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Correcting the misperceptions about nicotine and NRT With 2007 less than 2 months old, many of us have already forgotten those promises we made to ourselves on December 31st. Lose weight. Save money. Spend more time with family. One of the top resolutions people make every year but fail to realize is to quit smoking. Smoking cessation success rates are incredibly low whether the attempt is made on January 1st, July 1st or any other day of the year. NTCC’s work can help to make those attempts a reality and increase successful cessation among tobacco users. NTCC has identified five strategic initiatives for 2007 to promote and support tobacco cessation. 1. Consumer Demand Initiative: Even though most smokers report a desire to quit, many have been slow to adopt products and services proven to help them. The Consumer Demand Initiative is focused on identifying innovative strategies for increasing the demand for, and the use of, evidence-based tobacco cessation products and services. One of the reasons smokers are reluctant to use products like nicotine replacement therapies (NRT) is because of the misperceptions that they have about them.
Another way to increase demand for products and services is to develop new options and choices for consumers to assist them in quitting.
2. Health Literacy Initiative: A multitude of materials and products are available to assist tobacco users in quitting. But what happens when someone is not able to comprehend the content of the materials or can’t understand how to use the products? This question touches on an essential issue in health literacy. Health literacy, which is the ability to obtain, understand, and use health information and services, may be a contributing factor in the lack of use of evidence-based tobacco cessation products and services. An initial review of some existing materials shows that many of these may not be appropriate for smokers with lower health literacy skills. This year, NTCC has convened a Health Literacy Workgroup to discuss potential ideas on how to address health literacy and tobacco cessation treatment in new and existing products, materials, and activities.
3. New Media Initiative: Communication has rapidly evolved in the last decade and continues to develop at an accelerated pace. New media forms including websites, blogs, email, CD/DVDs, mobile phones, and Podcasts have the potential to reach new and expanding audiences. This is an opportunity for NTCC and its partners to determine ways to use these new and emerging technologies to promote tobacco cessation. Initially, NTCC will review the tobacco cessation content of Wikipedia, an online encyclopedia. Wikipedia is written collaboratively by volunteers, allowing most articles to be changed by almost anyone with access to the Web site.
4. Provider Outreach Initiative: For many individuals who make resolutions to quit, their health care provider can be an important source of information on tobacco cessation treatment. In an effort to get more health care providers to take a more active role in promoting cessation with their patients, NTCC will attempt to educate and empower all healthcare professionals, including doctors, nurses, physician assistants, and medical school students, about the important role they can play in tobacco cessation.
5. Smoke-free Policies Initiative: Do you live in one of the more than 100 new localities or nine new states that enacted smoke-free laws in 2006? We hope so. As these policies are implemented, an increased demand for cessation services often is created.
Through these initiatives, NTCC hopes to make tobacco cessation a reality for the millions that attempt to quit each year. For more information on these initiatives or on the National Tobacco Cessation Collaborative, please contact Todd Phillips at tphillip@aed.org. . Use of Cessation Methods Among Smokers Aged 16-24 Years in the US in 2002: Teens not using assisted quit methods to kick the habit According to data from the 2003 National Youth Smoking
Cessation Survey, smokers aged 16–24 years who had ever
tried to quit smoking were more likely to make unassisted quit
attempts than to use assisted quitting methods. This study,
conducted by the Roswell Park Cancer Institute, found that of
the 13 assisted methods recommended by the Public Health Services,
only one (talking with a nurse, doctor, or dentist) was used by
at least 20% of teens. Other assisted methods, including
calling a quitline, going to a support group and talking with
a counselor, were used by less than 5% of this group. The study
reported that six of the 11 unassisted methods were used by at
least 36% of the respondents. This includes attempts to
quit by decreasing the number of cigarettes smoked (88.3%), not
buying cigarettes (56.0%), telling others they no longer smoked
(44.5%), and switching to “light” cigarettes (36.1%).
Scan of Human Genome May Help Unlock the Genetic Contribution to Tobacco Addiction Researchers, funded by the National Institute on
Drug Abuse, completed the first scan of the human genome to identify
genes not previously associated with nicotine addiction.
The findings, published in the online issue of the Journal
of Human Molecular Genetics, reinforce the evidence that
genetic risk factors contribute to tobacco addiction. The study
also focused on genetic variants in previously suspected gene
families. Smoking behaviors, including the onset of smoking, smoking
persistence (current smoking versus past smoking), and nicotine
addiction, cluster in families. Results of this study bring scientists
one step closer to understanding why some smokers become addicted
to nicotine. Efforts to understand nicotine addiction are important
so that new approaches can be developed to reduce tobacco use.
Tailoring of smoking cessation medications to an individual's
genetic background may significantly increase the efficacy of
treatment.
Study Finds
Going Online Helps Smokers Quit: A study conducted at the University of Maryland’s
Robert H. Smith School of Business analyzed the effectiveness
of Internet support networks in helping smokers quit. Despite
a body of research examining the effects of social support on
quitting smoking, there is limited evidence on the effectiveness
of social support provided by online “strangers.”
Given the proliferation of interactive technologies for connecting
individuals in electronically mediated environments, it is important
to investigate behaviors in these contexts. Researchers investigated
how social support provided through an online virtual community
influences its members’ smoking cessation behaviors.
They examined the online behavior of 411 Quitnet.com users who
were able to get support any time from their quitting partners
by visiting the site and posting on the Web forums.
Survey Shows Majority of American Employers Believe They Should Help Employees Quit Smoking According to a new survey released by the National
Business Group on Health, employers ranked smoking among their
top three employee health priorities along with high blood pressure
and obesity. Eighty-two percent of employers also thought they
should take steps to help employees quit smoking. Most employers
believed the best way to encourage smokers to quit is by establishing
smoke-free workplaces. However, more than three-quarters
(78 percent) of employees surveyed who work at companies with
smoke-free workplaces say the policy is not effective in motivating
them to quit. The survey found that employees who smoke most wish
that employers would offer access to smoking cessation benefits
to help them quit. This key difference between employer and employee
perceptions has important implications for the policies employers
adopt to help their employees quit smoking.
State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2005 A study from the Centers for Disease Control and
Prevention (CDC) finds that state coverage of proven and effective
cessation services for Medicaid recipients is low. Because Medicaid
recipients have approximately 38% greater smoking prevalence than
the overall U.S. adult population, they are disproportionately
affected by tobacco-related disease and disability. In 2005,
41 states and the District of Columbia offered some sort of coverage
for tobacco-dependence treatment including cessation counseling
and/or pharmacotherapy while nine states offered no coverage to
Medicaid recipients. The report also found that two-thirds
of states (25) required some sort of patient cost sharing which
research has found results in decreased use of treatment. Only
one state, Oregon, covered all medications approved by the U.S.
Food and Drug Administration (FDA) for cessation and all three
forms of counseling recommended by Public Health Service clinical
practice guidelines.
Organization, Financing, Promotion, and Cost of U.S. Quitlines, 2004 A study published in the American Journal of
Preventive Medicine finds that tobacco quitlines provide
tobacco cessation treatment at a remarkably modest cost. The study,
conducted at the University of Wisconsin School of Medicine and
Public Health analyzed a survey of the 38 quitlines in operation
in 2004 to obtain baseline information about their organization,
financing, promotion and cost. The survey, conducted by the North
American Quitline Consortium, found that median state quitline
operating budgets in 2004 were $500,000 which translates to a
median per capita cost of 14 cents and a median cost per adult
smoker of 85 cents. In comparison with other medical treatments,
the cost is extremely modest when compared with the total economic
cost of smoking of $3,931 per year per smoker.
Nicotine in U.S. cigarettes rising, Harvard study finds According to a study done at the Harvard School
of Public Health, the amount of nicotine that smokers typically
inhale per cigarette rose by 11 percent from 1998 to 2005. Researchers
analyzed data submitted by major cigarette brands to the Massachusetts
Department of Public Health. Nicotine yields rose in cigarettes
of each of the four major manufacturers and across all major cigarette
market categories. To boost amounts of nicotine inhaled by smokers,
cigarette makers intensified the concentration of nicotine in
their tobacco and modified cigarette designs to increase the number
of puffs per cigarette, the Harvard researchers said.
In Clue to Addiction, a Brain Injury Halts Smoking Scientists studying stroke patients reported in the journal Science that an injury to a specific part of the brain called the insula appears to instantly and permanently break a smoking habit. The insula is a prune-size region under the frontal lobes that is thought to register gut feelings and is apparently a critical part of the network that sustains addictive behavior. The findings are based on a small study but it could alter the course of addiction research and help develop new therapies for cessation treatment that focus on this area of the brain. For more information, see web link: C-Change and Ad Council partner to promote cancer prevention interventions C-Change and The Ad Council have partnered to develop and launch a communication strategy that aims at increasing employer health plans’ coverage and employee utilization of cost-effective cancer prevention interventions. The two year initiative will promote the value and ultimate cost-savings associated with the evidence-based prevention and early detection services, including smoking cessation. The messages will be disseminated to public and private employers, human resources directors, benefits managers, company executives, benefits consultants, and benefits brokers to increase health insurance coverage of the screenings and early detection through employee benefit programs. Access to cancer prevention services will become
increasingly important as the nation’s healthcare cost crises
forces employers and insurance providers to make difficult benefits
decisions. A recent report compiled by Milliman consultants,
“Cancer Screening: Payer Cost/ Benefit thru Employee Benefits
Programs,” demonstrates that covering and promoting established
screening recommendations through employer-sponsored programs
can be done at a low cost for employee benefit programs.
Oprah’s Smoking Challenge Update Since O, The Oprah Magazine urged its readers to quit smoking in November 2005, hundreds have responded and joined the online quit-smoking community on the message boards. O magazine chose 5 women on the boards who, despite the support, were still smoking. The magazine recruited a professional, Dr. Steven A. Schroeder, professor of medicine at the University of California, San Francisco, and director of its Smoking Cessation Leadership Center. He spoke to the five women on the phone, and suggested a personal cessation plan for each of them, including using nicotine replacement therapy, prescription pharmaceuticals, and behavioral therapy. For more information, see web link:
New nicotine product marketed as cigarette alternative With smoking bans becoming more common, a new nicotine
filled hand gel called Nicogel claims to offer a four-hour craving
respite. Billed as a cigarette replacement for times when
smoking is inconvenient, over-the-counter Nicogel will be entering
the U.S. market on drugstore shelves by the spring. To some
tobacco opponents, a product that focuses more on sustaining than
stopping still has health risks. “The most important concern
is that using a bridge product like Nicogel may discourage smokers
from making a serious attempt at quitting," said Thomas J.
Glynn, Ph.D., who spoke for the American Cancer Society. "From
a public health perspective that's a very big concern." Some
argue that Nicogel hasn't been shown to be effective or safe,
unlike nicotine-replacement therapies. Also, unlike NRT
products such as patches, gums, and inhalers that contain pharmaceutical-grade
nicotine, Nicogel contains tobacco and therefore could be carcinogenic.
Obama Quitting Smoking with Nicorette After struggling to quit smoking in the past, Sen.
Barack Obama is trying again. In an interview with the Chicago
Tribune, Obama (D-Ill.) said he resolved to quit his cigarette
habit over the winter holidays, just weeks before his expected
presidential campaign would make photographers and reporters an
even more regular part of his life. He said that although
he has never been a heavy smoker, he has quit for periods over
the last several years but then slipped back into the habit. On
the cusp of a potential presidential bid seemed the right time
to quit for good, he said. "I've never been a heavy smoker,"
Obama told the Chicago Tribune. "I've quit periodically over
the last several years. I've got an ironclad demand from my wife
that in the stresses of the campaign I don't succumb. I've been
chewing Nicorette strenuously."
AQC learned this week that the March 2007 issue of O, The Oprah Magazine lists 1-800-QUIT-NOW as one of 5 must-have numbers on speed dial. The plug for QUIT NOW appears in the O Zone section of the magazine. Banyan Communications had pitched the number to the magazine in the fall of 2006, when the groundwork for the 1-800-QUIT-NOW promotions campaign began—the promotion's target audience is among the magazine's readership.
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