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Creating Changes in Tobacco Policy: The Role of Young People in Strategy Development and Implementation

Denice A. Dennis, Colleen Floyd-Carroll,
Mary Anne Morgan, and Diane F. Reed, Tobacco Prevention Project
Contra Costa Health Services, Martinez, California


After two (2) years of intensive community education and organizing work, the Contra Costa County (California) Board of Supervisors adopted a tobacco-free youth ordinance. The ordinance bans self-service displays and the sale, distribution, or promotion of tobacco gear. It requires non-complying merchants to be licensed, and bans outdoor tobacco advertising within 1,600 feet of schools and public playgrounds. At the very beginning of the campaign, the Tobacco Prevention Project and members of the community Tobacco Prevention Coalition understood that passage of the ordinance would require an intensive, youth-driven community education and advocacy campaign. A youth mobilization project - named TIGHT (Tobacco Industry Gets Hammered by Teens) by the youth - was created to provide a vehicle for youth involvement in policy work. Choosing a participatory model that gives young people a meaningful voice in the efforts to change community norms regarding tobacco has created interesting challenges for a project based in a health department. Youth have become full members of the county coalition, and Regional Youth Coordinators represent the youth perspective at planning meetings. This case study will describe the development of TIGHT and how youth were the core of the campaign to pass a countywide ordinance, as well as to roll out the tobacco-free youth ordinance to all 18 incorporated cities in the county. Lessons learned around youth inclusion and integration into policy work is also addressed.


Children and youth are rarely given the opportunity or resources to research, define and address issues that affect their lives. Public policies intended to benefit children and youth are nearly always developed with little or no meaningful input from youth themselves, and programs designed to serve youth are generally run for them, rather than by them. Not surprisingly, youth are best served when they have more than just a token role in decision making and participation. One ethnographic study of community-based programs, for example, found that at-risk inner-city youth prefer to be in organizations that they feel give them greater self-control and self-respect, and higher expectations for their own futures. Another project demonstrated that teenagers, including those living in the most difficult circumstances, can make a strong contribution to research and action on their own behalf, if given the opportunity, respect and support that they need.

The development of TIGHT

In 1996, the Contra Costa County Board of Supervisors and the Conference of Mayors declared that creating a generation of "tobacco-free" youth was a regional public health priority. The Board asked the County's Tobacco Prevention Coalition to develop a comprehensive strategy, including a policy paper and model ordinance to reduce the impact of tobacco advertising on youth and reduce youth access to tobacco. The Tobacco Prevention Coalition and the Tobacco Prevention Project, Contra Costa County's local lead agency, were in the process of shifting from concentrated clean indoor air activities to youth-focused issues. The Youth Task Group (an ad hoc group of the Coalition), was formed at the same time that the decision was made to jointly develop a 1997 document entitled Tobacco-Free Youth: Assessing Policy Options Which Reduce Demand for and Supply of Tobacco to Young People in Contra Costa County. A model tobacco-free youth ordinance was developed based on this policy paper.

Given that policy change was going to occur and that policy change needs to include those who would be impacted by the policy, a decision was made to create a youth-driven community education and advocacy project that could resist the tactics the tobacco industry would use to defeat it. It was believed that no significant change in community norms would occur unless youth had a clear ownership in shaping policy and participating in community education. TIGHT was thus created to provide the vehicle for youth involvement. The goals of the project were to:

  1. Train teams of youth in community outreach and organizing;
  2. Develop diverse local youth leadership in communities targeted by the tobacco industry;
  3. Prepare youth to work with policy makers, community leaders, merchants and other adult decision makers; and
  4. Develop leadership skills including public speaking, problem solving, action plan/strategy development, volunteer recruitment, planning and facilitating meetings, managing group dynamics and conflict, media advocacy, and sharing healthy values and codes of conduct among their peers.

In order to accomplish these goals, youth needed basic preparatory education and training to enable them to become involved in the process in a substantial and meaningful way. Training was also needed for adults who were staff or coalition members who were not used to working with youth on an equal basis. A full-time adult coordinator advocated for youth to be at the table as full partners, not as tokens, and for youth to have a meaningful voice in the decision-making and agenda-setting processes. The team structure of the youth project also contributed to leadership development. Based on a fish ladder model developed by Colleen Floyd-Carroll, the project coordinator, youth are encouraged to take on increasing responsibility as volunteers and to move into outreach worker and then youth coordinator positions or other endeavors such as college or higher-level positions.

Youth as agents of change

In March 1997, regional youth teams began to research tobacco industry targeting in their own communities. Youth walked through neighborhoods, documenting the presence of the tobacco industry, including the location of tobacco billboards, and advertising inside and outside of stores. The youth learned to recognize how various communities are targeted based on ethnic makeup and economic resources. In addition to formal learning experiences, the youth coordinators, outreach workers and advocates all learn through hands-on meetings and presentations to policy makers, community groups, and school groups.

TIGHT youth themselves also have made an impact on the ways in which policy makers and the program respond to youth. Perhaps the most dramatic evidence of the role of the youth in both defining the Tobacco Prevention Project's scope of work and in passing the ordinance are the results of a staff planning retreat in 1998. TIGHT challenged the original plan to award mini-grants to community organizations to help roll out the tobacco-free youth ordinance. The regional youth coordinators argued that TIGHT knew the issues and were doing the organizing work well already, and questioned funding organizations that did not have this experience. The Tobacco Prevention Project agreed and the whole scope of work changed as a result.

Lessons learned

  • Youth do make a difference in changing tobacco policies. The county's tobacco-free youth ordinance was supported by a 5-0 vote among the Board of Supervisors in November 1998, and at least three of the Board members agreed that the youth presence made a difference in the outcome of the discussions. This has proved true in rolling out the ordinance to cities as well: many city officials are timing the ordinance hearings to correspond with the availability of local youth to attend.
  • Working with young people new to the workforce and who are working with the community requires traditional organizations to assume unconventional roles: teaching youth a work culture, easing bureaucratic constraints to give them the room they need to mobilize communities, and making the institution responsive to the needs that youth have as new workers.
  • Adequate resources must be allocated to do this kind of youth work. TIGHT requires a full-time health education specialist dedicated to making things work for the youth and their community. It also requires that the coordinator assist the youth organizers and outreach workers in addressing the issues in their lives that are potential barriers to their continued work with the project. These issues may include transportation, family abuse, or keeping up with schoolwork. Ongoing education and training for the volunteers and the staff must also be planned into the program.
  • Vigilance is required to maintain a commitment to youth and their own processes of setting priorities and defining the agenda, rather than to fall into the trap of viewing the youth as a vehicle for accomplishing predetermined goals. TIGHT has struggled over the past year to maintain the founding principles AND to stay involved in rolling out the tobacco free youth ordinance in cities across the county, as resources do not permit the original youth development model to be applied in every city across the county. In light of these conflicts, TIGHT is currently in the process of redefining its work and priorities.

Presented at the National Conference on Tobacco and Health, Orlando, 1999.