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Volunteer to Clear the Air

Champion for Smoke-free Air Recognition

The Tennessee Department of Health aims to collect information regarding support and adoption
of local-level voluntary smoke-free air policies.  Information provided will be for internal use by the Tennessee Department of Health only.
1. From the list below, which best describes the entity you are representing?
Please select based on response to first question.
Please select based on response to first question.
4. Would you or your organization like to request support from the Tennessee Tobacco Use Prevention and Control Team?
The Tennessee Tobacco Use Prevention and Control Team will reach out only to those who wish to provide contact information.
Your information will not be shared or distributed.
5. How are you taking action towards smoke-free air in your community?Select all that apply.
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5. How is your business taking action towards smoke-free air in your community?Select all that apply.
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5. How is your health council taking action towards smoke-free air in your community?Select all that apply.
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5. How is your school/district taking action towards smoke-free air in your community?Select all that apply.
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5. How is your local government taking action towards smoke-free air in your community?Select all that apply.
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5. How is your parks and recreation department taking action towards smoke-free air in your community?Select all that apply.
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5. How is your organization taking action towards smoke-free air in your community?Select all that apply.
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The section below requests information regarding voluntary smoke-free air policies currently in effect within your community.  This information will be used to create a directory of voluntary smoke-free air policies statewide.
5. Do you wish to report a voluntary smoke-free air policy currently in effect within your community?Please select Yes only if a voluntary smoke-free air policy is currently established.
6. Please identify for which area(s) this policy applies. *This question is required.Select all that apply.
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