Through the Master Settlement Agreement (MSA) between the states and the tobacco companies, New Jersey now has an historic opportunity to create and implement a sustained, comprehensive tobacco control program to decrease tobacco use. Under the leadership of Governor Whitman, twenty percent (20%) of the first payment of settlement funds will be dedicated for such a program. Our mission is to decrease sickness, disability, and death among New Jerseyans associated with the use of tobacco and exposure to environmental tobacco smoke. This goal cannot be achieved by state and local governments alone. The New Jersey Department of Health and Senior Services (DHSS) remains committed to partnering with community and legislative leaders, health professional societies, advocacy groups including New Jersey Breathes and its coalition members, the American Cancer Society, American Lung Association, American Heart Association, New Jersey GASP, regional "Communities Against Tobacco," and educators to achieve this vision.

Tobacco use is the single most preventable cause of death and disease in New Jersey. Each year too many New Jerseyans are diagnosed with cancer, cardiac, pulmonary, and other diseases which significantly impact their quality of life, and more than 12,830 New Jersey residents die from diseases directly related to tobacco use. The problem of tobacco use is community-wide. Exposure to environmental tobacco smoke (ETS) reduces the quality of life for smokers and non-smokers. When community partners are included in the overall development and implementation of a comprehensive tobacco plan, there is increased commitment by the community to address the problem of tobacco use and to help in shifting community norms to non-acceptance of tobacco use. Altering community norms can produce changes in attitudes and behaviors surrounding tobacco use and reduce its negative impact on New Jerseyans.

Tobacco is addictive; nearly seven out of ten smokers want to quit, but less than 3% of those who want to quit are successful each year. Key strategies for limiting tobacco use include a focus on preventing the initial addiction as well as treatment for current smokers.

Achieving our goal will take time and sustained resources. Knowledge, attitudes, and behaviors surrounding tobacco use have evolved over time and have been shaped by many years of tobacco advertising. More than one in five adults in New Jersey still smoke, and smoking rates among older youth have been on the rise in this decade. Those who continue to smoke in the 1990s are a tougher audience than those who have already quit. It is expected to take twenty years to see a permanent decrease in the use of tobacco by New Jersey residents.

The Mission of the Comprehensive Tobacco Control Program of the New Jersey Department of Health and Senior Services is to decrease sickness/disability and death (morbidity and mortality) among New Jerseyans associated with the use of tobacco and exposure to environmental tobacco smoke. We will accomplish our mission by working with new and existing partners.

The Goals of the Program are:

1. To decrease the acceptability of tobacco use among all populations;

2. To decrease the initiation of tobacco use by youth under 18 years of age and those 18-24 years of age;

3. To increase the number of youth and adult tobacco users who initiate treatment;

4. To decrease exposure to environmental tobacco smoke (ETS); and,

5. To reduce disparities related to tobacco use and its effects among different population groups.

DHSS will use the following principles to achieve the goals outlined above:

• Government alone cannot realize the goals of this program. Achieving reductions in tobacco use for all New Jerseyans will require that DHSS work with existing partners and create new partnerships that can work together towards this shared vision;
  
• Changes in human behavior are difficult to achieve, and a sustained, comprehensive effort over a generation is required to achieve and maintain changes in tobacco use across all ages and communities;
  
• Changes in knowledge and attitude precede changes in behavior and should be expected early in program implementation;
  
• Program design must be evidence-based, building on best practices in New Jersey and other States;
  
• Program components must be designed to target populations most in need of services and those groups which are hardest to reach;
  
• Ongoing evaluation of all interventions must be integrated into the program development and implementation to determine if the interventions are being conducted as planned, to permit assessment of pre-determined benchmarks and outcomes, and to allow for course correction; and,
  
• No program component is exclusive of the others; therefore, it is imperative to appropriately implement each one as part of the comprehensive tobacco control plan.

Using these policy principles, the Comprehensive Tobacco Plan will include five strategic interventions and an evaluation of the overall plan. The strategic interventions include:

• Youth Tobacco Awareness/Marketing and Communications Campaign (ages 5-24)
  
• Community Partnerships
  
• Programs Focused on Youth
  
• Treatment of Nicotine Addiction (Cessation)
  
• Enforcement

The purpose of this plan is to outline the mission, goals and overall strategic framework that form the basis of the New Jersey Department of Health and Senior Services' (DHSS) Implementation Plan for a statewide, comprehensive program to limit tobacco use in New Jersey. A successful program must include all components outlined in this plan as they build upon one another. No single component alone can effectively reduce tobacco use. In the program's first year program components will be developed based on a budget of $18.6 million. DHSS envisions that these components will be expanded based on a substantial increase in dedicated funds in future years. Increased funds will be needed to fully implement a comprehensive tobacco control program in New Jersey.

This Strategic Plan is the first step in what is expected to be an interactive and iterative process to develop a detailed Implementation Plan for New Jersey's Comprehensive Tobacco Control Program. DHSS is committed to working with its partners in this planning process. The Department will create Advisory Panels on Comprehensive Tobacco Control to the Commissioner of DHSS, for the strategic interventions and to monitor evaluation. A variety of partnerships is integral to the success of a comprehensive tobacco control program. Partnerships with current advocacy and service organizations and legislators as well as community and business coalitions yet to be developed will provide the overall framework for this program.

This document may only be reproduced in its entirety. No portion of this document may be reproduced without the permission of the New Jersey Department of Health and Senior Services. © 1999 New Jersey Department of Health and Senior Services.

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