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"Since the 1st edition of this monograph was published in 2004, there have been numerous developments in the statistical and computational methods used in multilevel and longitudinal modeling. Mixed-effects modeling has been solidified as a primary means for accurately and efficiently estimating a wide-variety of multilevel and longitudinal models. More complex models that include cross-level interactions, cross-classified random effects, alternative covariances structures, and the like appear much more frequently in the health and social sciences research literature. Sophisticated mixedeffects modeling procedures are now incorporated in most comprehensive statistical software packages (including R, Stata, and SAS), and thus there is less need for specialized multilevel software"--

"Creating a sustainable program for long-term success" was the focus of Washington's 2000 strategic plan. In 2002, this theme was still evident. While Washington was faced with some difficult challenges, the foundation had been laid to continue to improve and expand its tobacco control program. The program benefited from a supportive leadership, ample funding, a health conscious public, and an improving tobacco control network. For this evaluation, preventing youth initiation and promoting cessation were identified as the top two program goals for FY 2002. Partners agreed with these priorities, emphasizing the importance of demonstrating to the Legislature that the program was affecting prevalence rates. Minor changes to the list were suggested: broadening the definition of youth to include 18-24 year olds due to the targeting of this group by the tobacco industry; and including cessation for pregnant women as a sub-goal of promoting cessation. The statewide quit line was generally viewed as a successful activity, partly due to good promotion and continued evaluation. The partners identified the following strengths and challenges of Washington's program: • The dedication and experience of the tobacco control professionals and advocates was identified as a major strength of the program, with recognition specifically given to the DOH program staff. • The timely development of a detailed strategic state plan that continued to provide guidance beyond the first year of the program was viewed as a strength. • The very existence of a tobacco control network was identified as a positive factor. However, the lack of cohesiveness among partners was seen as a challenge. • While some thought that the current funding level of the program was a positive factor, most felt that more funding was needed to reach the CDC minimum funding level. • Major political challenges were the state budget crisis and the securitization of future MSA funds. • The lack of capacity/infrastructure at the local and state levels also impeded the implementation of tobacco control activities.

"Creating a sustainable program for long-term success" was the focus of Washington's 2000 strategic plan. In 2002, this theme was still evident. While Washington was faced with some difficult challenges, the foundation had been laid to continue to improve and expand its tobacco control program. The program benefited from a supportive leadership, ample funding, a health conscious public, and an improving tobacco control network. For this evaluation, preventing youth initiation and promoting cessation were identified as the top two program goals for FY 2002. Partners agreed with these priorities, emphasizing the importance of demonstrating to the Legislature that the program was affecting prevalence rates. Minor changes to the list were suggested: broadening the definition of youth to include 18-24 year olds due to the targeting of this group by the tobacco industry; and including cessation for pregnant women as a sub-goal of promoting cessation. The statewide quit line was generally viewed as a successful activity, partly due to good promotion and continued evaluation. The partners identified the following strengths and challenges of Washington's program: • The dedication and experience of the tobacco control professionals and advocates was identified as a major strength of the program, with recognition specifically given to the DOH program staff. • The timely development of a detailed strategic state plan that continued to provide guidance beyond the first year of the program was viewed as a strength. • The very existence of a tobacco control network was identified as a positive factor. However, the lack of cohesiveness among partners was seen as a challenge. • While some thought that the current funding level of the program was a positive factor, most felt that more funding was needed to reach the CDC minimum funding level. • Major political challenges were the state budget crisis and the securitization of future MSA funds. • The lack of capacity/infrastructure at the local and state levels also impeded the implementation of tobacco control activities

Partners identified the following strengths and challenges of New York's tobacco control program: • The experience and leadership of the DOH TCP Director was a major strength of the program. • Clean indoor air efforts throughout the state were also a strength. • Partners were concerned about the security of funding due to the large state and city budget deficits. • The highly politicized DOH environment and slow grant process were viewed as barriers to the program. • Little support from state policymakers and the influence of the tobacco industry made implementing a comprehensive program challenging.

Dedicated tobacco control partners and a comprehensive program contributed to Hawaii's tobacco control program experiencing several successes, including the adoption of clean indoor air ordinances in all of the counties and a high cigarette excise tax. State budget shortfalls and prioritization of other issues in the Legislature have been a challenge for the program, but with the leadership of the State Department of Health Tobacco Prevention and Education Program (DOH TPEP) and a coordinated effort among partners, Hawaii's program will continue to grow and thrive. help finance construction of the new medical school was hurtful to the program. Partners identified the following strengths and challenges of Hawaii's tobacco control program: • The dedication of the professionals working in tobacco control was viewed as a major strength of the program. Some partners also specifically mentioned the DOH TPEP staff as being highly committed. • The ability to sustain the tobacco control program funding was viewed as a challenge due to the state's difficult economic situation. • Partners also felt that there was a need for more coordination and infrastructure. Some felt that there was no designated coordinating agency to oversee the entire program.

Dedicated tobacco control partners, adequate funding, and strong leadership from the Partnership for a Healthy Mississippi (The Partnership) contributed to Mississippi turning a two-year pilot project into a model tobacco control program. Effective youth programs, a strong community coalition structure, and a comprehensive approach are just some of the many characteristics that have moved Mississippi to the forefront of tobacco control and have already impacted tobacco use prevalence rates. Despite the challenging political and financial climates, Mississippi continues to improve and expand their program.

Missouri's tobacco control program has been greatly challenged by an unsupportive political climate, inadequate program funding, and a state budget deficit. Despite these barriers, the program has benefited from dedicated tobacco control professionals, committed coalitions, and recent efforts in policy change. It is hoped that continued efforts in strengthening community groups and a unified implementation of a strategic plan will help Missouri's program progress in its efforts.

Michigan's tobacco control program has been greatly challenged by an unsupportive political climate, a state budget deficit, and inadequate program funding. Despite these barriers, the program has benefited from strong tobacco control experience and leadership, a supportive network of tobacco control partners, and recent local clean indoor air efforts. It is hoped that the new Governor and Legislature will provide more support for tobacco control, helping Michigan's program to progress in its efforts. Program Strengths & Challenges Partners identified the following strengths and challenges of Michigan's tobacco control program: • Partners described the Tobacco Section staff as very dedicated, knowledgeable, and committed to tobacco control and a major strength of Michigan's program. • The statewide coalition, Tobacco Free Michigan Action Coalition, and its members were viewed as strengths. • A few partners identified local coalitions and their grassroots efforts as positive characteristics of Michigan's tobacco control program. • The lack of tobacco control program funding was the most significant challenge for the program. • Michigan's political climate was a challenge. In particular, many partners felt the lack of support by the previous Engler Administration impeded the program tremendously.

Partners identified the following strengths and challenges of New York's tobacco control program: • The experience and leadership of the DOH TCP Director was a major strength of the program. • Clean indoor air efforts throughout the state were also a strength. • Partners were concerned about the security of funding due to the large state and city budget deficits. • The highly politicized DOH environment and slow grant process were viewed as barriers to the program. • Little support from state policymakers and the influence of the tobacco industry made implementing a comprehensive program challenging.

The Center for Tobacco Policy Research at the Saint Louis University Prevention Research Center is conducting a three-year project examining the current status of 12-15 state tobacco control programs. The project aims to: 1) develop a comprehensive picture of a state's tobacco control program to be used as a resource for tobacco control agencies and policymakers; 2) examine the effects of political, organizational, and financial factors on state tobacco control programs; and 3) learn how the states are using the CDC's Best Practices for Comprehensive Tobacco Control Programs. This Profile has been developed as a resource for tobacco control partners and policymakers to use in their planning and advocacy efforts. The Indiana Profile presents both quantitative and qualitative results collected over a two-month period, beginning in July 2002.

Partners identified the following strengths and challenges of New York's tobacco control program: • The experience and leadership of the DOH; TCP Director was a major strength of the program. • Clean indoor air efforts throughout the state were also a strength. • Partners were concerned about the security of funding due to the large state and city budget deficits. • The highly politicized DOH environment and slow grant process were viewed as barriers to the program. • Little support from state policymakers and the influence of the tobacco industry made implementing a comprehensive program challenging.