Tobacco Use

CAI works with a wide range of stakeholders to change tobacco-related policies and behaviors within municipalities, neighborhoods, schools, businesses, and more, through population- and community-level strategies. For nearly two decades, we have developed comprehensive curricula and toolkits to engage stakeholders, implement strategies for tobacco prevention, strengthen clinical systems that improve access to tobacco cessation treatment and reimbursement for providers, and supported providers in addressing emerging issues such as electronic nicotine devices.

Early in this work, we recognized the immediate need for new and innovative approaches to address tobacco disparities among low-income, minority, and otherwise marginalized and under-resourced populations. It was clear that while improvements were being made in reducing rates of tobacco use across the country, poor communities, particularly communities of color, have been left behind in the advancements made in tobacco control. The aggressive behavior of the tobacco industry in poor communities and communities of color has exacerbated disparities. While the tobacco field has shown the importance of policy in tobacco control, we believe that community ownership, through authentic community engagement and identification of social norms that need to be strengthened, can further strengthen policy —and we have worked with communities to develop model programs in these areas.

CAI’s current work to address tobacco use is largely focused on community-based initiatives that allow residents—especially those who are disproportionately affected and historically not included in these conversations—to design, lead, implement, and evaluate activities that reduce tobacco use and health disparities in their communities. Our Project BAT (Black people Against Tobacco), funded by the U.S. Centers for Disease Control and Prevention (CDC), and our Advancing Tobacco-Free Communities project, funded by New York State’s Department of Health, are working in Jackson, Mississippi; Atlanta, Georgia; and Buffalo, New York; to bring this vision to reality, with community members leading the design and implementation of strategies to effect policy change in retail settings, workplaces and housing; social norms change; and improved access to tobacco cessation services.

We have also been working with the New York State Department of Health for more than seven years as the Center for Health Systems Improvement for a Tobacco-Free NY, supporting statewide and regional efforts to implement large-scale policy and systems changes that support universal access to evidence-based tobacco dependence treatment services across New York State. In addition, we’re working with communities who are pursuing policy and systems changes within health care systems and organizations that serve populations for which smoking rates have remained stagnant over the past decade (individuals with low incomes, low educational attainment, LGBTQ+ identifying, serious mental illness, substance use disorders, and/or physical disabilities).

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