What’s Next for Tobacco Control Efforts? Health Equity Related Lessons Learned from a National Qualitative Study on Tobacco Control and Prevention

Context: Despite gains in the tobacco prevention and control movement, tobacco products remain a threat, with specific populations at greater risk. Objective: The purpose of this paper is to examine the role that leaders in the tobacco prevention and control movement have played in progress achieved to date and identify recommendations for the future using a health equity framework. The purpose of this paper is to examine the role that leading organizations in the tobacco prevention and control movement have played in progress achieved to date, identify future recommendations within the context of current public health priorities (e.g., obesity prevention), and explore potential for tobacco prevention and control using a health equity framework. Design: Qualitative key informant interviews were conducted with representatives from four key tobacco prevention and control organizations and their partners. Setting: Interviews were conducted on-site at tobacco prevention and control organization offices or by telephone. Participants: Key informant interviews (n=87) were conducted during July-December of 2017. Main outcome measures: Interviewees describe their work in providing technical assistance to leading public health and policy efforts in tobacco prevention and control. Interviews were transcribed verbatim and coded for meaning units. This analysis was conducted November 2017-January 2018. This study was determined exempt from review by the University of Nebraska Medical Center Institutional Review Board. Results: Three overarching themes emerged from our analysis: (1) maintaining tobacco prevention and control as a public health issue, (2) the importance of health equity in tobacco prevention and control work, and (3) planning for the next generation of tobacco prevention and control advocates. Certain populations remain untouched by broad public health approaches to reduce tobacco use. Conclusions: Tailored, focused, and comprehensive approaches to address health equity in tobacco prevention and control work across specific communities are needed. Adopting a health equity lens across public health priority areas (e.g., obesity, opioids, and tobacco prevention and control) could reduce prevalence among vulnerable groups for multiple conditions