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Evaluating ASSIST - A Blueprint for Understanding State-level Tobacco Control: NCI Tobacco Control Monograph Series No. 17 (Paperback)
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Evaluating ASSIST - A Blueprint for Understanding State-level Tobacco Control: NCI Tobacco Control Monograph Series No. 17 (Paperback)
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With this volume, the National Cancer Institute (NCI) presents the
17th monograph of the Tobacco Control Monograph series. This
monograph documents the evaluation of a groundbreaking NCI program.
The American Stop Smoking Intervention Study for Cancer Prevention,
known as ASSIST, put into practice NCI's commitment to prevent and
reduce tobacco use across all populations and age groups. ASSIST
took evidenced-based interventions from controlled studies and
implemented them in the larger community of 17 states. Its
underlying rationale-that significant decreases in tobacco use
could be realized only with interventions that changed the social
environment such that smoking was non-normative-was a significant
departure from previous tobacco control programs and in the
vanguard of the "new" public health. Prior to ASSIST, few states
addressed tobacco use at the population level. The ASSIST legacy
remains today in the tobacco control professionals whose work
continues to reduce the burden of disability and death caused by
tobacco. ASSIST raised significant conceptual and practical
challenges for its evaluation team. These challenges included
context-dependent implementation and the diffusion of ASSIST and
ASSIST-like interventions into non-ASSIST states. In addition, the
evaluation did not begin until several years after ASSIST was
implemented, and its budget was limited. What had been envisioned
as a simple evaluation of a demonstration project became a complex
evaluation effort that engaged a diverse group of scientists and
practitioners and required numerous sources of data. The resulting
evaluation successfully documented the effectiveness of ASSIST. It
also validated the causal pathway described in NCI's 1991 Smoking
and Tobacco Control Monograph 1: Strategies to Control Tobacco Use
in the United States: A Blueprint for Public Health Action in the
1990's-that comprehensive interventions can change the social
environment of tobacco use and subsequently result in decreased
tobacco use. This monograph stands alone as a documentation of the
ASSIST evaluation and describes the challenges met in evaluating a
program that was influenced by numerous forces outside the
program's control. However, this monograph may also be viewed as a
companion to NCI Tobacco Control Monograph 16, which reviews the
ASSIST program in detail. Together these two monographs provide a
detailed history and evidence base that document the success of an
NCI initiative that began with a series of research hypotheses,
tested those hypotheses with community-based interventions, and
ultimately fielded a demonstration program that fundamentally
changed tobacco use prevention and control in the United States.
This volume and several future volumes in the Tobacco Control
Monograph Series have important implications for research,
practice, and policy in tobacco control as well as in other areas
of public health. Lessons learned from tobacco prevention and
control can be applied to a variety of public health issues,
including physical activity, diet and nutrition, overweight and
obesity, and substance abuse. NCI is committed to disseminating
this cross-cutting knowledge to the widest possible audience so
that others can benefit from the experience of the tobacco
prevention and control community. By so doing, NCI is increasing
the evidence base for effective public health interventions and
improving the translation of research to practice and policy.
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