Washington 98109. Program Title: FreshStart. Contact: Mr. Dave Harrelson, Adult Education Coordinator (206)283-1152. Description: The American Cancer Society's FreshStart program is offered. For more informztion, see the detailed program description in Part 1. 368 1335. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: Freedom From Smoking Clinic. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: The American Lung Association's Freedom From Smoking clinic is available for $35. For more information, see the detailed program description in Part 1. 1336. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: Freedom From Smoking Manuals. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: The American Lung Association's Freedom From Smoking self-help manuals are available. For more information, see the detailed program descriptions in Part 1. 1337. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: In Control. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: The American Lung Association's In Control videocassette smoking cessation program is available. A program manual is also included. For more information, see the detailed program description in Part 1. 1338. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: Quit Kits. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: This free quit smoking kit includes helpful hints and strategies for success, learning why one smokes, and discovering coping skills for tough situations. A guide to smoking cessa- tion methods, rules for healthy lungs, and buttons are available. 1339. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: School Health Education. Contact: Ms. Margo Harris, Program Manager (206)441-5100. 369 Description: This program is provided by the American Lung Association of Washington staff and trained volunteers. School talks are presented to students in kindergarten through grade 12. Lungs Are For Lite health teaching modules are used in elementary grades. Smoking Deserves A Smart Answer, a prevention curriculum, is used with grades 5 and6. The health effects of smcking and cigarette advertising, especially counter advertising, are stressed in junior and senior high school. 1440. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2525 Third Avenue, Seattle, Washington 98121. Program Title: Smoking And Pregnancy. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: The American Lung Association's Smoking And Pregnancy program is offered. For more information, see the detailed program description in Part 1. 1441. AMERICAN LUNG ASSOCIATION OF WASHINGTON, 2625 Third Avenue, Seattle, Washington 98121. Program Title: Smoking In The Workplace. Contact: Ms. Margo Harris, Program Manager (206)441-5100. Description: Working actively toward the goal of a Smoke-Free Society in the Year 2000, the American Lung Association of Washington works closely with area businesses to establish smoking policies in the workplace setting. The American Lung Association of Washington staff provide workplace seminars, present informational talks to businesses, and serve on com- pany committees providing consultation services. BREMERTON-KITSAP COUNTY HEALTH DEPARTMENT, 109 Austin Drive, Bremerton, Washington 98312. 1442. Program Title: You And Me Tobacco Free. Contact: Ms. Meg Hagemann, Health Educator (206)478-5235. Description: . This organization assists in the coordination of community ef- forts in the arena cf tabscco-free education. Department staff act as consultants for individuals and groups seeking to become tobacco-free by providing information (pamphlets, videos, self tests) and referral to a variety of tobacco cessa- tion programs in their areas. A major focus is on the five school districts within the county. In addition, there are infor- mational brochures and displays in the three health clinics. Staff in the Maternal and Child Health and Family Planning programs provide tobacco-free information and referral to clients on a one-to-one basis and work jointly with the regional American Cancer Society to facilitate community participation in the annual Great American Smokeout. All tobacco products, including smokeless tobacco are emphasized. Finally, the department participates in a number of health fairs throughout the county and provides display boards and pamphlets relating to the dangers of tobacco use and how to kick the habit. 1443. GROUP HEALTH OF SPOKANE, West 1500 Fourth Avenue, Spokane, Washington 99204. Program Title: Free And Clear. Contact: Mr. Torney Smith, Member Education Manager (509)838-7992. Description: Free And Clear is a highly structured 5-day program in which the skills necessary to achieve permanent abstinence from smoking are learned. The system is based on the philosophy that quitting is easier when one knows how to do it. Techni- ques for preventing and eliminating urges to smoke are taught. This systematic approach allows quitting smoking while mini- mizing the problems of weight gain and irritability. The program begins with a free introductory meeting during which the procedures are explained in detail. The actual treatment program begins 1 week later, with four consecutive daily ses- sions of 1-1/2 to 2 hours each. A complete packet of tools and materials is included for the basic program cost. Once com- pleted, the program can be repeated free of charge for mem- bers who have a completior. certificate and return with their packet of materials. 1444. SACRED HEART MEDICAL CENTER, 101 West Eighth Avenue, Spokane, Washington 99204. Program Title: | Am Joe's Lung. Contact: Pam White, S.P., Coordinator, Media and Workshop Services (509)455-3390. Description: See an inside view of an average lung under normal condi- tions and learn why smog, dust, and smoke can take your breath away. 1445. SACRED HEART MEDICAL CENTER, 101 West Eighth Avenue, Spokane, Washington 99204. 370 Program Title: Let's Call It Quits. Contact: Pam White, S.P., Coordinator, Media and Workshop Services (509)455-3390. Description: In this 27-minute program, broadcast twice a month to patients at the medical center, Tom Bosley humorously portrays a man’s attempt to stop smoking. 1446. SACRED HEART MEDICAL CENTER, 101 West Eighth Avenue, Spokane, Washington 99204. Program Title: Smoking: How To Stop. Contact: Pam White, S.P., Coordinator, Media and Workshop Services (509)455-3390. Description: This broadcast program follows a typical smoker as she gradually reduces the number of cigarettes she smokes until she stops. 1447. SAINT PETER HOSPITAL, 413 North Lilly Road Olympia, Washington 98506. Program Title: FreshStart. Contact: Ms. Dorothy Tenkhoff, Health Promotion (206)456-7246. Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 1448. SAINT PETER HOSPITAL, 413 North Lilly Road, Olympia, Washington 98506. Program Title: Smoke Stoppers. Contact: Ms. Dorothy Tenkhoff, Health Promotion (206)456-7246. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase I! provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and main- tenance system. 1449. SEATTLE-KING COUNTY DEPARTMENT OF PUBLIC HEALTH, 110 Prefontaine Place South, Suite 600, Seattle, Washington 98104. Program Title: Controlling Smoking. Contact: Mr. Benjamin Leifer, Public Health Educator (206)587-2798. Description: This health department program has four major areas of ac- tivity. The first major activity is smoking cessation classes for employees of King County and the city of Seattle. Classes are facilitated by a public health educator and occupational health nurse and are based onthe American Cancer Society's FreshStart Program, with the addition of six sessions, for a total of 10 classes over approximately 3 months. The second area of activity regards worksite smoking policy development for the local government. Health department staff developed a worksite smoking policy that applies to the 5,000 employees of King County and participated in the Seattle City Council sponsored committee to develop a policy for the city’s 10,000 employees. Third, cancer risk reduction for health department patients is emphasized. Staff work with health care providers to include smoking and other cancer risk factors in history- taking as a basis for education, referral, and followup. Lastly, the department provides general community education includ- ing television and radio public service announcements and collaboration with local voluntary health agencies on smoking education events. 1450. TACOMA-PIERCE COUNTY HEALTH DEPART- MENT, 3629 South D Street, Tacoma, Washington 98408-6897. Program Title: Heart Disease Prevention. Contact: Ms. Nancy Cherry, Director, Family and Community Health Services (206)591 -6485. Description: As part of the Cardiovascular Risk Reduction screening program, an individual employee's smoking history is docu- mented and referral to smoking cessation resource is provided. Worksite consultation and assistance in becoming smoke-free are offered. 1451. WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES, OB-39, Olympia, Washington 98504. Program Title: FreshStart. Contact: Mr. Leslie F. James, Director of Administrative Support (206)753-2630. 371 Description: The American Cancer Society's FreshStart program is offered. For more information, see the detailed program description in Part 1. 1452. WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES, DIVISION OF HEALTH, ET- 24, Olympia, Washington 98504. Program Title: Getting Started In Health Education. Contact: Mr. James M. Glick, Jr., Health Service Administrator (206)753-5909. Description: These programs are funded through the Division of Health, Department of Social and Health Services, and are offered quarterly both on and off carnpus through State colleges and universities. Resources and training materials related to health are offered from many agencies. A health education curriculum with emphasis on smoking/smokeless tobacco usage geared to each teacher's level of teacher responsibility has to be developed before course credit is given. Evening classes are offered one night a week for 12 weeks and run 3 hours each evening. On-campus classes are usually offered through summer school and a 1-week course usually runs 7 hours a day, while a 2-week course is usually 4 hours per day. 1453. WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES, Health information/Policy Development Section, ET-24, Olympia, Washington 98504. Program Title: Washington Wellness Coordinators. Contact: Mr. Jimmy Sectore and Mr. James Glick Jr., Health Services Administrator (206)753-5310 and (206)753-5909. Description: This is a group of employees from all walks of life whose su- pervisors have appointed them to sit in with the other coor- dinators to represent their departments. The main function of the group in the beginning was to compare and catalog various health promotion activities that were going on not only within State government, but also in City governments, County governments, local health departments, school districts, and through volunteer agencies. Since that time, the Washington State Legislature has enacted a bill that targets all 71,000 State employees within the State for a health wellness program. The program will be administered by the Depart- ment of Personnel, and the Washington Wellness Coor- dinators will be serving as an advisory group to provide input to the coordinators for the wellness program. Most programs currently being offered through the State agencies emphasize smoking cessation. WEST VIRGINIA 1454. AMERICAN CANCER SOCIETY, WEST VIRGINIA DIVISION, INC., 2428 Kanawha Boulevard East, Charleston, West Virginia 25311. Program Title: FreshStart. Contact: Mr. Alan Mills, Director of Public Education (304)344-3611. Description: The American Cancer Society’s FreshStart program is offered. For more information, see the detailed program description in Part 1. 1455. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. Program Title: Biofeedback Smoking Education Project. Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304}342-6600. Description: The American Lung Association’s Biofeedback Smoking Education Project is offered to area schools. For more information, see the detailed program description in Part 1. 1456. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. Program Title: Freedom From Smoking At Work. Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304)342-6600. Description: The American Lung Association of West Virginia provides consultation to area businesses in determining smoking policies. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. 1457. Program Title: Freedom From Smoking Clinics. 372 Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304)342-6600. Description: The American Lung Association’s Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1458. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304)342-6600. Description: The American Lung Association's Freedom From Smoking program manuals are provided at minimal or no cost. For more information, see the detailed program description in Part 1. 1459. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. Program Title: Freedom From Smoking Seminar. Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304)342-6600. Description: This educational program lasts 2 to 3 hours and uses several educational components to enlighten smokers about the cigarette habit and methods for quitting. 1460. AMERICAN LUNG ASSOCIATION OF WEST VIRGINIA, Post Office Box 3980, Charleston, West Virginia 25339. Program Title: in Control. Contact: Ms. Kathi K. Elkins, Assistant Executive Director (304)342-6600. Description: The American Lung Association’s self-help videocassette 8 OW Re eet program is available for library loan or purchase. For more information, see the detailed program description in Part 1. 1461. MONONGALIA COUNTY HEALTH DEPART- MENT, 453 Van Voorhis Road, Morgantown, West Virginia 26505. Program Title: Smoking And Your Baby. Contact: Donna Jeffries, R.N., and Sally Taylor, R.N., Program Coordinators (304)599-0670. Description: Patients are screened upon admission into the Maternal Program. A smoker's chart is flagged and entered in the spe- cial counseling program. In addition, 10-day community-wide workshops are held quarterly. While this program primarily targets pregnant women, it is open to everyone. 1462. WEST VIRGINIA DEPARTMENT OF HEALTH, Of- fice of the Director, 1800 Washington Street, East, Charleston, West Virginia 25305. Program Title: Behavioral Risk Factor Surveillance System. Contact: Mr. Robert H. Anderson, Acting Director, Division of Health Promotion (304)348-0644, Description: The Department of Health participates in the Centers for Dis- ease Control's Behavioral Risk Factor Surveillance System. Each month adults are randomly selected for telephone inter- views and are asked questions about their lifestyles as they relate to risk factors for preventable morbidity and mortality. With regard to tobacco use, the Department estimates the prevalence of cigarette smoking and smokeless tobacco use by standard demographic variables. WISCONSIN 1463. AMERICAN CANCER SOCIETY, WISCONSIN DIVISION, INC., 615 North Sherman Avenue, Box 8370, Madison, Wisconsin 53708. Program Title: FreshStart. Contact: Ms. Nancy Freeman, Director of Public Education (608)249-0487. Description: The American Cancer Society’s FreshStart smoking cessa- tion clinic is offered. For more information, see the detailed program description in Part 1. 1464. AMERICAN CANCER SOCIETY, WISCONSIN DIVISION, INC., 615 North Sherman Avenue, Box 8370, Madison, Wisconsin 53708. Program Title: Smokeless Tobacco Cessation. Contact: Ms. Nancy Freeman, Director of Public Education (608)249-0487. Description: This program involves forming a temporary coalition of com- munity leaders in government, education, and media to plan a multifaceted education and information program on smoke- less tobacco, targeted to all age groups. 373 1465. AMERICAN CANCER SOCIETY, WISCONSIN DIVISION, INC., 615 North Sherman Avenue, Box 8370, Madison, Wisconsin 53708. Program Title: Tobacco-Free Young Wisconsin. Contact: Ms. Nancy Freeman, Director of Public Education (608)249-0487. Description: . This five-part program includes teaching modules for youth education in schools, the development of model policies for smoke-free schools, support for legislation to prohibit sale or free distribution of tobacco to minors, media campaigns that promote nonsmoking targeted to youth and pregnant women, and professional education efforts to health professionals serving youth. 1466. AMERICAN CANCER SOCIETY, WISCONSIN DIVISION, INC., 615 North Sherman Avenue, Box 8370, Madison, Wisconsin 53708. Program Title: Wisconsin Athletes Against Cancer. Contact: Ms. Nancy Freeman, Director of Public Education (608)249-0487. Description: This program uses professional athletes as speakers and media role models as spokespersons against smokeless tobacco use. 1467. AMERICAN CANCER SOCIETY, WISCONSIN DIVISION, INC., MILWAUKEE METRO DISTRICT OFFICE, 11401 West Watertown Plank Road, Post Office Box 26555, Milwaukee, Wisconsin 53226. Program Title: FreshStart. Contact: Ms. Nancy Freeman, Director of Public Education (414)453-4500. Description: The American Cancer Society’s FreshStart program is used with adult education efforts that emphasize generalized can- cer prevention and lifestyle modification. For more information, see the detailed program description in Part 1. 1468. AMERICAN HEART ASSOCIATION, WISCONSIN AFFILIATE, 795 North Van Buren, Milwaukee, Wisconsin 53202. Program Title: Calling It Quits. Contact: Ms. Patricia Bush, Program Director (414)271-9999 or (800)242-9236. Description: This educational program, developed by the American Can- cer Society, is offered to worksite wellness programs. This material is also provided to numerous health fairs and general public inquiries. For more information, see the detailed program description in Part 1. 1469. AMERICAN HEART ASSOCIATION, WISCONSIN AFFILIATE, 795 North Van Buren, Milwaukee, Wisconsin 53202. Program Title: Save A Sweet Heart. Contact: Ms. Patricia Bush, Program Director (414)271-9999 or (800)242-9236. Description: The Wisconsin Affiliate developed this campaign to promote nonsmoking for schools several years ago. For more information, see the detailed program description in Part 1. AMERICAN LUNG ASSOCIATION OF WISCON- SIN, 1330 North 113th Street, Suite 190, Milwaukee, Wisconsin 53226. 1470. 374 Program Title: Cigarette Break-Away. Contact: Ms. Amy Kinosian, Program Director (414)258-9100 or (800)242-5160. Description: The Cigarette Break-Away is a one-session, multicomponent program, designed to help a large number of people quit smok- ing at one time. The components include two hypnotic induc- tions, a medical presentation, information about behavior change strategies, a gramatic film, and group activities. In ad- dition, each participant receives a maintenance package con- taining a self-hypnosis tape, A Lifetime Of Freedom From Smoking manual, and a tip sheet outlining potential trigger situations and possible coping strategies. Throughout the program, emphasis is placed heavily on the responsibility that each individual must take to practice a nonsmoking lifestyle and use the maintenance package wisely. The single session approach has special appeal for people who work irregular hours or whose schedules do not permit a long-term commit- ment to a program. It is ideal for implementing in the workplace as well as in a community setting. 1471. AMERICAN LUNG ASSOCIATION OF WISCON- SIN, 1330 North 113th Street, Sulte 190, Milwaukee, Wisconsin 53226. Program Title: Freedom From Smoking Clinics. Contact: Ms. Amy Kinosian, Program Director (414)258-9100 or (800)242-5160. Description: The American Lung Association's Freedom From Smoking clinics are offered. For more information, see the detailed program description in Part 1. 1472. AMERICAN LUNG ASSOCIATION OF WISCON- SIN, 1330 North 113th Street, Suite 190, Milwaukee, Wisconsin 53226. Program Title: Freedom From Smoking Self-Help. Contact: Ms. Amy Kinosian, Program Director (414)258-9100 or (800)242-5160. Description: Avariety of self-help formats are now available for the general public and for use in both health care and workplace settings. For more information, see the detailed program descriptions in Part 1. 1473. AMERICAN LUNG ASSOCIATION OF WISCON- SIN, 1330 North 113th Street, Sulte 190, Milwaukee, Wisconsin 53226. Program Title: School Smoking Prevention. Contact: Ms. Amy Kinosian, Program Director (414)258-9100 or (800)242-5160. Description: These programs, designed to prevent students from smoking, include: Kristy Koala Healthy Lungs Program (grades K-1); Our Breathtaking Lungs (grades 2-3); Marijuana: A Second Look (grades 4-6); Students Teaching Students (grades 5-6) and Breathing for Two (grades 10-12). For more information, see the detailed program descriptions in Part 1. 1474. BELLIN HEALTH CONNECTION, BELLIN MEMORIAL HOSPITAL, 215 North Webster, Green Bay, Wisconsin 54301. Program Title: Freedom From Smoking. Contact: Ms. Kathryn Mertz, Program Coordinator (414)433-3638. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 1475. BROWN COUNTY COMMUNITY HEALTH NURS- ING SERVICE, Northern Buliding, 305 East Wal- nut Street, Post Office Box 1600, Green Bay, Wisconsin 54301. Program Title: Heaithy Heart. Contact: Karen Sandmire, R.N., Coordinator and Judy Friederichs, R.N., Project Director (414)436-3361. Description: This program provides for hypertension screening in in- dustries and public sites. If an individual indicates a current history of smoking, they are counseled regarding risk of smok- ing and availability of cessation programs. A comparison chart of cessation programs is shared with them. 1476. BURNETT GENERAL HOSPITAL, Post Office Box 99, Grantsburg, Wisconsin 54840. Program Title: Five Day Plan. Contact: Ms. Vicki Estes-Bruff, Nutrition and Health Educator (715)463-5353. 375 Description: The Seventh-Day Adventists’ Five Day Plan is offered. Diet consultation for weight maintenance is available without charge. For more information, see the detailed program descriptions in Part 1. 1477. BURNETT COUNTY HEALTH SERVICES, BUR- NETT COUNTY GOVERNMENT CENTER, Route 1, Box 300-114, Siren, Wisconsin 54872. Program Title: FreshStart. Contact: Ms. Jeanne Lincoln, Prograrn Coordinator (715)349-2141. Description: The FreshStart program developed by the American Cancer Society is offered once a year to County residents. For more information, see the detailed program description in Part 1. 1478. DANE COUNTY COMMUNITY SUPPORT AND PUBLIC HEALTH DIVISION, 1206 Northport Drive, Room 107, Madison, Wisconsin 53704- 2088. Program Title: Cardiovascular Risk Reduction Program. Contact: Arlene Finley, R.N., B.S.N., Cardiovascular Risk Reduction Coordinator (608)241-4481, Description: Smoking and health is a component of the health department's 2-year grant funded Cardiovascular Risk Reduction Program primarily aimed at farmers. Cardiovascular risk reduction is addressed through a program of adult health education, coun- seling, and screening services. During individual counseling, tobacco use is assessed and presented as a risk factor in developing cardiovascular problems. People are referred to community smoking cessation programs. 1479. DIVINE SAVIOR HOSPITAL AND NURSING HOME, INC., 1015 West Pleasant Street, Portage, Wisconsin 53901. Program Title: Freedom From Smoking. Contact: Ms. Paula Korn, Community Health Educator (608)742-4131 ext.429. Description: The American Lung Association's Freedom From Smoking programs are offered each year. For more information, see the detailed program description in Part 1. 1480. DIVINE SAVIOR HOSPITAL AND NURSING HOME, INC., 1015 West Pleasant Street, Portage, Wisconsin 53901. Program Title: Break-Away. Contact: Ms. Paula Korn, Community Health Educator (608)742-4131 ext.429. Description: Break-Away is a one-time, 3-hour program that involves hyp- nosis. Trained personnel, including a psychologist, physician, and certified facilitators, are used. 1481. DODGE COUNTY NURSES, Courthouse, Juneau, Wisconsin 53039-1373. Program Title: Community Education. Contact: Ms. Ruth Lindegarde, Assistant Director of Nurses (414)386-2771. Description: Various 1-hour programs are offered to schools focusing on the health effects associated with tobacco use. Health fairs, sponsored by the department, are used as active dissemina- tion programs for literature on smoking and tobacco use. 1482. DODGE COUNTY NURSES, Courthouse, Juneau, Wisconsin 53029-1373. Program Title: FreshStart. Contact: Ms. Ruth Lindegarde, Assistant Director of Nurses (414)386-2771. Description: The American Cancer Society’s FreshStart program is offered in the community and in local industry. For more information, see the detailed program description in Part 1. 1483. KENOSHA HEALTH DEPARTMENT, 625 52nd Street, Kenosha, Wisconsin 53140. Program Title: Tobacco Use Education. Contact: Ms. Marialyce Kornkven, Health Services Coordinator (414)656-81 70. Description: Through its free screening clinics, the Health Department provides counseling and education regarding tobacco use to 376 all patients. Persons interested in cessation are provided with self-help manuals, individual counseling, and referral information. 1484. LA CROSSE COUNTY HEALTH DEPARTMENT, Grandview Bullding, 1707 Main Street, La Crosse, Wisconsin 54601. Program Title: Freedom From Smoking. Contact: Ms. Mary Anne M. Snyder, Department Health Educator (608)785-9723. Description: The smoking cessation programs follow the curriculum as es- tablished by the American Lung Association. For more information, see the detailed program description in Part 1. 1485. LAKELAND MEDICAL ASSOCIATES, LTD., Post Office Box 549, Woodruff, Wisconsin 54568. Program Title: Hypnosis. Contact: Charles Michels, M.S.W., Program Coordinator (715)356-3292. Description: The program includes 3 hours of individual sessions: the evaluation session, the hypnosis session, and two followup sessions. A tape is provided of the hypnosis session. 1486. MADISON DEPARTMENT OF PUBLIC HEALTH, City-County Building, Room 507, 210 Martin Luther King, Jr. Boulevard, Madison, Wisconsin §3710. Program Title: Cardiovascular Risk Reduction Program. Contact: Susan Haag, R.N., Public Health Nurse Coordinator (608)266-4821. Description: The Cardiovascular Risk Reduction program is for low-income adults, 18-55 years of age, who are patients of a local com- munity health center, and who are determined to be at high risk for cardiovascular disease. Participants who smoke are provided with self-help materials from the National Institutes of Health and the American Cancer Society, or they may at- tend the FreshStart program of the American Cancer Society offered every 2 months at the health center. 1487. MARSHFIELD CLINIC, 1000 North Oak Avenue, Marshfield, Wisconsin 54449. Program Title: Freedom From Smoking. Contact: Donna Bowman, R.N., Patient Education Coordinator (715)387-5066. Description: The American Lung Association’s Freedom From Smoking program is offered. For more information, see the detailed program description in Part 1. 1488. MARSHFIELD CLINIC, 1000 North Oak Avenue, Marshfield, Wisconsin 54449. Program Title: Smoking Cessation Hypnosis Group. Contact: Program Coordinator, Department of Clinical Psychology (715)387-5441. Description: The hypnosis group meets once for 2 hours. During the first hour the group discusses smoking habits, previous attempts at quitting, and reasons for quitting. The second hour is devoted to group hypnotic induction. While under induction, the power of suggestion is used to make the process of quitting less difficult. 1489. MILWAUKEE HEALTH DEPARTMENT, Municipal Building, Room 209, 841 North Broadway, Milwaukee, Wisconsin 53202. Program Title: Smoking Cessation Programs. Contact: Kurt D. Eggebrecht, M.Ed., Public Health Educator I! (414)278-3635. Description: Information and materials provided by the American Lung As- sociation, the American Cancer Society, and the March of Dimes are distributed through libraries, clubs, and prenatal Clinics. The American Lung Association's Freedom From Smoking program and the American Cancer Society's Fresh- Start program are both offered to interested individuals. For more information on these programs, see the detailed program descriptions in Part 1. 1490. PERSONAL GROWTH AND COUNSELING CENTER, 1270 Main Street, Green Bay, Wiscon- sin 54302. Program Title: Freedom From Smoking Addiction. Contact: Mr. L.V. Teofilo, Program Coordinator (414)432-0626. 377 Description: This is a comprehensive program intended to assist people in quitting smoking. There are three main aspects to this ap- proach: 1) hypnosis with posthypnotic suggestion for eliminat- ing smoking behavior; 2) self-hypnosis training for daily reinforcement of smoking cessation suggestions; and 3) hyp- notherapy-hypnosis combined with a variety of counseling ap- proaches for awareness and resolution of underlying psychological aspects of the smoking addiction. This third aspect is most significant in allowing the client to become a nonsmoker (not just quit) on a permanent basis, without having to continually fight the urge to return to smoking. The cost is $55 per hour. Approximately three to six sessions are needed. The program facilitator is a Nationa! Certified Counselor and Registered Professional Hypnotherapist. 1491. PRICE COUNTY PUBLIC HEALTH NURSING SERVICE AND HOME CARE AGENCY, Courthouse, Phillips, Wisconsin 54555. Program Title: Family Planning Clinics. Contact: Jean Goodwin, R.N., Instructor (715)339-3054. Description: At initial and annual visits to the Family Planning Clinics, clients are asked if they smoke and effects of smoking are dis- cussed. Relationships between oral contraceptive side effects and smoking are noted. Handouts are distributed. Followup is continuous throughout client’s participation in the program. 1492. PRICE COUNTY PUBLIC HEALTH NURSING SERVICE AND HOME CARE AGENCY, Courthouse, Phillips, Wisconsin 54555. Program Title: Great American Smokeout. Contact: Charlene Jebens, R.N., B.S.N., Director (715)339-3054, Description: One day a year, in cooperation with the American Cancer Society’s Great American Smokeout, schools are provided with buttons, posters, literature, coloring books, comic books, and movies. 1493. PRICE COUNTY PUBLIC HEALTH NURSING SERVICE AND HOME CARE AGENCY, Courthouse, Phillips, Wisconsin 54555. Program Title: Prenatal Classes. Contact: Jean Goodwin, B.N., Instructor (715)339-3054. Description: As part of a series of prenatal classes, effects of smoking and living in a smoke-filled environment are discussed. Women and partners are encouraged to quit or cut down. Women are polled at future sessions to see if changes were made. 1494. SHAWANO COUNTY PUBLIC HEALTH SERVICE, Court House, Shawano, Wisconsin 54166. Program Title: Cardiovascular Risk Reduction. Contact: Sandra J. Dodge, R.N., Blood Pressure Coordinator (715)524-2169. Description: As part of this program, a tobacco use cessation service is offered to all participants. The Quit Smart manual and relaxation tape are available on loan. 1495. SAINT FRANCIS MEDICAL CENTER, 700 West Avenue South, La Crosse, Wisconsin 54601. Program Title: Smoke Stoppers. Contact: Ms. Debera Wangen-Thala, Supervisor, Health and Fitness Services (608)785-0940 ext.2251. Description: Smoke Stoppers, developed by the National Center for Health Promotion, is a three-phase smoking cessation program. Phase | prepares the individual for quitting; Phase II provides the techniques, guidance, support, and structure for cessa- tion; and Phase Ill provides an ongoing support and maintenance system. 1496. SAINT FRANCIS MEDICAL CENTER, 700 West Avenue South, La Crosse, Wisconsin 54601. Program Title: The Decision Is Yours. Contact: Ms. Debera Wangen-Thala, Supervisor, Health and Fitness Services (608)785-0940 ext. 2251. Description: A respiratory therapist speaks to students on the decision to smoke. Information and materials are provided relating to cigarettes, drugs, and chewing tobacco. 1497. WINNEBAGO COUNTY PUBLIC HEALTH NURSE, Park View Health Center, Post Office Box 68, Winnebago, Wisconsin 54985. Program Title: Smoking Education. Contact: Ms. Marsha Brightman, Program Coordinator (414)235-5100. Description: The hazards of smoking, especially as related to cardiac and pulmonary diseases, are discussed with patients and families individually and in group settings. Printed materials are avail- able from the March of Dimes, American Heart Association, American Lung Association, and the U.S. Department of Health and Human Services, and provided to interested individuals. 1498. WOOD COUNTY HEALTH DEPARTMENT, Court- house, 400 Market Street, Post Office Box 8095, Wisconsin Rapids, Wisconsin 54495-8095. Program Title: FreshStart. Contact: Kandace Marzofka, R.N., P.H.N., Program Coordinator (715)421-8525. Description: The American Cancer Society's FreshStart program is offered twice a year to all Gounty employees. For more information, see the detailed program description in Part 1. WYOMING 1499. AMERICAN HEART ASSOCIATION OF WYOM- ING, INC., 1320 Hugur Avenue, Cheyenne, Wyoming 82001-4917. Program Title: Calling It Quits. Contact: Gretchen Zuber, M.Ed., Program Director (307)632-1746. Description: The American Heait Association's Calling It Quits program is offered. For more information, see the detailed program description in Part 1. 1500. AMERICAN HEART ASSOCIATION OF WYOM- ING, INC., 1320 Hugur Avenue, Cheyenne, Wyoming 82001-4917. Program Title: Save A Sweet Heart. Contact: Gretchen Zuber, M.Ed., Program Director (307)632-1746. Description: The American Heart Association’s Save A Sweet Heart program is offered. For more information, see the detailed program description in Part 1. 1501. AMERICAN HEART ASSOCIATION OF WYOM- ING, INC., 1320 Hugur Avenue, Cheyenne, Wyoming 82001-4917. Program Title: Let’s Talk About Smoking. Contact: Gretchen Zuber, M.Ed., Program Director (307)632-1746. Description: The American Heart Association's Let’s Talk About Smoking program is offered. For more information, see the detailed program description in Part 1. 1502. AMERICAN LUNG ASSOCIATION OF WYOMING, Post Offlce Box 1128, Cheyenne, Wyoming 82001. Program Title: Smoking Education And Cessation. Contact: Ms. Patricia Stanley, Executive Director (303)638-6342. 379 Description: The American Lung Association offers a wide range of educa- tional materials on the topic of smoking. Materials to target audiences include workplace smoking program; smoking and pregnancy; self-help and clinic cessation programs throughout the State; and public education materials, buttons, and posters. 1503. WYOMING DEPARTMENT OF HEALTH AND SO- CIAL SERVICES, Hathaway Bullding, 4th Floor, Chayenne, Wyoming 82002-0710. Program Title: Health Risk Reduction Program. Contact: Mr. Menlo Futa, Public Health Program Representative (307)777-6011. Description: The Health Risk Reduction Program (HRR) is responsible for smoking activities in Wyoming at the State level. The major smoking-related objective of the program is to reduce the proportion of adults who smoke to below 25 percent by 1990. Smoking activities are carried out in two major areas: school health education and smoking policies. In the area of school health, HRR distributes | Love Not Smoking coloring books and its own smoking posters to Wyoming schools. Its efforts also include lending several films to schools, promoting cur- riculums that include tobacco education, and participating in a resource center for tobacco education materials that in- cludes materials available from the voluntary health organiza- tions. HRR will also participate in the Smoke-Free Class of 2000 Project with the voluntary organizations. With regard to program development, HRR has helped to im- plement a smoking policy for the State Health Department. It consults with other State agencies, local government, and private employers in implementing worksite smoking policies. SMOKING AND HEALTH ADVOCACY GROUPS Collaborative efforts have grown substantially in the past 25 years among voluntary organizations, profit and nonprofit groups, State and local government entities, and special inter- est groups that educate the public on the effects of tobacco use or nonsmokers’ rights. in many States, there is active cooperation on the part of numerous organizations, including major voluntary groups, such as the ACS, the AHA, and the ALA; State health and education departments; public health agencies and associations; health insurers; health care ad- ministrators; and professional medical groups. These groups generally focus their efforts on education and legislation atthe State and local levels and provide information on these efforts to their members. Six States in New England and eight States in the Rocky Mountain area have formed regional task forces to accelerate efforts in support of the challenge for a tobacco-free society. Member donations and in-kind services support the work of these groups. Small grassroots organizations, formed in the 1960s and 1970s, were active in promoting public education on the health effects of smoking. Numerous local nonprofit groups were formed, and the number of active groups continued to grow in ALABAMA Coalition For A Tobacco-Free Alabama c/o American Lung Association Office of Health Promotion and Information 434 Monroe Street - Room 644 Montgomery, Alabama 36130-1701 (205)261-5095 ALASKA Alaska Council on Smoking or Health Post Office Box 201018 Anchorage, Alaska 99520-1028 (907)243-5642 ARIZONA Arizonans Concerned About Smoking in Public Places 1866 East Vinedo Lane Tempe, Arizona 85284 (602)992-1519 Arizonans for Nonsmokers’ Rights The Coalition for Smoke-Free Air Post Office Box 35201 Phoenix, Arizona 85069 (602)938-0838 381 the early 1980s. As clean indoor air legislation became a local priority issue and awareness of the effects of smoking on health became widespread, some groups consolidated. Other groups, having accomplished their original goals, became inactive, Numerous local smoking and health advocacy groups across the country are currently active and have memberships rang- ing from a few members to thousands. Their work is sup- ported mainly by dues and private contributions. They distribute newsletters and lists of restaurants with provisions for nonsmokers. The groups publish policy information on worksite smoking for employers and employees, provide guidelines for advocacy efforis on clean indoor air legislation, and circulate materials for youth education on the use of tobacco. The groups described above are listed alphabetically by State below. National advocacy organizations are listed in the jurisdiction where they are headquartered. Nonsmokers Association of Sun City 9914 Hawthorne Drive Sun City, Arizona 85351 (602)977-7548 Nonsmokers, Inc. Post Office Box 12666 Tucson, Arizona 85732-2666 (602)323-3699 Rocky Mountain Challenge — see Utah ARKANSAS Arkansans for Nonsmokers’ Rights Post Office Box 7697 Little Rock, Arkansas 72217 (501)378-7870 Arkansas Coalition for a Smoke Free Society Post Office Box 3857 Little Rock, Arkansas 72203 (501)664-3480 (ACS) (501)224-5864 (ALA) (501)375-9148 (AHA) Arkansas Nonsmokers’ Rights Foundation 12253 River Crest Drive Little Rock, Arkansas 72212 (501)225-1176 CALIFORNIA Ariericans for Nonsmokers’ Rights American Nonsmokers’ Rights Foundation Suite 500 2054 University Boulevard Berkeley, California 94704 (415)841-3032 Coalition on Smoking and Tobacco (COST) c/o American Cancer Society Mountain Valley Unit 114 West 7th Avenue Chico, California 95926 (916)342-4567 Environmental Health Committee Post Office Box 23817 San Jose, California 05135-3817 (408)256-7967 Stop Teenage Addiction to Tobacco Post Office Box 50039 Palo Alto, California 94303 (415)723-0059 COLORADO Aspen GASP Post Office Box 1594 Aspen, Colorado 81612 (303)925-8990 Coalition for a Tobacco-Free Colorado 1600 Race Street Denver, Colorado 80207 (303)331-8300 GASP of Colorado (Group to Alleviate Smoking Pollution) Post Office Box 12103 Boulder, Colorado 80303-0020 (303)444-9799 Rocky Mountain Challenge — see Utah Youth Educational Services (YES), Inc. Suite 1950 1600 Broadway Street Denver, Colorado 80202 (303)830-6725 382 CONNECTICUT Connecticut Coalition on Smoking or Health c/o Connecticut Interagency Council on Smoking Connecticut State Department of Health 79 Elm Street Hartford, Connecticut 06101 (203)566-6618 (203)734-4532 New England Coalition for Disease Prevention, Health Protection and Health Promotion Task Force Towards a Smoke Free Society c/o American Lung Association of Connecticut South Central Branch 364 Whitney Avenue New Haven, Connecticut 06511 (203)777-6821 (802)656-4187 World Organization for Science and Health 125 Brett Lane Fairfield, Connecticut 06430 (203)255-8776 DISTRICT OF COLUMBIA Action on Smoking and Health 2013 H Street, N.W. Washington, D.C. 20006 (202)659-4310 Advocacy Institute Suite 600 1730 Rhode Island Ave., N.W. Washington, D.C. 20036 (202)659-8475 Coalition on Smoking OR Health 1607 New Hampshire Ave., N.W. Fourth Floor Washington, D.C. 20009 (202)234-9000 District of Columbia Interagency Council on Smoking and Health 1875 Connecticut Avenue, N.W. Room 816 Washington, D.C. 20009 (202)673-7786 District of Columbia Tri-Agency Coalition for the Smoke-Free Class of 2000 clo American Cancer Society 1825 Connecticut Avenue, N.W. Room 315 Washington, D.C. 20009 (202)483-2600 National Council for Clean Indoor Air Suite 403 316 Pennsylvania Avenue, S.E. Washington, D.C. 20003 (202)547-0005 Tobacco Free America Project 1029 Vermont Avenue, N.W. Suite 710 Washington, D.C. 20005 (202)628-0277 FLORIDA GASP of Miami Post Office Box 45-0952 Miami, Florida 33245-0952 (305)868-1003 Right to Breathe, Inc. Post Office Box 7772 Naples, Florida 33941 (813)262-7767 Tri-Agency Florida Coalition on Smoking or Health c/o American Heart Association, Florida Affiliation Post Office Box 33035 St. Petersburg, Florida 33733-8035 (813)894-7400 GEORGIA DOC (Doctors Oughta Care) 1423 Harper Street Augusta, Georgia 30912 (404)721-2739 Georgians Against Smoking Pollution Post Office Box 450981 Atlanta, Georgia 30345 (404)296-9526 HAWAII Hawaii Interagency Council on Smoking and Health 245 North Kukui Street Honolulu, Hawaii 96817 (808)395-2160 Hawaiian Islands Nonsmokers’ Organization 109 Poloke Place Honolulu, Hawaii 96822 (808)946-3361 ILLINOIS Illinois Interagency Council on Tobacco and Disease 1440 West Washington Boulevard Chicago, Illinois 60607 (312)243-2000 383 Non-Smokers Singles Club of Northern Illinois Post Office Box 391 Wauconda, Illinois 60084 (815)385-4755 (312)381-0614 INDIANA St. Joseph County Interagency Council on Smoking and Health c/o United Health Services 711 East Colfax Avenue South Bend, Indiana 46617 (219)234-3136 ° KANSAS Citizens for Clean Indoor Air for Greater Kansas City Post Office Box 40454 Overland Park, Kansas 66204 (913)631-4632 Kansans for NonSmokers Rights Post Office Box 204 Topeka, Kansas 66601-0204 (913)272-8180 Smoke Free Class of 2000 Project c/o American Lung Association of Kansas 4300 Drury Lane Post Office Box 4426 Topeka, Kansas 66604 (913)272-9290 Task Force on Hazards of Tobacco Consumption c/o Kansas Department of Health and Environment Forbes Field Topeka, Kansas 66620-0001 (913)296-1226 Wichita GASP, Inc. Box 17062 Wichita, Kansas 67217 (316)584-6876 LOUISIANA Nonsmokers Rights Council of Louisiana 333 St. Charles Avenue Suite 500 New Orleans, Louisiana 70130 (504)523-5864 Sierra Club — Delta Chapter 3225 Jena Street New Orleans, Louisiana 70125 (504)891-0386 MAINE The Badvertising Institute Post Office Box 643 Deer Isle, Maine 04627 (207)348-9978 Coalition On Smoking Or Health c/o Maine Department of Human Services Division of Health Promotion and Education Bureau of Health State House Station 11 Augusta, Maine 04333 (207)289-5180 New England Coalition — see Connecticut MARYLAND Bowie GASP Post Office Box 863 Bowie, Maryland 20715 (301)262-5867 Nonsmokers Travel Club 8928 Bradmoor Drive Bethesda, Maryland 20817 (301)530-1664 MASSACHUSETTS Coalition For A Smoke-Free Massachusetts By The Year 2000 c/o American Heart Association, Massachusetts Affiliate 33 Fourth Avenue Needham Heights, Massachusetts 02194 (617)449-5931 GASP of Massachusetts 25 Deaconess Road Harris Hall #421 Boston, Massachusetts 02215 (617)266-2088 Institute for the Study of Smoking Behavior and Policy John F. Kennedy School of Government Harvard University 79 Kennedy Street Cambridge, Massachusetts 02138 (617)495-0806 New England Coalition ~ see Cannecticut Stop Teenage Addiction to Tobacco Post Office Box 60658 Longmeadow, Massachusetts 01116 (413)567-7587 Tobacco Products Liability Project Northeastern University School of Law 400 Huntington Avenue Boston, Massachusetts 02115 (617)437-2026 384 MICHIGAN People Against Tobacco Smoke (PATS) Post Office Box 4394 , Auburn Hills, Michigan 48057 (313)852-7287 MINNESOTA A Smoke-Free Generation Heaith Association Center 2221 University Avenues, S.E. Suite 400 Minneapolis, Mirinesota 55414 (612)927-3526 Association for Nonsmokers — Minnesota 1421 Park Avenue South Minneapolis, Minnesota 55404 (612)339-1902 Minnesota Coalition for a Smoke-Free Society 2000 Health Association Center Suite 400 2221 University Avenue, S.E. Minneapolis, Minnesota 55414 (612)378-0902 MISSOURI Citizens for Clean Indoor Air for Greater Kansas City - see Kansas Missouri GASP, Inc. (Group to Alleviate Smoking Pollution) 6 Manor Lane St. Louis, Missouri 63135-1213 (314)521-0299 MONTANA Rocky Mountain Challenge — see Utah NEBRASKA The Nebraska Clean Indoor Air Coalition 301 Centennial Mail South Post Office Box 95007 Lincoln, Nebraska 68409-5007 (402)471-2101 NEW HAMPSHIRE New England Coalition - see Connecticut NEW JERSEY Environmental Improvement Associates 109 Chestnut Street Salem, New Jersey 08079 (609)935-4200 New Jersey GASP {Group Against Smoking Pollution) 105 Mountain Lane Summit, New Jersey 07901 (201)273-9368 Tri-Agency Coalition on Smoking or Health c/o American Heart Association, New Jersey Affiliate Post Office Box 1900 North Brunswick, New Jersey 08902 (201)821-2610 NEW MEXICO FRENDS Favorable Recreational Educational Natura! Diversified Smokefree Events Post Office Box 25972 Albuquerque, New Mexico 87125 (505)892-0291 New Mexico Committee on the Public Health Impact of Smoking Post Office Box 968 Santa Fe, New Mexico 87504-0968 (505)827-2378 (505)265-0732 New Mexico Nonsmoker Protection Projects Post Office Box 657 Los Alamos, New Mexico 87544 (505)672-9263 The Group to Alleviate Smoking Pollution in New Mexico GASP of New Mexico 9204 Gutierrez Street Albuquerque, New Mexicc 87111 (505)888-4694 (505)294-3803 Rocky Mountain Challenge — see Utah Women Concerned About Smoking Post Office Box 968 Santa Fe, New Mexico 87504-0968 (505)827-2378 NEW YORK American Council on Science and Health 1995 Broadway, 16th Floor New York, New York 10023 (212)638-5577 GASP of New York (Group Against Smoking Pollution) 7 Maxine Avenue Plainview, New York 11803 (516)938-0080 385 New Yorkers for Nonsmokers’ Rights 432 Livingston Avenue Albany, New York 12206 (518)436-1148 People for a Smoke-Free Indoors 122 East 57th Street Suite 4R New York, New York 10022 (212)832-8858 Right to Breathe 18 Warren Street McKownville, New York 12203 (518)489-1188 The New York City Anti-Smoking Ad Contest Suite 32F 375 South End Avenue New York, New York 10280 (212)269-3843 NORTH CAROLINA North Carolina GASP (Group to Alleviate Smoking Pollution) 105 Higbee Street Durham, North Carolina 27704 (919)471-0988 NORTH DAKOTA ~ Rocky Mountain Challenge — see Utah Tobacco Free North Dakota Coalition c/o North Dakota State Health Department Capitol Building Bismarck, North Dakota 58505 (701)224-2493 OHIO Citizens Against Tobacco Smoke (CATS) Post Office Box 36236 Cincinnati, Ohio 45236 (513)984-8833 Cleveland Non-Smoking Singles 23500 Center Ridge Road West Lake, Ohio 44145 (216)734-7351 Ohio GASP (Groups Against Smoking Pollution) Post Office Box 14774 Cleveland, Ohio 44114 (216)321-2320 PENNSYLVANIA Greater Philadelphia Interagency Council on Smoking and Health One Reading Center, Suite 800 1101 Market Street Philadelphia, Pennsylvania 19107 (215)592-5450 Group Against Smog and Pollution (GASP) Post Office Box 5165 Pittsburgh, Pennsylvania 15206 (412)441-6650 Nonsmokers Rights Committee c/o American Lung Association of Southeast Pennsylvania 302 North Main Avenue Scranton, Pennsylvania 18504 (717)346-1784 Northwest Pennsylvania Coalition on Smoking and Health c/o Erie County Department of Health 606 West Second Street Erie, Pennsylvania 16507 (814)454-5811 Pittsburgh Association for Nonsmokers’ Rights Post Office Box 4983 Pittsburgh, Pennsylvania 15206 (412)795-4241 RHODE ISLAND New England Coalition — see Connecticut SOUTH DAKOTA CAPS (Citizens Against Public Smoking) Route 2, Box 46 Hitchcock, South Dakota 57348 (605)266-2513 Rocky Mountain Challenge — see Utah TEXAS ACAT Association for Clear Air in Texas Suite 106 2727 Inwood Road Dallas, Texas 75235 (214)351-2228 Caring for Nonsmokers 7022 South Jan Mar Drive Dallas, Texas 75230 (214)361-6192 FANS Friends of Austin Nonsmokers Post Office Box 180451 Austin, Texas 78718 (512)926-9600 386 Texas Association of Nonsmokers 5201 South Seventh Street Abilene, Texas 79605 (915)694-0240 Texas Interagency Council on Smoking or Health c/o American Lung Association of Texas 3520 Executive Center Drive Suite G-100 Austin, Texas 78731-1698 (512)343-0502 Texas Smoke Free Indoor Air Coalition c/o American Lung Association of Texas 3520 Executive Center Drive Suite G-100 Austin, Texas 78731-1698 (512)343-0502 UTAH Coalition for a Tobacco-Free Utah c/o Utah Department of Health 288 North 1460 West Post Office Box 16660 Salt Lake City, Utah 84116-0660 (801)479-2009 Rocky Mountain Tobacco-Free Challenge c/o Utah Department of Health Bureau of Health Promotion and Risk Reduction 288 North 1460 West Salt Lake City, Utah 84116-0660 (801)538-6120 VERMONT New England Coalition — see Connecticut VIRGINIA Northern Virginia GASP (Group to Alleviate Smoking Pollution) 6904 Barnack Drive Springfield, Virginia 22152 (703)569-4570 Virginia GASP (Group to Alleviate Smoking in Public Places) Post Office Box 38134 Richmond, Virginia 23231 (804)795-2006 Virginia Interagericy Council on Tabacco OR Health c/o American Lung Association 311 South Boulevard Richmond, Virginia 23221 (804)355-3295 Virginians for Clean Air Post Office Box 5846 Charlottesville, Virginia 22905 (804)295-9343 WASHINGTON FANS Fresh Air for Nonsmokers 610 South Milroy Olympia, Washington 98502 (206)866-0352 FANS Fresh Air for Nonsmokers Post Office Box 25 Richiand, Washington 99352 (509)373-2532 FANS Fresh Air for Nonsmokers Post Office Box 24052 Seattle, Washington 98124 (206)932-7011 Smoking Policy Institute Suite 526 914 East Jefferson Street Seattle, Washington 98122 (206)324-4444 WEST VIRGINIA Federation of Active Nonsmokers Post Office Box 2980 Charleston, West Virginia 25339 (304)342-6600 387 WISCONSIN Southern Wisconsin GASP 1342 Pleasant Street Lake Geneva, Wisconsin 53147 (414)248-0224 Wisconsin Tri-Agency Coalition c/o American Heart Association of Wisconsin 795 North Van Buren Street Milwaukee, Wisconsin 53202 (414)271-9999 WYOMING Coalition for a Tobacco Free Wyoming c/o American Heart Association of Wyoming, Inc. 1320 Hugur Avenue Cheyenne, Wyoming 82001-4917 (307)632-1746 Rocky Mountain Challenge — see Utah Wyoming GASP 2672 Jefferson Street Laramie, Wyoming 82070 (307)745-9338 Name of Organization Action on Smoking and Health (OC) Advocacy Inathute (DC) Alaska Council on Smoking or Health (AK) American Council on Science and Health (NY) American for Nonsmokers' Rights (CA) American Nonsmokers' Rights Foundation (CA) SMOKING AND HEALTH ADVOCACY GROUPS Year Founded 1967 1983 1980 1978 1976 Arizonans Concemed About Smoking in Public Places (AZ) 1976 Arzonans for Nonsmokers’ Rights/The Coalition for Smoke-Free Alr (AZ) Arkansans for Nonsmokers' Rights (AR) Arkansas Coalltion for a Smoke Free Society (AA) Arkansas Nonsmokers' Rights Foundations (AR) Association tor Clear Air in Texas (ACAT) (TX) Association for Nonamokers — Minnesota (MN) Aspen GASP (CO) The Badvertlelng Institute (ME) Bowle (GASP) (MD) Caring for Nonsmokers (TX) Citizens Against Public Smoking (CAPS) (SD) Citizens Against Tobacco Smoke (CATS) (OH) Citizens for Clean Indoor Air for Greater Kansas Clty (KS) Cleveland Non-Smoking Singles (OH) Coalition for a Smoke-Free Massachusetts By the Year 2000 (MA) Coalition for a Tobacco-Free Alabama (AL) Coalition for a Tobacco-Free Colorado (CO} Coalition for A Tobacco-Free Utah (UT) Coalition for a Tobacoo-Free Wyoming (WY) Coalition on Smoking and Tobacco (COST) (CA) Coalition on Smoking OR Health (DC) Goaliton on Smoking or Health (ME) Connecticut Coalition on Smoking or Health (CT) District of Columbia Interagency Council on Smoking and Health (OC) District of Columbia Tri-Agency Coalition for the Smoke-Free Class of 2000 (DC) Doctors Oughta Care (OC) (GA) Environmental Heath Committee (CA) Environmental Improvement Associates (NJ) 1984 1983 1988 1986 1985 1973 1965 1975 1974 1984 1985 1984 1977 1966 1974 1970 1982 1988 1978 1983 1977 Other: 1 research, 2 health factities, 3 women, 4 Iktigation, 5 social 32 ORGS 20 ORGS 20 ORGS 3 ORGS 8 ORGS 3 ORGS 20 ORGS 12 ORGS ORGS IND/ORGS ra Of x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x x ee a v tit, ral uM OM OM RM MOM x a oO Bo Oy wor s-eereeerererk “2337 °°?? 7 eer7-"7 eee SMOKING AND HEALTH ADVOCACY GROUPS - CONTINUED Name of Organization Favorabie Recreational Educational Naturat Olversified Smokefree Events (FRENDS) (NM) Federation of Active Nonsmokers (WV) Freeh Air for Nonsmokers (FANS-Olympia) (WA) Freeh Alr for Nonsmokers (FANS-Richiand) (WA) Fresh Alr tor Nonsmokers (FANS-Seattio) (WA) Friends of Austin Nonsmokers (FANS) (TX) GASP of Colorado (CO) GASP of Massachusetts (MA) GASP of Miami (FL) The Group to Alleviate Smoking Pollution in New Mexico (NM) GASP of New York (NY) Group Against Smog and Pollution (GASP) (PA) Georglans Against Smoking Pollution (GA) Greater Philadelphia interagency Council on Smoking and Health (PA) Hawall Interagency Council on Smoking and Health (HI) Hawallan Istands onsmokers' Organization (HI) Ilinols interagency Counck on Tobacco and Disease (IL) Institute for the Study of Smoking Behavior and Policy (MA) Kansans for NonSmokers Rights (KS) Minnesota Coalition for a Smoke-Free Society 2000 (MN) Missouri GASP, Inc, (MO) National Council for Clean Indoor Air (OC) The Nebraska Ciean Indoor Alr Coalition (NB) New England Coalkion for Disease Prevention, Health Protection and Health Promotion (CT) New Jersey GASP (NJ) New Mexico Committee on the Public Health Impact of Smoking (NM) New Mexico Nonsmoker Protection Projects (NM) The New York City Anti-Smoking Ad Contest (NY) New Yorkers for Nonsmokers' Rights (NY) Nonsmokers Association of Sun City (AZ) Nonsmokers, Inc. (AZ) Nonsmokers Rights Committee (PA) Nonsmokers Rights Council of Louisiana (LA) Non-Smokers Singles Club of Northern tBinois (IL) Nonsmokers Travel Club (MD) Year Founded 1975 1975 1984 1984 1979 1983 1977 1974 1972 1984 1972 1969 4975 1984 1964 1984 1983 1980 1984 1986 1985 1974 1987 1983 1983 1976 1983 1975 1983 Other: 1 research, 2 health facilities, 3 women, 4 litigation, 5 social Membership SR 1000 450 IND/ORG 34 ORGS NA 35 ORGS 50 ORGS ORGS ORGS IN 8 STATES 3000 5 ORGS NIA uM MM MOM Mt x «x MM MO 389 MOM MM MO x x x x x x x x x x x x x x x x x x x x x x x x x x x x 2 1 x x x 2 x x x x x x x x x x x x x x x x x x x x x x x x x x 5 x 5 ee ezee- seer" goes e7-seeger”-e8 §° SMOKING AND HEALTH ADVOCACY GROUPS - CONTINUED a Oe ff a / << Founded Mombership o er ol rl of ef om Loe 7 Name of Organization North Carolina GASP (NC) 1986 80 x x x x sl Northem Virginia GASP (VA) 1980 100 x x x x | Northwest Pennsylvania Coalition on Smoking and Health (PA) x x x I Ohlo GASP (OH) 1983 4000 x x , sit People Against Tobacco Smoke (PATS) (Mi) 1984 150 x x a Peopte for a Smoke-Free indoors (NY) 1986 500 x x x x x s/i Pittsburgh Association for Nonsmokers' Rights (PA) 1976 x x x s/l Right to Breathe (NY) x I Right to Breathe, Inc. (FL) 1978 x 1 Rocky Mountaln Tobacco-Free ORGS IN Challenge (UT) 1984 8 STATES x x r St. Joseph County Interagency Council on Smoking and Heaith (IN) 1973 & ORGS x x wt Sierra Club — Delta Chapter (LA) 1969 NAT AFFIL x x x 1 Smoke Free Class of 2000 Project (KS) 1987 x svt A Smoke-Free Generation (MN) 1984 sO x Ws Smoking Policy Institute (WA) 1985 200 x x n Southern Wisconsin GASP (Wi) I Stop Teenage Addiction to Tobacco (MA) 1985 1000 x x x 1 vs Stop Teenage Addictlon to Tobacco (CA) 1985 x x vs Task Force on Hazards of Tobacco Consumption (KS) 12 ORGS x al Texas Association of Nonsmokers (TX) x 1 Texas Interagency Council on Smoking or Health (TX) 1983 ORGS x x x 3 Texas Smoke Free indoor Air Coalition (TX) 1986 x x x s/l Tobacco Free America Project (DC) ORGS x x x x n Tobaoco Free North Dakota Coalition (ND) 1986 20 ORGS x x x x x 8 Tobacco Products Liability Project (MA) 1984 N/A x 4 n TrbAgency Coalition on Smoking or Health (NJ) x x wi Tri-Agency Florida Coalition on Smoking or Health (FL) 1983 ORGS x x 8 Virginia GASP (VA) 1986 250 x x x x x aft Virginia interagency Council on Tobacco Or Health (VA) x x x s Virginians tor Clean Alr (VA) 1986 200 x x x x x ( Wichita GASP, Inc. (KS) 1975 150 x x sl Wieconsin Tr-Agency Coalition (Wi) 1982 INOD/ORGS x x x x 8 Women Concerned About Smoking (NM) 1988 ORGS x 3 al World Organization for Science and Health (CT) 1983 N/A x vs Wyoming GASP (WY) x x s Youth Educational Services, inc. (YES) (CO) 1987 x x x nish Other: t research, 2 health facilities, 3 women, 4 litigation, S social 390 oO eS Ye U.S. GOVERNMENT PRINTING OFFICE: 1990 717- 025 29271