Key Points: Montana's new five-step initiative was advanced by an appointed workgroup of statewide and local advocates to: 1) Identify the problem, 2) Develop a strategic initiative, 3) Launch the initiative via a statewide campaign, 4) Assess results, and 5) Plan future action. The successful initiative spans several best practices, including youth prevention, counter-marketing, and statewide and local programs. This comprehensive approach has the number of Montana spit tobacco users accessing Montana's Tobacco Quit Line skyrocketing and has increased community awareness about spit tobacco use hazards in a state with one of the highest use rates nationwide.

Learning Objectives: Understand the growing threat of spit tobacco addiction. Learn the strategic planning process for launching a statewide initiative, including how to set and meet measurable objectives.

Benefits: Reynolds American's recent purchase of a leading spit tobacco manufacturer indicates that spit tobacco sales are a key industry response to proliferating smoke-free regulations. Spit tobacco addiction causes oral cancer and other diseases and may be associated with cardiovascular disease. Especially where spit tobacco use is high, states must address this growing addiction. Proactive comprehensive programming can prevent initiation and encourage quitting, while supporting the tobacco-free norm.

Implementation will produce short-term measurable results (increased Quit Line calls from spit tobacco users) and long-term spit tobacco use decline (revealed in state tobacco use surveys). Measurable benefits include revised understanding of spit tobacco health threats and social norm change associated with negative attitudes, increased cessation, and decreased initiation.