Problem/Objective: Communities of Excellence Plus (CX Plus) is a comprehensive training and technical assistance program created by the Tobacco Technical Assistance Consortium (TTAC) that augments the Communities of Excellence Program developed by the American Cancer Society in 2001. The purpose of the CX Plus Program is to assist comprehensive state programs in building and strengthening tobacco control capacity at the local level. TTAC has collaborated with five states since 2004 to mobilize local level advocates, promote their collaboration and cooperation, and instruct them on strategic approaches to achieve tobacco-related social norm changes in their communities.

Methods: The training engages teams of local level tobacco control advocates in 2.5 days of small- and large-group instruction, as well as six months of ongoing, individualized post-training technical assistance. Primary elements of the training include: linking tobacco control to other health priorities; ensuring diversity; developing a tobacco control plan; engaging in effective policy advocacy; countering the tobacco industry; conducting community-based tobacco cessation; and engaging in communications around policy advocacy to help communities create and sustain positive advances in tobacco control.

Results: Process and outcome evaluation results consistently show that the CX Plus training and follow-up technical assistance model strengthens local efforts by fostering teamwork, providing knowledge and skills, and guiding participants through a strategic process to effect change.

Conclusions: The CX Plus Program is a useful tool for comprehensive state tobacco control programs seeking training and technical assistance solutions to enhance planning and implementation of effective tobacco control strategies at the local level.