Tobacco Policy Research Group

The Tobacco Policy Research Group headed by Jean Forster conducts research projects involving policies to reduce tobacco use by young people.

The research serves to monitor use, assess trends and the need for future intervention, promote local policy enforcing age of sale laws and limiting exposure to second-hand smoke in public places. It includes a participatory action research project with the Native American population in Minneapolis.


AICTP-lotoThe American Indian Community Tobacco Project (AICTP) was funded by ClearWay Minnesota. The AICTP was a unique partnership between the University of Minnesota and the Twin Cities American Indian community. The partnership, co-led by Jean Forster of the University of Minnesota, John Poupart of the American Indian Policy Center and members of the Twin Cities American Indian community, sought to gain insight on the attitudes and beliefs about tobacco use and misuse, community readiness to address tobacco misuse, and community and cultural strengths to reducing tobacco misuse. The project was modeled on community-based participatory research principles and reality-based research practices.

AICTP Background

It is well known that compared to other ethnic/racial groups, American Indians misuse tobacco earlier, at higher rates, and with more severe health consequences. Smoking rates among American Indians vary by geographic and cultural factors, but are highest in the Northern Plains area that includes Minnesota . According to the Behavioral Risk Factor Surveillance System (BRFSS), 48% of Indian men and 40% of women in this area report current cigarette smoking (CDC, 2003b). The IHS (2002) indicates that 42% of pregnant women and 40% of diabetics in Minnesota misuse tobacco.

American Indians in Minnesota have disproportionately higher rates of health problems associated with tobacco misuse. In Minnesota four of the five leading causes of death among American Indians are related to tobacco misuse: cancer, coronary heart disease, diabetes, and chronic lung disease (MDH, 2003).

Little is known about why tobacco misuse is so high among American Indians in this region. Likewise, little is known about effective strategies to prevent tobacco misuse among Indian people. Methodological and conceptual flaws limit the usefulness of most of the published research on American Indians. Research findings are reduced and taken out of context, until they bear little relationship to the lived reality of Indian people. Rarely are American Indians involved in planning, implementation and interpretation of research on their communities.

The AICTP partners came together in 2001 to begin to address these issues. The research was driven by the questions generated by Indian people, who also collected the information, and also helped analyze, interpret and disseminate it in a way that will be useful to the urban Indian community. The AICTP was intended to expand the knowledge base of and about the Twin Cities American Indian community regarding all types of tobacco use, and provided the basis for developing an intervention strategy specific to the urban Indian community.

Community Events

Events to raise awareness –
In October 2004 the first Honor with Tobacco event was held at the Minneapolis American Indian Center. The event was the result of a planning group of several Twin Cities American Indian organizations (Division of Indian Work, Ginew Golden Eagles, Indian Health Board, Indigenous Peoples Task Force, MN Native American Council on Tobacco). Activities included: tobacco pouch making, traditional tobacco plants, kinnickinick demonstrations, elder storytelling, teen talking circles, cessation programs, a feast and an obstacle course. More than 250 people attended this event.

Events to share what we learn about tobacco use and misuse –
The Honor with Tobacco event was hosted annually to raise awareness about tobacco use and misuse; to share new information as it is learned. This was also done in partnership with other Twin Cities American Indian organizations committed to raising the health of this community.

AICTP Publications

  1.  Forster JL, Rhodes KL, Poupart J, Baker LO, Davey C for the American Indian Community Tobacco Project Steering Council. Patterns of tobacco use in a sample of American Indians in Minneapolis-St. Paul. Nicotine & Tobacco Research 9(Suppl 1):S29-S37, 2007.
  2. Forster JL, Brokenleg I, Rhodes KL, Lamont GR, Poupart J. Cigarette smoking among American Indian youth in Minneapolis-St. Paul. American Journal of Preventive Medicine 35(6S):S449-S456, 2008.
  3. Nadeau M, Blake N, Poupart J, Rhodes K, Forster JL. Circle of Tobacco Wisdom: Learning About Traditional and Commercial Tobacco with Native Elders. American Journal of Preventive Medicine. 43(5S3):S222-S228. 2012. PMCID: PMC3481548
  4. American Indian Community Tobacco Projects, Tribal Tobacco Use Project Survey, Findings from Minnesota American Indian Communities, 2013
  5.  American Indian Community Tobacco Projects, Tribal Tobacco Use Project Survey, Twin Cities Urban American Indian Community Report, 2013.


The Minnesota Adolescent Community Cohort Study (MACC) study was designed to measure the effects of tobacco prevention and control programs aimed at youth in the state of Minnesota and to gain a better understanding of the process by which young people go from non-smokers to smokers as they get older. Over 4,000 youth participated in this study of tobacco use and attitudes among teens and young adults in the Midwest.

Research Design

Research Design

Research Design: The prospective, longitudinal design provided information about the link between local tobacco control programs and changes in behavior that affect susceptibility, acquisition, and prevalence of use of tobacco by youth and young adults. We also collected additional information about the tobacco environment our participants may have been exposed to as young adults, including normative expectations of groups and organizations with which they were affiliated (e.g., sports teams, volunteer organizations, religious organizations, social clubs). Data were gathered on multiple variables at the individual, community, and state levels. Project Investigators were faculty and staff in the Division of Epidemiology and Community Health at the University of Minnesota, staff at the Minnesota Department of Health, and staff at Clearwater Research, Inc.

The Researchers

Principal Investigator: Jean Forster, PhD, MPH, Professor and Principal Investigator
Jean was been involved in all aspects of the study including survey and sampling design, data analysis, and formulating the model on smoking progression in the MACC sample. She has numerous publications on public health policy as a prevention study and adolescent tobacco use. Jean teaches courses in public health policy and legislative advocacy skills for public health.

Co-Investigators

Darin Erickson, PhD Associate Professor

Toben Nelson, ScD Assistant Professor

Traci Toomey, PhD Professor

Rachel Widome, PhD MHS, Assistant Professor

Kelvin Choi, PhD, MPH, Investigator, National Institute on Minority Health and Health Disparities

Peter Rode, Research Scientist, Minnesota Department of Health

Research Staff:
Lindsey Fabian, MPH – Project Director
Rose Hilk – Programmer
Kathleen Lenk, MPH – Research Fellow

Former Investigators:
Debra Bernat, PhD
Cheryl Perry, PhD
Vincent Chen, PhD

PhD Dissertations:
Kelvin Choi, PhD, MPH
Rachel Widome, PhD, MHS
Charu Mathur, PhD, MPH, MBBS
Nina Alesci, PhD, MPH
Elizabeth Klein, PhD, MPH

Participants

Over 4,000 teens and young adults from Minnesota, North Dakota, Michigan and Kansas were originally recruited to participate in the MACC Study in 2000-2001.

Characteristics of MACC Participants in October 2010:
Gender:
Male
Female
49%
51%
Age Range: 20-27 yrs
Grade Level:
High School
College
Employed Full Time
7%
55%
31%
Ethnicity:
African American
Native American
Asian
Hispanic
Caucasian
Other/missing
5%
3%
2%
3%
82%
5%

Participant Follow-Up

How was the MACC sample selected?
Teens participating in MACC were selected at random from the states of Minnesota, Kansas, North Dakota, South Dakota, and the Upper Peninsula of Michigan. Clearwater Research, Inc., which conducted the survey, did the initial recruitment in the fall of 2001. Participation in the study was strictly voluntary.

Did all the participants stay in the study?
MACC was very successful in retaining participants. If participants moved or changed their phone number they were asked to contact the MACC researchers or Clearwater Research to provide new contact information. Additionally, staff from the University’s Health Survey Research Center (HSRC) assisted with tracking participants who moved or changed phone numbers.

How long did MACC track the participants?
The National Cancer Institute funded this study through 2014. By the time the interviews were done, many of the participants were in their late 20s and some in their early 30s. This was the first cohort study examining tobacco use and uptake in teens as they transition into adulthood.

MACC Baseline & Survey

2000-2008, over 4,000 youth were contacted every six months by telephone and asked about their attitudes and practices regarding tobacco. The original sample consisted of teens that were 12-16 years old in 2000. An additional group of 12 year olds was recruited in 2001.

Beginning in October 2010, this same cohort of participants were contacted annually to answer similar questions, though expanded to include measures concerning alcohol use and exposure to alcohol policies.

The phone interview lasted between 10-20 minutes, depending upon the smoking status of the respondent.

A copy of the full MACC baseline survey that was conducted in 2000-2001 can be found here.

Where MACC participants lived at the beginning of the project:


Where MACC participants were living 10 years later:

The MACC Survey


What was the survey about?
The MACC survey asked questions regarding participant attitudes and behaviors with respect to tobacco. The survey took about 15 minutes to complete.

What sorts of things did you hope to learn from the survey?
Very little is known about how teenagers transition from being a non-smoker to a regular smoker, which was a big part of our research. In addition, because we followed participants as they got older, we were able to learn more about smoking in young adults, which has not been the subject of much research. We also examined the impact that non-smoking laws have on teen tobacco use, what impact tobacco prevention and control programs have on tobacco use in teens and what impact alcohol use and exposure to alcohol policies have on tobacco use in adults.

How did you interview so many teens?
This was a telephone survey. Until 2008, Clearwater Research staff interviewed participants once every six months, completing about 800 interviews a month. Beginning in October 2010, participants were contacted once a year. Clearwater Research contacted about 650 participants each month. The interviews were conducted using computer-assisted software allowing responses to be coded into a computer while the participant was on the phone..

Publications & Most Recent Presentations

Publications

Published

2015

Choi K, Forster JL. Frequency and characteristics associated with exposure to tobacco direct mail marketing and its prospective effect on smoking behaviors among young adults from the US Midwest. American Journal of Public Health. 104(11): 2179-2183, 2014. PMCID: PMC4192087

Taylor N, Choi K, Forster JL. Snus use and smoking behaviors: preliminary findings from a prospective cohort study among U.S. Midwest young adults American Journal of Public Health. Published online ahead of print http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302536 PMCID: PMC4358180

2014

Choi K, Fabian LE, Brock B, Engman KH, Jansen J, Forster JL. Availability of snus and its sales to minors in a large Minnesota city. Tobacco Control 2014;23:449-451. PMCID: PMC4039575

Choi K, Forster JL. Tobacco direct mail marketing and smoking behaviors in a cohort of adolescents and young adults from the upper Midwest: a prospective analysis. Nicotine & Tobacco Research 2014; 16(6):886-889. PMCID: PMC4015100

Choi K, Forster JL. Beliefs and experimentation with electronic cigarettes: a prospective analysis among young adults. American Journal of Preventive Medicine 2014; 46(2):175-178. PMCID: PMC3930913

Erickson DJ, Lenk KM, Forster JL. Latent classes of young adults based on use of multiple types of tobacco and nicotine products. Nicotine & Tobacco Research 2014; 16(8):1056-1062. PMCID: PMC4155422

Lenk KM, Toomey TL, Shi Q, Erickson DJ, Forster J. Do sources of cigarettes among adolescents vary by age over time? Journal of Child and Adolescent Substance Abuse 2014; 23(2):137-143. PMCID: PMC3927921

Mathur C, Stigler MH, Erickson DJ, Perry CL, Forster JL. Transitions in smoking behavior during emerging adulthood: A longitudinal analysis of the effect of home smoking bans. American Journal of Public Health 2014; 104(4): 715-720. PMCID: PMC4001790

2013

Choi K, Fabian LEA, Jansen J, Lenk KM, Forster JL. Young adults’ support for adult-ratings for movies depicting smoking and for restrictions on tobacco magazine advertising. World Medical & Health Policy 2013; 5(4):335-346. PMCID: PMC4254926

Choi K, Forster JL. Awareness, perceptions, and use of snus among young adults from the upper Midwest region of the U.S. Tobacco Control. 2013;22(6):412-417 PMCID: PMC4047643.

Choi K, Forster JL. Characteristics associated with awareness, perceptions, and use of electronic nicotine delivery systems among young US Midwestern adults. American Journal of Public Health 2013; 103(3):556-561. PMCID: PMC3567225

Klein EG, Bernat DH, Forster JL, Lenk KM. Nondaily smoking patterns in young adulthood. Addictive Behaviors 2013; 38(7): 2267-2272. PMCID: PMC3655707

Klein EG, Forster JL, Erickson DJ. Longitudinal predictors of stopping smoking in young adulthood. Journal of Adolescent Health 2013; 53(3):363-367. PMCID: PMC3755032

Mathur C, Erickson DJ, Stigler MH, Forster JL, Finnegan JR. Individual and neighborhood socioeconomic status effects on adolescent smoking: A multilevel cohort-sequential latent growth analysis. American Journal of Public Health 2013; 103(3):543-548. PMCID: PMC3673491

2012

Bernat DH, Choi K, Erickson DJ, Lenk KM, Forster JL. Short-term effects of Minnesota’s comprehensive statewide smoke-free law on young adults. American Journal of Preventive Medicine 2012; 43(5): S156-S162. PMCID: PMC3481548

Bernat DH, Klein EG, Forster JL. Smoking initiation during young adulthood: A longitudinal study of a population-based cohort. Journal of Adolescent Health 2012; 51(5):497-502. PMCID: PMC3479406

Choi K, Fabian LEA, Mottey N, Rian AC, Forster JL. Young adults’ favorable perceptions of snus, dissolvable tobacco products and electronic cigarettes: Findings from a focus group study. American Journal of Public Health 2012; 102(11):2088-2093. PMCID: PMC3469759

Choi K, Forster JL, Erickson DJ, Lazovich D, Southwell B. The reciprocal relationships between changes in adolescent perceived prevalence of smoking in movies and progression of smoking status. Tobacco Control 2012; 5(21):492-496. PMCID: PMC4034130

Goldade K, Choi K, Bernat DH, Klein EG, Okuyemi KS, Forster JL. Multilevel predictors of smoking initiation among adolescents: Findings from the Minnesota Adolescent Community Cohort (MACC) study. Preventive Medicine 2012; 54:242-246. PMCID: PMC3319284.

Klein EG, Bernat DH, Forster JL. Young adult perceptions of smoking in outdoor park areas. Health and Place 2012;18(5):1042-1045. PMCID: PMC4066329

Lenk KM, Rode P, Fabian LEA, Bernat, DH, Klein E, Forster J. Cigarette use among young adults: Comparisons between two-year college students, four-year college students, and those not in college. Journal of American College Health 2012; 60(4):303-308. PMCID: PMC4032113

2011

Choi K, Forster JL, Erickson DJ, Lazovich D, Southwell B. Prevalence of smoking in movies as perceived by teenagers: longitudinal trends and predictors. American Journal of Preventive Medicine 2011; 41(2):167-173. PMCID: PMC3142694

Choi K, Toomey TL, Chen V, Forster JL. Awareness and reported consequences of a cigarette tax increase among older adolescents and young adults. American Journal of Health Promotion 2011 Jul;25(6):379-386. PMCID: PMC4148485

Fabian LEA, Bernat DH, Lenk KM, Shi Q, Forster J. Smoke-free laws in bars and restaurants: Does support among youth and young adults change after a statewide smoke-free law? Public Health Reports 2011; 126(5): 669-676. PMCID: PMC3151184

Jansen P, Toomey TL, Nelson TF, Fabian LEA, Lenk KM, Forster JL. Sources of cigarettes among adolescent smokers: Free or purchased? American Journal of Health Education 2011; 42(3):154-160. NIHMSID: NIHMS350693

Forster JL, Chen V, Perry CL, Oswald J, Willmorth M. The Minnesota Adolescent Community Cohort Study: Design and baseline results. Prevention Science 2011; 12(2): 201-210. PMCID: PMC408985

2010

Bernat D, Erickson D, Shi Q, Fabian L, Forster JL. Short-term effects of a comprehensive statewide smoke-free law on opportunities to smoke. American Journal of Preventive Medicine 2010; 39(6SI):s23-S29. PMCID: PMC3062471

2009

Alesci NL, Forster JL, Erickson DJ. Did youth smoking behaviors change before and after the shutdown of Minnesota Youth Tobacco Prevention Initiative? Nicotine and Tobacco Research 2009; 11:1196-1204. PMCID: PMC2746837

Bernat DH, Klein EG, Fabian LEA, Forster JL. Young adult support for clean indoor air laws in restaurants and bars. Journal of Adolescent Health 2009; 45(1):102-104. PMCID: PMC2756736

Bernat DH, Lazovich D, Forster JL, Oakes JM, Chen V. Area-level variation in adolescent smoking. Preventing Chronic Disease. 2009; 6(2). http://www.cdc.gov/pcd/issues/2009/apr/08_0048.htm. PMCID: PMC2687848

Klein EG, Forster JL, Erickson DJ, Lytle LA, Schillo B. The relationship between local clean indoor air policies and smoking behaviors in Minnesota youth. Tobacco Control 2009; 18(2): 132-137. PMCID: PMC2741406

Klein EG, Forster JL, Erickson DJ, Schillo B, Lytle LA. Does the type of clean indoor air policy significantly affect bar and restaurant employment in Minnesota cities? Prevention Science 2009; 10(2): 168-174. PMCID: PMC2670359

Lenk KM, Chen V, Bernat DH, Forster JL, Rode P. Characterizing and comparing young adult intermittent and daily smokers. Substance Use and Misuse 2009; 44(14): 2128-2140. PMCID: PMC2796605

Toomey TL, Chen V, Forster JL, Van Coevering P, Lenk KM. Do cigarette prices vary by brand, neighborhood, and store characteristics? Public Health Reports 2009; 124(4): 535-540. PMCID: PMC2693167

2008

Bernat DH, Erickson DJ, Widome R, Perry CL, Forster JL. Adolescent smoking trajectories: Results from a population-based cohort study. Journal of Adolescent Health 2008; 43(4): 334-340. PMCID: PMC2743902

2007

Forster JL, Widome R, Bernat DH. Policy interventions and surveillance as strategies to prevent tobacco use in adolescents and young adults. American Journal of Preventive Medicine 2007; 33(6, Supplement 1): S335-S339.

Lazovich D, Forster JL, Widome R, VanCoevering P. Tobacco possession, use, and purchase laws and penalties in Minnesota: Enforcement, tobacco diversion programs, and youth awareness. Nicotine & Tobacco Research 2007; 9(Supplement 1): S57-S64.

Widome R, Forster JL, Hannan P, Perry CL. Longitudinal patterns of youth access to cigarettes and smoking progression: Minnesota Adolescent Community Cohort (MACC) study (2000-2003). Preventive Medicine 2007; 45: 442-446. PMCID: PMC2255062.


Most Recent Presentations

2015 (5)

Erickson DJ, Lenk KM, Forster JL. Modern methods for analyzing behavior over time: Examples from the MACC community-based cohort. Society for Epidemiologic Research. Denver, CO. June 2015.

Carlson S, Fabian L, Widome R, Forster JL. Barriers and motives in quitting smoking among young adults: The role of socioeconomic status. Society for Epidemiologic Research. Denver, CO. June 2015.

Widome R, Musselman J, Mathur C, Fabian LEA, Lenk K, Forster JL. Youth smoking and educational attainment in young adulthood. SRNT 21st Annual Meeting. Philadelphia, PA. February 2015.

Choi K, Taylor N, Forster JL. Sources and number of coupons for tobacco products received and their associations with intention to use snus. SRNT 21st Annual Meeting. Philadelphia, PA. February 2015.

Choi K, Taylor N, Musselman J, Forster JL. Awareness, use, and beliefs about novel tobacco products and their trends among young adults: Findings from the MACC Study. SRNT 21st Annual Meeting. Philadelphia, PA. February 2015.

2014 (4)

Choi K, Taylor N, Forster JL. Snus experimentation as a gateway to smoking among young adults. SRNT 20th Annual Meeting. Seattle, WA. February 2014.

Choi K, Forster JL. Tobacco direct mail marketing: frequency, content and prospective effect on smoking behaviors of young adults. SRNT 20th Annual Meeting. Seattle, WA. February 2014.

Mathur C, Toomey TL, Lenk KM, Fabian LEA, Erickson DJ, Forster JL. Developmental trajectories of comorbid alcohol and tobacco use among young adults. American Public Health Association Annual Meeting. New Orleans, LA. November 2014.

Musselman J, Fabian LEA, Toomey TL, Erickson DJ, Nelson T, Forster JL. Comparison of alcohol-related problems between college and non-college young adult populations. American Public Health Association Annual Meeting. New Orleans, LA. November 2014.

2013 (4)

Choi K, Forster JL. Young adults’ exposure to pro-snus and pro-electronic cigarette messages and use of these products. SRNT 19th Annual International Meeting. Boston, MA. March 2013.

Choi K, Forster JL. Tobacco direct mail marketing and smoking behaviors in a cohort of adolescents and young adults: A prospective analysis. SRNT 19th Annual International Meeting. Boston, MA. March 2013.

Choi K, Forster JL. Tobacco direct mail marketing and smoking behaviors in a cohort of adolescents and young adults: A prospective analysis. 2013 Cancer Disparities Summit, Minnetonka, MN. June 2013.

Jansen J, Choi K, Forster JL. The association between Snus and smoking initiation and cessation. SER, June 2013.

2012 (5)

Choi K. Influence of perceived exposure to smoking in movies on smoking cessation behaviors in young adults. Society for Prevention Research Annual Meeting. Washington, DC. May 2012.

Choi K. Young adults’ perceptions, awareness, and use of electronic cigarettes: implications for health promotion. Society for Prevention Research Annual Meeting. Washington, DC. May 2012.

Choi K, Forster J. Influence of perceived exposure to smoking in movies on smoking cessation behaviors in young adults. Society for Epidemiologic Research Annual Meeting. Minneapolis, MN. June 2012

Fabian LEA, Jansen J, Choi K, Lenk KM, Forster JL. Tobacco marketing strategies: What do young adults think? American Public Health Association Annual Meeting. San Francisco, CA. October 2012.

Lenk K, Erickson D, Forster J. Use of multiple types of tobacco products among young adults. American Public Health Association Annual Meeting. San Francisco, CA. October 2012.

Resources

University of Minnesota Web Sites

University of Minnesota Transdisciplinary Tobacco Use Research Center

University of Minnesota Cancer Center : http://www.cancer.umn.edu

Government Sites

CDC Tobacco Information and Prevention Source (TIPS)  : http://www.cdc.gov/tobacco

National Cancer Institute Tobacco Control Research Branch : http://dccps.nci.nih.gov/tcrb/

National Institute on Drug Abuse : http://www.nida.nih.gov/

Professional Organizations

American Cancer Society : http://www.cancer.org

American Lung Association : http://www.lungusa.org

Society for Research on Nicotine and Tobacco : http://www.srnt.org

Other Web Sites

Addressing Tobacco in Managed Care : http://www.ahip.org/

Americans for Non-Smokers Rights : http://www.no-smoke.org

American Legacy Foundation : http://www.americanlegacy.org

Campaign for Tobacco-Free Kids : http://www.tobaccofreekids.org

Database and Educational Resources for Treatment of Tobacco Dependence : http://www.treatobacco.net

Legacy Tobacco Documents Library : http://legacy.library.ucsf.edu

ClearWay Minnesota: http://www.clearwaymn.org

Tobacco News and Information: http://www.tobacco.org


The Clean Indoor Air Consequences (CIAC) study evaluated potential consequences of clean indoor air ordinances. By looking at data from 10 Minnesota communities with varying levels of indoor smoking regulation, the study examined impacts on revenue and employment in bars and restaurants, numbers and types of alcohol-serving businesses, and crime near these establishments.

The CIAC study took advantage of a natural experiment that occurred in Minnesota, whereby some communities adopted ordinances banning smoking in all restaurants and bars, others  adopted ordinances with exemptions, and others did not adopt any clean indoor air ordinances. Researchers analyzed monthly data on employment and crime, quarterly reports of taxable revenue, and annual counts of on-sale alcohol businesses from January 2003 through December 2007 for 10 cities in Minnesota. Measurements were compared over time and between communities. CIAC was funded through a grant from ClearWay Minnesota.

CIAC Publications

  1.  Collins NM, Shi Q, Forster JL, Erickson DJ, Toomey, TL. Effects of clean indoor air laws on bar and restaurant revenue in Minnesota cities. American Journal of Preventive Medicine 39(6SI):S10-S15, 2010.
  2. Klein EG, Forster JL, Erickson DJ, Lytle LA, Schillo B. Economic effects of clean indoor air policies on bar and restaurant employment in Minneapolis and St. Paul, Minnesota. Journal of Public Health Management & Practice 16(4):285-293, 2010.
  3. Klein EG, Forster JL, Erickson DJ, Lytle LA, Schillo B. Does the type of CIA policy significantly affect bar and restaurant employment in Minnesota cities? Prevention Science 10(2):168-74, 2009. PMC2670359
  4. Klein EG, Forster JL, Erickson DJ, Lytle La, Schillo B. The relationship between local clean indoor air policies and smoking in youth. Tobacco Control 18:132-137, 2009. PMCID:  PMC2741406
  5.    Klein EG, Forster JL, Collins NM, Erickson DJ, Toomey TL. Employment change for bars and restaurants following a statewide clean indoor air policy. American Journal of Preventive Medicine 39(6S1):S16-S22, 2010.


The Tobacco Free Youth Recreation study (TFYR) was a community based participatory research project funded by ClearWay Minnesota. The Principal Investigator on this project was Jean Forster at the University of Minnesota.

The University partnered with the Tobacco Free Youth Recreation (TFYR) Program and the Minnesota Recreation and Park Association (MRPA) to conduct an observational study to determine current policies pertaining to tobacco use on Minnesota park and recreation grounds, and to assess park staff, local policymaker, and citizen support for restricting tobacco use in outdoor park and recreation areas.

TPOP Publications (Tobacco Policy Options for Prevention)

  1. Forster JL, Komro K, Wolfson M. Survey of city ordinances and local enforcement regarding commercial availability of tobacco to minors. Tobacco Control 5(1):46-51, 1996.
  2. Forster JL, Wolfson M, Murray DM, Wagenaar AC, Claxton AJ. Perceived and measured availability of tobacco to youth in fourteen Minnesota communities: the TPOP study. American Journal of Preventive Medicine 13(3):167-174, 1997.
  3. Wolfson M, Forster JL, Claxton AJ, Murray DM. Adolescent smokers’ provision of tobacco to other adolescents. American Journal of Public Health 87(4):649-651, 1997.
  4. Forster JL, Wolfson M, Murray DM, Blaine TM, Wagenaar AC, Hennrikus DJ. The effects of community policies to reduce youth access to tobacco. American Journal of Public Health 88(8):1193-1198, 1998.
  5. Blaine TM, Forster JL, Hennrikus D, O’Neil S, Wolfson M, Pham H. Creating tobacco control policy at the local level: implementation of a direct action organizing approach. Health Education & Behavior 24(5):640-651, 1997.
  6. Boyle RG, Claxton AJ, Forster JL. The role of social influences and tobacco availability on adolescent smokeless tobacco use. Journal of Adolescent Health 20:279-285, 1997.
  7. Forster JL, Wolfson M. Youth access to tobacco: policies and politics. Annual Review of Public Health 19:203-235, 1998.
  8. Chen V, Forster JL. The long-term effect of local policies to restrict retail sale of tobacco to youth. Nicotine & Tobacco Research 8(3):371-377, 2006.

Tobacco Free Future (TFF) Publications

  1. Blaine TM, Guire DK, Forster JL. STEPES: The Development and Testing of a Database Program Monitoring Tool. In: Steckler A, Linnane L (eds) Process Evaluation for Public Health Interventions and Research, San Francisco, CA: Jossey Bass, Inc.: pp. 293-320, 2002.
  2. Alesci N, Forster JL, Blaine T. Smoking visibility, perceived acceptability, and frequency in various locations among youth and adults. Preventive Medicine 36:272-281, 2003
  3. Komro K, McCarty M, Forster J, Blaine T, Chen V. Parental, family and home characteristics associated with cigarette smoking among adolescents. American Journal of Health Promotion 17(5):291-299, 2003.
  4. Forster JL, Chen V, Blaine TM, Perry CL, Toomey T. Social exchange of cigarettes by youth. Tobacco Control 12:148-154, 2003.
  5. Eisenberg M, Forster JL. Adolescent smoking behavior: measures of social norms. American Journal of Preventive Medicine 25(2):122-128, 2003.