Don, I have no idea about your business, but maybe I can give some insight.
1. do Facebook. create a nice page and feed it with ONLY articles and links to interesting stuff. I mean, if you create an article ON THE FORUM, do mention it on you page on facebook. Be active there, but don't lose focus: your site is what matters.
2. creating a youtube channel is good, you can create videos about how to handle tobacco etc. Again, have no clue, but I assume you can do a lot of stuff. Promote facebook and youtube pages on the forums, but don't forget you use social media to attract people TO YOUR site not vice-versa.
3. You can upgrade to the latest 4.2 version. I wouldn't recommend VB5, it's still buggy. I wouldn't put a live site on it, if they paid me to do so.
As for the forums, I'd lose the activity stream in the main page. You can disable it from the admin panel (PM me if you need more details or want me to do it, takes 2 seconds) and leave the normal forum index to show. It's way better than that crap listing of latest stuff.
You can monetize with Adsense (if they allow the niche), Text-Link-Ads.com, Linkworth.com, BuySellAds.com etc. The best would be to have your own advertisers. Create a nice advertise page, with some stats and the prices. This way you don't lose commission.
Let me know if you'd like me to go more into specifics