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Appendix D: 

Guidelines for Comprehensive 

Local Tobacco Control Programs 

(National Association of County and City Health Officials1)

1. Community Interventions: 

$3.99 to $6.75 per person, per year

For meaningful change to occur in the way 

tobacco products are marketed, sold, and used, 

community involvement is essential. For example, promoting smokefree environments and 

enforcing policies that restrict tobacco advertising help to change social norms about tobacco 

use. Raising taxes on tobacco is among the most 

effective ways to reduce use, especially among 

young people and the poor. Restricting access 

to tobacco products discourages youth from initiating tobacco use, and with the new Food and 

Drug Administration legislation, localities will have 

more opportunity to influence where, when, and 

how tobacco products are displayed and sold.

2. Health Communications: 

$0.65 to $1.95 per person, per year

There is considerable evidence that communication campaigns are effective at reducing tobacco 

consumption. A well-coordinated mass-media 

campaign that reaches a wide market and warns 

individuals about the dangers of tobacco use can 

promote cessation and prevent initiation in the 

general population and hard-to-reach groups. 

Media messages can have a powerful influence 

on public support for tobacco control policies and 

help reinforce school and community efforts.

3. Cessation Interventions: 

$2.04 to $5.94 per adult, per year

More than two-thirds of adult smokers report a 

desire to quit. Cessation interventions offer the 

quickest and largest short-term public health 

benefit compared with any other component 

of the comprehensive tobacco control program. Many effective treatments for tobacco 

dependence now exist but are underused. 

Health care systems must better identify, treat, 

and refer patients addicted to tobacco use.

4. Program Administration 

and Management: The larger 

of 5% of program budget or 

one-quarter to one full-time 

equivalent (FTE) dedicated staff

Each local health department requires dedicated personnel who can perform strategic 

planning, staffing, and fiscal management functions, and a well-trained work force that has the 

skills required to carry out program activities. For 

even the smallest of populations, at least onequarter full-time equivalent (FTE) staff member 

should be dedicated to tobacco control programming and oversight and can also serve as 

chronic disease lead. As the size of the population and the program increases, staff resources 

beyond one FTE to implement tobacco interventions should be derived from the recommended 

budgets of the other program components.

5. Surveillance and Evaluation: 

10% of program budget

Surveillance and evaluation are essential 

elements of a comprehensive tobacco control program. A successful program should 

assess the use of tobacco, local factors contributing to tobacco use, and progress toward 

planned outcomes and should report data that 

are useful to policymakers and the public.

Reference

1. National Association of County & City Health 

Officials. 2010 Program and Funding Guidelines 

for Local Comprehensive Tobacco Control 

Program; <http://www.naccho.org/toolbox/tool.

cfm?id=1994>; accessed: December 2, 2013.