Smoking Patterns in Oregon Youth: Effects of Funding and Defunding of a Comprehensive State Tobacco Control Program

Purpose: Comprehensive tobacco control programs have included school-based prevention programs as a key strategy to reach adolescents. Unfortunately, these programs have undergone extensive budget reductions in recent years. In 2003, funding for the Oregon Tobacco Prevention and Education Program was reduced by about 70%, and the school component was entirely defunded. To assess the effects of program funding and subsequent defunding on smoking prevalence within targeted Oregon schools, we compared the change in 30-day smoking prevalence between grades 8 and 11 in school districts in two periods: namely, during funding and after funding was eliminated. Methods: We used annual school-based survey data for grades 8 and I I to describe district-level changes in smoking prevalence in five age cohorts: two during the funding period and three after defunding. Each cohort was comprised of districts whose 8th-graders completed the Survey and participated again 3 years later. Using mixed models, we compared the change in 30-day adjusted smoking prevalence among cohorts in funded districts, defunded districts, and districts that never received funding. Results: Smoking prevalence growth was significantly higher among cohorts from the defunded period than for cohorts from the funded period (p = .04) and was not significantly different from schools that were never-funded (p = .79). Conclusions: In Oregon, funding a school component of a comprehensive tobacco control strategy was associated with depressed uptake of smoking. Gains were quickly lost upon program defunding. School programs are in important strategy if they are long term, comprehensive, and. reinforced in the larger environment. (C) 2009 Society for Adolescent Medicine. All rights reserved.