Partnerships

in Tobacco Prevention and Control
Acknowledgements

This guide was produced for the Centers for Disease Control and Prevention by the Center for Public 

Health Systems Science at the Brown School at Washington University in St. Louis. 

Primary contributors:

Stephanie Andersen, Laura Brossart, Rebecca Ballard, Amy Endrizal, Erin Foster, Isaiah Zoschke, Tim Poor, Elyse 

Vesser, Douglas Luke, Sarah Moreland-Russell

Input was provided by:

Cathy Callaway, Carissa Holmes, Joann Kang, Michon Mabry Jeter, Karla S. Sneegas, Renee Wright

Input for the case studies was provided by:

Tiffany Johnson, Mississippi Office of Tobacco Control

Charlotte Williams, Mississippi Office of Tobacco Control

Cheryl Bettigole, Philadelphia Department of Public Health

Ryan Coffman, Philadelphia Department of Public Health

Other contributions:

Photographs on pages 5 and 24 courtesy of Gustavo Torrez, Campaign for Tobacco-Free Kids

Photographs on pages 14 and 15 courtesy of Cynthia Hallett, Americans for Nonsmokers’ Rights

Photographs on pages 16 and 28 courtesy of Carly Caminiti, Health Resources in Action

Photograph on page 17 courtesy of Patty Barahona, Youth Leadership Institute

Photograph on page 18 courtesy of Shaunda Scruggs

Photograph on page 19 courtesy of Sally Herndon, North Carolina Tobacco Prevention and Control Branch

Photograph on page 22 courtesy of John Daley, Colorado Public Radio

Photograph on page 37 courtesy of Wayne Tormala, Arizona Bureau of Tobacco and Chronic Disease
Table of Contents

Guide to the Reader .......................................................................... 1

Making the Case ............................................................................. 2

Brief History .................................................................................. 3

How to ....................................................................................... 4

What are Partnerships in Commercial Tobacco Prevention and Control? ............... 4

Preparing to Partner .................................................................. 5

Forming Coalitions ................................................................... 11

Achieving Goals with Partners ....................................................... 14

Advancing Health Equity and Reducing Disparities .................................. 25

Working Together Effectively ......................................................... 29

Evaluating Partnerships .............................................................. 32

Sustaining Partnerships .............................................................. 36

Providing Support ........................................................................... 39

Case Studies ................................................................................. 40

Case for Investment ......................................................................... 44

Resources ................................................................................... 46

References .................................................................................. 53
Partnerships l 1

GUIDE TO THE READER

Purpose

The Center for Public Health Systems Science at 

Washington University in St. Louis is developing a 

set of user guides funded by the Centers for Disease 

Control and Prevention (contract 75D30120C09195) 

for the Best Practices for Comprehensive Tobacco 

Control Programs—2014 (Best Practices 2014), 

an evidence-based tool to help states develop 

comprehensive tobacco control programs.1

The purpose of the user guides is to help tobacco 

control staff and partners implement evidence-based 

best practices by translating research into practical 

guidance. The guides focus on strategies (e.g., programs 

and interventions) that have shown strong or promising 

evidence of effectiveness. Recommendations in this 

guide are suggestions for programs working to develop 

strategic partnerships and coalitions. Programs can 

follow these recommendations according to their 

needs, goals, and capacity. 

Content

This user guide updates recommendations in the 

2009 Best Practices User Guide: Coalitions.

2

 State and 

community partnerships continue to be essential 

to change behavior and social norms around 

commercial tobacco use.1

 According to Best Practices 

2014, partnerships “can keep tobacco issues before 

the public, combat the tobacco industry, enhance 

community involvement and promote community 

buy-in and support, educate decision makers, and 

help to inform policy change.”1

 This guide expands the 

recommendations of the 2009 Coalitions user guide to 

include partnerships that form for a narrow, strategic 

purpose and larger, more complex coalitions. It gives 

program managers information on how to develop 

effective partnerships and coalitions as a part of a 

comprehensive tobacco control program.

Links to More Information

Each instance of italicized, bolded blue text in the guide 

indicates a link to an additional resource or a page 

within the guide itself with more information. Website 

addresses for all of the blue resources noted throughout 

the guide are also included in the Resources section. 

Organization

8 Making the Case: A brief overview of why it is

important for tobacco control programs to form 

partnerships

8 Brief History: How partnerships have led the

movement to reduce commercial tobacco use

8 How to: Strategies to involve partners in

commercial tobacco prevention and control efforts 

8 Providing Support: How tobacco control

programs can support partnerships

8 Case Studies: Real-world examples of how

partnerships have advanced commercial tobacco 

control goals

8 Case for Investment: Information to raise

awareness about the importance of commercial 

tobacco control partnerships

8 Resources: Publications, toolkits, and websites to

help in planning efforts

Best Practices for Comprehensive 

Tobacco Control Programs–20141

The Best Practices 2014 is an evidence-based 

guide to help states plan, establish, and 

evaluate comprehensive commercial tobacco 

prevention and control programs. The report

offers recommendations and evidence for five

essential components of effective programs:

• State and community interventions

• Mass-reach health communication

interventions

• Cessation interventions

• Surveillance and evaluation

• Infrastructure, administration, and

management
MAKING THE CASE

Making the Case for Partnerships 

Ending the commercial tobacco use epidemic will require the coordinated efforts of many people.3 Partnerships can 

create the capacity to achieve goals that programs may not have the authority or flexibility to reach on their own. As 

programs are asked to do more with fewer resources, partnerships have become even more critical to commercial 

tobacco control efforts.4

 Partnerships help programs:

8 Develop synergy

Partnerships bring together people with different strengths and experiences. When people pool their different 

skills and knowledge to work toward a common goal, they are able to do more than they could on their own.5

8 Build capacity

Partnerships help commercial tobacco control staff gain knowledge about different communities, learn new 

skills, and improve existing skills.6

 In turn, partners develop relationships and skills that enhance their ability to 

address community problems.7

8 Drive policy change

The most effective interventions combine program and policy strategies to influence social norms about 

commercial tobacco use and exposure to secondhand smoke.1 Partners can lead policy change, informed by the 

science and best practices.

8 Enhance credibility

Partnerships get trusted leaders and reputable organizations involved in tobacco control issues.4 Their support 

generates interest and increases credibility for the program’s activities.4

8 Counter tobacco industry influence

Partnerships create a broad base of support to combat the powerful influence of the tobacco industry and 

expose its practices.6 Program staff and partners can work together to develop effective methods to counter the 

industry’s tactics.3

8 Advance health equity and reduce disparities

Partners bring a diversity of lived experiences, viewpoints, and skills to tobacco control efforts. Forming multilevel, multi-sector, diverse, and inclusive partnerships can also help programs reach priority groups and focus 

resources on advancing health equity and reducing tobacco-related disparities.5

8 Sustain commercial tobacco control efforts

Partnerships build community support for tobacco control strategies.6 When partnership activities end, 

community members can use the skills they have learned and the relationships they have built to continue 

working to reduce commercial tobacco use and address social determinants of health in their community.8

Partnerships l 2
BRIEF HISTORY

Fifty Years of 

Partnership 

In the 1960s, people began to grow concerned about 

the harmful effects of smoking and the tobacco 

industry’s tactics. In response, nonsmokers’ rights 

groups began forming across the United States. Their 

concerns were warranted; in 2006, a federal court 

ruled that the industry had conspired for decades to 

mislead the public.9 These groups have since evolved 

into partnerships and coalitions that work at grassroots, 

local, state, and national levels. Starting with the 

National Cancer Institute’s American Stop Smoking 

Intervention Study (ASSIST) in 1990 and continuing 

through multiple Surgeon General Reports and the 

publication of CDC’s Best Practices 2014, national 

programs have worked to reinforce partners’ roles in 

commercial tobacco control.1,3,10

Coalitions are a special type of partnership that have 

successfully promoted policy change despite an 

often unfavorable cultural and legislative climate for 

their work.11 Their resolve has created a permanent 

role for partner organizations in tobacco control. 

One of the first coalitions to counter the industry 

and engage priority populations was in 1990 when 

national, local, and faith-based organizations joined 

forces against menthol cigarette marketing targeted 

at Philadelphia’s Black community.12 In 2013, the 

City of Chicago spearheaded a coalition of national 

and local organizations against the harms of flavored 

tobacco. As a result, the city passed a restriction on 

flavored tobacco product sales within 500 feet of 

schools.13 Government agencies recognize the need 

for partnerships to strengthen and sustain programs. 

Over the past 20 years, many government investments 

in programs have required community partnerships as 

a funding condition.5 Budget constraints have forced 

programs to do more with less, which may explain the 

rise in popularity of public health partnerships.4,14

In 2000, CDC formed the National Networks, a 

consortium of national organizations to prevent 

commercial tobacco use in populations experiencing 

tobacco-related disparities. In 2009, CDC focused 

on coalitions in the first Best Practices User Guide, 

which reviewed evidence on coalitions and provided 

recommendations on supporting coalition partners.2

Today, partnerships and coalitions are working to 

raise awareness of the importance of environments 

free of commercial tobacco, educate about the impact 

of tobacco prices, create health communications 

campaigns, and promote cessation. As of April 2020, 

27 states and 1,131 communities had laws requiring 

all non-hospitality workplaces, bars, and restaurants 

to be smokefree.15 Nearly all states have increased their 

cigarette taxes since 2002.16 States and communities 

across the country are forming partnerships to counter 

the tobacco industry’s impact in retail stores, including 

restricting the sale of flavored tobacco products.17

Figure 1. History of Commercial Tobacco Control Partnerships

Partnerships l 3
HOW TO

What are Partnerships 

in Commercial Tobacco 

Prevention and 

Control?

Partnerships are formed when two or more 

organizations work together to reach a common goal.18

Often the term “partnership” is used interchangeably 

with terms like alliance, coalition, collaboration, or

network. Partnerships occur along a continuum, 

ranging from organizations who work independently 

on a single project to partners who act almost as a 

single organization. Most partnerships work within the 

middle of this range.18 Partnerships also vary in their 

purpose, membership, and structure. 

Source: Campaign for Tobacco-Free Kids

Strategic partnerships come together for a narrow 

purpose.19 These partnerships can include joint ventures 

and public-private initiatives. Working together gives 

the partners a strategic advantage, and each adds 

value to the activities of the other partners.20 Strategic 

partnerships help programs seize new opportunities 

and work together on community issues.21 They often 

involve only those organizations needed to reach their 

goal and may disband once the goal is reached.19 These 

partnerships often lack a formal infrastructure and 

meet only as needed.19

Coalitions are a special type of partnership that are 

more complex and broader in scope than strategic 

partnerships.20 They have diverse and inclusive 

membership, bringing together people and organizations 

with wide-ranging skills and knowledge.5

 Coalitions 

tend to have formal structures for communication and 

decision-making, including shared vision and mission 

statements, rules, goals, and objectives.5

 They may be 

statewide or focus on one community or population. 

Although statewide coalitions are not typically funded by 

tobacco control programs, working together is important 

to advance tobacco control goals.

Coalitions address broad problems that cross 

traditional organizational boundaries and need 

multiple solutions.18 They are sometimes also referred 

Partnerships l 4
to as community-wide partnerships. Coalitions are 

particularly important in building momentum for 

change in communities where the tobacco industry 

plays a large role in the culture and economy.22

Table 1 describes unique features of strategic 

partnerships and coalitions. Both types of partnerships 

contribute to commercial tobacco control goals by 

implementing parts of the program’s strategic plan, 

providing training, and evaluating program outcomes.21

Preparing to 

Partner

Rushing to form strategic partnerships 

and coalitions without proper 

preparation may result in ineffective 

partnerships or damage relationships 

between partners. Programs can 

prepare to form successful partnerships 

of any size by defining a clear need for 

the partnership, developing partnership 

infrastructure, and identifying potential 

partners. When program staff are ready 

to form a new partnership or coalition, 

they can follow the steps on page 8. 

For more guidance on developing 

coalitions, see page 11.

Defining the Need

A first step in forming a partnership is understanding 

why the partnership is needed.23 Sometimes the need 

may be clear. For instance, a program working to 

reduce tobacco-related disparities may need better 

access to community members or a program promoting 

smokefree air may want to reach business leaders.

Table 1. Unique Characteristics of Strategic Partnerships and Coalitions 

Characteristic Strategic Partnerships Coalitions

Purpose • Seize new opportunities

• Respond quickly to emerging trends

• Good choice for partners not yet able to 

make a longer-term commitment

• Work on complex problems that are unlikely to 

be solved by one organization

• Address a variety of tobacco control or public 

health issues

• Cross traditional organizational boundaries

Membership • Only those organizations needed to reach 

a specific goal

• A diverse, inclusive mix of organizations that 

bring together many skills and perspectives

Structure • Informal structures and procedures

• Temporary

• Meet only as needed

• Formal communication and decision making 

structures

• Shared vision, mission, and goals

• Longer-term commitment

• Regular meeting schedule

Adapted from Butterfoss20 and Colorado State Tobacco Education & Prevention Partnership19

Partnerships l 5

HOW TO
Other times, it may be unclear what is needed to achieve 

better results. Staff can conduct a SWOT analysis to 

better understand the program’s strengths, weaknesses, 

opportunities for success, and threats to achieving goals 

(Figure 2). Learn more at the Minnesota Department of 

Health’s SWOT Analysis web page.

Once a program identifies a need to form a partnership, 

it is important to decide what type of partnership is 

needed to reach their goals. For example, a strategic 

partnership may be the best approach to tackle a 

single straightforward issue. A coalition can be a more 

effective way to work together on a variety of issues or 

a complicated problem that needs wide community 

involvement and skills from different fields.5

Figure 2. SWOT Analysis

Adapted from CDC28 and the Minnesota Department of Health29

Developing Partnership Infrastructure

Programs that are prepared to partner have leaders 

who help develop staff skills, policies, and resources 

necessary for partnering. When leaders believe 

that partnerships are important, they will include 

partnering as part of a program’s strategic agenda and 

may dedicate staff time and resources to developing and 

sustaining partnerships.24 Leaders are also influential 

communicators. By talking about the benefits of 

partnerships, they can build support throughout the 

organization.25 Program staff can help gain leadership 

support by explaining:26

• How the partnership aligns with leadership’s 

priorities

• Why leadership support for the partnership 

matters

• What added value the partnership will bring to 

the program’s work

• What leadership can do to help 

Staff may need training to effectively form 

partnerships and make sure that new partnership 

opportunities are not missed.27 Training in working 

with others, such as conflict management and 

customer service skills, can help keep 

new partnerships strong.24 Depending 

on the partnership, staff training may 

also include how to work with people 

from different cultures. See page 25

for more on working with partners 

from diverse backgrounds.

Building Representative 

Coalitions

The most effective coalitions actively 

engage populations who are most 

directly affected by commercial tobacco 

use, such as members of certain racial/

ethnic minority groups, LGBTQ 

communities, communities with low 

income or education, and Native 

communities.30,31 These are often the 

people who hold the least power and 

resources. Diverse, representative 

coalitions that share power and 

leadership with community members are 

better equipped to make lasting change.30

Learn more about building shared 

leadership on page 12 and engaging 

community partners on page 25.

Partnerships l 6

HOW TO
Identifying Potential Partners

Deciding who to partner with is one of the most 

important decisions staff will make when forming 

partnerships. Having the right partners can build 

momentum for commercial tobacco control; having the 

wrong partners can waste time and energy and set back 

a program’s goals. Staff can look for partners who: 

• Are seen as trustworthy and credible by people 

who represent the community4

• Bring something valuable to the partnership, 

such as technical skills32

• Can help achieve goals32

• Provide access to resources or networks4

• Have a stake in the outcome32

• Do not have any real or perceived conflicts of 

interest with the program, such as an affiliation 

with the tobacco industry32

To develop a list of potential partners, program staff can 

ask trusted advisors and gatekeepers to identify sectors 

that are important to engage in commercial tobacco 

control work.33 They may also be able to give referrals 

or make connections at events and conferences. 

Programs may also issue a broad call for partners. The 

call does not have to be announced publicly, but can be 

shared with many potential partners to avoid pressure 

on a single partner to take part or the appearance of 

preferential treatment.4

 For a list of potential partners 

and how they can contribute, see Table 2 on page 8.

A CLOSER LOOK: Public-Private Partnerships 

Public-private partnerships share skills and resources between public organizations like tobacco 

control programs and private businesses, individuals, and charitable branches of companies.6 These 

partnerships help programs be innovative and agile, share messages with a wider audience, develop 

staff skills, and build support for tobacco control outside the public sector.6 Public-private partnerships 

have shared the cost of state quitlines and added cessation to employee health benefits.34

Although private organizations can make strong partners, they may have different missions and cultures 

than public organizations. For instance, businesses may be responsible to shareholders and often operate 

on short timelines.6 While businesses (including healthcare organizations like hospitals, insurers, and 

physician groups) may not share all of the program’s goals, they care about the effects of commercial 

tobacco use on employee health care costs and productivity and the potential impact of regulations 

on their business.35 Understanding differences, identifying potential conflicts of interest, and finding 

common ground early on can help develop successful partnerships.6

 To form public-private partnerships, 

programs can take the following steps:35

• Research the partner’s mission, vision, and corporate culture

• Explain to partners how they can benefit from the partnership, focusing on shared interests and 

return on investment

• Understand differences between the partner’s fiscal years and the program’s grant funding cycles

• Limit complex health terms in communications with partners 

• Create work plans with short timelines

Partnerships l 7

HOW TO
Table 2. Potential Tobacco Control Partners

Partner Type Link to Commercial Tobacco Control Partner Activities

Businesses People who smoke are more likely to miss 

work and use health care services.3

 Smokefree 

workplaces protect employees from secondhand 

smoke exposure.36 Workplace policies and 

practices that support cessation make quitting 

tobacco easier for employees and encourage 

them to use cessation coverage.36

• Provide comprehensive cessation 

coverage to employees

• Form cost-sharing partnerships 

with state quitlines

• Make workplaces tobacco-free

Chronic disease programs Tobacco dependence is a chronic disease 

that often relapses and increases the risk of 

other chronic illnesses.3,37 Chronic disease 

prevention programs may be willing to align 

efforts with tobacco control programs to 

reduce costs and improve outcomes.

• Pool resources and coordinate 

efforts

• Train program staff and other 

partners

• Create joint health communications

Communications specialists 

and news outlets

Communications specialists have experience 

creating ads, planning media placements, and 

arranging opportunities for news coverage. 

Newspapers and radio stations may support 

program goals and publish content that 

promotes commercial tobacco control efforts.

• Help programs adapt existing ads 

and create new ads

• Offer free ad placement or reduced 

development costs

• Publish letters to the editor, Op-Eds, 

and news stories

Community members Community members know best how 

commercial tobacco use, secondhand smoke 

exposure, and the tobacco industry affects 

them and their families. They can add valuable 

information, insight, and credibility to 

commercial tobacco control efforts.

• Educate decision makers about how 

tobacco impacts their communities 

• Help select evaluation measures and 

review data

• Share program updates with other 

community members

Decision makers Elected officials and other community leaders 

represent community members and respond 

to their concerns, including those related 

to tobacco. They are an important audience 

to educate about the harms of commercial 

tobacco use.

• Write letters to the editor

• Serve as coalition or partnership 

spokespersons

• Adopt and implement policies that 

address commercial tobacco use 

and exposure

Faith-based organizations Faith-based organizations such as churches, 

mosques, temples, or health ministries are 

central hubs of community activity.38 They 

have strong credibility among community 

members and care about their health.38

• Educate faith communities about 

commercial tobacco control issues

• Serve as champions to lead efforts or 

build community support

• Speak as trusted voices for 

community well-being

Groups representing

populations affected by 

tobacco-related disparities

Certain populations are more likely to use 

commercial tobacco and less likely to be able 

to quit, such as some racial/ethnic groups and 

people with lower education and income.3,39

Organizations who represent these groups can 

reach the population and add credibility to 

commercial tobacco control efforts. 

• Share insight about the population’s 

culture and key concerns

• Help programs develop strategies 

that match community needs and 

values

• Promote the Quitline and other 

cessation resources

• Develop and adapt ads for nonEnglish speakers and other groups

Partnerships l 8

HOW TO
Table 2 cont. Potential Tobacco Control Partners

Partner Type Link to Commercial Tobacco Control Partner Activities

Healthcare partners Hospitals, health systems, and health insurers 

can help make commercial tobacco cessation 

screening and treatment a part of every 

patient visit.40 Integrating commercial tobacco 

use treatment into routine clinical care and 

offering comprehensive cessation coverage can 

increase the chances of quitting successfully.1

• Screen every patient for tobacco use and

offer those who use commercial tobacco

help to quit at every visit

• Improve insurance coverage for evidencebased cessation treatment

• Refer patients to state quitlines for

cessation support

Legal technical 

assistance providers

Legal technical assistance organizations, such 

as the Public Health Law Center, are experts 

on the legal aspects of commercial tobacco 

control and know about emerging policies and 

tobacco products.

• Develop and share educational and

training resources

• Help decision makers draft policy and

enforcement language

• Help with legal challenges from the

tobacco industry

National Networks Although smoking is at an all-time low, 

prevalence remains high among certain 

groups.41 CDC funds eight National 

Networks to address tobacco-related and 

cancer-prevention disparities and serve 

as national leaders in commercial tobacco 

prevention and control.

• Provide training and technical assistance

to help local partners implement culturally

responsive, evidence-based strategies

• Engage priority populations in

commercial tobacco control strategies

• Implement health communications

campaigns

National tobacco 

control organizations

National partners play an important 

leadership role in tobacco control.1,42 Partners 

can use their influential voices to communicate 

with decision makers and build public support 

for reducing commercial tobacco use.

• Develop media campaigns

• Provide technical assistance to develop and

implement commercial tobacco control

strategies

• Collect surveillance data

Regulatory agencies 

and law enforcement

Regulatory agencies and law enforcement are 

responsible for administration, oversight, and 

enforcement of tobacco control laws at the 

national, state, and local levels. They enforce 

smokefree laws, conduct retailer compliance 

checks, and work to prevent tobacco tax evasion.

• Help plan for enforcement activities

• Educate the community about existing and

new policies

• Make sure business owners follow policies

Schools and 

universities

Young people spend much of their day in 

school, making schools an important setting 

for tobacco-free interventions.43 Youth 

with lower academic achievement are also 

more likely to use tobacco than their higher 

achieving peers.39

• Make school campuses and events tobaccofree

• Educate youth about the dangers of

commercial tobacco use

• Connect youth with tobacco control

program activities

Youth Tobacco companies continue to use tactics to 

appeal to youth and promote their products in 

places visited by young people.44 When young 

people learn they are being manipulated by the 

tobacco industry, they are more likely to get 

involved.45 Youth bring a fresh perspective to 

tobacco control efforts.46,47

• Conduct store assessments and

neighborhood audits

• Monitor youth tobacco sales

• Share messages on social media

• Serve as spokespersons on tobacco control

policy interventions to decision makers

Partnerships l 9

HOW TO
Steps for Forming Partnerships

Every partnership is unique. Strategic partnerships 

may come together quickly, while coalitions may 

include a formal application process. Although 

partnerships may form in different ways, they often 

share these common steps:48

• Research: Gather information about the partner’s 

interests, trustworthiness, and past performance.

• Explore: Talk with the partner to learn more 

about them and areas of shared interest.

• Convene: Have a more in-depth conversation to 

talk about specific projects and begin building 

a relationship.

• Agree: Develop written guiding principles that 

outline the partnership’s purpose and partner 

roles and responsibilities.

• Implement: Carry out the activities described in 

the written guidance.

• Monitor: Closely track partnership activities to 

make sure timelines are met and unexpected 

challenges are dealt with.

• Evaluate: Assess the partnership’s successes and 

failures, and evaluate the potential for future 

partnerships.

Figure 3 shows how the steps fit together to form a 

partnership cycle. The cycle begins with gathering 

information to decide whether the partnership can 

succeed. Important considerations are whether the 

partner has a similar mission and culture, leadership 

support, and adequate resources to devote to the 

partnership. Assessing whether there are potential 

conflicts of interest between the program and partner, 

such as other pending contracts or tobacco industry 

influences, is also important.4

Figure 3. Steps for Forming Partnerships

Adapted from CDC Foundation48

Once a candidate has been identified, an exploratory 

conversation can help programs gauge the partner’s 

interest. If there is mutual interest, follow-up meetings 

can help partners get to know each other better and 

start discussing the details of the partnership.21

A Memorandum of Understanding (MOU) is a 

nonbinding document that details the purpose 

of the partnership and expectations of partners.4

 

While a formal MOU may not be necessary for all 

partnerships, recording the results of these meetings in 

a written guidance document helps secure a partner’s 

commitment.4

 Partnerships formed quickly may still find 

it helpful to draft guiding principles later on to clarify 

how partners will work together and measure success.4

What is included will depend on the partnership, but 

often includes the following information:4

• Contact information for each partner

• Partners’ assets, strengths, and resources 

• Partners’ potential conflicts of interest

• Description of the problem the partnership aims 

to address

• Goals and objectives of the partnership

• Roles and responsibilities of partners

• A plan for how partners will make decisions and 

communicate about activities

• Measures for evaluating the partnership

• The end date of the agreement and how it can be 

revised, renewed, or ended

As they begin working together, periodic monitoring 

helps partners stay on track to meet goals. Evaluating 

successes and challenges completes the partnership 

cycle and informs future partnerships.

Partnerships l 10

HOW TO
Forming Coalitions

Coalitions are a special type of partnership that bring 

together a large, diverse group of partners. Coalitions 

are most useful when:

• The problem or goal is complex23

• Many parts of the community need to be 

involved23

• Partners are duplicating efforts23

• A new opportunity arises, such as funding, 

information, or policy changes49

Developing coalitions requires an extra level of 

commitment and planning. It begins with a core group 

of partners who want to achieve the same long-term 

goal.5

 These partners provide initial resources to 

form the coalition.5 Initial partners do not have to 

be members of top-level leadership to form a new 

coalition. For instance, youth from the Vietnamese 

Youth Development Center led the development 

of a coalition to create healthy corner stores in 

San Francisco’s Tenderloin neighborhood.50 They 

encouraged partners to come together by gathering 

data about the unhealthy food, alcohol, and commercial 

tobacco products sold in their community and 

presenting it to local organizations and city agencies.50

It is important to have realistic expectations about the 

time and resources it takes to set up the coalition. 

Coalition development takes an average of 12 months.51

The actual time frame may very depending on the 

scope of the problem the coalition will address.14

Partners who have worked together before may be able 

to come together more quickly.52 It is also important to 

take the time to involve community members as equal, 

active partners.33

Questions to Ask Before 

Forming a Coalition20

• Does the problem affect a wide range 

of people?

• Does the problem require information 

and skills from multiple sectors?

• Is broad public education needed?

• Is any organization already 

responsible for this work?

• Do other organizations see the 

problem as a priority and want to 

work together to address it?

• Is the problem best addressed 

through a joint approach?

• Are potential members willing to give 

up control over coalition activities 

and share decision making?

• Are there resources that can be 

shared to do the work?

Partnerships l 11

HOW TO
Having a strong infrastructure in place 

can help a new coalition be successful. 

Effective coalitions have skilled 

leadership, diverse membership, a 

shared mission and vision, and formal 

policies and procedures to guide the 

coalition’s work.53

Building Shared 

Leadership

It is important to engage members of 

communities that are most impacted 

by tobacco use. By sharing power 

with a wide range of community 

stakeholders, rather than leading 

from the top down, coalitions can 

gain a broader understanding of the 

root causes of commercial tobacco use disparities.30

Strong coalition leaders have the skills, relationships, 

and vision to combine individual interests into a 

shared strategy for community change.53 Potential 

leaders include partners who are respected by their 

organizations, communities, and other coalition 

members. An important role of coalition leaders is to 

foster and share leadership among members.30

It is important to choose leaders who can:

• Organize efforts5

• Encourage partners to take on decisionmaking responsibilities, and acknowledge those 

contributions5

• Instill a sense of shared ownership in the 

coalition’s work33

• Effectively communicate with partners and 

community members5

• Manage conflicts if they arise8

Some coalitions may select a lead agency or 

organization to guide their efforts. A lead agency can 

be a part of the coalition or a separate organization 

with staff who can help plan, manage, and support the 

coalition’s activities.20 It may be necessary for leaders 

from traditional “top-down” organizations to switch 

to a community-based leadership model in which 

community members share in the key tasks, including 

managing resources.30

Characteristics of a Good Lead 

Agency20

• Strong links to and respect for the 

community

• The respect of community 

organizations and leaders

• Deep understanding of community 

health issues and priority populations

• Belief in collaboration 

• Adoption of tobacco control policies 

within the organization (e.g., tobaccofree workplace) 

• Staff support

• Ability to positively promote the 

coalition and its work

Partnerships l 12

HOW TO
Recruiting Members

Coalitions address complex issues that require the skills 

of many different partners. Their efforts can change 

the community significantly, and having broad-based 

support helps ensure that these changes are accepted 

and sustained.54 Including partners from different 

backgrounds and community sectors also enables the 

coalition to better understand the community’s needs.

Offering a variety of ways for people to contribute 

can help encourage more people to join. Some 

members may want to have a more active role in 

the coalition; others may be more interested in 

networking opportunities.5

 Members often have 

other work demands, so it is important to offer 

several participation levels. Coalition members fall 

into five types:

• Active Members who are regularly involved 

in coalition activities and meetings, assume 

leadership roles, and help recruit new partners5

• Part-Time Members who split their 

responsibilities among several staff from their 

organization and take turns attending events 

and meetings5

• Inactive Members who rarely attend coalition 

meetings but may be asked to help with specific 

activities or to become active members later5

• Active Supporters who occasionally attend 

meetings, lend credibility to the coalition, 

promote events and activities, and help create 

community connections5

• Virtual Supporters who have expressed interest 

in or support for coalition activities online (e.g., 

liking the coalition’s Facebook page or following 

its Twitter account)19

Understanding Community 

Context

Community context includes all of the 

community characteristics that affect how 

a coalition works.5

 They can influence 

coalitions at any stage, from recruiting 

partners to implementing strategies.5

 Some 

factors that can affect coalitions include:55

• Previous successful coalitions

• The level of trust between community 

organizations and members

• Local politics and history

• Readiness for change

• Geographic location (e.g., rural or 

urban settings)

• Demographic makeup of the 

community

• Culture and values

Creating a Shared Mission and Vision

Vision and mission statements help keep the coalition 

focused. The vision states what the coalition wants to 

achieve. It is short and to-the-point—it may be only a 

single sentence—so that it is easy to communicate to 

new partners and the community. The mission describes 

what the coalition will do to make its vision a reality. 

Keeping these statements broad encourages diverse 

membership and innovative strategies.23 All coalition 

partners have their own mission statements. To develop 

a joint vision and mission, partners can discuss each 

other’s goals, approaches to community issues, and 

personal or organizational strengths and challenges.21

Finding similarities and differences between partners 

can help develop joint statements that satisfy everyone’s 

interests. Updating statements annually helps ensure 

new opportunities are not missed.23

Establishing Policies and Procedures

Policies and procedures guide the coalition’s work. 

They can include written goals and objectives, bylaws, MOUs or other written guiding principles, and 

committee descriptions. These formal structures 

help coalitions engage partners, pool resources, and 

plan and implement strategies.5 Developing and 

documenting these structures also makes it more likely 

that coalition outcomes will be sustained.5

Learn more about forming coalitions in the Coalitions 

Start-Up Tools from CoalitionsWork.

Partnerships l 13

HOW TO
Achieving Goals with 

Partners

The ultimate purpose of a partnership is to achieve 

a common goal. Tobacco control partnerships pool 

resources to achieve the shared goals of reducing 

commercial tobacco use and preventing initiation.5

When partners work together in new ways, they 

can create innovative solutions to tough problems.56

Partnerships work best when their strategies 

complement and reinforce the other work of the 

program.57 Strategic partners and coalitions can work 

on the following strategies:

• Raising awareness about the importance of 

smokefree and tobacco-free environments

• Educating about the impact of tobacco product 

prices

• Reducing exposure to tobacco advertising and 

promotion

• Promoting cessation

• Communicating the dangers of commercial 

tobacco use

• Advancing health equity and reducing tobaccorelated disparities

Creating Smokefree and Commercial 

Tobacco-Free Environments

Exposure to secondhand smoke causes chronic 

illnesses, such as heart disease, and other serious 

health conditions.3 Smokefree laws make it clear 

that smoking is unsafe and unacceptable. They are 

especially important for protecting people with the 

greatest exposure to secondhand smoke: Blacks, youth, 

people living below the poverty level, and residents of 

multiunit housing.58

Partnerships have been instrumental in leading the 

movement for clean air, especially local coalitions. 

Partners run many of the places covered by voluntary 

smokefree and commercial tobacco-free policies, such 

as universities, workplaces, and hospitals. Partners 

can also help programs find champions and educate 

community members about the importance of clean air.

As e-cigarette use remains high among young people, 

many states and communities are including these 

products in smokefree laws.59 The aerosol produced 

by e-cigarettes is not harmless and can contain 

harmful and potentially harmful chemicals, including 

nicotine.60 Because e-cigarettes may resemble cigarettes, 

including them in indoor air laws can simplify policy 

enforcement and help the community maintain 

smokefree norms.60 Learn more about the risks of 

e-cigarette use in the CDC resource, Electronic 

Cigarettes: What’s the Bottom Line? States are also 

including prohibiting marijuana smoking in indoor 

air laws. As of January 2021, 18 states have included 

marijuana in smokefree laws.15

The Smokefree Atlanta coalition includes over 50 partner organizations. Atlanta 

passed new smokefree protections that went into effect in January 2020. 

Source: Americans for Nonsmokers’ Rights

Identifying Champions

Smokefree laws work best when they are supported 

by a community leaders and residents with diverse 

backgrounds.61 Partners can help programs connect 

with these potential champions. In Birmingham, 

Alabama, partners reached out to local clergy and nearly 

100 neighborhood association presidents, who then 

spread the word about the importance of smokefree 

environments. Birmingham passed a comprehensive 

smokefree law covering over 300,000 residents.61

Partnerships l 14

HOW TO
In San Francisco, California, youth from the Girls 

After School Academy worked with community 

leaders and tenants to create smokefree public 

housing developments. Involving tenants gave the 

initiative credibility with developers and led one of the 

developments to go smokefree.62 Read more in the San 

Francisco Tobacco-Free Project’s case study.

A CLOSER LOOK: Community Members and Entertainment Partners Support 

Smokefree Ordinance in New Orleans

After Hurricane Katrina devastated 

New Orleans, Louisiana, in 2005, the 

city looked for ways to rebuild. The 

Louisiana Campaign for Tobacco-Free 

Living wanted to protect the health 

of residents, visitors, and workers 

while promoting New Orleans’ 

famous attractions. Recognizing 

that Louisiana had one of the lowest 

percentage of employees covered by 

smokefree workplace protections, the 

campaign began reaching out to Black 

communities and health organizations 

to build community support for a 

comprehensive smokefree ordinance.63

The partnership also engaged New 

Orleans’ vibrant entertainment 

business community. Casino 

operators, musicians, bar and 

restaurant staff, and other hospitality 

workers shared personal stories about 

the harms of secondhand smoke exposure.64 Smokefree events featuring local bars and music venues 

promoted the campaign.63 In 2015, the New Orleans City Council unanimously passed a comprehensive 

smokefree ordinance making all workplaces, including bars, restaurants, and casinos, smokefree.63

The ordinance has been good for business. Six months after it went into effect, 78% of residents approved 

of the new law and business revenues had increased.63,64 Partnership-driven media coverage featuring 

well-known local entertainers helped spread word of its success.64 By August 2017, Baton Rouge, 

Louisiana’s capital city, and 11 other Louisiana cities passed their own comprehensive smokefree laws.65

Partners celebrate one year of smokefree air in New Orleans during the French Quarter 

Festival in 2016 Source: Americans for Nonsmokers’ Rights

Educating about Smokefree Benefits

Partners are natural educators because they are 

connected to the community and have credibility 

with community members. They can bring attention 

to the impact of secondhand smoke exposure where 

it may not be a priority.61 They can also clarify 

misunderstandings that may keep others from lending 

their support.61 Partners can lay the groundwork 

Partnerships l 15

HOW TO
for smokefree environments through community 

education and partnership building activities, such as:

• Collecting data on public support for clean air

or secondhand smoke exposure61

• Developing fact sheets, toolkits, or other

materials about the dangers of secondhand

smoke and the effectiveness of smokefree laws61

• Talking with community organizations,

landlords, and businesses about the benefits of

clean air61

• Writing letters to the editor and Op-Eds in

support of smokefree and commercial tobaccofree environments66

For example, partners in Louisiana set the stage 

for smokefree spaces by building local community 

coalitions, organizing smokefree hospitality events, and 

educating entertainment and hospitality workers. They 

also created the Healthier Air for All campaign to share 

messages about the importance of smokefree air. 

Supporting Implementation

Partners not only play a key role in raising awareness 

about the importance of smokefree protections, they 

are also messengers about new smokefree policies. 

Partners can educate the public and local businesses 

about the reason for the changes, when they will go 

into effect, and how they will be enforced. Since new 

smokefree policies increase cessation, partners can 

also help spread the word about resources to help quit 

commercial tobacco.67

Partners can also celebrate businesses and organizations 

that create smokefree spaces, which in turn may 

encourage others to follow their lead. For example, the 

American Nonsmokers’ Rights Foundation created the 

#ReopenSmokefree social media campaign to recognize 

the dozens of casinos that chose to reopen as smokefree 

spaces after COVID-19 related–restrictions were lifted 

and to encourage others to do the same.68

When new laws go in effect, partners can keep 

community support strong by maintaining a presence 

in the community and communicating through 

media outlets about the importance of comprehensive 

smokefree protections.69 Learn more in the Americans 

for Nonsmokers’ Rights tip sheet, Implementing Your 

New Smokefree Law.

Educating About the Impact of Tobacco 

Product Prices

Research shows that raising the price of tobacco 

products is the most effective way to prevent initiation 

and reduce commercial tobacco use.1 It can also 

generate revenue to fund programs and counter protobacco influences.3

 Pricing strategies include:

• Raising taxes on tobacco products70

• Setting a minimum price and pack size for

tobacco products70,71

• Prohibiting discounts and coupons70

• Reducing tax avoidance and evasion through tax

stamps and enforcement70

Increasing the price of tobacco products has strong 

public support.72 Community members can help build 

awareness about the impact of pricing tactics and create 

momentum for change. Legal experts and staff from 

other state agencies are also critical to help partners 

develop and implement legally sound strategies.

Members of Massachusetts’ The 84 youth coalition raise awareness about 

industry pricing tactics Source: The 84 ©2017 Marilyn Humphries

Educating the Public about Pricing Tactics

Many people who do not smoke are unaware of the 

tobacco industry’s pricing tactics.73 These tactics make 

commercial tobacco more attractive and accessible, 

Partnerships l 16

HOW TO
especially to youth and other priority populations 

(those that are most impacted by tobacco use).71

Partners can document tobacco prices and promotions, 

like discounts and coupons. Sharing the results with 

community members can raise awareness about the 

problem of inexpensive tobacco products. 

Gathering pricing data can be as simple as walking 

through the community and observing tobacco 

advertising for pricing and discount information. 

Working in groups of four to six people, partners 

can take photographs or videos of tobacco prices and 

promotions advertised on signs and functional items 

like gas pumps.74 They may want to focus on prices near 

particular places, such as parks or schools. Partners 

can share the photos and their personal stories about 

how tobacco product prices impact their communities 

with community leaders and the public. Learn more 

about using photography to document social issues 

in the Community Tool Box resource, Implementing 

Photovoice in Your Community.

Youth leaders in San Francisco share data they helped to collect on access to tobacco, alcohol, and unhealthy foods 

in area stores Source: Youth Leadership Institute

Providing Legal and Technical Expertise

Innovative pricing strategies are still being tested 

in many communities. Developing an evidencebased, legally sound strategy may require specialized 

knowledge beyond that of program staff.73 Attorneys 

and tobacco control law centers 

have the skills and experience 

to help states develop a 

successful strategy and plan for 

enforcement.73

Pricing strategies often overlap 

with the responsibilities of 

departments of agriculture, 

revenue, and commerce. 

Program staff can work 

with these partners to plan 

how existing policies will be 

enforced. For instance, the 

New York City Department 

of Finance enforces cigarette 

tax laws and the Department 

of Consumer Affairs issues 

tobacco retailer licenses and 

inspects stores for violations.75

The city Department of 

Health & Mental Hygiene worked with staff from these 

departments to limit price discounting and reduce 

cigarette smuggling from places with lower tax rates. 

Learn more about pricing strategies in the Center for 

Public Health Systems Science resource, Pricing Policy: 

A Tobacco Control Guide. 

Reducing Exposure to Tobacco 

Advertising and Promotion

The tobacco industry focuses most of its marketing 

efforts in retail stores, such as convenience stores, gas 

stations, groceries, and pharmacies.75 Research has 

shown that these tactics work; exposure to tobacco 

advertising encourages youth to begin using tobacco 

products and progressing to regular use.44 Strategies to 

reduce the influence of the tobacco industry in retail 

stores include:76

• Restricting the number, location, density, and

types of tobacco retailers, including those that

sell e-cigarettes

• Restricting point-of-sale advertising

• Restricting product placement

Partnerships l 17

HOW TO
• Increasing the minimum 

sales age for all tobacco 

products and enforcing 

the federal Tobacco 21 law 

at the state level

• Prohibiting the sale of 

flavored tobacco products, 

including menthol

Local communities and coalitions 

across the country have led the 

way in adopting innovative retail 

strategies.77,78 These partners have 

surveyed and mapped tobacco 

retailers, educated tobacco 

retailers, and built partnerships 

with the private sector, like 

corner store owners, to support 

retail efforts.50,79

Surveying and Mapping Tobacco Sales

Community surveys, store assessments, and maps of 

store locations can expose industry tactics aimed at 

priority populations and find where change is most 

critical. Gathering this information takes time and 

resources; partners can offer the people power to 

gather data from across the community. Partners can 

gather data by:

• Conducting store assessments and “walking” 

audits to document tobacco product advertising 

and promotions80

• Researching tobacco retailer permit data 

collected by health departments and licensing 

agencies81

• Conducting youth purchase surveys to monitor 

illegal sales of tobacco products82

• Creating maps of where tobacco retailers are 

located in neighborhoods81

The Standardized Tobacco Assessment for Retail 

Settings (STARS) is a simple, 20-item tool to collect 

information about tobacco product advertising and 

promotion in retail stores. STARS takes about 10 

minutes to complete on a smartphone or on paper and 

does not require special training. Learn more about 

STARS and the companion tools to assess vape shops 

(vSTARS) and flavored tobacco products (fSTARS) on 

the Counter Tobacco website.

Involving youth in retail efforts is especially helpful to 

reveal advertising tactics aimed at young people and 

raise public awareness about tobacco advertising. Staff 

can prepare youth to collect data by teaching them 

about the history of tobacco advertising and training 

them on how to talk with store employees. 

Safety is a top priority when involving youth in 

activities. Obtaining parental consent, coordinating 

transportation, sending youth in pairs, conducting 

background checks, and providing adult supervision 

can help ensure a safe and fun experience for young 

people.83,84 Learn more about engaging youth in CDC’s 

Best Practices User Guide: Youth Engagement in 

Tobacco Control and Prevention.

San Mateo County, California, tobacco control coalition member conducts staff appreciation visits with local 

tobacco-free pharmacies Source: San Mateo County Health

Engaging Tobacco Retailers

Asking retailers to share their questions or concerns 

about the potential impacts of retail tobacco strategies 

helps create effective, enforceable strategies.85 Programs 

and partners can take these steps to engage retailers:

• Reach out to business associations to connect 

with their members75

Partnerships l 18

HOW TO
A CLOSER LOOK: North Carolina’s Partners Inspire Action

Ranked 44th nationally in tobacco 

control funding, North Carolina’s 

Tobacco Prevention and Control Branch 

(TPCB) understands the importance of 

partnerships. “We try to build partnerships 

to make up for what we do not have in 

funding,” said Sally Herndon, head of the 

TPCB. In October 2018 the TPCB and its 

coalition partners organized its annual 

strategic planning meeting of nearly 100 

invitees. “We have many wonderful partners 

who are doing amazing work in tobacco 

control but who did not necessarily know 

about and link with each other’s work. Our 

goal was to educate, connect, and inspire 

action,” she added. They planned this 

event, as one member said, “like you plan 

a wedding—it’s all about relationships and 

getting folks to know each other.”

The coalition meeting began with a welcome and an overview of evidence-based strategies to reduce 

commercial tobacco use, including funding, price increases, tobacco-free policies, easy access to effective 

treatment, and hard-hitting media campaigns. Next, the participants engaged with data through a 

gallery walk featuring graphics showing North Carolina’s progress in building a comprehensive program. 

Participants gave feedback on sticky notes about what they saw, identified what they thought was missing, 

and shared ideas for future collaboration. 

Panel presentations gave partners a chance to share their varied work. Together with youth partners, 

the North Carolina Alliance for Health discussed the e-cigarette epidemic among youth. The TPCB 

described its work with Rescue, a health behavior change marketing agency, to develop mass-reach 

tobacco prevention campaigns. Representatives from the state’s Division of Health Benefits presented an 

update on Medicaid managed care access to commercial tobacco use treatment. The executive director 

of the Greater Charlotte Apartment Association shared how the Smoke-Free Apartment Certification 

Program was good for business and “an amenity worth bragging about.” 

The summit met its goals of educating, connecting, and inspiring the partners. After the meeting, 

partners became more active in seeking sustainable funding for media campaigns, offering tobaccouse treatment in community health clinic settings, and strengthening local tobacco-free policies. For 

example, after having learned about progress to cover tobacco use treatments through the state Medicaid 

program, partners have increased their efforts to provide commercial tobacco use treatment to patients 

at tobacco-free community behavioral health centers. Local health directors and county commissioners 

focused on expanding regulations to make government buildings, grounds, and public places tobaccofree. Inspired by the smokefree housing efforts in Charlotte, leaders of the Triangle Apartment 

Association voted to adopt a similar program. 

Coalition members meet to learn more about commercial tobacco control work 

in North Carolina

Partnerships l 19

HOW TO
• Educate businesses 

about the health risks of 

commercial tobacco use 

and secondhand smoke 

exposure76

• Publicly recognize 

businesses that 

voluntarily stop selling 

tobacco or reduce 

tobacco advertising in 

their stores86

• Offer technical assistance 

and resources to 

businesses that are 

working to comply50

For example, retailer opposition 

was a challenge to community 

efforts to restrict the sale of 

menthol tobacco products in St. Paul, Minnesota. 

Commercial tobacco control partners met with retailers 

and the city to educate them about the importance of 

restricting youth access to flavored products, including 

menthol. Retailers were able to voice their concerns and 

meeting participants agreed to create a support plan to 

help small businesses to reposition their businesses to 

focus on other products.87

Assurances of voluntary compliance can help enforce 

tobacco retail policies while limiting retailer exposure 

to multiple lawsuits for violations.88 These binding 

agreements commit large retailers to comply with 

commercial tobacco retail policies.88

Raising Community Awareness

Teaching partners about the effects of tobacco 

marketing can help them educate the community about 

the importance of retail strategies. Partners can attend 

community events, speak with the news media, and 

present at community meetings. Potential partners 

include economic development groups, business 

associations, and business owners. In New York City, 

partners liked having a few simple talking points about 

the problem of commercial tobacco use and their goals 

to use when speaking on behalf of the city’s efforts to 

reduce youth access to inexpensive tobacco.75

Data on the health and economic impact of retail 

strategies can also make the case for change. In 

Minneapolis, Minnesota, partners countered retailer 

claims that menthol restrictions would hurt their 

business by using industry trade publication data to 

show that tobacco products accounted for only a small 

portion of store profits.87 In contrast, the products came 

at a high cost to the health of communities, especially 

those targeted by years of tobacco industry marketing.87

Learn more about reducing tobacco industry influence 

in retail stores in the Center for Public Health Systems 

Science resource, Point-of-Sale Strategies: A Tobacco 

Control Guide.

Promoting Cessation

Although most people who smoke want to quit, 

most do not use evidence-based commercial tobacco 

cessation treatments.39 Partnerships are critical to help 

programs connect people who smoke to cessation 

support. Hospitals and health systems can make sure 

that every patient is screened for commercial tobacco 

use and offered help to quit at every visit. Private 

health insurers, state health plans, and state Medicaid 

programs can improve insurance coverage of cessation 

counseling and medication and support state quitlines.1

Learn more about each of the following cessation 

strategies in the CDC Best Practices User Guide: 

Cessation in Tobacco Prevention and Control.

Partnerships l 20

HOW TO
Making Health Systems Changes 

More than 8 in 10 people who smoke see their doctor 

every year, and most patients who smoke value their 

doctor’s advice about quitting.1 Healthcare providers 

from many specialties can be partners in treating 

commercial tobacco use and dependence, including 

pediatricians, pharmacists, and nurses. Programs 

can also work with partners from many healthcare 

settings, including outpatient and inpatient care, 

public and private practices, and settings with one or 

many providers. 

Health systems changes may include assigning staff to 

ask about commercial tobacco use, including reminders 

in electronic health records, and creating a referral 

system to connect patients to cessation resources.1

 For 

more on the components of health systems changes, 

see the Tobacco Cessation Change Package: A Million 

Hearts® Action Guide. 

Health systems change initiatives often bring together 

partners from across the system to implement these 

changes, including leadership, providers, healthcare 

staff, IT staff, and quality improvement specialists. 

Partners may be more willing to adopt health systems 

changes when they learn about the feasibility, economic 

benefits, and improved health outcomes for patients.1

Providers may also need training to screen for 

commercial tobacco use or technical assistance to make 

the changes. For example, the North Carolina Division 

of Public Health joined with partners at the Duke 

Smoking Cessation Program and the University of 

North Carolina Tobacco Treatment Program to develop 

the Duke-UNC Tobacco Treatment Specialist Training 

Program. The nationally accredited training program 

trains healthcare providers in person and online on 

integrating commercial tobacco treatment into any 

clinic or practice.89

Online training is an increasingly popular training 

format. Learn more about online training options at Rx 

for Change and the University of Wisconsin’s Tobacco 

Treatment Training.

Improving Cessation Coverage

Improving insurance coverage for evidence-based 

cessation treatment increases the number of people 

who try and succeed in quitting smoking.90,91 An 

important first step in improving cessation coverage is 

educating partners on what is meant by comprehensive 

cessation coverage. It includes:1

• Covering individual, group, and telephone 

counseling

• Covering all seven FDA-approved cessation 

medications (i.e., nicotine patch, gum, lozenge, 

nasal spray, and inhaler, bupropion, and 

varenicline)

• Eliminating or reducing barriers to treatment, 

such as co-pays or prior authorization

• Promoting available coverage to people who use 

commercial tobacco and to healthcare providers 

to increase awareness and use

• Monitoring and reporting use and availability of 

cessation treatment

Learning about the economic and health benefits 

of cessation coverage can encourage insurers and 

employers to take action. CDC’s 6|18 Initiative web 

page can help program staff talk to businesses about the 

importance of reducing commercial tobacco use. To 

learn more about starting a 6|18 Initiative team, see the 

Association of State and Territorial Health Officials’ fact 

sheet, Partnership: What Goes into Building a 6|18 

Initiative Team.

Programs may want to team up with a single large 

employer to serve as a model for other employers. For 

instance, Get Healthy Philly first approached the City 

of Philadelphia to expand cessation services to nearly 

7,000 city employees and their families.82 Their success 

encouraged other large employers to follow suit.82 Learn 

more about Get Healthy Philly’s efforts in the case study 

on page 42.

Supporting State Quitlines

Quitlines are free, evidence-based telephone helplines 

for people who want to quit smoking.1 They may also 

offer other resources, like web-based help and text 

messaging. Callers receive practical advice on how to 

quit, individual counseling, referrals to other services, 

and, in some states, cessation medication.1

State quitlines are highly effective.37 Using quitlines 

increases the chance of quitting successfully, and 

Partnerships l 21

HOW TO
using both quitline counseling and medication is 

more effective than using either alone.37 Quitlines 

are especially important for people who have limited 

access to cessation resources, such as people without 

health insurance or those who live far from a 

healthcare provider.92

Organizations that represent or serve priority 

populations are important partners to improve quitline 

reach to these groups. For example, Asian American 

community organizations can reach and refer clients 

who speak Asian languages to the state quitline.

Public-private partnerships have successfully funded 

state quitlines and helped to sustain their services.1

Health insurers, large employers, foundations, and 

trusts are potential private partners.93 Focusing on large 

health plans and employers helps partnerships have the 

greatest impact by expanding quitline reach to many 

people at once.94 Forming cost-sharing partnerships 

with the state Medicaid agency or state employee 

benefits program is a way to lead by example and show 

the benefits of partnering.95 Program staff can begin 

discussions with potential partners by focusing on the 

effectiveness of quitlines and the return on investment 

for partners.95

Dr. Robin Deterding of the Children’s Hospital Colorado speaks at a press 

conference in Denver, Colorado Source: John Daley/Colorado Public Radio

Financial constraints may impact the number of 

callers a quitline can serve. But states have found that 

potential partners appreciate when the program works 

with partners first before requiring cost-sharing or 

strategically limiting services.94 Learn more about how 

partners can support quitlines at the North American 

Quitline Consortium’s Public-Private Partnership 

Initiative.

Lobbying Restrictions on 

Federal Funding

Decision makers are important partners 

in commercial tobacco control work, but 

it is critical that programs understand 

special restrictions that come with 

federal funding. While educating and 

raising public awareness about issues are 

important activities of a commercial tobacco 

control program, lobbying efforts are not 

permitted.96 Prohibited activities that are 

considered lobbying include advocating for 

or against a specific piece of legislation or 

encouraging constituents to ask decision 

makers to support a specific bill.96 Instead, 

programs can focus on: 

• Educating decision makers and the 

public

• Researching interventions and 

communicating findings

• Implementing effective strategies

For more information about which activities 

are allowed, read the CDC resource, Antilobbying Restrictions for CDC Grantees.

Communicating About the Dangers of 

Commercial Tobacco Use

Communications campaigns share impactful messages 

about the risks of commercial tobacco use and how to 

get help to quit. Creating effective campaigns is often 

a group effort. They are developed with the help of 

communications specialists and community partners 

who create new materials, plan media placements, and 

arrange earned media opportunities. The group may 

Partnerships l 22

HOW TO
share messages on social media and distribute program 

materials.66 Partners also extend the reach of campaign 

messages by sharing them with their partners and the 

communities they represent. 

Learn more about each of the following health 

communications strategies in CDC’s Best Practices 

User Guide: Health Communications in Tobacco 

Prevention and Control.

Developing and Placing Ads

Effective communications campaigns include paid 

media ads placed on channels that reach wide 

audiences, such as television, radio, billboards, public 

transit, newspapers, magazines, or the internet.1

Experienced health communications partners can help 

develop ads, or, in many cases, adapt materials from 

existing campaigns. The CDC’s Media Campaign 

Resource Center allows free access to ads for programs 

to adapt and reuse.

Partners who have trusted relationships with the 

audience can help recruit participants to review ads and 

decide which are most easily understood, believable, 

and motivating.66 Partners may also be able to develop 

surveys and offer space for testing ads. For some 

campaigns, it may be important to translate materials 

into different languages. Partners who work with 

communities can connect the program with native 

speakers for help translating and testing ads.

Planning how often ads will 

run, where ads will be placed, 

and how much placements will 

cost may require technical skills 

beyond the capacity of program 

staff. Communications specialists 

can use their knowledge and 

experience to analyze what can be 

done with a program’s resources. 

They can recommend the best 

media placements to reach the 

intended audience, and get better 

deals for media buys.66 These 

specialists often work for media 

agencies that contract with the 

tobacco control program. Other 

branches of the state agency, 

local coalitions, and programs 

in other states may be able to share referrals for media 

contractors or valuable knowledge from their own 

experiences developing campaigns. 

Working with News Media

News stories add credibility to paid media campaigns, 

convey additional information, and continue the 

conversation even after paid ads are off the air or 

out of print.97 Partners with respected voices in the 

community, such as healthcare providers, youth, 

and decision makers, can generate news coverage. 

Partners can author letters to the editor and Op-Eds, 

speak at program events, and hold press conferences. 

Promoting the campaign at partners’ events can also 

gain news coverage. 

Partners are most likely to generate media interest 

when they are talking about newsworthy events, 

announcing breaking news, or sharing locally relevant 

information.66 To prepare partners to work with the 

news media, programs can give talking points and 

regularly update them on campaign progress. Templates 

for news releases and letters to the editor make it easy 

for partners to quickly and knowledgeably speak on 

behalf of the campaign. 

Distributing Program Materials

Programs can also take advantage of partners’ 

networks to share flyers, infographics, fact sheets on 

Partnerships l 23

HOW TO
new scientific evidence, cessation 

resources, or recent policy changes. 

Having partners share materials 

can reduce costs and coordinate 

messages. 

An information-sharing network in the 

form of monthly newsletters, a listserv, 

or dedicated website helps partners 

quickly communicate updates.66

Emphasizing the connections between 

commercial tobacco use and other 

health issues can encourage partners 

to share these messages with a wider 

audience. 

Sharing Messages on Social 

Media

Social media has become a normal 

part of life for many Americans, with 

72% of U.S. adults using at least one platform for social 

networking as of 2019.98 Although young adults use 

social media at the highest rates (90%), use among 

those 65 and older has tripled to 40% since 2010.98

Social media use is also increasingly common among 

organizations.99 Partners can leverage their own social 

media networks to share campaign messages and 

update their audiences on commercial tobacco control 

news and events.79

When sharing partners’ posts, it can help to develop 

criteria about who to like, tag, or share (e.g., featured 

partners; pages sharing relevant, truthful information; 

messages you want to highlight).100 To make it easier for 

partners to share social media messages, programs can 

tag partners in posts, create content for partners to 

share, and develop a schedule to coordinate posts. For 

example, the Vermont Department of Health created a 

social media toolkit for partners about the impact of 

commercial tobacco use on people with behavioral 

health disorders.101 The toolkit included social media 

content and a calendar that instructed partners when to 

share posts.101

Tobacco control partners pose for a photo Source: Campaign for Tobacco-Free Kids

Social Media Sharing Tips

Social media content is easier for partners to 

share when messages:101

• Discuss trending health topics or 

news

• Use fewer characters than the 

maximum allowed so that partners 

can add their own text

• Ask users to do something, such as 

Share, Like, or Comment

• Include content that encourages users 

to participate in conversations, such 

as quizzes, questions, or challenges

• Cross-promote other channels, by 

including links to Twitter, Facebook, 

or YouTube

Partnerships l 24

HOW TO
Advancing 

Health Equity 

and Reducing 

Disparities 

Despite declines in cigarette use 

across the U.S., disparities still exist 

in commercial tobacco use, tobaccorelated disease and death, and access 

to cessation treatment among certain 

groups.31 These differences are closely 

linked to systematic disadvantages and 

social determinants of health such as age, disability, 

education, income, occupation, geographic location, 

race, ethnicity, sex, sexual orientation, gender identity, 

behavioral health status, or military status.1,31,102 Health 

equity is attained when all people can reach their full 

health potential.1

Reducing tobacco-related disparities and advancing 

health equity among these groups requires the 

skills and knowledge of partners from many levels, 

sectors, and backgrounds.7

 While not all partners 

may have experience in public health or commercial 

tobacco control, they have valuable knowledge about 

the community’s beliefs and culture.61 Meaningful 

engagement with partners who have strong ties to the 

community is essential to include priority populations 

and build community capacity. 

Engaging Community Partners

Effective strategies to reduce disparities meaningfully 

involve many different partners from the beginning.61

To increase diversity, programs can collaborate 

with community members and a wide variety of 

organizations, such as:

• Local youth groups and youth-serving 

organizations101

• Lesbian, gay, bisexual, transgender, and queer/

questioning (LGBTQ+) support groups31

• Behavioral health treatment centers31

• Organizations serving active-duty military 

personnel and veterans31

• Faith-based organizations38

• Members of local tribal nations31

• National Networks serving specific populations 

(learn more about the eight funded networks at 

CDC’s web page)103

• Other community groups working to achieve 

health equity61

Formal recruitment processes can engage partners 

who represent priority populations. For example, a 

Request for Proposals can bring in partners from larger 

organizations or from diverse geographical areas.61 For 

any recruitment method, it is important to learn which 

organizations are essential to the community. 

Developing Cultural Humility

Some partners may lack experience working with 

priority populations. Understanding other cultures 

and examining one’s own beliefs are important when 

working with people affected by tobacco-related 

disparities.

Programs can help partners by encouraging them to 

start a process of self-reflection, known as cultural 

humility.104 It is different from cultural competence, 

which focuses on gaining knowledge and “achieving” 

competence. Instead, cultural humility is a continual 

process of learning and self-awareness.

Partnerships l 25

HOW TO
Partners can practice cultural humility by:104

• Taking a self-assessment to recognize their own 

values and biases

• Using mindfulness techniques to recognize their 

own thoughts and emotions and those of others

• Thinking about the culture and experiences of 

people from priority groups

• Forming partnerships with people who 

have lived experiences that match those of 

community members

• Learning about the community’s history, 

especially with commercial tobacco

• Avoiding stereotyping and consider that people 

from the same population may have different 

experiences and values

Learn more about developing cultural humility in the 

article, Cultural Humility: Essential Foundation for 

Clinical Researchers. See an outline and examples of 

a self-assessment in the Community Tool Box toolkit, 

Enhancing Cultural Competence.

It is also helpful for partners to be aware of others’ 

communications styles, preferred languages, and 

literacy levels.66 For tips on improving cross-cultural 

communication skills, see the U.S. Department of 

Health & Human Services’ Guide to Providing Effective 

Communication and Language Assistance Services.

Role of Faith-Based Organizations in Reducing Disparities

Faith-based organizations like churches, mosques, synagogues, and temples can be effective partners in 

reducing tobacco-related disparities because they:38 

• Are centers of community life for many priority populations 

• Have traditionally served as a trusted source of guidance and inspiration, especially in Black 

communities 

• Understand their communities and their needs 

• Share concerns for the well-being of their congregations that can align closely with commercial 

tobacco prevention goals

For example, a partnership of community stakeholders, 26 local churches, and a team from the University 

of Kentucky developed and implemented Faith Moves Mountains, a smoking cessation program for 

underserved, high-risk communities in rural Appalachia.105 Faith-based partners incorporated their 

own relevant religious components, and participants included but were not limited to church members. 

Participants appreciated the convenience, the support and comfort of existing social connections, and 

access to free nicotine-replacement therapies.105

Involving Partners in Reducing 

Disparities

Working closely with partners who that represent 

priority populations increases the likelihood that 

strategies focus on relevant issues.61

Partners can help organize and contribute to focus 

groups, collect data for community assessments, 

and review health communications messages. Learn 

more about conducting community assessments with 

partners on page 27. As respected members of the 

community, partners can also speak on behalf of the 

program about the impact of commercial tobacco use. 

For example, members of the Native American Tobacco 

Coalition of Montana educated tribal members on 

Partnerships l 26

HOW TO
the dangers of commercial tobacco and the difference 

between ceremonial and commercial use. Armed 

with this knowledge, tribes created smokefree indoor 

environments, including making casinos smokefree.61

Learn more about how to work with partners to reduce 

disparities in the CDC’s Best Practices User Guide: 

Health Equity in Tobacco Prevention and Control and 

at Networking2Save, CDC’s consortium of National 

Networks focused on eight priority populations.

Working with Partners to Conduct Community Assessments

Community assessments help programs 

understand the impact of commercial 

tobacco use on a community. People in 

a community may live in the same area 

or share characteristics such as race 

or ethnicity, LGBTQ+ status, religion, 

or culture.106 Although each person is 

different, the group may have similar 

needs, strengths, and histories that are 

important to recognize.5

 Some of the 

questions that community assessments 

can answer include:106

• Who is part of the community?

• What are the rates of 

commercial tobacco use, 

secondhand smoke and aerosol 

exposure, and cessation in the community? 

• What does the community view as the main area of need? What other needs have been identified 

by the community and how do they relate to tobacco control?

• What strategies have been tried before? What worked and what did not?

• What is the level of community knowledge on this topic?

• What discrimination-related barriers may affect community members?

• What strategies will most effectively protect the community from commercial tobacco use and 

secondhand smoke and aerosol exposure?

• How can programs identify and reach out to community leaders and partners?

Involving trusted community members in developing and disseminating assessments can help 

encourage others to take part. Partners can also hold public forums, administer surveys to community 

members, or review public records. Learn more in the Community Tool Box toolkit, Assessing 

Community Needs and Resources. 

Partnerships l 27

HOW TO
A CLOSER LOOK: Partners Focus on Social Justice to End Sales of Flavored 

Tobacco Products in Massachusetts

Candy, fruit, and menthol 

flavored commercial tobacco 

products entice people who 

do not smoke to try tobacco 

and are harder to quit than 

unflavored products.107 The 

tobacco and e-cigarette 

industries also heavily 

target flavored products to 

Black, Latinx, and LGBTQ+ 

communities.108 In fact, over 

80% of all Black/African 

American people who smoke 

use menthol cigarettes.107 In 

Massachusetts, the popularity 

of flavored tobacco products 

threatened to undercut the 

state’s progress in reducing 

youth tobacco use and 

commercial tobacco–related 

disparities.107

To push back against the industry’s targeted marketing tactics, the Boston-based public health institute 

Health Resources in Action created the Fight All Flavors campaign. The goal of the campaign was to raise 

awareness about the need to end sales of flavored tobacco products, including menthol cigarettes.109 The 

campaign brought together youth and other partners from communities of color, neighborhood groups, 

faith-based organizations, healthcare, and public health. Together, the partners spent months educating 

and mobilizing members of communities targeted by flavored tobacco marketing.109

Organizers also used a brief signed by all eight CDC-funded National Networks outlining how menthol 

tobacco products can further harm populations already at risk for tobacco disparities. They distributed 

this statement to state legislators through the legislative news service before a flavored tobacco bill was 

brought for a vote.

In November 2019, Massachusetts passed the first state law ending the sale of all flavored tobacco 

products, including menthol. The coalition’s work did not end there. Before the law went into effect in 

June 2020, the coalition launched the No Menthol. Know Why. campaign to educate people who use 

flavored tobacco about which products will no longer be sold, how the law will improve health in their 

communities, and how to get help quitting commercial tobacco.108

Digital ad from the No Menthol. Know Why. campaign Source: Health Resources in Action

Partnerships l 28

HOW TO
Working Together 

Effectively

Equipping partners to work together effectively makes 

the time and resources they invest in the partnership 

worthwhile.5 Well-managed strategic partnerships and 

coalitions plan for how partners will contribute to goals 

and interact with other partners. These processes are 

important for all partnerships but can be especially 

critical for coalitions with many members. Successful 

partnerships have the following features:5

• Clearly defined partner roles

• Effective meetings 

• A process for making group decisions

• A system for communicating with partners

• Work groups to distribute tasks across larger 

partnerships

• Strategies for managing potential conflict

Defining Partner Roles

Clearly defined roles and expectations help partners 

contribute to tobacco control goals. Partners contribute 

most effectively when their roles match their strengths 

and fit the tobacco control 

program’s needs.110 Partners 

may be able to serve multiple 

roles, for example, recruiting 

others and serving as 

spokespeople. Offering a 

variety of roles also helps 

partners build new skills.111

One way to develop clear 

roles is to write out each 

partner’s responsibilities in 

a collaborative work plan.8

Joint work plans describe 

partners’ duties, assign tasks, 

and include due dates. Work 

plans also include benchmarks 

to show how partners’ work 

contributes to the partnership’s 

larger goals.

Conducting Effective Meetings

Partners use meetings to exchange information and 

ideas, make group decisions, share successes and 

setbacks, and ask questions. Regular meetings help 

partners stay on track and make progress toward goals. 

For some partnerships, meeting twice a year with 

frequent communication in between may be enough. 

Other partnerships, especially those with short timelines, 

may want to meet monthly or weekly. If community 

members or youth are included as partners, it is 

important to schedule meetings when they can attend, 

such as evenings or weekends. Providing transportation 

or child care can also help increase involvement.110

Partners are busy professionals, so using meeting 

time wisely is important. When partners believe that 

meetings make good use of their time, they may be 

more likely to attend future meetings and events.110

Effective meetings have these features:

• A clear purpose112

• A structured agenda113

• A skilled leader113

• Ground rules for participation112

• Time for networking112

• Follow-up communication about tasks and 

deadlines113

Partnerships l 29

HOW TO
In meetings that involve many partners, differences 

in participant roles can make it seem as though some 

voices are more valued than others. To encourage 

everyone to participate, program staff can ask partners 

to introduce themselves using information other than 

job title (such as what neighborhood they live in) 

and place equal importance on everyone’s ideas when 

recording notes.110

A good meeting leader keeps participants focused 

and makes sure everyone has a voice. Throughout the 

meeting, the leader:113

• Checks to make sure partners follow the agenda 

and stay on time

• Summarizes the meeting results

• Asks for input from people who have not spoken

• Protects people from personal attacks

• Encourages the group to revisit difficult issues if 

they cannot agree 

Alternating who leads meetings can share power and 

build capacity of partners without a tobacco control 

background. Find more tools for effective meetings in 

the Coalition Building Tools section of the Coalitions 

Work website.

Meeting Virtually

In-person meetings are now moving to 

virtual formats. Virtual meetings let people 

attend from multiple locations and can be 

more convenient for busy partners. To host 

engaging virtual meetings:

• Hold meetings when they are 

convenient for most attendees.

• Keep virtual meetings short, or take 

frequent breaks in longer meetings.

• Record meetings for partners who are 

unable to attend live. 

• For meetings with a lot of 

interaction, limit participants to 

small groups so that everyone has 

the chance to speak.

Making Group Decisions

A fair and transparent decision-making process 

helps build trust and prevents power from being 

concentrated among a few partners.113 Partners can 

set rules such as discussing one issue at a time, giving 

everyone an equal right to be heard, and requiring 

majority support to take action. It is also important to 

establish a process for decisions that need to be made 

urgently, such as reviewing and approving materials.

Consensus building can help achieve broad support 

for big decisions like changing strategic direction, 

applying for a new grant, or hiring staff.113 To build 

consensus, discussion continues until everyone’s most 

important needs are met. For each member, parts 

of the agreement may not be ideal, but they can live 

with the outcome and will support the decision.113

Decisions made by consensus are more likely to be 

implemented successfully, but may take longer to 

reach.113 Achieving consensus may be a new strategy 

for some partners, so training in group discussion, 

listening, and conflict resolution beforehand can help 

smooth the way to agreement. 

Communicating with Partners

Frequent communication connects partners to the 

tobacco control program and to each other. It helps 

partners stay up to date on progress toward goals, 

understand their responsibilities, and prepare for 

meetings. Communication can also increase partner 

involvement and motivation.23

Partnerships l 30

HOW TO
The right mix of communication tools depends on the 

partners involved and the goals of the partnership. At 

a minimum, it is important to set up a way to share 

project updates, new scientific evidence, or other 

resources. This kind of information can be effectively 

shared through e-newsletters or websites.8

Programs may also want to create a way for partners to 

interact with each other, such as a listserv or web-based 

document that everyone can edit.8

 These tools allow 

partners to share ideas and support each other outside of 

meetings. Online chat forums or webinars add real-time 

interaction, especially for long-distance partnerships.8

Online collaboration tools (e.g., Microsoft Teams, Asana, 

and Trello) are useful for assigning tasks, tracking 

progress, and keeping partners accountable. 

Forming Work Groups

Work groups include a small number of partners and are 

often used in larger partnerships to carry out activities. 

For example, a work group might focus on a specific 

strategy like smokefree air. Work group members may 

collect data, find resources, meet with stakeholders, 

develop an action plan, or coordinate messages with the 

broader coalition.114 Effective work groups meet at least 

monthly, include members that represent the diversity of 

the larger group, and communicate regularly with other 

work groups and the overall partnership.114

To form work groups, tobacco control staff decide 

how many groups there will be, how partners will 

be assigned to a group, and who will 

lead each group. Work group chairs 

communicate with the larger partnership, 

develop agendas, and lead meetings.115

Managing Potential Conflict

Disagreements are a natural part of 

working together, especially in large 

partnerships. Partners may clash over 

strategic direction, different personalities, 

adding new partners, or allocating 

resources.113 But when conflict escalates, 

it can drain partners’ energy and lead to 

turnover, reluctance to conduct activities, 

or recruitment challenges.116

Effective meetings, clear decision-making 

processes, and frequent communication 

can help avoid many sources of conflict. Programs 

can also reduce conflict by clearly defining roles and 

balancing different viewpoints.113

Learn more about managing conflict in the Tobacco 

Technical Assistance Consortium’s Reaching Higher 

Ground: A Guide for Preventing, Preparing for, and 

Transforming Conflict for Tobacco Control Coalitions.

Dealing with Disagreement

If conflict occurs, the following strategies can 

help ease tension:113

• Remind partners to follow ground 

rules.

• Acknowledge intense emotions 

instead of ignoring them.

• Explore partners’ underlying 

interests.

• Take a break.

• Keep differences of opinion from 

becoming personal attacks.

• Focus on areas where some 

agreement exists.

Partnerships l 31

HOW TO
Evaluating Partnerships

Evaluating strategic partnerships and coalitions for 

strengths, outcomes, and areas of improvement is just 

as important as evaluating the program’s commercial 

tobacco control strategies. Evaluating partnerships 

helps programs track progress toward goals and 

improve partnership effectiveness.117 It can also build 

partners’ evaluation skills that they can use within their 

own organizations.117 Programs can follow these six 

steps to effectively evaluate partnerships: 

• Step 1: Engage partners

• Step 2: Describe the partnership

• Step 3: Focus the evaluation

• Step 4: Gather credible evidence

• Step 5: Analyze data and draw conclusions

• Step 6: Share results and ensure use

Partnership evaluation activities can be completed 

separately or integrated into the program’s overall 

evaluation plan. More guidance on completing the 

six steps of evaluation is also available in the CDC 

workbook, Developing an Effective Evaluation Plan.

Step 1: Engage partners

Partners who are involved in the evaluation 

from the beginning are more likely to support its 

recommendations.118 Partners can help evaluate 

partnerships by:118

• Deciding which questions to ask

• Testing evaluation tools

• Collecting data

• Interpreting and sharing results

For coalitions with many partners, it may not be 

practical to involve everyone in the evaluation. A 

workgroup of 8-10 partners is ideal.117 It is especially 

important to involve program staff, community 

members, and partners who would use evaluation 

results, such as community groups and decision 

makers.117 Allowing time for partners to work through 

conflict and come to agreement is important to 

meaningfully engage partners in evaluation.117

Step 2: Describe the partnership

Defining the partnership’s purpose and key activities 

helps partners develop realistic expectations for 

what questions can and cannot be answered by the 

evaluation.117 When partners know what to expect, they 

can plan for how they will use the results. 

For more complex partnerships like coalitions, it may 

help to describe the partnership using a logic model. 

A logic model is a diagram showing all activities of the 

partnership and how they relate to intended outcomes. 

Learn more about how to develop logic models in the 

CDC workbook, Introduction to Program Evaluation 

for Public Health Programs: A Self-Study Guide.

Step 3: Focus the evaluation

Partnership evaluations typically examine how 

partners work together and what has happened 

because of the partnership. Questions may ask about 

collaboration processes, membership, activities, and 

outcomes.118 Programs may have limited resources 

to collect and analyze data about partnerships. 

Focusing on the most important questions about 

the partnership, rather than trying to answer every 

question that partners may ask, can make the most 

of evaluation resources. For sample partnership 

evaluation questions, see Table 3 on page 35.

Partnerships l 32

HOW TO
Partnership activities and resources change often. 

Staff and partners may want to add questions for new 

activities or adjust questions for strategies that have 

ended, scaled down, or changed. Updating questions 

helps recommendations match the partnership’s 

current strategies. 

Step 4: Gather credible evidence

It is important that partners view data gathered as 

believable, trustworthy, and relevant. If partners do not 

trust the data source or collection method, they may 

reject it when making changes to the partnership.117

To collect data that partners can trust and rely on, 

programs can ask partners to help select methods, 

data sources, and key outcome measures.117 Tools like 

the Wilder Collaboration Factors Inventory can help 

assess how partners work together.

Developing a shared set of evaluation measures that 

are used by all partners can enhance the evaluation’s 

credibility and make it easier to assess partnership 

progress and outcomes.119 An easy way for partners to 

contribute to a shared measurement system is through 

an online portal. For example, the Mississippi State 

Department of Health’s Office of Tobacco Control uses 

the Tobacco Reporting and Progress System (TRAPS) 

to track data entered by partners on their activities. 

Program staff can also check partner progress in real 

time using the system’s charts and maps.120

Step 5: Analyze data and draw 

conclusions

Programs may be tempted to skip this step for shortterm partnerships or those with limited resources. But 

it is important to devote adequate time to data analysis 

so that recommendations are useful and relevant. 

Table 3. Sample Partnership Evaluation Questions

Question Type Sample Questions

Partnership infrastructure • Do partners represent priority populations and a mix of community sectors? 

• Do partners understand the goals of the partnership?

• Do partners have the capacity and authority to make change?

• Are the roles and responsibilities of partners clear?

• Does the partnership have skilled leadership, staff support, and adequate 

funds to achieve its goals?

How partners work together • What process does the partnership have for making decisions?

• Do partners have a way to share timely information with each other?

• Are partnership meetings productive? 

• Are work groups functioning well?

• Do partners build an environment of trust and respect?

• Are partners satisfied with how the partnership is working and its progress 

toward goals? 

• What training have partners received and how have their skills improved? 

What training is still needed? 

• Is membership sustained over time? Why do members leave the partnership?

Partnership outcomes • Is the partnership on track to achieve goals and objectives? 

• How is the partnership contributing to environmental or practice changes? 

• To what extent is the partnership improving health outcomes? 

• Is the partnership increasing community capacity to solve problems?

• Have there been any unintended outcomes of the partnership’s work?

• What other external factors affect the partnership (e.g., changing tobacco 

product landscape or support for commercial tobacco control)?

Adapted from CDC, Division for Heart Disease and Stroke Prevention121

Partnerships l 33

HOW TO
Partners can add new insights, especially 

if they help carry out activities or work 

with the population.117 Partners may 

draw different or even conflicting 

conclusions when analyzing the data.122

The following questions can help guide 

discussion and reach consensus:122

• Why were the data gathered? 

Do the results answer all the 

questions?

• Were the results expected?

• Do the results address the 

priorities of partners?

• How do the results compare 

with those of similar 

partnerships?

• How does the social and 

political environment affect the results?

• How do the results inform goals?

Step 6: Share results and ensure use

Sharing evaluation results with partners helps put 

recommendations into action. Partners may prefer to 

receive information in different ways. For example, 

decision makers may only have time to read a brief 

summary, while local grantees prefer the detail of a 

full report. 

Planning ahead can make sure evaluation results get 

used. Program staff can take the following steps to 

increase the likelihood of using evaluation results:117

• Ask partners what they want to know.

• Tailor content and format for each audience.

• Communicate findings in several ways, such as 

reports, presentations, or social media posts.

• Create interim reports when partnerships 

are new, short-term, or occurring in rapidly 

changing environments. 

• Schedule follow-up meetings with partners to 

discuss results.

Learn more about sharing evaluation results in the CDC 

workbook, Developing an Effective Evaluation Report.

Evaluating How Coalitions 

Work

How well coalition members work 

together can impact the coalition’s ability 

to achieve its goals. If a member feels the 

coalition is successful, they are more likely 

to participate; if not, they are more likely 

to drop out.123 Programs can evaluate 

coalition functioning by assessing factors 

such as member representation, role clarity, 

satisfaction, decision making, and conflict.20

Information such as membership records, 

attendance sheets, and other activity records 

show an informal picture of members’ views 

on how well the coalition works. 

It can also be helpful for members to assess 

their own involvement in the coalition. 

Reflecting on their participation can 

encourage more effective membership, 

which improves coalition functioning. 

Coalition Works created a helpful selfassessment, “Am I a High Functioning 

Coalition Member?”

Partnerships l 34

HOW TO
Using Social Network Analysis to Understand Partnerships 

Social network analysis is a tool to 

show the links among members 

of a partnership or other network 

of people or organizations. 

Tracking these relationships 

can help partnerships better 

understand how to work 

effectively together.124 To create 

a social network diagram, the 

program identifies people who 

are knowledgeable or trusted 

within the partnership, conducts 

a survey to learn how partners 

interact with each other, and plots 

the information on a network 

map. Partners are represented by 

shapes, usually circles. Different 

types of partners may be shown 

in different colors. Lines represent 

connections between partners.124

Social network analysis can help 

answer the following questions:124

• Who is in the partnership and how strong are relationships among the partners? 

• How does information flow into and out of the partnership? 

• Who are key influencers in the partnership?

• How have relationships changed over time?

• How could partners be better connected? 

Partnerships can hire outside specialists to conduct social network analysis, or use online tools, such as 

the PARTNER tool, to conduct surveys and create network maps themselves.Learn more about social 

network analysis at the Center for Public Health Systems Science’s web page, What Can Social Network 

Analysis Do for You?

An example network map representing partners with more connections as larger circles and 

using colors to represent different partner types

Partnerships l 35

HOW TO
Sustaining Partnerships

Despite the importance of tobacco control partnerships, 

many are unable to sustain their efforts. Funding alone 

does not ensure sustainability. Sustained partnerships 

are effectively managed and fulfill a continuing 

purpose.5 They have the following characteristics:

• Supportive program infrastructure

• Adequate time for sustainability planning

• Strategies to keep partners engaged

• Ongoing recruitment of new partners

Maintaining Partnership Infrastructure

Long-term partnerships have diverse and multi-year 

funding sources. To manage day-to-day operations, 

they have shared values, committed leadership, 

and clear policies and procedures.125 Partners begin 

developing this foundation when partnerships are 

formed and keep it strong by regularly reviewing 

partnership infrastructure for gaps and improvements. 

Funding is particularly important to consider for 

coalitions, which often tackle longer-term, more 

complex issues than other partnerships. Grants and 

fundraising can support 

partnership activities. These 

external funding sources may 

require that the partnership 

show effectiveness. See more 

about evaluating strategic 

partnerships and coalitions 

on page 32. The ability to 

generate funds internally can 

also help sustain partnerships. 

In coalitions, internal funds 

can come from membership 

dues that organizations pay to 

be involved in the coalition or 

other financial contributions 

of members.20

In addition to securing 

funding, coalitions and other 

partnerships can take the 

following steps to sustain 

infrastructure:

• Review and refine the partnership’s policies and 

procedures7

• Create a resource development committee to 

look for new ways to diversify and strengthen 

the partnership’s resources126

• Plan for transferring leadership23

• Evaluate partnership activities, successes, and 

challenges7

Learn more about developing a strong program 

infrastructure to support partnership activities 

in CDC’s Best Practices User Guide: Program 

Infrastructure in Tobacco Prevention and Control.

Planning for Sustainability

Including a partnership in the program’s overall 

sustainability plan ensures a vision for the partnership’s 

future and the resources to achieve that vision.7

 The 

plan can outline which partnership activities will 

be sustained, what resources are needed, and what 

potential funding sources exist.127 Coalitions may 

wish to develop their own sustainability plan. Ideally, 

sustainability planning begins during the early 

development of a coalition and continues throughout 

its life. Although the plan may be written by a small 

Partnerships l 36

HOW TO
Partnerships l 37

HOW TO

group, it is important to gather perspectives from as 

many coalition members as possible. 

Planning for leadership changes is an important 

part of coalition sustainability plans.127 It is likely 

there will be leadership changes during the life of a 

coalition. Sustainability plans can include action steps 

for outgoing leadership to take to ensure a smooth 

transition, as well as guidance for new leaders as they 

take on their new role. 

Online tools such as the Center for Public Health 

Systems Science’s Program Sustainability Assessment 

Tool and CDC’s A Sustainability Planning Guide for 

Healthy Communities can help gather input from many 

partners and create a sustainability action plan.

Keeping Partners Engaged 

Over time, the enthusiasm that helped form a 

partnership can decrease. Competing priorities and 

new opportunities may make it hard for partners to 

sustain their original level of involvement. Focusing 

on the 6 R’s of engagement can help keep people 

committed to the partnership:23

• Recognition: People want to be recognized for 

their contributions. 

• Respect: People want their ideas, values, and 

time to be respected.

• Role: People want to clearly understand their 

role in the partnership.

• Relationships: People want the chance to build 

personal and professional relationships.

• Reward: People expect the rewards of 

participating to outweigh the costs.

• Results: People want to see their participation 

lead to results they care about.

Coalitions can keep members engaged by assigning them 

to meaningful tasks that fit their skill sets.128 This will 

allow members to make significant contributions to the 

coalition’s work and increase their commitment. Sharing 

tobacco-related news and updates also helps keep 

partners interested.129 Regular training for all members 

can increase their skills and equip them to take on bigger 

roles both within and outside the partnership.128

Arizona Bureau of Tobacco and Chronic Disease celebrates partners’ 

commitment to tobacco control with Most Valuable Partner Awards

Sustaining Coalitions

The following characteristics are important 

to sustain coalitions:125

• Diverse, multi-year funding sources

• Ability to generate funds internally

• Involvement in meaningful work

• Demonstrated outcomes

• Shared values that guide how the 

coalition operates

• Committed leadership

• Sound financial and program 

management

• Members who will speak on behalf of 

the coalition

• Respect and credibility

Learn more about sustaining coalitions in 

the Coalitions Sustainability Tools from 

Coalitions Work.
Recruiting New Partners

Turnover is a natural part of partnering, especially in 

large coalitions with many members. As partners form 

connections, they may learn about other opportunities. 

Unplanned and poorly managed turnover may make 

it difficult to coordinate activities, develop trust, and 

achieve goals.130 To prepare for turnover, staff can 

periodically review the following questions:23

• Who else in the community can help achieve the 

partnership’s goals? 

• What roles are unfilled or need to be created? 

Who could best fill these roles?

• What do potential partners bring to the 

partnership? 

• When is the right time for new partners to join? 

• What potential barriers exist to recruiting new 

partners, and what strategies can overcome 

those barriers?

Existing members may already have relationships with 

potential partners and can speak about the importance of 

the partnership. Programs can prepare partners to recruit 

new people by ensuring they are ready to answer questions 

about the level of commitment and the new partner’s 

role.131 For tips on recruiting partners, see page 6. 

Ending the Partnership

In some cases, it may not be possible to sustain the 

original partnership. It may have achieved its goals. 

Community needs also change over time, and a new 

issue may take priority over the partnership’s original 

focus. Partners that worked well together may still be 

able to continue the partnership by shifting emphasis.130

For instance, a successful partnership for tobaccofree restaurants may turn its attention to tobacco-free 

casinos. In other cases, one or more of the partners 

may not want to continue the partnership. Partnerships 

work best when all partners value the partnership and 

want to contribute.8

Coalition Member Gap Analysis132

A member gap analysis can help larger partnerships and 

coalitions decide who is missing from the partnership. 

To conduct a member gap analysis: 

1. Start with a list of the sectors wanted for the 

partnership (e.g., business, faith-based, health, 

family, and children’s services).

2. At a partnership meeting, write each sector 

on a sheet of paper. Include a few examples of 

organizations for each sector and mount the 

sheets on the walls of the room.

3. Give each partner a name tag.

4. Have everyone get up and quickly attach their 

name tag to a sheet.

5. Name the sectors where current partners come 

from. Often membership is skewed toward a few sectors, while other sectors have only a few or no 

representatives.

6. Brainstorm organizations from the underrepresented sectors that might make good partners.

7. Choose existing partners to contact these organizations about joining the partnership.

Partnerships l 38

HOW TO
PROVIDING SUPPORT

How Can Tobacco Control Programs Support 

Partnerships?

Tobacco control program staff can take the following actions to support strategic partnerships and coalitions:

Coordination and Collaboration 

8 Act as the convener, bringing all partners to the table on a regular basis.

8 Involve partners in the program’s strategic planning process and developing Requests for Proposals.

8 Ask partners how program staff can better support them and their communities.

Administrative Support 

8 Assign regional program staff to support local partners and coordinate efforts statewide.

8 Develop and share materials that can be used by partners (e.g., toolkits, news releases, and social media posts).

8 Provide a way for partners to interact (e.g., listservs, websites, and conference calls).

8 Share surveillance and evaluation data with partners that they can use to promote the program’s activities and 

successes.

Training and Technical Assistance 

8 Routinely assess partners’ skills and ask about training needs.

8 Train partners in commercial tobacco control, cultural competence, and conflict management.

8 Offer individualized technical assistance to each partnership based on its needs.

Partnerships l 39
CASE STUDIES

Mississippi Case Study

Coalitions help over 180 communities go smokefree, protecting 36% of Mississippians

Mississippi Tobacco-free Coalitions logo

State program andcoalitions promote smokefree air

In 2010, the Mississippi State Department of Health’s

Office of Tobacco Control received funding from CDC

to raise awareness about the importance of smokefree

environments. While other efforts to pass a statewide

smokefree law had been unsuccessful, local communities

were focused on becoming smokefree. Guided by the

2009 Best Practices User Guide: Coalitions, the Office

worked with Mississippi’s 34 tobacco-free coalitions.

These coalitions were first funded in 2008 to educate

local communities about the benefits of smokefree 

environments. As of March 2021, 174 communities had 

passed smokefree laws, as well as seven counties,

protecting 36% of Mississippi’s population.133

State office focuseson strengthening local coalitions

To expand smokefree environments, the Office started 

by strengthening the state’s local tobacco control 

coalitions. Program staff hosted trainings, conducted 

educational presentations, created handouts, and 

provided technical assistance. A Department of Health 

project officer was named as an on-call smokefree 

expert for coalitions seeking help. Coalition members 

could phone in and receive one-on-one help from this 

staff member. 

The Office also required coalitions to develop clearly 

defined work plans that included recommendations 

for representative coalition membership. Coalitions 

recruited members from 13 key sectors, including 

law enforcement, the media, public health, and 

education. The work plans also included activities, such 

as mapping community resources. The plans made 

sure that coalitions could continue to make progress 

on comprehensive smokefree environments across 

Mississippi even if resources became scarce. 

Coalitionsbegin efforts byassessing local communities

Coalitions began smokefree efforts by learning about 

the priorities and demographics of their communities. 

For example, they found that community leaders were 

most willing to 

support 

smokefree 

policies just after 

taking office. 

During other 

times, coalitions 

maintained their 

presence in 

communities 

through 

continued 

community 

education. Coalitions also found that support for 

smokefree environments varied geographically. In coastal 

Mississippi, where gaming is a large revenue source, 

casinos that allowed smoking sometimes opposed 

smokefree strategies. Coalitions were able to prevent 

opposition before it started by developing relationships 

with many different community members, including 

local business owners. To build community support, they 

publicly recognized businesses who volunteered to go 

smokefree. This helped decision makers to see the 

popularity of smokefree communities and gave them the 

confidence to support smokefree strategies.

Community assessments also revealed that decision 

makers valued the perspectives of local champions. Local 

leaders met one-on-one with decision makers to educate 

them about the benefits of smokefree environments. 

They also spoke to city boards or local community 

organizations. “The coalitions are effective because 

decision makers listen to local champions,” said Tiffany 

Johnson, Bureau Director of the Office on Tobacco 

Control. “They trust information when it comes from 

someone who lives and works in the community.”

State office continuously monitors coalition progress 

To keep coalition progress on track, the Office 

continuously evaluated coalition activities and 

outcomes. Four project officers from the Office 

provided oversight and technical assistance to coalition 

directors. Each officer served eight or nine coalitions in 

Partnerships l 40
an assigned region. Project officers monitored turnover 

and member engagement, working to help coalitions 

stay diverse and keep participation rates high. 

Coalition members also used an online reporting 

system to track progress and activities. Members 

recorded data, such as number and type of activities or 

number of meeting attendees, and it was reviewed by 

their project officer and external reviewers. If coalitions 

had challenges meeting their goals, project officers 

worked to get them back on track. The Office also used 

these data to understand geographical differences and 

shift focus to locations in need. 

Mississippi coalitions focus on multi-unit housing

Coalitions across the state are building on their 

successes by extending smokefree protections to multiunit housing. In response to the 2016 Department 

of Housing and Urban Development rule requiring 

smokefree public housing, the Office is training 

coalitions to work with local housing authorities and 

developing a smokefree housing toolkit. The Office 

also plans to involve coalitions in other tobacco 

control strategies. These strategies include educating 

retailers about not selling tobacco products to minors, 

promoting the state quitline, and working with youth 

programs to prevent commercial tobacco use.

Figure 4. Mississippi Smokefree Communities Trend

Source: Mississippi Tobacco Data137

“The coalitions are effective 

because decision makers listen 

to local champions. They trust 

information when it comes from 

someone who lives and works in 

the community.”

– Tiffany Johnson, Bureau Director

Partnerships l 41

CASE STUDIES
Philadelphia Case Study

Get Healthy Philly works with large employers to expand cessation coverage

Get Healthy Philly logo

Philadelphia Department of Health forms partnerships 

to reduce smoking and promote active living

Philadelphia’s smoking prevalence among adults had 

been increasing since 2002, peaking at more than 27% in 

2008.134 As the prevalence topped those of the 10 largest 

U.S. cities, the Philadelphia Public Health Department 

sought a new approach to make high-impact policy, 

systems, and environmental changes.135 With funding 

from CDC’s Communities Putting Prevention to Work

initiative, the Department formed Get Healthy Philly 

in 2010, a collaboration of government, academic, 

community, and private-sector organizations.135

Get Healthy Philly partners work together to make 

Philadelphia a healthy, active, and smokefree city.135

Improving access to evidence-based cessation treatments 

was among Get Healthy Philly’s first priorities. 

Historically, the Department focused on clinical tobacco 

treatment. But it recognized that the cost per person 

who quit was high, and the program could still support 

important clinical interventions and reach more people 

by expanding access to proven cessation resources. Get 

Healthy Philly turned to its partners for help.

Get Healthy Philly partners encourage employers to 

expand access to cessation resources

The Department formed a partnership with the College 

of Physicians of Philadelphia to educate mid-sized 

and large employers about the benefits of expanding 

cessation coverage and the best way to provide 

cessation resources to employees. The partnership’s 

first success was getting the City of Philadelphia to 

cover cessation treatment for nearly 7,000 employees 

and their families.82 The City agreed to cover six of the 

seven FDA-approved smoking cessation treatments.82

The coverage included civil service, court, and union 

employees and the first five years of their retirement. 

The City’s early adoption of these changes served as 

a model for other employers. Dedicated Department 

staff kept up the momentum by continually educating 

potential partners about the model. 

Several other large employers followed suit, hosting 

smoking cessation classes, reducing barriers to 

accessing treatments, and adopting tobacco-free 

policies.82 These changes expanded coverage for nearly 

50,000 workers and their families.82

Get Healthy Philly continued supporting employers 

after implementation, talking with human resources 

departments about enhancing resources and 

communicating with employees about the changes. 

For instance, the program worked with the City of 

Philadelphia to highlight successes of employees who 

quit smoking and promote the new resources. The 

response was so strong among City employees that the 

program created a video and poster campaign of people 

who quit smoking sharing their stories to motivate their 

colleagues. Inspired by a similar campaign from the 

University of Massachusetts Memorial Medical Center, 

the “Ex-Smoker Hall of Fame” traveled to City offices 

across Philadelphia, culminating in an event with the 

mayor to recognize their achievements. The campaign 

was so successful that Get Healthy Philly has expanded 

it to three community employers.

Program staff provide comprehensive technical 

assistance on employee wellness

Get Healthy Philly staff worked to develop a broad skill 

set focused on overall employee health. When educating 

employers about cessation access, Get Healthy Philly 

staff encouraged them to make other changes, such 

as installing healthy vending machines and creating 

tobacco-free workplaces. They helped employers

Partnerships l 42

CASE STUDIES
implement these changes by reviewing existing 

workplace policies, drafting new policies, training 

security staff on enforcement, and developing 

communications. Ryan Coffman, Tobacco Policy and 

Control Program Manager at Get Healthy Philly, says of 

the strategy, “In working with large employers, we try to 

go beyond sending them a flyer to assist them in creating 

a tobacco-free culture of health within their workforce. If 

we can be a one-stop shop for them, they appreciate it.”

The program also created a network of partners who had 

implemented similar strategies in many different settings. 

When a new partner had a question, Get Healthy Philly 

staff could connect them to a partner with experience. 

This network was invaluable support for partners as they 

made wellness changes in their organizations.

“Ex-Smoker Hall of Fame” poster featuring employee of Philadelphia 

Department of Behavioral Health and Intellectual disAbility Services

Philadelphia focuses on strong partnerships in all areas 

of tobacco control

Partnerships continue to be central to Get Healthy 

Philly’s cessation efforts. The program has worked 

with managed care organizations to improve Medicaid 

cessation coverage. To develop a cessation media 

campaign, the program formed academic and media 

partnerships.82 Recently, Get Healthy Philly added 

unique partnerships with the Philadelphia Prison System 

and Community Behavioral Health network to improve 

employee and patient access to cessation treatment.139

Get Healthy Philly also applied lessons learned from 

working with employers to form successful partnerships 

in other tobacco control areas. For example, the 

program worked with small businesses to limit sales 

of tobacco products and collaborated with behavioral 

health facilities to implement tobacco-free policies. “We 

try to find ways that tobacco prevention and control 

speaks to issues that organizations and members of 

our community care about,” says Coffman. “In my 

discussions with communities, I try to talk about 

tobacco’s effects on occupational, social, financial, 

and emotional health and wellness. I think this helps 

communities see that this issue is still very much with us, 

and that tobacco use impacts not just length of life but 

quality of life for the populations they serve or represent.”

Get Healthy Philly’s collaborative approach is already 

showing strong results. Since reaching its peak in 2008, 

adult smoking had declined by 18% in 2015.136 Although 

Philadelphia’s smoking prevalence still outpaces other 

large cities, it is expected to decline even further as the 

full effects of two tobacco tax increases (in Philadelphia 

in 2014 and statewide in 2016) are realized.136

“ We try to find ways that tobacco 

prevention and control speaks 

to issues that organizations and 

members of our community care 

about.”

– Ryan Coffman, Tobacco Policy 

 and Control Program Manager

Partnerships l 43

CASE STUDIES
CASE FOR INVESTMENT

Why Invest in Partnerships?

Partnerships are essential to reduce commercial tobacco use and change social norms.1 As programs are asked to do 

more with fewer resources, partnerships have become critical to commercial tobacco control efforts. They mobilize 

communities and bring together resources to help programs achieve more than they could on their own.5

History and Adoption

For almost 50 years, partnerships have strengthened the 

national commercial tobacco control movement and 

expanded the reach of state and local tobacco control 

programs. For example, the early work of nonsmokers’ 

rights groups focused on the health effects of smoking 

and evolved into tobacco control coalitions that work at 

local, state, and national levels. 

Since the 1990s, national organizations like CDC 

and the National Cancer Institute have worked to 

reinforce partners’ roles in tobacco control.1,3,10 In 

2006, CDC formed the National Networks to address 

commercial tobacco use and related health disparities. 

CDC expanded its National Networks in 2018 with 

the formation of Networking2Save, a consortium of 

eight National Networks that bring together partners 

from across tobacco and cancer control to address the 

prevalence of commercial tobacco use and tobaccorelated cancers.103

Support for partnerships continues to increase as 

government agencies and foundations recognize the 

importance of partnerships to strengthen prevention 

programs. Partnerships have enhanced commercial 

tobacco control efforts in states and communities 

across the country. As of 2021, 61 percent of Americans 

are protected by local or state comprehensive smokefree 

laws, 48 states have increased cigarette taxes since 2000, 

and local partners across the country are working to 

counter the tobacco industry’s advertising tactics.15,16,22

Scientific Evidence

Due to the limited evaluation of partnership efforts, 

evidence linking tobacco control partnerships to 

positive health outcomes is still emerging.137 Research 

on coalitions has noted the key role that they play 

in program outcomes, but it is difficult to separate 

and measure their contributions.137 Major national 

reports continue to recognize partnerships as powerful 

contributors to changing social norms.1,3,10 Strategic 

partnerships and coalitions can be even more effective 

when they have a program’s full support, include 

diverse community representation, and use evidencebased practices.7,138

Examples of successful partnerships continue to 

emerge as programs involve partners in planning 

and implementing strategies. Partners have helped 

raise awareness about the importance of tobaccofree environments, educate about the impact of 

increased tobacco product prices, reduce tobacco 

product advertising, expand cessation coverage, and 

reduce tobacco-related disparities.2,10,61 For example, 

partners have educated businesses about the benefits 

of tobacco-free workplaces in Oklahoma.138 They have 

also limited tobacco product discounts in New York 

City, and improved cessation coverage for nearly 57,000 

employees in Philadelphia.75,82

By creating and supporting partnerships, programs 

can continue to mobilize communities and sustain 

community change.

Partnerships l 44
Cost 

Commercial tobacco use is the leading cause of 

preventable disease and death in the U.S.3

 Each year, 

smoking-related illness in the U.S. costs more than 

$300 billion, including nearly $170 billion in direct 

healthcare costs for adults and more than $156 billion 

in lost productivity.3,139 By forming partnerships to 

reduce commercial tobacco use and secondhand smoke 

exposure, programs and partners can work together to 

decrease the health and economic burden of tobacco use. 

While the financial investment in tobacco control 

partnerships is relatively low, the return on investment 

can be high. Successful partnerships leverage their 

members’ resources and expertise to enhance tobacco 

control programs and public health outcomes. Partners 

often contribute significant amounts of their time and 

services because they are committed to the partnership’s 

vision. Members are more likely to contribute when 

they feel valued, benefit from the partnership, and can 

see the results of their efforts.20

To sustain partnerships, it is important that programs 

and partners seek a variety of financial resources. When 

partners are involved in securing funding, they are 

more likely to become invested in the partnership.20

Sustainability

Partnerships help make commercial tobacco control 

a permanent focus of community health. Creating 

strategic partnerships and coalitions allows programs 

to bring together community talents and expertise 

and develop an action plan to address local tobacco 

control issues.7,118 Partners become champions for 

tobacco control strategies, promoting change within 

their organizations and throughout the community.7

Committed partners continue this work even when the 

partnership comes to an end.24

Partnerships also help programs reach a wider 

audience. Programs can tap into partners’ networks to 

share campaign messages, tobacco control news, and 

information about cessation resources. By educating 

decision makers and the public on the dangers of 

commercial tobacco use and on the importance of 

tobacco control, partners build community support for 

future tobacco control strategies.137

Partnerships l 45

CASE FOR INVESTMENT
RESOURCES

Tobacco Prevention 

and Control

6|18 Initiative (2018)

Publisher: Centers for Disease Control and Prevention

Summary: Overview of the 6|18 Initiative with strategies 

and resources to reduce commercial tobacco use 

through partnerships 

https://www.cdc.gov/sixeighteen

Assessing Community Needs and Resources Toolkit 

(2018)

Publisher: Community Tool Box

Summary: Step-by-step guidance and resources for 

assessing a community’s needs and resources

http://bit.ly/ctb_assessing

Best Practices for Comprehensive Tobacco Control 

Programs—2014

Publisher: Centers for Disease Control and Prevention

Summary: Strategies and funding recommendations to 

plan and implement state tobacco control programs 

http://bit.ly/bp_2014

Best Practices User Guide: Cessation (2020)

Publisher: Centers for Disease Control and Prevention

Summary: Steps that state tobacco control staff and 

partners can take to promote health systems change, 

improve cessation coverage, and support state quitlines

https://bit.ly/cdc_cessation

Best Practices User Guide: Health Communications 

in Tobacco Prevention and Control (2018)

Publisher: Centers for Disease Control and Prevention

Summary: Steps that state tobacco control staff 

and partners can take to develop effective health 

communications

http://bit.ly/cdc_communications

Best Practices User Guide: Health Equity in Tobacco 

Prevention and Control (2015)

Publisher: Centers for Disease Control and Prevention

Summary: Steps that state tobacco control staff and 

partners can take to promote health equity and reduce 

tobacco-related disparities

http://bit.ly/cdc_healthequity

Best Practices User Guide: Program Infrastructure 

in Tobacco Prevention and Control (2017)

Publisher: Centers for Disease Control and Prevention

Summary: Steps that state tobacco control staff and 

partners can take to build strong program infrastructure

http://bit.ly/cdc_programinfrastructure

Best Practices User Guide: Youth Engagement in 

Tobacco Prevention and Control (2019)

Publisher: Centers for Disease Control and Prevention

Summary: Steps that state tobacco control staff and 

partners can take to engage youth as part of a 

comprehensive tobacco control program 

http://bit.ly/cdc_youthengagement

Building Relationships with People from Different 

Cultures

Publisher: Community Tool Box

Summary: Information on how to learn about and build 

relationships with people from other cultures 

http://bit.ly/ctb_relationships

Community Leaders Toolkit: Educating Community 

Leaders

Publisher: Center for Public Health and Tobacco Policy

Summary: Worksheets to plan for meetings with 

community leaders

http://bit.ly/cphtp_toolkit

Cultural Humility: Essential Foundation for Clinical 

Researchers

Publisher: Applied Nursing Research 

Author: Yeager KA, Bauer-Wu S

Summary: Discussion of the cultural humility process and 

its role in research

http://bit.ly/yeager_humility

Partnerships l 46
Developing an Effective Evaluation Plan: Setting 

the Course for Effective Program Evaluation (2011)

Publisher: Centers for Disease Control and Prevention 

Summary: Workbook to develop an evaluation plan

http://bit.ly/cdc_effectiveevaluation

Developing an Effective Evaluation Report: Setting 

the Course for Effective Program Evaluation (2013)

Publisher: Centers for Disease Control and Prevention

Summary: Workbook to develop a final evaluation report

http://bit.ly/cdc_evalreport

Electronic Cigarettes – What’s the Bottom Line? 

Publisher: Centers for Disease Control and Prevention 

Summary: Graphic summary on the health effects of 

e-cigarettes 

http://bit.ly/cdc_bottomline

Enhancing Cultural Competence

Publisher: Community Tool Box

Summary: Toolkit for assessing and enhancing cultural 

competence in your organization or community

https://ctb.ku.edu/en/enhancing-cultural-competence

Evaluate: SWOT Analysis Tool

Publisher: Centers for Disease Control and Prevention

Summary: Interactive document for conducting a 

SWOT analysis of a program’s strengths, weaknesses, 

opportunities, and threats

http://bit.ly/cdc_swot

Guide to Providing Effective Communication and 

Language Assistance Services

Publisher: U.S. Department of Health and Human Services

Summary: Strategies for health care providers and 

administrators to communicate health information to 

diverse groups of people

https://hclsig.thinkculturalhealth.hhs.gov

The Health Consequences of Smoking—50 Years of 

Progress: A Report of the Surgeon General (2014)

Publisher: U.S. Department of Health and Human Services

Summary: Overview of the progress made to reduce 

commercial tobacco use over the last 50 years and the 

continued burden of tobacco-related death and disease

http://bit.ly/sgr_2014

Healthier Air for All

Publisher: Louisiana Campaign for Tobacco-Free Living 

Summary: Website for campaign to expand partnering for 

comprehensive smokefree protections in Louisiana 

http://healthierairforall.org

Implementing Photovoice in Your Community

Publisher: Community Tool Box 

Summary: Guide to the Photovoice process of using 

photos and videos to share one’s environment and 

experiences with others 

http://bit.ly/ctb_photovoice

Implementing Your New Smokefree Law

Publisher: Americans for Nonsmokers’ Rights 

Summary: Tip sheet for communities seeking to introduce 

and implement new smokefree measures

http://bit.ly/anr_smokefreelaw

Introduction to Program Evaluation for Public 

Health Programs: A Self-Study Guide (2011)

Publisher: Centers for Disease Control and Prevention

Summary: Guide for planning and implementing 

evaluation activities using CDC’s Framework for 

Program Evaluation in Public Health 

http://bit.ly/cdc_pubhealth

Media Campaign Resource Center (2018)

Publisher: Centers for Disease Control and Prevention

Summary: Searchable archive of CDC-licensed 

commercial tobacco control advertisements

http://www.cdc.gov/tobacco/media_campaigns

Partnerships l 47

RESOURCES
Networking2Save: CDC’s National Network 

Approach to Preventing and Controlling Tobaccorelated Cancers in Special Populations 

Publisher: Centers for Disease Control and Prevention

Summary: Links to web pages for eight National Networks 

to reduce commercial tobacco use in special populations

http://bit.ly/cdc_networking2save

Partnership: What Goes into Building a 6|18 

Initiative Team?

Publisher: Association of State and Territorial Health 

Officials

Summary: Fact sheet for state and territorial health 

departments, with strategies for starting an effective 

6|18 Initiative team

https://www.astho.org/ASTHOBriefs/6-18-Initiative/

Point-of-Sale Strategies: A Tobacco Control Guide 

(2014)

Publisher: Center for Public Health Systems Science and 

the Tobacco Control Legal Consortium

Summary: Strategies to reduce advertising and promotion 

of tobacco products in retail stores as part of a 

comprehensive tobacco control program 

http://bit.ly/cphss_pointofsale

Pricing Policy: A Tobacco Control Guide (2014)

Publisher: Center for Public Health Systems Science and 

the Tobacco Control Legal Consortium

Summary: Information on developing and implementing 

tobacco product pricing policies 

http://bit.ly/cphss_policypricing

Public Housing Authority Smoking Limitations 

(2010)

Publisher: San Francisco Tobacco-Free Project

Summary: Case study on how youth from Girls After 

School Academy worked with partners to encourage 

smokefree public housing

https://sanfranciscotobaccofreeproject.org/case-studies/gasa

Program Sustainability Assessment Tool (2012)

Publisher: Center for Public Health Systems Science

Summary: Tool to assess tobacco control and other 

programs’ sustainability and guide sustainability 

planning

https://sustaintool.org

Public Health Law Center

Publisher: Mitchell Hamline School of Law

Summary: Webinars and resources on commercial 

tobacco control topics, such as T21, e-cigarettes, and 

enforcement

https://www.publichealthlawcenter.org/

Rx for Change (2019)

Publisher: University of California, San Francisco

Summary: Free online training for healthcare providers 

on treating commercial tobacco use

http://rxforchange.ucsf.edu

Smokefree Policies in Multi-Unit Housing (2019)

Publisher: American Lung Association

Summary: Tools and resources to help housing properties 

go smokefree

http://bit.ly/ala_smokefreehousing

Store Assessment Tools

Publisher: Counter Tobacco

Summary: Tools and resources to collect data about 

tobacco product advertising and promotion in stores

http://bit.ly/ct_tools

SWOT Analysis

Publisher: Minnesota Department of Public Health

Summary:Information on how to conduct a SWOT 

analysis and community examples

http://bit.ly/mdh_swot

Tobacco Cessation Change Package: A Million 

Hearts® Action Guide (2020)

Publisher: Centers for Disease Control and Prevention

Summary: Quality improvement tool to help providers 

incorporate commercial tobacco treatment into clinical 

settings

http://bit.ly/millionhearts_changepackage

Partnerships l 48

RESOURCES
Tobacco Treatment Training (2019)

Publisher: University of Wisconsin Center for Tobacco 

Research and Intervention

Summary: Free online training for healthcare providers 

on treating commercial tobacco use, including 

comprehensive training for mental health and 

substance use providers

http://bit.ly/uw_training

What Can Social Network Analysis Do for You

Publisher: Center for Public Health Systems Science

Summary: Introduction to the concepts and steps of social 

network analysis

http://bit.ly/3pvqWrl

What You Need to Know About Background 

Screening (2013)

Publisher: U.S. Department of Justice, National Center for 

Missing and Exploited Children 

Summary: Guidebook on screening potential employees 

and volunteers who will work with youth 

http://bit.ly/usdoj_backgroundscreening

Strategic Partnerships

Building Partnerships: A Best Practices Guide (2013)

Publisher: Community Partnerships Interagency Policy 

Committee

Summary: Guidance for when and how to form effective 

partnerships

http://bit.ly/cpipc_guide

Evaluating Partnerships to Prevent and Manage 

Chronic Disease (2009)

Publisher: Preventing Chronic Disease

Author: Butterfoss FD

Summary: Six-step approach to evaluating partnerships

http://bit.ly/butterfoss_evaluating

Creating and Maintaining Partnerships (2018)

Publisher: Community Tool Box

Summary: Guiding questions and resources for forming 

partnerships 

http://bit.ly/ctb_partnerships

Evaluation Guide: Fundamentals of Evaluating 

Partnerships (2008)

Publisher: Centers for Disease Control and Prevention

Summary: Tools for state and local health departments to 

evaluate partnerships 

http://bit.ly/cdc_evalpartners

CDC’s Guiding Principles for Public-Private 

Partnerships: A Tool to Support Engagement to 

Achieve Public Health Goals (2018)

Publisher: Centers for Disease Control and Prevention

Summary: Guidebook for establishing public-private 

partnerships to address public health problems

http://bit.ly/cdc_principles

Healthy Retail: Collaboration Workbook (2016)

Publisher: ChangeLab Solutions

Summary: Worksheets to help program staff form 

partnerships in the retail environment

http://bit.ly/changelab_collaboration

The Implementation Road: Engaging Community 

Partnerships in Evidence-based Cancer Control 

Interventions (2015)

Publisher: Health Promotion Practice

Author: Breslau E, Weiss E, Williams A, Burness A, 

Kepka D

Summary: Successes and challenges for partnerships in 

using evidence-based strategies to increase cancer 

screening in rural communities

http://bit.ly/breslau_implementation

Involving People Most Affected by the Problem 

(2018)

Publisher: Community Tool Box

Summary: Strategies to form partnerships with priority 

populations

http://bit.ly/ctb_involving

Partnerships l 49

RESOURCES
Partnering with CDC

Publisher: Centers for Disease Control and Prevention

Summary: Overview of CDC’s public-private partnerships 

and resources for partnership development

https://www.cdc.gov/partners/partnering.html

Partnership Evaluation Guidebook and Resources 

(2011)

Publisher: Centers for Disease Control and Prevention

Summary: Evaluation methods and tools to help state 

public health programs evaluate partnerships

http://bit.ly/cdc_partnershipsevaluation

Partnerships: Frameworks for Working Together

Publisher: Compassion Capital Fund

Summary: Strategies to help community organizations 

form and maintain partnerships 

http://bit.ly/ccf_framework

The Power of Collaborative Solutions (2010)

Publisher: Jossey-Bass

Author: Wolff T

Summary: Principles for effective community partnerships 

http://bit.ly/wolff_collaborative

Public-Private Partnership Initiative

Publisher: North American Quitline Consortium

Summary: Initiative to help states form cost-saving 

partnerships with private and public health insurers

http://bit.ly/naqc_partnership

A Structured Approach to Effective Partnering: 

Lessons Learned from Public and Private Sector 

Leaders

Publisher: Centers for Disease Control and Prevention

Summary: Framework for developing effective strategic 

partnerships

http://bit.ly/cdc_structured

Wilder Collaboration Factors Inventory (2019)

Publisher: Amherst H. Wilder Foundation

Summary: Free online tool to assess partnership 

performance 

http://bit.ly/wilder_factors

Coalitions

Am I a High Functioning Coalition Member?

Publisher: Coalitions Work

Summary: Self-assessment checklist for coalition 

members to rate their own involvement 

http://bit.ly/coalitionswork_functioning

Case Studies from Community Coalitions: 

Advancing Local Tobacco Control Policy in a 

Preemptive State (2015)

Publisher: American Journal of Preventive Medicine

Author: Douglas M, Manion C, Hall-Harper V, Terronez 

K, Love C, Chan A

Summary: Strategies and lessons learned from tobacco 

control coalitions in states with preemption laws 

http://bit.ly/douglas_casestudies

Coalition Building I: Starting a Coalition (2018)

Publisher: Community Tool Box

Summary: Information on what coalitions are and how to 

establish them

http://bit.ly/ctb_starting

Coalition Building II: Maintaining a Coalition (2018)

Publisher: Community Tool Box

Summary: Steps for maintaining or deciding to end a 

coalition 

http://bit.ly/ctb_maintaining

Coalitions and Partnerships in Community Health 

(2007)

Publisher: Jossey-Bass

Author: Butterfoss FD

Summary: Step-by-step guide to build, manage, and 

evaluate coalitions

http://bit.ly/butterfoss_coalitions

Coalitions Work Tools (2007)

Publisher: Coalitions Work

Summary: Checklists, surveys and other tools to build, 

manage, and sustain coalitions 

http://coalitionswork.com/resources/tools

Partnerships l 50

RESOURCES
Collective Impact (2011)

Publisher: Stanford Social Innovation Review

Author: Kania J, Kramer M

Summary: Description of the five conditions necessary 

to achieve collective impact through cross-sector 

collaboration 

http://bit.ly/kania_collectiveimpact 

Collective Impact Forum (2014)

Publisher: Collective Impact Forum 

Summary: Tools, resources, and advice to guide crosssector coalition development and activities 

http://bit.ly/collectiveimpactforum

The Collective Impact Model and Its Potential for 

Health Promotion: Overview and Case Study of a 

Healthy Retail Initiative in San Francisco (2015)

Publisher: Health Education and Behavior

Author: Flood J, Minkler M, Hennessey Lavery S, Estrada 

J, Falbe J

Summary: Description of the Collective Impact model 

and coalition efforts to reduce tobacco and alcohol sales 

in San Francisco

http://bit.ly/flood_collectiveimpact

Determinants of Community Coalition Ability to 

Support Evidence-Based Programs (2010)

Publisher: Prevention Science

Author: Brown L, Feinberg M, Greenberg M

Summary: Coalition features that helped implement 

evidence-based programs in Pennsylvania

http://bit.ly/brown_determinants

Guide to Evaluating Collective Impact: Learning and 

Evaluation in the Collective Impact Context (2014)

Publisher: Collective Impact Forum

Author: Preskill H, Parkhurst M, Juster J

Summary: Three-part guide on how to plan and conduct 

an evaluation of coalition activities 

http://bit.ly/cif_guide

Organizing a Strategic Policy Coalition

Publisher: Center for Public Health Practice

Summary: Free online course on why and how to form a 

strategic policy coalition

http://bit.ly/cphp_coalition

Predictors and Level of Sustainability of 

Community Prevention Coalitions (2008)

Publisher: American Journal of Preventive Medicine

Author: Feinberg M, Bontempo D, Greenberg M

Summary: Features that helped sustain coalitions in 

Pennsylvania

http://bit.ly/feinberg_sustainability

Reaching Higher Ground: A Guide for Preventing, 

Preparing for, and Transforming Conflict for 

Tobacco Control Coalitions (2010)

Publisher: Tobacco Technical Assistance Consortium

Author: Dukes EF, Solomon M

Summary: Strategies for preventing and managing conflict 

within coalitions

http://bit.ly/dukes_higherground

A Sustainability Planning Guide for Healthy 

Communities

Publisher: Centers for Disease Control and Prevention

Summary: Step-by-step guide to develop a coalition 

sustainability plan

http://bit.ly/cdc_sustainability

Sustaining Tobacco Control Coalitions Amid 

Declining Resources (2007)

Publisher: Health Promotion Practice 

Author: Carver V, Reinert B, Range L

Summary: Strategies used by tobacco control coalitions in 

Mississippi to sustain funding

http://bit.ly/carver_sustaining

Partnerships l 51

RESOURCES
Case Studies 

Mississippi

Office of Tobacco Control

Publisher: Mississippi State Department of Health

Summary: Information on the Mississippi state tobacco 

control program’s activities, partners, and resources 

http://bit.ly/ms_tobaccocontrol

Mississippi Tobacco Data

Publisher: Social Science Research Center, Mississippi 

State University

Summary: Data and interactive charts on tobacco use and 

tobacco control activities in Mississippi 

http://mstobaccodata.org

Mississippi Tobacco-Free Coalitions

Publisher: Mississippi State Department of Health

Summary: List of county-level tobacco-free coalitions 

funded by the Mississippi State Department of Health, 

Office of Tobacco Control 

http://bit.ly/ms_coalitions

Philadelphia

Get Healthy Philly

Publisher: City of Philadelphia Department of Public 

Health

Summary: Vision and activities of the Get Healthy Philly 

program 

https://www.phila.gov/programs/get-healthy-philly

Tobacco Policy and Control Program

Publisher: Philadelphia Department of Public Health

Summary: Overview of Get Healthy Philly’s Tobacco 

Policy and Control Program with links to cessation 

services

http://bit.ly/phila_tpcp

Partnerships l 52

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This document was produced for the Centers for Disease Control and Prevention by the 

Center for Public Health Systems Science at the Brown School at Washington University 

in St. Louis.

Suggested citation:

Centers for Disease Control and Prevention. Best Practices User Guide: Partnerships in Tobacco 

Prevention and Control. Atlanta, GA: U.S. Department of Health and Human Services, Centers 

for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health 

Promotion, Office on Smoking and Health, 2021.

Ordering information:

To download or order copies of this report, go to www.cdc.gov/tobacco or to order single copies, 

call toll-free 1-800-CDC-INFO or 1-800-232-4636.

More information:

For more information about commercial tobacco control and prevention, visit CDC’s Smoking & 

Tobacco Use website at www.cdc.gov/tobacco.