December 2007


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




Happy New Year: What You Can Do for Smokers Who Resolve to Kick the Habit

Now is the time when millions of Americans make their New Year's resolutions to quit smoking. Even with the best intentions and determination, many will unfortunately fail.

Part of the reason is that most smokers who try to quit are not using or are not aware that there are effective, evidence-based treatments that can help them be successful. As a way to provide useful and accurate information to support these smokers in their attempts to effectively and successfully quit this year, please a take minute to review the sample op-ed template below.

You can make the most of this timely opportunity to help smokers quit by contacting your local newspaper and encouraging them to include the op-ed, tailored for your particular state or city, in an upcoming issue. Happy New Year!

Sample Op-Ed

Many smokers across the country are making New Year's resolutions to quit smoking this year. There's no time like the present for them to join the 46 million Americans who have successfully become nonsmokers, or former smokers.

Quitting is the most important thing people can do to improve their health. The benefits of quitting are remarkable and almost immediate. Within 20 minutes of giving up tobacco, elevated blood pressure and pulse decrease; in two days, the ability to smell and taste is enhanced; in two weeks, circulation improves; and in one year, the risk of a heart attack is cut in half. Quitting also has long-term benefits. After 10 years, the risk of lung cancer drops to as little as one-half that of continuing smokers, and the risk of other cancers (mouth, throat, esophagus, bladder, kidney, and pancreas) also decreases.

Seventy percent of adult smokers report a desire quit, and although as many as 40 percent make a serious quit attempt each year, most smokers who try to quit fail. A key reason is that most smokers who try to quit don't use effective, evidence-based treatments that could significantly improve their success rates.

There are many choices to help people quit smoking; however only certain treatments have been proven effective. These are:

  • Prescription medications including bupropion SR (Zyban or Wellbutrin) and newly approved varenicline (Chantix).
  • Prescription nicotine replacement therapy including the nicotine inhaler and nicotine nasal spray.
  • Over-the-counter nicotine replacement therapy including the nicotine patch, nicotine gum, and nicotine lozenge.
  • Cessation counseling including individual, group, face-to-face or telephone counseling.

Combining treatment methods may increase long-term quit rates compared with using a single type of treatment alone. The more support smokers have to quit, the better their chances are for success, and for a healthier, smoke-free 2008!

For more information on quitting call 1-800-QUIT-NOW or contact your health care provider.

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Research Highlights

Depressed Young Adults More Likely to Start Cigarette Smoking

A new report released by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that young adults who have suffered from depression within the past year are at a higher risk of initiating substance use including cigarette smoking and use of alcohol or illicit drugs.

The report, Depression and the Initiation of Cigarette, Alcohol, and Other Drug Use among Young Adults, indicates that 9.4 percent of people aged 18 to 25, or approximately 3 million young adults in the United States experienced one or more major depressive episodes in the past year.

Young adults experiencing major depression are about 60 percent more likely to have started smoking than those who are not depressed. That is one of the major findings of the largest national survey on substance use and health by a division of the U.S. Department of Health and Human Services.

Other notable findings were that depressed young adults are twice as likely to have initiated use of an illicit drug and twice as likely to have started abusing pain relief medication.

"This study clearly reveals that too often people turn to cigarettes or other substances to try to deal with depression, creating a double jeopardy for their health and wellbeing," said Dr. Terry Cline, administrator of the Substance Abuse and Mental Health Services Administration.

The report is notable because of the size of the database -- nearly 135,000 interviews with persons aged 12 or older, including almost 45,000 young adults - and it was conducted during the course of the 2005 and 2006 National Survey on Drug Use and Health (NSDUH) surveys. This database is one of the largest and most detailed of its kind.

For more information, see web link:
The NSDUH Report: Depression and the Initiation of Alcohol and Other Drug Use among Young Adults


The Effectiveness and Cost Effectiveness of Telephone Counseling and the Nicotine Patch in a State Tobacco Quitline

Increasing the level of Quitline smoking cessation services and offering free nicotine patches are a successful and cost-effective way to reduce smoking rates, according to a new study published in the December issue of Tobacco Control.

The study looked at 4,600 smokers and is the largest randomized trial ever conducted on the effectiveness and cost-effectiveness of alternative Quitline services and polices.

Smokers in the study were randomly assigned to one of six levels of services when they called the Oregon Tobacco Quitline: brief counseling (one 15-minute call) with or without NRT, moderate counseling (one 30-minute call and one follow-up call) with or without NRT, or intensive counseling (one 30-minute call and four follow-up calls) with or without NRT.

More than 21 percent of the smokers quit after receiving intensive counseling plus NRT, compared to 11.7 percent of the smokers who quit after brief counseling with no NRT. Successful quitting was defined as abstinence from all forms of tobacco for 30-plus days at the 12-month follow-up interview. The study also found that satisfaction with Quitline services also increased with the more intense levels of service, rising to 92.5 percent satisfaction from 53.9 percent from those who just received brief counseling.

As expected, costs per participant were higher for increased levels of service, ranging from $67 for brief counseling with no NRT to $268 for intensive counseling plus NRT. The added costs of increased counseling and NRT were offset by their increased effectiveness, and all levels of service were highly cost-effective enhancements to brief counseling with no NRT.

For more information, see web link:
Tobacco Control 2007; 16 (Suppl 1):i53-i59


Cost Effectiveness of the Oregon Quitline "Free Patch Initiative"

According to a new study published in the December issue of Tobacco Control offering free nicotine replacement therapy as part of Quitline counseling can dramatically increase the number of smokers who quit and reduce the average cost per quit.

The study found that the number of callers to the Oregon Tobacco Quitline jumped from 6,426 to 13,646 annually, and their quit rates nearly doubled, when Oregon promoted Quitline services by combining one 30-minute telephone counseling session with a free two-week supply of nicotine replacement therapy using "earned" or unpaid media to increase calls from smokers.

Prior to this initiative, the Oregon Tobacco Quitline provided one 30-minute telephone counseling session with no NRT and promoted the service through paid advertising. Analysis of the one-year results showed that the free NRT initiative was extremely successful even though its total costs were higher than the costs of the pre-initiative program ($2.25 million versus $1.97 million) because:

  • the number of callers nearly doubled (from 6,428 to 13,646)
  • quit rate nearly doubled (from 8.2 percent to 15.7 percent)
  • number of quitters quadrupled (from 527 to 2142)
  • cost per quit fell more than $2,600 (from $3,778 to $1,050)

For more information, see web link:
Tobacco Control 2007; 16 (Suppl 1):i47-i52


Stop Smoking Services Are Reducing the UK's Health Gap, Study Shows

In a study published in the December issue of Tobacco Control, researchers found that of the 1.5 million smokers supported by the UK's National Health Service (NHS) stop smoking services, smokers from poorer areas were using these services - and successfully quitting - more often than those from more affluent communities.

The study analyzed data from 1.5 million smokers who were treated by NHS stop smoking services in the three-year period between April 2003 and March 2006. It compared data from smokers who accessed services in areas designated as disadvantaged compared with other parts of England.

The study found that although quit rates were slightly lower for smokers from the disadvantaged areas (52.6 percent at four weeks compared with 57.9 percent elsewhere) services were treating them in larger numbers than their more affluent neighbors (16.7 percent of smokers in the disadvantaged areas were treated, compared with 13.4 percent elsewhere). The overall effect was that a higher proportion of smokers in the more disadvantaged areas were successful in quitting (8.8 percent) than those in more affluent areas (7.8 percent).

This shows that the NHS stop smoking services are helping to reduce inequalities in health caused by smoking, say researchers from the University of Bath's Tobacco Control Research Group and the University of Edinburgh.

"Our study shows that the NHS stop smoking services are helping to reduce the health gap between rich and poor, which is good news for the overall health of the nation," said Dr Linda Bauld from the University of Bath.

NHS stop smoking services were established in 1999 to help smokers to quit. They offer smokers counseling from trained advisers, one to one or in groups, plus access to cessation medications such as nicotine replacement therapy (NRT).

For more information, see web link:
Tobacco Control, 2007; 16 (6): 400-404


Smoking and the Risk of Type 2 Diabetes

Smoking is linked with an increased risk for type 2 diabetes, according to a review and meta-analysis published this month in the Journal of the American Medical Association.

Researchers out of the University of Lausanne in Switzerland conducted a review and meta-analysis of 25 studies exploring the association between active smoking and the incidence of type 2 diabetes or other glucose metabolism disruptions. Together, they included 1.2 million participants, with nearly 46,000 new cases of diabetes reported during follow-up periods ranging from 5 to 30 years.

Active smokers were found to have a 44 percent increased risk of developing type 2 diabetes, compared with nonsmokers. There also appeared to be a dose-response relationship: those who smoked 20 or more cigarettes a day had a 61 percent increased risk for diabetes, while lighter smokers had only a 29 percent increased risk. Former smokers had a 23 percent increased risk for developing type 2 diabetes.

Based on these findings, the authors conclude that a link between smoking and diabetes clearly exists. What remains to be determined is whether this relationship is causal. The link may be explained by smoking causing disruptions in insulin sensitivity and secretion and/or the fact that smoking is often found in combination with other unhealthy habits.

For more information, see web link:
JAMA, 2007; 298 (22)


Teen Smoking Resumes Decline

The number of U.S. teens who smoke has shown significant declines in recent years, particularly among those in their early teens. These declines can be seen in lifetime, 30-day, and daily smoking rates, according to the latest Monitoring the Future (MTF) study.

After warning last year of an end to the decline in daily smoking among younger teens, particularly 8th graders, the study found a resumption of that decline this year. Following a decade of substantial improvement, daily smoking among young people in their early and middle teens stopped declining last year, following a deceleration of the decline in the years immediately preceding.

"That should eventually translate into many fewer illnesses and premature deaths for this generation of young people," said University of Michigan Distinguished Research Scientist Lloyd Johnston, the study's principal investigator.

Compared to peak levels in the mid-1990s, past 30-day smoking rates in 2007 are down by 54 percent among 10th graders and 41 percent among 12th graders. The researchers expect that smoking rates among 10th and 12th graders will continue to decline as the current 8th graders, who smoke at lower rates, get older. The rates of past 30-day smoking now stand at 7 percent, 14 percent, and 22 percent across the three grades.

Daily smoking has declined even more sharply during the past decade-by half for 12th graders from recent peak levels and more than two thirds for 8th graders. In 2007, daily smoking is reported by 3 percent of 8th graders, 7 percent of 10th graders, and 12 percent of 12th graders.

Many fewer young teens even try cigarettes today compared to the mid-1990s. In 1996 half (49 percent) of all 8th graders indicated that they had ever smoked a cigarette, whereas in 2007 little more than one fifth of them (22 percent) said they had. But by the end of 12th grade, 46 percent of students in 2007 reported at least trying cigarettes, and 22 percent reported that they were currently smoking.

For more information, see external PDF:
University of Michigan News Release, December 11, 2007


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Other Cessation News

Minnesota Smoking Ban Drives More Smokers to Try Quitting

Just over two months since a statewide smoking ban took effect, a growing number of Minnesotans are trying to kick the habit.

Minnesota's two largest health plans and the anti-tobacco organization ClearWay say they've seen a sharp spike in the number of people turning to nicotine replacement products and smoking cessation counseling programs since the ban took effect Oct. 1.

Blue Cross and Blue Shield of Minnesota said that between September and October enrollment in its telephone counseling service jumped to 525, an increase of 43 percent. Compared with October 2006, the number of over-the-counter products like the patch and nicotine gum Blue Cross has provided its members tripled to a total of 10,000 claims.

The state's No. 2 health plan, Medica, said it has seen a 40 percent increase in the number of members seeking counseling to quit.

ClearWay Minnesota, which provides a variety of quit-smoking programs, reports similar trends. It said 693 people enrolled in its web-based program in October, up 8 percent from the same month a year earlier. Twenty-seven employers have asked ClearWay to supply an onsite smoking counselor in January to help their workers quit, compared with 76 companies in all of 2007, said Michael Sheldon, spokesman for ClearWay.

For more information, see web link:
WCCO Minneapolis News Story, December 11, 2007


U.S. Progress in Reducing Smoking at Risk Unless States Increase Funding for Tobacco Prevention Programs, Report Warns

A recently released report assesses whether the states are keeping their promise to use a significant portion of the 1998 multi-state tobacco settlement to address tobacco use in the United States. The report ranks the states based on their funding for tobacco prevention and cessation programs as compared to the funding levels recommended by the Centers for Disease Control and Prevention (CDC). The report, "A Broken Promise to Our Children: The 1998 State Tobacco Settlement Nine Years Later," was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association and American Cancer Society Cancer Action Network.

This report suggests that only three states meet CDC recommendations for tobacco prevention funding-Maine, Delaware, Colorado. And although states have increased funding for tobacco prevention and cessation programs by 20 percent to $717.2 million, the highest level in six years, this is only about 3 percent of the $25 billion states will collect from the tobacco settlement and tobacco taxes this year. Most states still fail to fund these programs at minimum levels recommended by the U.S. Centers for Disease Control and Prevention (CDC), and the states combined are providing less than half what the CDC has recommended.

The report's findings include:

  • Only three states-Maine, Delaware and Colorado-currently fund tobacco prevention programs at CDC minimum levels.
  • Only 17 other states fund tobacco prevention programs at even half the CDC's minimum amount.
  • Thirty states and the District of Columbia are spending less than half the CDC minimum, while Connecticut has appropriated no funding for tobacco prevention this year.
  • Total state funding for tobacco prevention amounts to less than 3 percent of the record $24.9 billion the states will collect this year from the tobacco settlement and tobacco taxes. Just 6.4 percent of this tobacco revenue would fund prevention programs in every state at CDC minimum levels.
  • The states' funding of tobacco prevention pales compared to the $13.4 billion a year spent on tobacco marketing and the nearly $100 billion spent each year on health care bills due to tobacco use.

For more information, see web link:
Campaign for Tobacco Free Kids News Release, December 12, 2007 A Toolkit for Implementing Smoke-Free Laws

The Robert Wood Johnson Foundation, in partnership with the Campaign for Tobacco-Free Kids and Americans for Nonsmokers' Rights, has created, a free online resource to help states and communities implement smoke-free laws. builds upon more than 20 years of experience implementing smoke-free laws and compelling evidence that smoke-free laws are good for health and business. The Web site is a clearinghouse for the activities, events, and tools states and communities need to consider in planning, implementing and supporting new or expanded smoke-free laws.

On visitors will find:

  • a step-by-step timeline for implementing smoke-free laws
  • sample media outreach materials
  • sample advertising to promote new laws
  • business outreach materials
  • smoking cessation resources.

All of the sample media and outreach materials on the website can be customized, reproduced, and distributed by states and communities in their efforts to publicize and support the effective implementation of smoke-free laws.

For more information, see external PDF:
Going Smoke-Free: Toolkit for Implementing Smoke-Free Laws


Smokers Cost Medicaid System Nearly $10 Billion

America's Medicaid system could spend nearly $10 billion less within five years if all Medicaid beneficiaries who smoke, quit. A new study released by the American Legacy Foundation found that effective smoking prevention and cessation programs could cut Medicaid costs by 5.6 percent.

The report, Saving Lives, Saving Money II, updates Legacy's 2002 report Saving Lives, Saving Money: Why States Should Invest in a Tobacco-Free Future, that presented estimated savings to state Medicaid programs associated with reductions in adult smoking rates. The 2007 report presents a powerful new analysis of the costs of smoking to state Medicaid programs over the course of the lives of a cohort of young smokers. A

ccording to the report, Medicaid spending attributable to current smoking ranges from $15 million in Wyoming to $1.5 billion in New York. Across all of the states, Medicaid expenditures would be $9.7 billion lower if all smokers in the system successfully quit.

The study went on to examine how much Medicaid programs would save over the course of young smokers' lives if they never smoked. If states could prevent all smoking among current 24-year-olds, Medicaid savings over their lifetimes would be between $1.4 million (in Alaska and Vermont) and $125 million (in Texas).

Another of the report's findings highlights a significant difference in the net cost of smoking for men versus women. Over the lifetime of a male smoker, the net cost of smoking to Medicaid is $6, but for women -- who make up 69 percent of Medicaid recipients - the cost is $1,372.

"This study underscores the need for strong and effective smoking prevention and cessation campaigns," said Cheryl G. Healton, Dr. PH, president and CEO of the American Legacy Foundation. "We hope that this report will serve as a tool for states to use when setting both long and short-term goals for reducing Medicaid expenditures associated with tobacco use."

For more information, see web link:
American Legacy Foundation Press Release, November 29, 2007


Tennessee Prisons to Use Tobacco Money to Help Inmates Stop Smoking

Tennessee prison officials still see tobacco-related contraband coming into their system regularly, even though prisons were smoke-free as of March.

That's why the Tennessee Department of Corrections is using $10,000 worth of tobacco settlement money to pay the American Lung Association of Tennessee to implement a system-wide smoking cessation program.

The program will offer classes in behavior modification for inmates and prison staff. Participants will have access to education materials at prison libraries and online. The program recommends coupling those resources with pharmaceutical assistance, so medicated lozenges will be provided, said Margaret Smith, American Lung Association of Tennessee's director of lung health programs.

The corrections department spends just under $59 million each year on health care for its 19,500 prisoners, or about $4,000 per inmate. And while it's hard to determine how much of that money goes to toward treating smoking-related health problems, doctors say smokers need almost 50 percent more health care than nonsmokers.

"It's the right thing to do for the taxpayers, for quality of life for staff and the inmates," Corrections Commissioner George Little said.

For more information, see web link:
WKRN Nashville News Story, December 16, 2007


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Conferences and Trainings

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American Cancer Society Legacy Centers for Disease Control and Prevention National Cancer Institute National Institute on Drug Abuse Robert Wood Johnson Foundation
Consumer Demand YTCC The National Partnership for Smoke Free Families