This application is for competitive renewal of funding for Tobacco Farmers and Tobacco Control (TFTC I), an R0l currently funded by NCI This study will be conducted in North Carolina, where more tobacco is grown than in all other states combined. In addition, due substantially to public and policy-maker concern about farmers, North Carolina lag far behind other states in tobacco control efforts. The original study (still ongoing) is a randomized intervention trial of 14 major tobacco-producing counties. Seven counties were assigned randomly to receive an intensive community organization and education intervention that encouraged diversification. The seven non-intervention counties served as a no-treatment comparison group. The efficacy of the intervention was evaluated among a cohort of over 1,000 tobacco fanners. In this competitive renewal (TFTC II) we propose to cease implementation of the TFTC I intervention and to monitor its impact, as well as the impact of the tobacco settlement and other tobacco/agricultural policy in the seven treatment and seven comparison counties that participated in TFTC I. In addition, we propose to add a statewide tracking system to the study to evaluate how the settlement is being implemented (and reactions to it), both in the 14 counties we have studied over the past three years and among statewide farmer organizations, health groups, other community organizations, and policy-makers. Specifically, TFTC II will: (a) assess whether tobacco farmers in the seven TFTC I intervention counties, compared to the seven control counties, will be less dependent on tobacco as source of family income; (b) examine the effects of the tobacco settlement on tobacco production and public health interests; (c) document the knowledge, attitudes, and behaviors of tobacco farmers and other tobacco-dependent community stakeholders about the impacts of changes in the tobacco farming sector; (d) collect data from health constituencies, tobacco fanners, tobacco-dependent community stakeholders, and from local, regional and stat economic development interests concerning the chances of successful diversification; and (e) identify areas of tobacco farmer misunderstanding of the impacts of tobacco control programs and tobacco industry business practices and asses; how tobacco control organizations can target these areas of misunderstanding with educational campaigns and other programs. We believe that as farmers become less dependent on tobacco, they will interfere less with tobacco control efforts. We suggest that farmer diversification and the subsequent economic development it produces will decrease public and policy-maker resistance to tobacco control.
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