1. BACKGROUND
   1. General:

      Evaluation and surveillance is absolutely integral to successful programming. Accurate baseline data will allow DHSS to measure current knowledge and attitudes about tobacco, current and past tobacco use by New Jerseyans, and the extent of tobacco control policies. This information will be used to quantify the goals and to refine the appropriate objectives for the comprehensive tobacco control plan. Evaluation activities will be used to measure the impact of the comprehensive program as a whole, as well as the individual strategic interventions. Evaluation data can be used to document the extent to which program components are achieving expected outcomes, to provide regular feedback relating to the implementation of programs, and to elucidate options for modifying activities to improve outcomes further.

   2. Current Practices in New Jersey:

      New Jersey currently supports the following surveillance and evaluation activities to measure data on tobacco usage and policies:

      1. DHHS has conducted the following surveys which include data on tobacco use:
         • 1993 Substance Abuse Treatment Needs Assessment Survey of Households in New Jersey (1994)
           
         • 1998 Substance Abuse Treatment Needs Assessment Survey of Households in New Jersey (to be published in 1999)
           
         • 1995 New Jersey Middle School Survey on Substance Use, Grades 7 & 8 - a statewide survey of middle school students to examine experimentation and utilization of alcohol, tobacco and other drugs by seventh and eighth grade students (1996)
           
         • 1999 New Jersey Middle School Survey on Substance Use, Grades 7 & 8 (to be published September, 1999)
           
         • Substance Use & Dependency Among NJ Juvenile Arrestees (1996)
           
         • Substance Use in a Youth Correctional Population: The Jamesburg Study (1995)
           
         • New Jersey Mature Citizens Survey (1996)
           
         • Substance Use and the Need for Treatment among New Jersey TANF Recipients (Temporary Assistance for Needy Families) (1998)
           
         • Substance Abuse Treatment Needs Assessment Survey of Homeless Shelters in NJ (1996)

      2. DHSS has contracted with Rutgers University to conduct key informant interviews in the public schools to identify barriers to collaborating with DHSS on data collection related to tobacco knowledge, attitudes, and behavior, and to recommend incentives to overcome these barriers.

      3. New Jersey participates in the national Behavioral Risk Factor Surveillance Survey (BRFSS). This survey provides information about tobacco usage in the adult population. In addition, some local school districts participate in the national Youth Risk Behavior Survey (YRBS). Unfortunately, New Jersey does not have a sufficient representative sample of schools participating to produce usable baseline data on youth tobacco knowledge, attitudes, and behaviors from YRBS.
         

      4. Every three years the Department of Law and Public Safety conducts a survey on drug and alcohol use among high school students that includes questions about cigarette use. The survey does not include questions which are sufficient to track knowledge and attitudes. Data was collected for the most recent survey in 1999, and a report will be available late in 1999.

      5. New Jersey GASP, a non-profit organization with DHSS funding, tracks the number of smoke-free restaurants and ordinances restricting tobacco in the State.

      6. The Department of Treasury tracks tax data on in-state tobacco sales.

      7. The federal government is conducting an outcome evaluation of the ASSIST program. This information will be used to compare the states with ASSIST programs to those states that do not receive ASSIST funds.

      8. DHSS manages the Cancer Registry to track the incidence of respiratory tract cancer and other cancers in New Jersey. It also maintains records on all hospitalizations, including diagnoses. Finally, DHSS maintains death records that include the cause of death. These data can be used to assess the impact of tobacco-related illnesses in New Jersey.

   3. Best Practices and Other States:

      CDC recommends participation in national surveillance systems such as BRFSS and YRBS to allow States to compare their efforts against other States' programs. The creation of local surveillance systems with special population data can complement this effort.

      Special surveys can be used to collect baseline data on knowledge, attitudes and behaviors of youth and adults regarding tobacco before implementing a comprehensive tobacco control program. These can include information relating to individual usage, community norms, marketing and ETS. In particular, California has used a wide range of tools to examine the effects of its program areas on achieving stated goals.

      Eight states, including Mississippi, Florida, and Texas, have conducted the Youth Tobacco Survey (YTS) for middle and high school students to collect baseline data relating to tobacco. These special surveys can be used periodically to measure change over time. DHSS has contracted with the University of Medicine and Dentistry of New Jersey, School of Public Health to conduct the Youth Tobacco Survey in New Jersey's public, private, vocational, and charter schools. Information learned from this survey is expected to be available early in 2000.

2. PROPOSED APPROACH

   This section outlines the proposed approach to implementing the evaluation component of this plan, including establishing basic principles and creating opportunities for public/private partnerships.

   1. Basic Principles
      1. Baseline data must be collected as soon as possible. These data are needed before goals are quantified and interventions begin and must include specific demographic (including race/ethnicity, gender, and age) and geographic elements. It must include data on knowledge, attitudes, and behavior related to tobacco.
         
      2. An Evaluation Workgroup comprised of local and national experts on tobacco control and evaluation will be developed to help to structure the overall program evaluation.
         
      3. Evaluation will include an overall comprehensive tobacco control program evaluation and individual component and grantee evaluations. All are necessary to determine which components are the most effective in New Jersey.
         
      4. Evaluation must consider both intermediate outcomes (individual knowledge, attitudes, and behavior; community policies) and ultimate outcomes (prevalence) as well as process issues.
         
      5. Funding for the marketing component should be performance- based with performance targets determined by baseline data and quantified program goals and objectives. It is essential that the new media campaign have an ongoing evaluation to judge not only market penetration but also attitude, knowledge, and behavior shifts among youth and young adults.

   2. Opportunities for Public/ Private Partnerships

      To implement the evaluation component of this plan, the following partnerships may be appropriate:

      1. Pharmaceutical companies (e.g. measurement of market penetration for stop-smoking aids, sales data);
         
      2. Universities and other research institutions.

This document may only be reproduced in its entirety. No portion of this document may be reproduced without the permission of the New Jersey Department of Health and Senior Services. © 1999 New Jersey Department of Health and Senior Services.

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