Evolution of a comprehensive tobacco control programme: building system capacity and strategic partnerships-lessons from Massachusetts

Background-Since the passage of a voter approved state referendum in 1992 t o establish a 25 cent increase on the excise tax on cigarettes and smokeles s tobacco, Massachusetts has received an average of $40 million annually fo r its tobacco control programme. This funding allowed Massachusetts to expa nd and develop its tobacco control programme to become one of the most comp rehensive in the world. Objectives-The development of the Massachusetts Tobacco Control Program is outlined, focusing on three stages of development: formation, strategic par tnership building,and shared leadership. Methods-The development of management structures, programmatic infrastructu re, communication and partnership networks, and advisory structures are tra cked throughout the three phases. Results-The use of pre-existing public health resources, implementation of a strong training component, a geographical management structure, the creat ion of public and private partnerships, and the development of a shared lea dership model contributed to building consensus and provided the foundation for coordinated approaches to tobacco control. Conclusion-Other states and countries can use lessons learned from Massachu setts about the organisational development of a comprehensive tobacco contr ol programme as they embark upon similar efforts.