Pre-Proposal Conference Health Equity Approaches to Support Maryland’s LGBTQ+ Youth and Young Adult Communities in Living Tobacc.pdf

Health Equity Approaches to Support Maryland’s LGBTQ+ Youth and Young Adult

Communities in Living Tobacco- and Cannabis-Free

Kelsey Holmes

Prevention and Health Promotion Administration

Center for Tobacco Prevention and Cessation

Pre-Proposal Conference

December 22, 2025

Mission and Vision

MISSION

The mission of the Prevention and Health Promotion Administration is to protect, promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through community-based public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations.

VISION

The Prevention and Health Promotion Administration envisions a future in which all Marylanders and their families enjoy optimal health and well-being.

Prevention and Health Promotion Administration

• Background

• Purpose

• Scope of Work

• Budget

• Application Requirements

Outline

Tobacco The use of the term “tobacco” used throughout this RFA refers to commercial tobacco, defined as tobacco that is sold by the tobacco industry, including cigarettes, vape or e-cigarettes, chewing tobacco, cigars and other products that contain addictive nicotine.

Commercial tobacco use is distinct from sacred tobacco used by some native cultures.

Cannabis The use of the term “cannabis” used throughout this RFA refers to the cannabis plant itself (e.g., its dried leaves or flowers) and any related Tetrahydrocannabinol (THC)-containing products that can be smoked or ingested, such as blunts, joints and pre-rolls, concentrates (vapes, wax, shatter, butter/budder, resin) and edibles (gummies, chocolates, tinctures, capsules). Cannabis is sometimes known as marijuana, weed, or by other names. This definition includes Delta 9 (the most potent naturally occurring and most commonly known form of THC) as well as Delta 8 and Delta 10 (naturally less potent forms of THC but often derived from hemp and highly concentrated in a lab to mimic or exceed Delta 9 potency). The term “Cannabis” does not refer to Cannabidiol (CBD)-containing products in this RFA.

Background- General CTPC

• Center for Tobacco Prevention and Control (CTPC) is part of Maryland Department of

Health (MDH)

• CTPC oversees a comprehensive statewide tobacco program and a cannabis public health program.

Background- Tobacco Program The overall goals for CTPC are aligned with CDC Best Practices, and include:

• Prevent initiation among youth and young adults;

• Promote quitting among adults and youth;

• Eliminate exposure to secondhand smoke; and

• Advance health equity by identifying and eliminating commercial tobacco product-related inequities and disparities.

To reach its goals, Maryland has created an infrastructure that encompasses:

● The Maryland Tobacco Quitline (Quitline), 1-800-QUIT-NOW, a free evidence-based telephone, web, and text counseling service to help tobacco users quit (www.smokingstopshere.com);

● Health system initiatives;

● Local health departments tobacco control programs;

● Community-based initiatives;

● Health communications activities;

● Network of statewide supporters and partners

● Two statewide resources centers; and o Legal Resource Center for Public Health Policy - Tobacco, and o Maryland Tobacco Control Resource Center (Maryland TCRC).7 http://www.smokingstopshere.com/

Background- Tobacco Priority Populations CTPC priority populations were determined based on tobacco use disparities and include:

• Maryland youth who have experienced childhood trauma and/or behavioral health conditions and are at risk for tobacco use initiation.

• Maryland adults who live below the poverty line and use tobacco.

• Maryland youth and adults who are disproportionately targeted by the tobacco industry and use tobacco including persons who are African Americans/Black, Hispanic/Latinx, and American Indians/Alaskan Natives, persons who are part of the LGBTQ+ community, and persons with mental or behavioral health conditions.

• Maryland adult frequent tobacco users (current or former) who are at risk of tobacco-related diseases.

Background- Cannabis Program The cannabis program structure of CTPC is based upon six core components:

• Monitor trends,

• Advance research,

• Build state/local capacity,

• Support providers/health systems,

• Partner with public safety, schools, and communities, and

• Improve public knowledge and awareness.

The MDH CTPC Cannabis Public Health Program infrastructure includes:

• Local health department cannabis prevention and control planning/implementation programs in each of Maryland’s 24 counties;

• Topical mass-media health communication and outreach materials for youth and adults;

• Partnerships with state and local partners, including education, behavioral health, and public health stakeholders; the Maryland Cannabis Administration; and Cannabis Public Health Advisory Council;

• A statewide law and policy resource center: the Legal Resource Center for Public Health Policy -

Cannabis, at the University of Maryland; and

• Development of cannabis public health monitoring, evaluation, and surveillance tools.

Background- Cannabis Priority Populations Based on data from national and statewide surveys and feedback from local health departments:

• Youth (elementary, middle, and high school),

• Young adults,

• Racial and ethnic minorities,

• LGBTQ+ communities,

• Pregnant, postpartum, and breast/chest feeding persons,

• Low income individuals, and

• People with behavioral health conditions or substance use disorders.

Background- CTPC Health Equity Commitment Statement The Center for Tobacco Prevention and Control (CTPC) is committed to identifying tobacco related health disparities, addressing the systemic barriers and social determinants of health that result in health inequities. CTPC commits to support policy change and evidence-based practices that promote inclusive tobacco prevention and cessation treatment services; develop funding opportunities that create partnerships to build capacity with community and faith-based organizations, local health departments, coalitions, educational institutions, health care providers and other interested partners; and empower Marylanders in obtaining their healthiest life possible, free from the harms of tobacco.

Background- Tobacco Disparities Tobacco use disparities related to this RFA:

• The tobacco industry targets some populations through aggressive marketing including LGBTQ+ communities.

• In addition, discrimination related to sexual or gender minority identity can cause added stress that may play a role in tobacco use.

• Maryland high schoolers who identify as lesbian or gay use tobacco products more

(24%), than those who identify as heterosexual or straight (14%).

• High schoolers who identify as transgender had higher tobacco use (19%) compared to those who identify as cisgender (16%).

• Smokers who identify as LGB have a higher rate of menthol cigarette use, which are easier to use and harder to quit.

• Nationally, 54% of lesbian or gay and 49% of bisexual smokers used menthol cigarettes, compared to 42% of heterosexual smokers.

Sources:

● 2022-2023. Maryland Youth Risk Behavior Survey and Youth Tobacco Survey (YRBS/YTS) https://ibis.health.maryland.gov/ibisph-view/query/selection/yrbs2013_2023/YRBSSelection.html

● Meyer. (2003). Minority Stress Model - An overview. Science Direct https://www.sciencedirect.com/topics/psychology/minority-stress-model.

● https://truthinitiative.org/research-resources/targeted-communities/tobacco-use-lgbtq-community, accessed October, 28, 2025.

Background- Cannabis Disparities Cannabis use disparities related to this RFA.

• Similar to tobacco, there is some evidence of a cross-sectional association between minority stress and cannabis use in LGBTQ+ communities.

• Maryland high schoolers who identify as gay, lesbian, or bi-sexual, currently use cannabis at about double the rate (25%) of high schoolers who identify as heterosexual (12%).

• Maryland high schoolers who identify as transgender currently use cannabis at a higher rate (21%) than those who do not identify as transgender (14%).

• In the 2022-2023 school year, of the Maryland high schoolers who used tobacco products, 67 percent of them also used cannabis products.

Sources:

● 2022-2023. Maryland Youth Risk Behavior Survey and Youth Tobacco Survey (YRBS/YTS) https://ibis.health.maryland.gov/ibisph-view/query/selection/yrbs2013_2023/YRBSSelection.html

● Dyar C. A Review of Disparities in Cannabis Use and Cannabis Use Disorder Affecting Sexual and Gender Minority Populations and

Evidence for Contributing Factors. Curr Addict Rep. 2022 Dec;9(4):589-597. doi: 10.1007/s40429-022-00452-5. Epub 2022 Nov 5.

PMID: 37637872; PMCID: PMC10449003.

Purpose The State is issuing this solicitation to support CTPC partners and community organizations in reducing tobacco- and cannabis-related health disparities in Maryland LGBTQ+ youth and young adult (ages 20 and younger) communities and to promote culturally appropriate tobacco and cannabis use prevention and cessation interventions that improve the overall health and wellbeing of these communities. The successful Applicant will conduct a needs assessment;

develop partnership networks; build community capacity; increase access to inclusive resources; develop tools and resources; and provide technical assistance to CTPC and its partners.

Scope of Work- ADA Requirements The Americans with Disabilities Act protects qualified individuals with disabilities from discrimination on the basis of disability in services, programs, and activities. Accessibility and inclusion of diverse populations are essential to reduce health disparities for vulnerable populations. Contractors must comply with all ADA requirements in their work to ensure the needs of persons with disabilities and other vulnerable populations are met. This includes, but is not limited to:

• Facilities and any venues used for meetings/conferences are accessible.

• Requested accommodations are provided in a timely manner; and

• Written and printed materials developed in accessible formats (easy to read, large print, etc.), or providing access to alternative formats.

For contracts which include direct patient care or service delivery through a program, the ADA requires entities provide full and equal access for people with disabilities. This includes, but is not limited to:

• Reasonable modifications of policies, practices, and procedures;

• Effective communication; and

• Accessible facilities.

Scope of Work- Project Description

• The overall goal(s) of the proposed project that encompasses all project years.

• How the proposed goals meet the needs of LGBTQ+ communities to support tobacco- and cannabis-free living.

• A collaboration strategy to form and manage partnerships and projects with CTPC partners and community organizations.

• A detailed description of how the proposed project will be implemented in Year 1, and a general description of how the proposed project will be implemented in the remaining project years.

• How the proposed project will build on the impact and momentum of previous project years.

Scope of Work- Project Elements Project elements:

• Needs Assessment

• Partnership Network

• Capacity Building

• Accessible and Inclusive Resources

• Tools and resource development

• Technical Assistance

*Not all of the project elements need to be addressed each year (see details in the RFA).

Scope of Work- Needs Assessment Conduct a needs assessment and literature review to identify the root causes of tobacco and cannabis disparities in LGBTQ+ youth and young adults in Maryland, social perceptions of tobacco use and cannabis use, (including dual tobacco use and cannabis use) and evidence-based or community recommended tobacco and cannabis use prevention methods and programs specific to the LGBTQ+ community.

• The needs assessment shall include identifying gaps or barriers on tobacco and cannabis prevention programming of organizations serving LGBTQ+ populations using recent existing data or primary data collection and what tools or resources would address the gaps or barriers for their clients to live cannabis-free.

• The needs assessment shall include community input from the LGBTQ+ communities and/or the organizations who serve these communities.

Scope of Work- Partnership Network Develop partnerships and create a network of community organizations serving the LGBTQ+ community to build their capacity to integrate tobacco- and cannabis-use prevention and cessation support into their community outreach and promote cross collaboration.

• The network shall include at least 5 partnerships with organizations representing all regions of Maryland (Western, Capitol, Central, Southern, and Eastern Shore).

• Additional partnerships can change throughout the project after approval by the Grant Monitor, but a minimum of 5 partners shall be part of the network throughout the five year period.

• This can include organizations who solely serve LGBTQ+ communities or organizations who serve an array of community members, but many of whom are part of LGBTQ+ communities.

• Institutions who serve all of Maryland can be included in the network as well.

• Applicants shall describe organizations either existing partners or potential partners to form this network.

*Letter of Intent to Partner requirements.

Scope of Work- Capacity Building Provide more in-depth and funded capacity building mentorship around youth and young adult-centered tobacco and cannabis use prevention and cessation implementation to the partners that are part of the network. The successful Applicant shall provide in-depth capacity building support with at least five community organizations who are part of the partnership network (at least one organization per Maryland region).

• Organizations should serve LGBTQ+ populations who have direct client and/or community interactions.

• Funded partners can differ from year to year or remain the same. However, if funded partners are part of the project for more than a year, then the program needs to build off of the work of the previous year.

• The successful Applicant shall work with the Grant Monitor to provide a detailed scope of work of their sub-recipients.

*Community partner funding stipulations.

Scope of Work- Accessible and Inclusive Resources Identify and increase awareness of existing evidence-based tobacco cessation treatment services available in Maryland, support tobacco cessation services, and tailor cannabis prevention messages to ensure they are inclusive to LGBTQ+ communities.

• Conduct an evidence-based review of prevention and cessation resources on LGBTQ+ inclusivity and provide a report with the findings. This will also include a list of practical actions to improve the resources and tools for implementation.

Scope of Work- Tool and Resource Development Develop and test tailored approaches and tools for tobacco and cannabis use prevention and cessation tailored to LGBTQ+ communities in Maryland and the organizations who serve these communities.

• Propose a method of addressing the gaps and barriers identified in the needs assessment conducted in Year 1 and previous tobacco needs assessments.

• If Applicants have already developed tools for similar purposes, then propose how these tools will meet the needs of the community and if they will be further tailored to meet the needs of the community.

Scope of Work- Technical Assistance Provide expertise and guidance on LGBTQ+ public health and unique challenges of tobacco and cannabis use prevention and cessation in LGBTQ+ communities to CTPC, partners, and Local Health Department staff.

• This can include, but is not limited to: webinars, presentations, other trainings or providing technical assistance on a specific issue.

• This includes maintaining and implementing previously developed evidence-based existing resources created through CTPC partnerships when relevant.

• Additional media assets developed in collaboration with CTPC’s mass communication contractor will also be made available by the Grant Monitor.

Scope of Work- Monitoring and Evaluation The Applicant shall monitor, measure, and evaluate all proposed strategies and activities.

• The Applicant shall propose initial evaluation objectives that are specific, observable, and measurable accomplishments that demonstrate how progress is being made towards the stated outcomes on the proposed work plan.

• The Applicant shall collect data to report on activities, monitor progress towards goals and objectives, and report results to CTPC.

• The narrative shall describe a proposed evaluation process that includes both process indicators (to see if project objectives are met) and impact/outcome measures that show the impact of the proposed activities and how they contribute to the goals of CTPC.

• Proposals shall include the anticipated outcomes and a narrative of the proposed evaluation plan and performance and evaluation measures as part of the work plan.

Scope of Work- Work Plan The Applicant must complete the detailed work plan template provided.

• The Applicant shall have a clear goal(s) and SMART objective(s) for the proposed project.

• The goals and objectives shall align with the purpose of the funding opportunity.

• Project activities for Year 1 shall be outlined in detail including the activity, steps, person responsible, timeline, performance measures, and evaluation measures.

• Project activities for Years 2 through 5 shall include the activity, person responsible, timeline, performance measures, and evaluation measures.

Scope of Work- Organizational Capacity

• Description of the organization (mission and vision statements, type of organization and how long the organization has been established).

• Experience working in public health and the organization's connection to LGBTQ+ communities.

• Organization’s experience and expertise in tobacco and cannabis use prevention and cessation and managing grant-funded projects.

• Experience in developing public health approaches and tools that are tailored to and tested with the community, community needs assessments, building partnerships, providing technical assistance, and working with partners and community organizations to build capacity.

• Organization’s approach to managing invoicing, reporting, and/or subcontracting processes.

• Highest budget the organization has managed.

• Organization’s ability to administratively support the project coordination/management of the agreement including data tracking, meeting bi-weekly, invoicing and submission of reports.

• Identify and describe key personnel on the proposed project (maximum of two key staff).

• Identify a “Grant Manager” who will be directly responsible for project coordination, tracking the progress, budget monitoring, reporting, invoicing, and collaborating/meeting with the Grant Monitor.

Scope of Work- Sustainability The Applicant shall describe how they will maintain partnerships and further grow the momentum and progress gained in Year 1, and in each additional year to support a sustainable approach beyond the scope of the funding.

Scope of Work- Reporting The Applicant shall describe how data to support the work plan performance measures will be collected and describe staff that will participate in data collection and reports including plans to prepare quarterly reports and track progress towards work plan performance measures/deliverables throughout the project period. All reports and supporting documents shall be submitted completely, accurately, and in a timely manner.

• Quarterly Reports

• Annual Reports

• Final Report

Scope of Work- Meetings

• Annual kick off meeting

• Bi-weekly meetings

Scope of Work- Other Potential Collaborations Upon award, the successful Applicant may be asked to communicate and work closely with the other agencies and entities listed below to support the proposed project objectives and/or to share project experiences, progress, lessons learned, and outcomes.

• CTPC Vendors/Grantees

• Local Health Departments

• Partnerships

• Network Meetings

• CTPC Evaluation Team and Contractors

Budget

• One Award

• Maryland state funding

• Five-years

• Year 1 = July 1, 2026 - June 30, 2027 = maximum of $200,000

• Year 2 = July 1, 2027 - June 30, 2028 = maximum of $200,000

• Year 3 = July 1, 2028 - June 30, 2029 = maximum of $200,000

• Year 4 = July 1, 2029 - June 30, 2030 = maximum of $200,000

• Year 5 = July 1, 2030 - June 30, 2031 = maximum of $200,000

• Indirect Cost rate = 7%

• Beginning in Year 2, at least 20% of the budget must be allocated to fund community partners.

*All future year awards are subject to availability of funding and successful implementation of the services specified in this RFA.

Application Requirements

• Budget

• Budget Form (template provided)

• Budget Narrative

• Project Narrative (do not include any budget or cost information)

• Transmittal Letter (template provided)

• Executive Summary

• Project Narrative including Scope of Work

• Work Plan (template provided)

• Required Documents

• RFA Document Checklist

• Conflict of Interest Affidavit Services Performed for Tobacco Industry

• Make sure to check one of the boxes, only one

• Conflict of Interest Affidavit and Disclosure

• Non-Supplantation Form

• Tax Exempt Form

• Signed W-9 with contacts and phone numbers

• At least two Letters of Intent

• Resumes/job role descriptions

For Questions email the Procurement Officer at LiChelle.Lindsey@maryland.gov