) The prevalence of tobacco use prevention public policies has increased dramatically in the past decade. However, very few businesses in rural communities comply with these public policies. A recent study revealed that 68% of tobacco outlets in rural communities in central Missouri do not comply with the state law banning tobacco sales to minors. Another study found that approximately 60% of businesses in rural communities in central Missouri do not comply with the state clean indoor air law. A survey in southeast Missouri revealed that more than 50% of police chiefs, city managers, and mayors are unaware that a state law exists restricting public smoking. This research study will evaluate the effectiveness of two different community organization models for advocating local compliance with federal and state tobacco use prevention policies (i.e., tobacco sales to minors and clean indoor air). A second component of the project will examine the effects of local compliance with tobacco use prevention policies on smoking rates among tenth grade students. Development of the two policy advocacy approaches has been guided by the locality development and social action models of community organization. The two models characterize the social and political contexts in which policy advocacy occurs and identify the intervention strategies that are needed to promote compliance with tobacco use prevention policies. A controlled study design will be used to evaluate the effectiveness of the interventions. Forty rural communities will be randomly assigned to one of five groups (Intervention I - Locality Development for Tobacco Sales to Minors, Intervention II - Social Action for Tobacco Sales to Minors; Intervention III - Locality Development for Clean Indoor Air; Intervention IV - Social Action for Clean Indoor Air; or Control). Outcome measures will be assessed at baseline and after a three year intervention phase. The evaluation also will characterize changes in intermediate outcomes (i.e., coalition empowerment, local law enforcement, school tobacco use environment, and media coverage) that may explain the success or failure of community interventions.
