Measuring infrastructure: A key step in program evaluation and planning

State tobacco prevention and control programs (TCPs) require a fully functioning infrastructure to respond effectively to the Surgeon General’s call for accelerating the national reduction in tobacco use. The literature describes common elements of infrastructure; however, a lack of valid and reliable measures has made it difficult for program planners to monitor relevant infrastructure indicators and address observed deficiencies, or for evaluators to determine the association among infrastructure, program efforts, and program outcomes. The Component Model of Infrastructure (CMI) is a comprehensive, evidence-based framework that facilitates TCP program planning efforts to develop and maintain their infrastructure. Measures of CMI components were needed to evaluate the model’s utility and predictive capability for assessing infrastructure. This paper describes the development of CMI measures and results of a pilot test with nine state TCP managers. Pilot test findings indicate that the tool has good face validity and is clear and easy to follow. The CMI tool yields data that can enhance public health efforts in a funding-constrained environment and provides insight into program sustainability. Ultimately, the CMI measurement tool could facilitate better evaluation and program planning across public health programs

State tobacco control expenditures and tax paid cigarette sales.

This research is the first nationally representative study to examine the relationship between actual state-level tobacco control spending in each of the 5 CDC's Best Practices for Comprehensive Tobacco Control Program categories and cigarette sales. We employed several alternative two-way fixed-effects regression techniques to estimate the determinants of cigarette sales in the United States for the years 2008-2012. State spending on tobacco control was found to have a negative and significant impact on cigarette sales in all models that were estimated. Spending in the areas of cessation interventions, health communication interventions, and state and community interventions were found to have a negative impact on cigarette sales in all models that were estimated, whereas spending in the areas of surveillance and evaluation, and administration and management were found to have negative effects on cigarette sales in only some models. Our models predict that states that spend up to seven times their current levels could still see significant reductions in cigarette sales. The findings from this research could help inform further investments in state tobacco control programs

Impacts of state tobacco control expenditures by Best Practice category on per capita cigarette sales: United States for years 2008–2012 quadratic model.

<p>Impacts of state tobacco control expenditures by Best Practice category on per capita cigarette sales: United States for years 2008–2012 quadratic model.</p

Impacts of state tobacco control expenditures by Best Practice category on per capita cigarette sales: United States for years 2008–2012 fixed effects panel threshold model.

<p>Impacts of state tobacco control expenditures by Best Practice category on per capita cigarette sales: United States for years 2008–2012 fixed effects panel threshold model.</p

Impacts of state tobacco control expenditures on Per Capita cigarette sales: United States for years 2008–2012.

<p>Impacts of state tobacco control expenditures on Per Capita cigarette sales: United States for years 2008–2012.</p

Descriptive statistics: United States for years 2008–2012.

<p>Descriptive statistics: United States for years 2008–2012.</p