Tobacco use is the single most preventable cause of death and disease in our society. Annually, in the United States, tobacco use causes more than 430,000 deaths. Direct medical costs related to smoking total at least $50 billion per year; lost productivity adds another $50 billion. Tobacco use is addictive: nearly 70% of smokers want to quit smoking, but only 2.5% are able to quit permanently each year. Most smokers start smoking as adolescents. One in three teenagers who are regular smokers will eventually die of smoking-related causes. Other tobacco products also have serious health consequences. Use of smokeless tobacco is associated with leukoplakia and oral cancer. There is also strong evidence of causal relationships between regular cigar use and cancers of the lungs, larynx, oral cavity, and esophagus. These consequences are of particular concern because in 1999, 15.3% of U.S. high school students smoked cigars and 6.6% used smokeless tobacco. The risks of tobacco use extend beyond the actual users. Nearly 9 of 10 nonsmoking Americans have been exposed to environmental tobacco smoke (ETS). Exposure to ETS increases nonsmokers' risk for lung cancer and heart disease. Among children, ETS is also associated with serious respiratory problems, including asthma, pneumonia, and bronchitis. In addition, scientific evidence now links ETS with sudden infant death syndrome (SIDS) and low birth weight. Tobacco control programs are designed ultimately to help reduce disease, disability, and death related to tobacco use. To determine the effectiveness of these programs, one must document and measure both their implementation and their effect. Program evaluation is a tool used to assess the implementation and outcomes of a program, to increase a program's efficiency and impact over time, and to demonstrate accountability. This document is a “how to” guide for planning and implementing evaluation activities. The manual reflects the priorities of the Centers for Disease Control and Prevention (CDC), Office on Smoking and Health (OSH), for program monitoring and evaluation. The purpose of this manual is to assist state tobacco control program managers and staff in the planning, design, implementation, and use of practical and increasingly comprehensive evaluations of tobacco control efforts. The strategy presented in this manual will aid those responsible for evaluation activities to demonstrate accountability to diverse stakeholders. In this case, accountability includes assessing and documenting the effectiveness of programs, measuring program outcomes, documenting implementation and cost effectiveness, and increasing the impact of programs.

This workbook applies the CDC Frameword for Program Evaluation in Public Health. The purpose of this workbook is to help public health program managers, administrators, and evaluators develop a joing understanding of what constitutes an evaluation plan, why it is important, and how to develop an effective evaluation plan in the context of the planning process.This workbook is intended to assist in developing an evalution plan but is not intended to serve as a complete resource on how to implement program evaluation.

The health and economic costs of tobacco use in military and veteran populations are high. In 2007, the Department of Veterans Affairs (VA) and the Department of Defense (DoD) requested that the Institute of Medicine (IOM) make recommendations on how to reduce tobacco initiation and encourage cessation in both military and veteran populations. In its 2009 report, Combating Tobacco in Military and Veteran Populations, the authoring committee concludes that to prevent tobacco initiation and encourage cessation, both DoD and VA should implement comprehensive tobacco-control programs.

Tobacco use is the single most preventable cause of death & disease. Implementing comprehensive tobacco control programs (TCP) produces substantial reductions in tobacco use. States should establish TCP that are comprehensive, sustainable, & accountable. This document draws upon best practicesÓ determined by analyses of State TCP. This best practicesÓ address nine components of comprehensive TCP: community programs to reduce tobacco use; chronic disease programs to reduce the burden of tobacco-related diseases; school programs; enforcement; statewide programs; cessation programs; counter-marketing; surveillance & evaluation; & administration & management.

This booklet for schools, medical personnel, and parents contains highlights from the 2012 Surgeon General's report on tobacco use among youth and teens (ages 12 through 17) and young adults (ages 18 through 25). The report details the causes and the consequences of tobacco use among youth and young adults by focusing on the social, environmental, advertising, and marketing influences that encourage youth and young adults to initiate and sustain tobacco use. This is the first time tobacco data on young adults as a discrete population have been explored in detail. The report also highlights successful strategies to prevent young people from using tobacco.