The 13th World Conference on Tobacco OR Health

Objective: To reduce the burden of tobacco use among an ethnically diverse, racially and culturally mixed community. The community is a potpourri of Native Hawaiian, Pacific Islander, Asian, Caucasian, Portuguese and other groups. No one group forms a majority. While Hawaii is a U.S. state, many of its communities resemble developing countries, remote, poor and rural. There are still operating plantations. Economic status ranges from wealthy entrepreneurs; to dirt poor plantation workers; to those who need three jobs to just get by.

Methods: By building a strong community coalition, Kauai has been able to leverage meager resources to successfully create a comprehensive tobacco control program. Small projects have brought about systems changes in schools, medical offices, hospitals and the plantations. By identifying champions from within various ethnic communities and providing them with training and the skills to translate the science of tobacco control to fit their own culture, communities are able to take ownership of tobacco control

Results: Kauai enjoys smoke free restaurants and most workplaces. The whole community rose up and stopped R.J. Reynolds from marketing “Kauai Kolada” candy flavored cigarettes that shamelessly exploited Hawaiian culture and icons. Youth smoking rates were reduced from 26% to 18% in three years. The adult smoking rate in Hawaii is third lowest of all U.S. states. Many project successes have brought additional funding from larger funding sources. Kauai's immigrant communities are largely Asian/Pacific Islanders. Many of our struggles and solutions may be applicable to developing countries, especially around the Asia/Pacific rim.