Bibliography on Smoking and Heaith.
Annual cumulation of Smoking and Health Bulletins.
Earlier editions of the bibliography, from 1970-1988 are
available 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 all 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 Phvsician Talks About Smokina.

A

Developed for physicians and other health care profes-
sionals who are called upon to speak to medical and lay
audiences on smoking and heatth.
Booklet: 55 pages. (Slides available for purchase,
National Audiovisual Center, (301)763-l 896.)

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:
  198&Women

1981-The Changing Cigarette (out of print)
1982-Canter
1983-Cardiovascular Lung Disease
1984-Chronic Obstructive Lung Disease
1985-Canter and Chronic Lung Disease in the Workplace
1986-Involuntary Smoking
1988-Nicotine Addiction.
198Q-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).

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 (WC)
The Center for Environmental Health and Injury Control
(CEHIC) of the CDC is conducting four research and analysis
projects on smoking and health, 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) Ill, in which thousands of
cotinine measurements will be taken, the EHLS is
developing immunologic and gas chromatography/mass
spectrometry (GCIMS) methods for serum cotinine
measurement. The GClMS 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 on a
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.

163


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.

National Institute for Occupational Safety and Health
PC)
The National Institute for Occupational Safety and Health
(NIOSH) conducts research on the causes of work-related
illness 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 and injuries 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

projects will be 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:

o Area Health -Education Centers Family Medicine
Department Grants;

o Family Medicine Residency and Training Grants;

o General Internal Medicine, Pediatrics Residency, and
Training Grants;

o Nursing Demonstration Project Grants;

o Nurse Practitioner and Nurse Midwife Grants; and

o 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 (HPIDP) 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 heatth care service
delivery. Hence, smoking cessation is:

o integrated as part of risk assessment in prenatal care;

o taught as part of anticipatory guidance in pediatric care:

o included in the HP/DP activities for adolescent patients:

o 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
models 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-

164


munities by making all IHS facilities smoke-free. The IHS set
a goal to make nonsmoking the social norm and reduce all
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 all 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 Heatth 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.

Natlonal 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,

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 lnstiiute 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 how to 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 asample
list of appropriate curricula.

Smoking Policy Questions and Answers, a series of 10
separate publications providing brief, practical advice
about contemporary smoking policy issues.

o Health Effects of Environmental Tobacco Smoke

o Implementation of Smoking Policies

9 Strategies for Selecting Smoking Cessation Programs

o Costs and Benefits of Smoking Restrictions in the

Workplace

o Smoking in the Workplace: Ventilation

o Smoking in the Workplace: Legal Issues

o Smoking Policies and the Unions

o Smoking Policies and Health Care Institutions

165


o Smoking and the Female Workforce

o 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 NCl's research, disease
prevention, and health promotion activities related to tobacco
??? 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 isthefocus
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:

o A Comprehensive Approach to the Prevention of
Smoking;

o Late Adolescent Smoking: Process Analysis and
Deterrence;

o School and Family-Oriented Cancer Prevention
Program;          ,

o Evaluation of School-Based Smoking Prevention;

o 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 off ice 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:

o Compliance with Nicotine-Bearing Chewing Gum;

o Physician Counseling for Smoking Cessation;

o Physician and Dentist Intervention for Smoking
Cessation;

o Smoking Cessation Delivered in Physicians' Offices;

o Evaluation of Physician and Dentist Interventions for
Smoking Prevention and Cessation; and

166


o 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 mediaand community intervention programs.
Efforts currently being supported include:

o Mass Media and Prevention of Adolescent Smoking;

o Approaches to Comprehensive Smoking Prevention;

o A Su Salud -A Media and Community Demonstration;

. Smoking Prevention Through Mass Media and School
Programs; and

o Community Interventions for Cancer Prevention.

Black-American interventions

The NCI currently supports eight intervention projects to ad-
dress 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 !ailoring 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:

o Smoking Prevention Among New York Hispanic Youth;

o Smoking Prevention in Hispanic Adolescents; and

o Smoking Cessation Intervention in Hispanics.

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 in the 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

167


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 Communlcatlons (NCI)

Through its press activities and answers to public inquiries,
the NCI 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, heafth 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 program 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 at a 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 1 O-l 8 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 AA0 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 Off ice 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 lOA24. Bethesda, Maryland 20892. The materials
available to professionals and the general public include:

o Quit For Good brochure for use by physicians and den-
tists;

o Helping Smokers Quit brochure for use by pharmacists;

9 Clearing The Air brochure on cessation techniques;

o Guia Para Dejar De Fumar Spanish language booklet for
seff-help smoking cessation;

9 Why Do You Smoke self-test;

o Chew Or Snuff Is Real Bad Stuff brochure on smokeless
tobacco;

o Cancer Prevention Brief: Tobacco, an overview of the
relationship of smoking to health problems; and

0 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, con!rol,
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-
-merits" 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 heafth 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.

o 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.

169

o 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.

o School-Based Opportunities For Tobacco Use Intewen-
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 sewe 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

commitment and physician followup. A more intensive
strategy is also described.

o 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 ir@ude 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; A's Your Business: A Guide To Heart And
Lung Health At The Workplace; and With Every Beat Of Your
Heart: An ldeabook 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 distributed 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 heafth 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 plus 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 acontrol 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 school heatth 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 School 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. P:eventive 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
heakh care providers in clinical settings. These recommenda-
tions appeared in the May 20, 1988, issue of the Journal of
the American MedicalAssociation. 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 memberorganiza-
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 all 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 Al-A, the NCI, and the
OSH. The DOD Smoking Working Group and individual repre-
sentativesfrom 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 betoobtain 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 off ice 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

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 cessarion 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
of 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
Smokeoui 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 f.acilities, and all naval hospitals
are required to offer group programs in smoking cessation.
Educationalclasses 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 se&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

171


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
and 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

American Lung Association
1740 Broadway
New York, New York 100194374
(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
Health and Temperance Department
6840 Eastern Avenue, N.W.
Washington, D.C. 20012
(202)722-6700

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-l 051

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-l 711

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

172


Office on Smoking and Health
Centers for Disease Control
Park Building, Room l-58
5600 Fishers Lane
Rockville, Maryland 20857
Public Inquiries:
(301)443-l 575

National Cancer Institute supports atoll-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 l-1 6
5600 Fishers Lane
Rockville, Maryland 20857
Technical Inquiries:
(301)443-l 690

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   represent the efforts of voluntary groups; State, county, and
level throughout the Nation. While not a complete listing of all   local departments of health; hospitals and clinics: and private
                          organizations in each State and in the Virgin Islands, Guam,

programs offered to the public, this directory includes
descriptions of over 1,500 programs. These programs

and Puerto Rico. Following this listing is a description of efforts
of smoking and health advocacy groups.

173


STATE AND LOCAL PROGRAMS

ALABAMA

0001.  ALABAMA DEPARTMENT OF PUBLIC HEALTH,
    644 State Office Building, Montgomery, Alabama
     36111.

Program Title:
Health 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, in the 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 15day 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
upa survival station at the State Heath 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 Offlce Park Drive, Suite 300,
   Blrmlngham, 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.

0003.  AMERICAN CANCER SOCIETY, ALABAMA
    DIVISION, 402 Office Park Drive, Suite 300,
    Birmingham, Alabama 35223.

Program Title:
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 ad&s 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 It 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 Off ice
    Box 9097, Birmingham, Alabama 35213.

Program Tftle:
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.

17s


0006.  AMERICAN HEART ASSOCIATION, ALABAMA
   AFFILIATE, 1449 Medical Park Drive, Post Off Ice
   Box 9097, Blrmlngham, Alabama 35213.

Program Title:
Save A Sweet Heart.

Contact:

Mr. James A. McDermott, Program Director
(205)592-7100.

Descr iptlon :

The Save A Sweet Heart program is a series of activities to
promote nonsmoking among junior and senior high school
students. For more information, see the detailed program
description in Part 1.

0007.  AMERICAN LUNG ASSOCiATiON OF ALABAMA,
   900 South 18th Street, Post Office Box 55209,
   Birmingham, Alabama 35255.

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 Pari 1.

0008.  AMERICAN LUNG ASSOCIATION OF ALABAMA,
   900 South 18th Street, Post Office Box 55209,
   Birmingham, Alabama 35255.

Program ntle:

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 Pari 1.

0009.  AMERICAN LUNG ASSOCIATION OF ALABAMA,
   900 South 18th Street, Post Office Box 55209,
   Birmingham, Alabama 35255.

Program Title:
Freedom From Smoking Instructor Training.

Contact:

Mr. James L. Hughes, Executive Director
(205)933-8821.

Descrlptlon:

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.

0018.  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.
For more information, see the detailed program description in
Part 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.

Descrlptlon:

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.

176


0013.  CULLMAN COUNTY HEALTH DEPARTMENT,
   500 Logan Avenue, SW., 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 in the
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 Off Ice
    Box 488, Annlston, 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.

Descrlptfon:

Clinic staff introduce and explain the lo-day smoking

0016.  AMERICAN CANCER SOCIETY, ALASKA
   DIVISION, INC., 406 West Flreweed Lane, Suite
    101, Anchorage, Alaska 99503.

Program Title:
FreshStart.

Contact:

Ms. Carol Wheeler, Program Director
(907)277-8696.

Descrlptlon:

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 Flreweed Lane, Suite
    101, Anchorage, Alaska 99503.

Program Title:
Quitter's Guide.

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.  MOelLE 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.

Descrlptlon:

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 resutts 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
localchapter of the American Cancer Society offers the Fresh-
Start program, in cooperation with the Health Department, free
of charge.

ALASKA

Contact:

Ms. Carol Wheeler, Program Director
(907)277-8696.

Descrlptlon:
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.

0018.  AMERICAN HEART ASSOCIATION, ALASKA AF-
   FILIATE, INC., 2330 East 42nd Avenue,
   Anchorage, Alaska 99508.

Progam Title:
In Control.

Contact:

Ms. Lynn McCarthy, Programs 8nd Communications Director
(907)563-3111.

Descrlptlon:

The American Lung Association's smoking cessation video

177


program, In Control, is availablefor rentor 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 8 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
a nonsmoking lifestyle. For more information, see the detailed
program description in Part 1.

0021.  AMERICAN LUNG ASSOCIATION OF ALASKA,
    605 Barrow Street, Suite 2, Anchorage, Alaska
     99510.

Program We:

Freedom From Smoking At Work.

Contact:

Ms. Nancy Babb Stone, Program Director
(907)276-5864.

D8SCrlptiOn:

The American Lung Association's Freedom From Smoking At
Work program is offered. For more information, see the
detailed program description in Part 1.

0022.  AMERICAN LUNG ASSOCIATION OF ALASKA,
   605 Barrow Street, Suite 2, Anchorage, Alaska
     99510.

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.

0023.  AMERICAN'LUNG ASSOCIATION OF ALASKA,
   605 Barrow Street, Suite 2, Anchorage, Alaska
     99510.

Program ntk
Growing Healthy.

Contact:

Ms. Nancy Babb Stone, Program Director
(907)276-5864.

Descrlptlon:

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 Networkof the United States Department of Education.
Longitudinal studies have been done on the project with
significant 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 ASSOClATlON OF ALASKA,
    605 Barrow Street, Suite 2, Anchorage, Alaska
     99510.

Program Title:
In Control.

Contact:

Ms. Nancy Babb Stone, Program Director
(907)276-5864.

Descrlptlon:

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, AnChOr898, Alaska
     99510.

Program Title:
Lungs Are For Life.

Contact:

Ms. Nancy Babb Stone, Program Director
(907)276-5864.

178


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 ASSOClATtON OF ALASKA,
   605 Barrow Street, Suite 2, Anchorage, Alaska
     99510.

Program Title:
Cctopuff In Kumquat.

Contact:

Ms. Nancy Babb Stone, Program Director
(907)276-5664.

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 ntle:

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 ASSOClATlON OF ALASKA,
   605 Barrow Street, Sutte 2, Anchorage, Alaska
     99510.

Program Title:

School Health Speakers Bureau.

contact:

Ms. Deborah Williams, Executive Director
(907)276-5864.

Descrlptlon:

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.

0028.  AMERICAN LUNG ASSOCIATION OF ALASKA,
   605 B8rrOW Street, Suite 2, Anchorage, Alaska
    99510.

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.

0030.  DEPARTMENT OF HEALTH AND SOCIAL SER-
   VICES, Kodiak Health Center, Post Office Box
   1216, Kodlak, Alaska 99615.

Program Title:

Education Of Smoking Risks.

Contact:

Ms. Rae Jean Blaschka, Public Health Nurse
(907)466-X31 9.

Descrlptlon:

In each of the villages on Kodiak Island, 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, Ameriian 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 ls harmful.

0031.  DEPARTMENT OF HEALTH AND SOCIAL SER-
   VICES, Kodiak Health Center, Post Office Box
   1216, Kodlak, Alaska 99615.

Program Title:
FreshStart.

Contact:

Ms. Rae Jean Blaschka, Public Health Nurse
(907)466-3319.

Descrlptlon:

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 ADVENTlST CHURCH, 1515 East
   Tudor Road, Anchorage, Alaska 99507.

Program Title:
Breathe-Free Plan To Stop Smoking.

Contact:
Mr. David J. Strike
(907)562-2721.

179


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.

0033.  AMERICAN CANCER SOCIETY, ARIZONA    0038.  AMERICAN CANCER SOCIETY, ARIZONA
    DIVISION, INC., CENTRAL REGION, 634 West       DIVISION, INC., SOUTHERN REGION, 634 West
   lndi8n School Road, Phoenix, Arizona 85013.         Indian School Road, Phoenix, Arizona 85013.

Program Title:
FreshStart.

Program Title:
FreshStart.

Contact:

Contact:

Ms. Carrie Bruner, Program Coordinator
(602)264-5861.

Ms. Courtney Upton, Program Coordinator
(602)790-2600.

Descrlptlon:

Description:

The American Cancer Society's FreshStart smoking cessa-
tion clinic is offered. For more information, see the detailed
program description in Part 1.

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, Phoenlx, Arizona
     85013.

0037.  AMERICAN CANCER SOCIETY, ARIZONA
    DIVISION, INC., WEST VALLEY REGION, 634
    West lndlan School Road, Phoenix, Arizona
     85013.

Program Title:
FreshStart.

Program Title:
FreshStart.

Contact:

Contact:

Ms. Mardy Sears, Program Coordinator
(602)890-0717.

Ms. Suzanne Gaither, Program Coordinator
(602)972-0788.

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.

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, Phoenlx, Arizona 85013.

0038.  AMERICAN CANCER SOCIETY, ARIZONA
    DIVISION, INC., WESTERN REGION, 634 West
    lndlan School Road, Phoenix, Arizona 85013.

Program Title:
FreshStart.

Program Title:
FreshStart.

Contact:

Contact:

Ms. Ann Kuttz, Program Coordinator
(602)526-3800.

Ms. Chris Bergman, Program Coordinator
(602)855-4357.

Description:

Descrlptlon:

The American Cancer Society's FreshStart smoking cessa-
tion clinic is offered. For more information, see the detailed
program description in Part 1.

The American Cancer Society's FreshStart smoking cessa-
tion clinic is offered. For more information, see the detailed
program description in Part 1.

180


0039.  AMERICAN HEART ASSOCIATION, ARIZONA
    AFFILIATE, 1445 East Thomas Road, Phoenlx,
     Arizona 85014.5794.

Program Title:
Heart At Work.

Contact:

Mr. Willi Baer, Program Director
(602)277-4646.

Descrlptlon:

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.

0040.  AMERICAN HEART ASSOCIATION, ARIZONA
    AFFIUATE, 1445 East Thomas Road, Phoenlx,
     Arizona 85014-5794.

Program Title:

Putting Your Heart Into The Curriculum.

Contact:

Mr. Willi Baer, Program Coordinator
(602)277-4846.

Descrlptlon:

This program is a series of four curriculum guides divided into
four grade-level components. The materials include modules
on the circulatory system, heart disease prevention, risk factor
modification, nonsmoking, and nutrition.

0041.  AMERICAN HEART ASSOCIATION, ARIZONA
    AFFILIATE, 1445 East Thomas Road, Phoenix,
     Arizona 85014.5794.

Program Title:

Save A Sweet Heart.

Contact:

Mr. Willi Baer, Program Director
(602)277-4646.

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.

0042.  AMERICAN HEART ASSOCIATION, ARIZONA
   AFFILIATE, 1445 East Thomas Road, Phoenix,
     Arizona 85014-5794

Program Title:
Speakers' Bureau.

Contact:

Mr. Willi Baer, Program Director
(602)277-4646.

181

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.

0043.  ARIZONA LUNG ASSOCIATION, 102 West
    McDowell Road, Phoenix, Arizona 85003.

Program Title:
In Control.

Contact:

Ms. Patrice Quarg, Program Director
(602)258-7505.

Descrlptlon:

This self-help program includes a videocassette, viewers'
guide, and audiocassette. In Control can be purchased or
rented 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 ntki:

Marijuana: A Second Look.

Contact:

Ms. Patrice Ouarg, Program Director
(602)258-7505.

Description:

This package program directed towards students in grades 4
through 8 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, Phoenlx, 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.

0046.  ARIZONA LUNG ASSOCIATION, 102 West
   McDowell Road, Phoenlx, Arizona 85003.

Program Title:
SMOKEBUSTERSI


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-l/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.

Descrlptlon:

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 112 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, Phoenlx, Arizona 85003.

Program Tttle:

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 oifering 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.

Descrlptlon:

This program determines the prevalence of tobacco and al-
cohol us0 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 tdevaluate 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 g-month intervals to evaluate any significant change or
improvement in behavior or attitude levels.

0050.  MARICOPA COUNTY DEPARTMENTOFHEALTH
    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.

Descrlptlon:

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 l-year intervals. A strong emphasis is placed on
the effects of smoking on the unborn child and the prevention
of relapse.

0051.  MARICOPA COUNTY DEPARTMENTOFHEALM
   SERVICES, 1825 East Roosevelt, Phoenix,
     Arizona 85006.

Program ntre:

Worksite Smoking Cessation.

Contact:

Ms. Christine Liberato, Chief, Bureau of Health Education
(602)258-6381.

Descrlptlon:

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. In addition to
the class, information on smoking and smoking cessation is
distributed and displayed throughout the program year.
Various smoking cessation self-helpmaterials and information
on smoking risks are distributed at the program kick-off event.
Motivational inserts are included with employee paychecks
before class meetir,gs and throughout the program year.

182


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.

Contact:

Mr. Brick Lancaster, Chief
(602)230-5833.

Deecrlptlon:

0052.   OFFICE OF HEALTH PROMOTlON AND EDUCA-
    TION, ARIZONA DEPARTMENT OF HEALTH
    SERVICES, 3008 North Third Street, Suite 103,
    Phoenix, Arizona 85012.

Arizona is planning to cooperate with eight other Rocky Moun-
tain States in establishing goals and projects for a tobacco-
free society during 1988.

Program Title:
Smokeless Tobacco.

0055.  PIMA COUNTY HEALTH DEPARTMENT, 888
    South Craycroft, Tucson, Arizona 85711.

Program Title:

Contact:                          Pregnant And Stop Smoking.

Jack Dillenberg, D.D.S., Chief, Office of Dental Health
(602)255-1866.

Contact:

Description:

Ms. Karen Fields, Community Nutrition Division
(602)745-6783.

This educational project was developed last year in coopera-
tion with the Qffice of Dental Heafth. The project provides
information and curriculum guides on smokeless tobacco to
schools and other groups by request.

Description:

0053.   OFFICE OF HEALTH PROMOTlON AND EDUCA-
    TION, ARIZONA DEPARTMENT OF HEALTH
    SERVICES, 3008 North Thlrd Street, Suite 103,
    Phoenix, Arizona 85012.

Program Title:
Perinatal Care Program.

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 bade 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.

Contact:

Ms. Lisa Hulette, Division of Family Health
(602)255-l 875.

0056.  PULMONARY ASSOCIATES, P-A., 1112 East
    McDowell Road, Phoenix, Arizona 85006.

Program Title:

Dsscrlptlon:

Quitting With Nicorette.

As part of this program, smoking assessment and referrals for
cessation classes are offered to clients.

Contact:

Bonnie Fahy, R.N., Program Coordinator
(602)258-4951.

00%.  OFFICE OF HEALTH PROMOTlON AND EDUCA-
   TION, ARIZONA DEPARTMENT OF HEALTH
    SERVICES, 3008 North Thlrd Street, Suite 103,
    Phoanlx, Arizona 85012.

Dsscrlptlon:

Program Tltls:
Rocky Mountain Free Challenge.

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, Llttle
    Rock, Arkansas 72205.

Program Tltls:
FreshStart.

Contact:
Ms. Barbara Brill, Health Educator
(501)661-2207.

Description:
The American Cancer Society's FreshStart smoking

183


cessation clinic is available. For more information, see the
detailed program description in Part 1.

0058.  ARKANSAS DEPARTMENT OF HEALTH, 4815
    West Markham Street, Llttle 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, YMCA% health main-
tenance organizations, and other facilities have been trained.

Other activities associated with the American Cancer Society
include program development and trainingforthe 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.

Descrlptlon:

The Seventh-Da Adventists' Nationally-implemented
program is offer ed! 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 Troillett 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

0061.  AMERICAN CANCER SOCIETY, CALIFORNIA    0062.  AMERICAN HEART ASSOCIATION, GREATER
   DIVISION, INC., BUTTE-GLENN-TEHAMA UNIT,       LOS ANGELES AFFILIATE, INC., 3550 Wilshire
    114 West Seventh Avenue, Chico, California       Boulevard, Fifth Floor, Los Angeles, Callfornla
     95926.                                   90010.

Program Title:                       Program Title:
FreshStart.                               Heart At Work.


Contact:                                   Contact:
Ms. Phyllis Bond, Executive Director              Ms. Annamarie Shaw, Program Coordinator
(916)342-4567.                         (213)385-4231.

Description:                        Description:
The American Cancer Society's FreshStart smoking cessa-   The American Heart Association's Heart At Work program is
tion clinic is offered at no cost to participants. For more   offered. For more information, see the detailed program
information, see the detailed program description in Part 1.    description in Part 1,

184


0063.  AMERICAN HEART ASSOCIATION, GREATER
    LOS ANGELES AFFILIATE, INC., 3550 Wllshlre
    Boulevard, Flfth Floor, Los Angeles, Callfornla
     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 ASSOCIATfON, GREATER
    LOS ANGELES AFFILIATE, INC., 3550 Wilshire
    Boulevard, Fifth Floor, Los Angeles, Callfornla
     90010.

Program Title:

Rx Your Prescription For A Healthy Heart.

Contact:

Ms. Annamarie Shaw, Program Coordinator
(213)~~4231.

Descrlptlon:

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 ASSOClATlON OF ALAMEDA
   COUNTY, 295 27th Street, Oakland, Callfornla
    94612-3694.

Program Tltb:

Biofeedback Smoking Education Project.

Contact:

Ms. Kris Hammar, Program Consultant
(415)893-5474.

Dsscrlptkn:

The American Lung Association's Biofeedback Smoking
Education Project is offered. For more information, see the
detailed program description in Part 1.

0066.  AMERICAN LUNG ASSOClATfON OF ALAMEDA
   COUNTY, 295 27th Street, Oakbnd, Callfornla
     94612-3694.

Program ntie:

Freedom From Smoking Clinics.

Contact:

Ms. Kris Hammar, Program Consultant
(415)893-5474.

Dsscrlptlon:

The American Lung Association's Freedom From Smoking
clinics are offered. A f.ee 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 ASSOClATlON OF ALAMEDA
    COUNTY, 295 27th Street, Oakland, California
    94612-3694.

Program Title:

Freedom From Smoking Clinics For Teens.

Contact:

Ms. Kris Hammar, Program Consultant
(415)893-5474.

Dsscrlptlon:

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.

0066.  AMERICAN LUNG ASSOClATlON OF ALAMEDA
   COUNTY, 295 27th Street, Oakland, California
    94612-3694.

Program Mle:

Freedom From Smoking Clinics In The Workplace.

Contact:

Ms. Mary Ellen O'Neill Creighton, Program Coordinator
(415)893-5474.

Descrlptlon:

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.

0069.  AMERICAN LUNG ASSOCIATION OF ALAMEDA
   COUNTY, 295 27th Street, Oakland, California
    94612-3894.

Program Mb:
Smoking And Pregnancy.

185


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 ASSOClATtON OF CALIFOR-
   NIA, 424 Pendleton Way, Oakland, Callfornla
     94621.

Program Title:

Smoke-Free Family Programs.

Contact:

Ms. Sylvia Scarborough, Director, Community Health
(415)638-5864.

Descrlptlon:

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 school students. The
California State Office works with 19 affiliates to promote and
provide consultation on all programs offered in the State.

0071.  AMERICAN LUNG ASSOClATlON OF CONTRA
    COSTA AND SOLANO COUNTIES, 105 Astrld
    Drive, Pleasant Hill, California 94523-4399.

Program Tltle:

Freedom From Smoking Clinics.

Contact:

Ms. Michelle Munn, Smoking Cessation Coordinator
(415)935-0472.

Descrlptlon:

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 ASSOClATlON OF CONTRA
    COSTA AND SOLANO COUNTIES, 105 Astrid
   Drive, Pleasant Hill, California 94523-4303.

Program ntle:

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 ASSOClATlON OF CONTRA
    COSTA AND SOLANO COUNTIES, 105 Astrid
    Drlve, Pleasant HIII, 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, Callfornla 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 effects of smoking, especially for pregnant smokers
and teenagers.

0075.  AMERICAN LUNG ASSOCIATION OF SAN
    FRANCISCO, 562 Mission Street, Suite 263, San
   Francisco, California 94105-2910.

Program Title:

Freedom From Smoking.

Contact:

Irene Rev&s-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

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community, and for pregnant women in prenatal clinics. Also,
&f-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 ASSOClATlON OF SANTA
    CLARA AND SAN BENITO COUNTIES, 1469 Park
    Avenue, San Jose, Callfornla 95126.

Program Title:
Ash Kickers Club.

Contact:

Ms. Margaret W. Leathers, Director of Programs
(408)998-LUNG.

Descrlptlon:

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.

0017.   AMERICAN LUNG ASSOClATlON OF SANTA
    CLARA AND SAN BENITO COUNTIES, 1469 Park
    Avenue, San Jose, Callfornla 95126.

Program Title:

CLASP - Counseling Leadership Against Smoking Pres-
sures.

Contact:
Ms. Margaret W. Leathers, Director of Programs
(408)998-LUNG.

Descrlptlon:

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 empbys 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 l-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.

0076.  AMERICAN LUNG ASSOClATlON OF SANTA
    CLARA AND SAN BENITO COUNTIES, 1469 Park
   Avenue, San Jose, Callfornla 95126.

Program Title:
Free Line.

Contact:

Ms. Margaret W. Leathers, Director of Programs
(408)QQ8-LUNG.

Descrlptlon:

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 ASSOClATlON OF SANTA
    CLARA AND SAN BENITO COUNTIES, 1469 Park
    Avenue, San Jose, Callfornla 95126.

Program Title:

Freedom From Smoking.

Contact:

Ms. Margaret W. Leathers, Director of Programs
(408)998-LUNG.

Descrlptlon:

The American Lung Association's Freedom From Smoking
program is offered. For more information, see the detailed
program description in Part 1.

0060.  AMERICAN LUNG ASSOClATlON OF SANTA
    CLARA AND SAN BENITO COUNTIES, 1469 Park
   Avenue, San Jose, Callfornla 95126.

Program Title:

Smoking And Pregnancy.

Contact:

Ms. Margaret W. Leathers, Director of Programs
(408)998-LUNG.

Descrlptlon:

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 ASSOClATlON OF SUPERIOR
    CALIFORNIA, 2732A Cohasset Road, Chico,
    Callfornla 95926.

Program Title:

Freedom From Smoking.

Contact:

Ms. Jeanne Jelke, Executive Director
(916)845-6864.

Descrlptlon:

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 ASSOClATlON OF VENTURA
   COUNTY, Post Offlce Box 1627, Ventura,
    Callfornla 93002.1627.

187