Problem/Objective: The Tobacco Prevention Program at Public Health Seattle King County has set an ambitious mission of making King County the hardest place to smoke and the easiest place to quit and live smoke free. This mission runs headlong into the political sensibilities of elected officials and public health officials who worry that new regulation or messages about social change are too extreme and will alienate the community. This reluctance is a result of pervasive industry messaging. Often, for example, cessation messages are seen as “nanny statism.” Program efforts won't move forward until these leaders understand the necessity of a comprehensive approach which reshapes social norms, enacts systems change, and creates strong policy.

Methods: The Tobacco Prevention Program mission was the starting point for a planning effort that articulated strategy, tactics, and logistics to achieve set goals and objectives. The planning effort analyzed the evidence base and rationale for each project in the program in order to demonstrate how the combination of efforts is essential to reaching the mission.

Results: The Program can now clearly demonstrate the strength of a comprehensive approach, one that uses multiple strategies to make it harder to smoke and easier to quit and live smoke-free, to leadership.

Conclusions: A comprehensive planning process promotes changes in both policy and social norms, and is the most effective way to protect public health. For example, efforts around wearing seat belts have resulted not only in laws, but in a change in social expectations. Smoking should be no different.