January 2010


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




NTCC National Priorities Activities Update

At last year’s NTCC Annual Meeting, several long-term, overarching priorities around tobacco cessation were introduced—the Tobacco Cessation Priorities for the Nation. Over the past year, NTCC and partners have been working on various initiatives and activities to address these priorities. Here is a sample of the many activities and accomplishments of NTCC and partners.

1. Increase consumer demand for evidence-based tobacco cessation treatments and services

  • The NTCC Consumer Demand workgroup worked on the various consumer demand products, including the IDEO Innovation Kit, the AJPM Consumer Demand Journal Supplement, and the PHS Guideline Consumer Card.
  • American Society of Clinical Oncology (ASCO) and Legacy are partnering to develop a tobacco cessation toolkit for use by oncologists to educate their patients about the negative effects of smoking on cancer treatments and to help them to quit smoking. The content of the toolkit will be derived from ASCO resources, as well as from the Legacy EX® Campaign.
  • Partnership for Prevention (Partnership) initiated several outreach efforts to increase information about tobacco use cessation and to promote utilization of these services. They launched a blog titledPrevention Matters” that regularly highlights and promotes cessations services. Partnership also added pod casting capability to their website allowing consumers to hear from experts on cessation and related topics.
  • MIKE-E, a hip-hop and spoken-word recording artist, philanthropist and youth motivator will be teaming with the American Cancer Society (ACS) to headline the AfroFlow Tour—a groundbreaking cancer awareness and tobacco cessation initiative aimed at American colleges and universities. The tour will perform on high-school and college campuses and at the ACS’s Relay-For-Life across the country. The Afroflow tour will make use of mobile and web technologies to get high-school and college age youth to commit to never smoking or to stop smoking. Afroflow concerts will be broadcast world-wide through Second Life so that they can be viewed and their music and ringtones downloaded.

2. Expand access to proven, effective treatments for tobacco addiction

  • ACS announced a strategic collaboration with Free & Clear® to provide a state-of-the-art cessation coaching program using best-in-class technology. The ACS Quit For Life® program operated by Free & Clear is jointly promoted by both organizations through employers, health plans and state public health agencies. The collaboration extended the reach of the program to 28 states and nearly 400 employers and health plans, helping more than 1,000 tobacco users per day.
  • As a result of the recommendations of the National Working Group, Partnership created the ACTTION (Access to Cessation Treatment of Tobacco in our Nation) State Grant Program. In early 2010, grants of $20,000 to $40,000 will be awarded to states for the implementation of innovative strategies to increase access to tobacco cessation treatments. The RFP is available on the ACTTION website: www.acttiontoquit.org.
  • Partnership, the Campaign for Tobacco-Free Kids and United Health Foundation produced an employer toolkit titled “Investing in a Tobacco-Free Future: How it Benefits Your Bottom Line & Community” that promotes inclusion of comprehensive cessation treatments in employer-provided health plans. The toolkit was mailed to all Fortune 500 CEOs and CFOs. A micro site was established to share resources: www.prevent.org/tobaccofreefuture.
  • American Lung Association (ALA) wrote, released and promoted several signature reports that advocate for access to cessation treatments: State Legislated Actions on Tobacco Issues, State of Tobacco Control, Helping Smokers Quit: State Cessation Coverage, Save Lives and Money: Help State Employees Quit Tobacco.
  • Multi-State Collaborative for Health Systems Change wrote and disseminated reports based on 23 case studies from member states: “Improving Health Care Systems to Reduce Tobacco Use: Lessons Learned From Stateshttp://www.multistatecessationcollaborative.org/HSC_Lessons_Learned_from_States.pdf and “Improving Health Care Systems to Reduce Tobacco Use: Promising Practices Case Studieshttp://www.multistatecessationcollaborative.org/HSC_Case_Studies.pdf.

3. Support an expanded research agenda to achieve advances in the reach, effectiveness and adoption of tobacco cessation interventions across both individuals and populations

  • The ACS Health Promotion Department, in collaboration with its Behavioral Research Center, is conducting a study to examine the effectiveness of sending smokers personalized, tailored emails timed around their quit date that contain professional advice on quitting.
  • The ACS Behavioral Research Center is currently conducting a randomized controlled study funded by the National Institute of Drug Abuse (NIDA) that tests the theory that romantic partners who provide emotional support to smokers experiencing stress during a quit attempt reduces anxiety and physiological stress responses. Results have the potential to demonstrate how social support actually helps smokers prevent lapses.
  • The University of Wisconsin-Center for Tobacco Research and Intervention (UW-CTRI) received a five-year grant from the National Cancer Institute that will examine combinations of cessation counseling and medications to help all smokers, regardless of their readiness or motivation to quit, to successfully break free of tobacco addiction. These studies will also evaluate strategies to improve adherence with cessation medications.
  • North American Quitline Consortium (NAQC) Quality Improvement Initiative has established standard methods for calculating outcomes such as reach, quit rates, and distribution of medications through quitlines; developed “best practices” for improving these outcomes; and engaged in benchmarking activities to highlight quitlines that are “best in the field” for reach, quit rates, and distribution of medications. See: http://www.naquitline.org/?page=qiihistory.

4. Increase national, state and local longitudinal surveillance of tobacco-use cessation, including quitting motivation and behaviors, treatment beliefs and use, services, and policies

  • Legacy is conducting a longitudinal panel of 5000 smokers in eight media markets to monitor changes in cessation-related knowledge, attitudes, beliefs, and behaviors
  • The ACS Behavioral Research Center is currently collecting data on smoking prevalence and psychosocial factors associated with smoking and quitting in its Study of Cancer Survivors, a population-based, longitudinal study of the quality of life among 5,110 cancer survivors. Results will be used to develop tailored cessation intervention strategies for this population.
  • The Centers for Disease Control and Prevention Office on Smoking and Health (CDC OSH) is fielding the National Adult Tobacco Survey which will provide in-depth cessation information at both national and state-specific levels. They also just completed the 2009 National Youth Tobacco Survey as well as the 2009 YRBS, both of which include cessation measures.
  • Since 2006, the ASCO Quality Oncology Practice Initiative® has enabled oncology practices to assess their performance relative to their peers on a menu of quality measures. Data consistently show that while oncology practices are documenting smoking status (on average 95% of the time), cessation counseling is offered to only to only a small percentage of smokers (on average 27%).

5. Build capacity for quitlines in order to provide universal access to evidence-based counseling and medications for tobacco cessation

  • ACS research staff are working with the CDC OSH to analyze existing data from a sample of state quitlines to examine utilization and cessation patterns among quitline callers age 18-24 years and among pregnant smokers.
  • NAQC issued a goal for 2015 to increase quitline capacity. NAQC will survey quitlines to assess their current capacity and the impact of the recession on quitline capacities, publish a report and encourage quitlines and advocates to use the report with budget decision-makers.
  • Through the Recovery Act, CDC OSH is providing state quitlines additional funding of $44.5 million for increasing capacity (resulting in an estimated 80,000 additional quitters).
  • Wisconsin Tobacco Quit Line staff, with support from UW-CTRI, monitor a variety of quitline call factors (e.g, percent of fax referrals reached, numbers of calls, percentage of callers enrolling in various programs and/or using NRT, utilization of Webcoach) both for quality control/quality improvement and to manage scarce resources efficiently.

6. Launch an ongoing, extensive, national paid media campaign on cessation to help Americans quit using tobacco

  • Legacy’s Become An EX media campaign is ongoing. In the past few months, ads have been on national TV and radio, in movie theaters, and in-flight on Delta. EX was also featured on “The Doctors” TV show and “Bassmasters” on ESPN2. New ads in conjunction with the Ad Council will begin in February.
  • ALA launched the Quitter in You promotional campaign: http://quitterinyou.org/.
  • CDC OSH Recovery Act funding will be used by states to expand state media campaigns (must dedicate 30% of funds to this effort).
  • ACS promotes the annual The Great American Smoke-out which offers support tools including telephone cessation coaching, and desktop and social networking applications to help people quit and stay quit. ACS has an official YouTube channel that features videos of its ad campaigns. Ads for smoking cessation including one for the Great American Smoke-out (GASO), as well as video-clips of media that mention GASO (e.g., Jimmy Kimmel Live).

7. Support the increase in the federal and state excise tax on tobacco to expand assistance for tobacco users who want to quit

  • NAQC has actively promoted an issue paper on the importance of earmarking a proportion of state and federal tobacco tax for cessation services to members and national partners.
  • CDC OSH has worked with states to increase tobacco taxes. Fifteen states increased tobacco taxes in 2009.
  • UW-CTRI educates legislators and other policymakers on the effects of increased tobacco excise taxes on youth initiation, adult cessation, and changes in revenue; about increases in the demand for cessation services as a result of such policy changes; and the necessity of ensuring that smokers have the necessary services to quit.
  • ACS’s 13 Divisions and ACS CAN (Cancer Action Network) actively promote smoke-free policies, tobacco taxes and increased funding for tobacco control prevention programs including cessation. They were an important part of the coalition that was successful in helping to secure a Federal tax increase of 62 cents/pack.

8. Link tobacco control public policy changes to increase cessation and treatment use and demand

  • NAQC updated the policy playbook and related fact sheets, encouraging quitlines to promote their services during smokefree policy implementation efforts and tobacco tax increases. See: http://www.naquitline.org/?page=playbook.
  • CDC OSH is working with the HHS Office of the Assistant Secretary to develop a national plan for tobacco control and is chairing 3 of the committees one of which is focused on policy.
  • Multi-State Collaborative will co-sponsor with national partners a multi-day conference (Fall 2010) focused on opportunities to advance systems and policy changes to address tobacco use within the context of the changing healthcare landscape.
  • Partnership communicated with members of the Congressional Prevention Caucus regarding the anticipated demand for cessation treatment use as a result of the increased federal tobacco tax. They are partnering with the ALA to host an April congressional briefing on the topic.

9. Promote the inclusion and use of tobacco control and cessation content in electronic health records (EHRs)

  • The NTCC EHR workgroup recently held a call with Dr. Jason Mitchell, assistant director of AAFP's Center for Health Information Technology. He educated the workgroup on the certification of EHR system. He also gave an overview of the federal HIT project and discussed how the workgroup can influence the process going forward.
  • American Academy of Family Physicians (AAFP) developed a guideline for integrating tobacco cessation treatment into electronic health records.
  • AAFP conducted a presentation at the 2009 AAFP Scientific Assembly: “Smokin’ EHRs: Integrating Tobacco Cessation Into Electronic Health Records.”
  • UW-CTRI Education and Outreach program staff have worked with several Wisconsin clinics and systems to develop EMR/EHR templates for treating tobacco dependence.
  • UW-CTRI has developed a partnership with Epic Systems Corporation, a leading developer of electronic medical record systems, and Dean Health System, to engage in research that would involve enhancing the tobacco dependence treatment information contained in the electronic medical record.

The 2010 NTCC Annual Meeting has been scheduled for March 30 at AED. At the meeting, we will review the NTCC priorities, discuss current activities, and plan new activities. Please contact Jessica Rowden at jrowden@aed.org for more information.

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Research Highlights

Lung Cancer Patients Who Quit Smoking Double Their Survival Chances

People diagnosed with early stage lung cancer can double their chances of survival over five years if they stop smoking compared with those who continue to smoke, finds a study published online in the British Medical Journal.

This is the first review of studies to measure the effects of continued smoking after diagnosis of lung cancer and suggests that it may be worthwhile to offer smoking cessation treatment to patients with early stage lung cancer.

Researchers at the University of Birmingham analyzed the results of 10 studies that measured the effect of quitting smoking after diagnosis of lung cancer on prognosis.

Differences in study design and quality were taken into account to minimize bias.

They found that people who continued to smoke after a diagnosis of early stage lung cancer had a substantially higher risk of death and a greater risk of the tumor returning compared with those who stopped smoking at that time. Data suggested that most of the increased risk of death was due to cancer progression.

Further analysis found a five year survival rate of 63-70 percent among quitters compared with 29-33 percent among those who continued to smoke. In other words, about twice as many quitters would survive for five years compared with continuing smokers.

These findings support the theory that continued smoking affects the behavior of a lung tumor, say the authors. They also provide a strong case for offering smoking cessation treatment to patients with early stage lung cancer.

Further trials are needed to examine these questions, they conclude.

For more information, see web link:
ScienceDaily January 22, 2010


Smoke Linked to Sleep Issues for Children With Asthma

Children with asthma who are exposed to secondhand smoke (SHS) have more sleep problems, according to research published online Jan. 18 in Pediatrics.

Kimberly Yolton, Ph.D., of the Cincinnati Children's Hospital Medical Center, and colleagues analyzed data from 219 children, aged 6 to 12 years, with physician-diagnosed asthma that had been recently treated. All children were exposed to SHS from at least five cigarettes at home each day. Children's cotinine levels were assessed, and caregivers responded to the Children's Sleep Habits Questionnaire.

The researchers found that greater SHS exposure was associated with longer delays to sleep onset, more frequent parasomnias and sleep-disordered breathing, more daytime sleepiness, and more overall sleep disturbance.

"The consequences of inadequate sleep in children are not trivial. Sleep disturbances have been linked with increased behavior problems, mental health problems, and poor school performance in children. In addition, effects of poor sleep in childhood can persist into adulthood in the form of obesity and behavior and mood disorders. Reduction in SHS exposure is an area with the potential for significant impact for physical and emotional health and school performance in the pediatric population," the authors conclude.

For more information, see web link:
Modern Medicine January 18, 2010


Adults' Breathing Troubles May Begin in Childhood

New research hints that how well your lungs function in adulthood and your risk of developing chronic breathing problems is partly determined in childhood.

In a study, researchers found that early childhood "disadvantage factors" -- such as being around someone who smoked or suffering lung infections - seemed to help fuel the development of chronic obstructive pulmonary disease, or COPD, much later in life.

"People with early life disadvantage have permanently lower lung function, no catch-up with age but a slightly larger decline in lung function and a substantially increased COPD risk," Dr. Cecilie Svanes, at Haukeland University Hospital in Norway, and colleagues report in the journal Thorax.

Among more than 13,000 men and women 20 to 45 years old, Svanes team found that 40 percent had at least one "childhood disadvantage" such as exposure to secondhand smoke, lung infections prior to the age of 5, having parents with asthma, or having a personal history of asthma.

The researchers compared how these early life "disadvantages" associated with lung function tests completed 9 years apart in roughly 7,700 of these individuals.

Compared with those having no "childhood disadvantages", COPD was six- and seven-times more likely, respectively, in men and women exposed to any three such factors, after allowing for multiple other factors, including current smoking and childhood asthma.

Exposure to two "disadvantages" seemed to confer five-times the COPD risk in men and doubled the risk in women.

Svanes and colleagues say their findings linking COPD to childhood factors are new and need confirmation in more detailed investigations. However, if confirmed, these findings suggest, "adult respiratory health to a large extent originates early in life," they conclude.

For more information, see web link:
Reuters Health January 14, 2010


UCSF Study Finds African-Americans Bear Disproportionate Burden Of Smoking Costs In California

African Americans comprise six percent of the California adult population, yet they account for over eight percent of the state’s smoking-attributable health care expenditures and 13 percent of smoking-attributable mortality costs, according to a new analysis by UCSF researchers.

In order to provide an objective picture of the disproportionate economic burden of tobacco use for African American Californians, the UCSF team assessed data from 2002, including health care costs related to smoking and productivity losses from smoking-caused mortality. Study findings are published in the January 2010 issue of the American Journal of Public Health.

“California has one of the most comprehensive tobacco control programs in the world, and smoking prevalence in the state has been declining steadily as a result. However, not all Californians have benefited equally from these efforts,” said lead author Wendy Max, PhD, professor-in-residence of health economics and co-director of the UCSF Institute for Health & Aging, School of Nursing. “Hopefully these data can be used to strengthen tobacco control programs and smoking cessation efforts throughout African American communities.”

Researchers analyzed smoking-attributable costs for diseases, such as cancer and cardiovascular disease, for which incidence is identified in the 2004 US Surgeon General Report as causally related to cigarette smoking. They focused on expenditures for ambulatory care, prescription drugs, inpatient care, and home health care. The team also assessed smoking-attributable mortality for Californians aged 35 years and older using three measures: deaths, years of potential life lost, and productivity losses.

Findings include:

  • African Americans lose more years (16.3) of life per death than other Californians (12.5 years) due to smoking-attributable causes. A total of 3013 African American Californians died of smoking-attributable illness in 2002, representing a loss of over 49,000 years of life and $784 million in productivity.
  • Adult smoking prevalence in 2002 for African Americans was 19.3 percent compared with 15.4 percent for all Californians.
  • The total cost of smoking for the African American community amounted to $1.4 billion in 2002, or $1.8 billion in 2008 dollars.

For more information, see web link:
UCSF News Release January 12, 2010


Quitline Messages That Stress Benefits of Quitting May Improve Smoking Cessation

Smokers who received gain-framed messaging from quitline specialists (i.e., stressing the benefits of quitting) had slightly better cessation outcomes than those who received standard-care messaging (i.e., potential losses from smoking and benefits of quitting), according to a new study published online January 7 in the Journal of the National Cancer Institute. Researchers also established that quitline specialists can be trained to provide gain-framed messaging with good fidelity.

Benjamin A. Toll, Ph.D., of the Department of Psychiatry, Yale University School of Medicine in New Haven, Conn., and colleagues randomly assigned 28 specialists working at the New York State Smokers' Quitline to two groups: one group delivered standard-care messaging and one was trained to deliver gain-framed messages. The researchers assessed whether specialists could be trained to consistently deliver gain-framed messages to smokers and evaluated the cessation outcomes of clients exposed to both kinds of messages. A total of 813 people were exposed to gain-framed messaging and 1,222 were exposed to standard messaging. Phone calls took place between March 2008 and June 2008.

Smokers who received gain-framed messaging reported statistically significantly more quit attempts and a higher rate of abstinence from smoking at the 2-week follow-up interview (99 of the 424 in gain-framed group vs. 76 of the 603 in the standard-care group). However, at 3 months there was no difference between the groups. Researchers also found that quitlines can train staff to deliver gain-framed messages in a consistent fashion.

"The fidelity outcomes from this study should encourage quitlines to test novel counseling strategies for their ability to increase smoking cessation rates and, thus, prevent cancer," the authors write. "Furthermore, gain-framed statements appear to be somewhat beneficial in enhancing short-term smoking cessation and other secondary outcomes, such as quit attempts and positive health expectancies."

For more information, see web link:
EurekAlert January 7, 2010


Quitting Smoking After Heart Attack Extends Lives

Confirming that it really is never too late to quit smoking, a new study finds that heart attack survivors who kick the habit live longer than those who keep puffing away.

The study, which followed more than 1,500 heart attack survivors for 13 years, also found a survival advantage for smokers who did not quit but managed to cut down on cigarettes.

Israeli researchers found that compared with first-time heart attack sufferers who continued to smoke, those who quit were 37 percent less likely to die during the study period. That was close to the risk reduction seen among heart attack survivors who had never smoked -- who had a 43 percent lower risk of dying during the study than persistent smokers.

Meanwhile, patients who had quit smoking sometime before their heart attack were half as likely to die during the study period as smokers who kept up the habit.

The findings, reported in the Journal of the American College of Cardiology, bolster the case for routinely offering heart attack patients smoking-cessation counseling -- which other studies have suggested can lower the risk of further complications.

"Smokers who have had a heart attack should be provided with appropriate interventions to help them quit," write Dr. Yariv Gerber and colleagues from Tel Aviv University.

The study included 1,521 adults age 65 and older who were treated at one of eight Israeli hospitals for a first-time heart attack in 1992 or 1993. At the time, 27 percent had never smoked, 20 percent were former smokers, and more than half were current smokers. After hospital discharge, a majority of smokers tried to quit; 35 percent managed to remain continuously abstinent over the next 10 to 13 years.

A total of 427 patients died during the 13-year study period. The risk was greatest among those who had continued to smoke, even with factors like obesity, exercise habits, education and income, and overall health taken into account.

And while quitting altogether was best, smokers who cut back after their heart attack also improved their outlook, Gerber's team found.

Among the 381 patients who continued to smoke, the risk of dying during the study period declined by 11 percent for every five daily cigarettes they cut out.

For more information, see web link:
Reuters Health December 30, 2009


Emphysema Linked to Secondhand Smoke

Childhood exposure to environmental tobacco smoke correlated with increased evidence of emphysema on lung scans of nonsmoking adults, data from a large cohort study showed.

Structural and quantitative indices of emphysema differed significantly on CT lung scans of adults with a childhood history of secondhand smoke exposure compared with those with a negative exposure history, Gina S. Lovasi, PhD, of the Mailman School of Public Health of Columbia University in New York, and colleagues reported online in the American Journal of Epidemiology.

Although not proof of a causal relationship, the findings add to existing evidence of detrimental effects of exposure to environmental tobacco smoke, according to the researchers.

"This finding suggests that the lungs many not recover completely from the effects of early-life exposures and adds to the literature on detrimental effects of environmental tobacco smoke exposure," Lovasi and colleagues concluded.

To explore associations between childhood exposure to environmental tobacco smoke and emphysema in nonsmoking adults, Lovasi and colleagues analyzed data from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of subclinical cardiovascular disease.

MESA involved 6,814 men and women ages 45 to 84, including 3,965 participants in a lung substudy.

The researchers' analysis included 1,781 participants in the lung study, all of whom were nonsmokers (verified by measuring urinary nicotine levels). The MESA protocol included cardiac CT that imaged about 70 percent of the lung volume from the carina to lung base. Each participant had two scans, and the scan with greater air volume was used for analysis.

Using the lung scans, investigators performed a standard quantitative measure (percent emphysema) and a fractal, structural measure (alpha) of early emphysema. Lower alpha values indicated more extensive emphysema.

The study population included 726 adults who had no childhood exposure to environmental tobacco smoke, 655 from households in which only the father smoked, 134 from households in which only the mother smoked, and 247 from households in which both parents smoked.

Investigators found that exposure to tobacco smoke in childhood was associated with a significantly lower alpha value (P=0.04 for trend) and significantly more emphysema (P=0.01 for trend).

Nonsmoking adults from households with two or more smokers had a mean alpha value that was 0.05 lower and emphysema involvement 2.8 percent greater compared with adults from households with no smokers.

The significant differences emerged after adjustment for demographic, anthropometric, parental, and participant characteristics, as well as cumulative environmental exposures in adulthood, such as residential air pollution and adult exposure to tobacco smoke.

Pulmonary function did not differ significantly by the extent of childhood exposure to environmental tobacco smoke.

For more information, see web link:
MedPage Today December 29, 2009


Two Medicine Combinations Shown Effective for Quitting Smoking

Smokers trying to quit smoking for the holidays have the best chance for success if they take the nicotine lozenge in combination with either bupropion (a pill) or the nicotine patch, according to researchers at the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI).

Researchers found that one in five smokers visiting their primary-care physician were willing to make a quit attempt using quit-smoking medication made available at their own clinic pharmacy at no cost. In the study, 1,346 patients at 12 primary-care clinics in southeastern Wisconsin were randomized to five medication treatment groups. In addition, counseling was offered through a telephone quit line. This study was funded by a grant from the National Institute on Drug Abuse, part of the National Institutes of Health (NIH).

The findings are published in the December issue of the Archives of Internal Medicine. Quit rates at the six month follow-up for the five treatment groups were:

  • nicotine lozenge and bupropion combined, 29.9 percent
  • nicotine lozenge and patch combined, 26.9 percent
  • nicotine lozenge, 19.9 percent
  • nicotine patch, 17.7 percent
  • bupropion, 16.8 percent

“While there is a small difference between the two combination therapies, the clear message here is that combining the lozenge with the nicotine patch or bupropion gives smokers the best chance to quit,” said Dr. Stevens Smith, lead researcher on the study. “The combination of bupropion and the lozenge was clearly superior to all three of the single-drug treatments.”

In this study, all participants received active medication. The findings are similar to a related NIH/UW-CTRI study published in the November issue of the Archives of General Psychiatry that compared the same five active-treatment groups to a placebo. That study, conducted with intensive counseling in a research setting, produced higher quit rates overall, with the combination of the patch and lozenge having the highest quit rates.

For more information, see web link:
UW-CTRI News Release December 14, 2009


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Other Cessation News

Legacy Files Appeal to Ohio Supreme Court

Legacy - a national public health foundation devoted to tobacco cessation and prevention – asked the Ohio Supreme Court to hear the appeal in its case seeking to preserve tobacco funds and the life-saving tobacco control programs they support in Ohio.

Former Ohio Attorney General Betty Montgomery, former Ohio Senate President Richard H. Finan and former Director of the Ohio Department of Health, J. Nick Baird MD, and a broad array of Ohio and national public health organizations and leaders filed Friend of the Court briefs in support of Legacy’s request that the Court hear the case. General Montgomery, Finan and Baird were instrumental in creating the Ohio Tobacco Use Prevention and Control Endowment Fund and, in their brief, explained that the General Assembly specifically intended that the Endowment Fund be permanently dedicated to tobacco use prevention and cessation programs for the benefit of Ohioans.

The Ohio and national public health organizations that have urged the court to hear the appeal include the Academy of Medicine Of Cleveland & Northern Ohio, the American Heart Association, the American Heart Association Great Rivers Affiliate, the American Lung Association, the American Lung Association Of Ohio, the American Cancer Society Ohio Division, the American Cancer Society Cancer Action Network, the Association Of Ohio Health Commissioners, the Campaign For Tobacco-Free Kids, the Ohio Public Health Association, and the Ohio State Medical Association.

A third brief was filed by the Citizen’s Commission to Protect the Truth which is comprised of former Surgeons General, Directors of the Centers for Disease Control and Prevention and U.S. Secretaries of Health and Human Services/ Health, Education and Welfare.

“The fact that our appeal is supported by the Ohio officials responsible for creating the Tobacco Use Prevention and Control Endowment Fund as well as numerous Ohio and national public health organizations and leaders, speaks volumes about the extraordinary importance of this case,” said Cheryl G. Healton, DrPH and president and CEO of Legacy. “We have spent our own funds on this litigation and if successful, are committed to preserving the endowment funds to be spent solely in Ohio on Ohio-based tobacco control programs. I want to reiterate that from the outset of this litigation, we have stated unequivocally that these funds will be spent solely on effective programs in Ohio to save lives from tobacco’s deadly toll. Accusations suggesting otherwise are simply false,” she said.

The action came in response to Legacy’s deep disappointment in the New Year’s Eve decision of the Ohio Court of Appeals of Franklin County, Tenth Appellate District. In that ruling, the appeals court reversed a lower court’s order permanently enjoining the State from dissolving the Tobacco Use Prevention and Control Endowment Fund. That decision represented a major step backward in the effort spearheaded by Legacy and others to safeguard the state's tobacco prevention money for its intended purpose: to save Ohioans' lives.

The 1998 MSA provided more than $200 billion to be paid to the states over 26 years in recognition of the lives and money lost to tobacco. To ensure that a substantial portion of its recovery was spent specifically on tobacco control, Ohio established OTPF and created an endowment for it. Most states have spent only a small fraction, if any, of their MSA funds to mitigate the tragic impact of the tobacco epidemic which claims the lives of more than 400,000 Americans each year.

In a state already feeling the brunt of the national recession, smoking costs Ohio more than $4 billion in annual health care costs and another $4.7 billion annually in smoking-related productivity loss (in 2004 dollars). A 2007 report by Legacy found that Ohio's Medicaid system could save $550 million within five years if all Medicaid beneficiaries who smoke, quit. Ohio would reap the third-largest savings of all the states, making the case that despite this economic downturn in Ohio, keeping these funds focused on tobacco control is a wiser long-term investment, ultimately saving Ohioans' lives and money.

For more information, see web link:
Legacy for Health News Release January 21, 2010


Smoking Cessation Leaders Team Up to Help 'Become an EX' Members Accomplish Their New Year's Resolutions to Quit Smoking

Setting a New Year's resolution to quit smoking is among one of the most common resolutions, but also one of the most difficult to keep. Many smokers who attempt to quit do so without any support, and the overwhelming majority of these quit attempts are unsuccessful. In fact, about 97 percent of all cold turkey quit attempts fail within six months.

To better help smokers looking to quit fulfill their New Year's resolutions, Legacy and GlaxoSmithKline Consumer Healthcare are partnering to offer free Nicorette® starter packs to more than 125,000 members of the EX® program (www.BecomeAnEX.org), where smokers "re-learn life without cigarettes" with a free, comprehensive three-step quit plan and access to a robust online community.

"New Year's is one of the most popular times for a smoker to consider quitting smoking; however, many smokers need support to do so successfully. Smokers who make the important decision to quit should utilize available resources to help them understand what to expect when quitting," said Dr. Cheryl Healton, president and CEO of Legacy. "EX is a program that provides smokers with the tools to help them 're-learn life without cigarettes.' Having access to a cessation medication can also help address cravings and withdrawal symptoms while quitting."

Nicotine replacement therapy, such as Nicorette, can help relieve cravings as a result of quitting smoking and can double a smoker's chances of quitting. It is recommended as a first-line treatment for smoking addiction by national and international guidelines and is thoroughly researched and highly accessible over the counter without a doctor's prescription.

Smokers interested in quitting can access free quit plans, tools and resources at www.BecomeAnEX.org and www.Nicorette.com.

For more information, see web link:
PRNewswire January 20, 2010


Gov. Paterson's Budget Delivers Health and Financial Wins by Increasing Cigarette Tax, Funding for Tobacco Prevention Programs

The budget proposed by Governor David Paterson will improve both New York’s physical and financial health by raising the state cigarette tax by $1 per pack and increasing funding by $8.3 million for the state’s highly successful tobacco prevention and cessation program. These measures are a win-win-win solution for New York: a health win, a financial win and a political win that is popular with voters. Together, these steps will continue New York’s dramatic progress in reducing tobacco use and its devastating toll in health, lives and health care costs. And the cigarette tax will raise much-needed revenue to help balance the budget and fund vital programs.

We urge the Legislature to join Governor Paterson in raising the cigarette tax and increasing funding for tobacco prevention programs. While the Governor’s proposal to increase funding for tobacco prevention is a positive step, the Legislature should go further and fully restore the $25.2 million that were cut from the program last year. These budget cuts severely undermined New York’s efforts to reduce tobacco use and put continued progress at risk. Even in these difficult budget times, tobacco prevention is a smart investment for New York that saves lives and reduces health care costs. To maximize the health and financial benefits, the Legislature should also increase tax rates on other tobacco products to parallel those on cigarettes.

New York has been a national leader in fighting tobacco use with well-funded tobacco prevention and cessation programs, a strong smoke-free workplace law and a cigarette tax of $2.75 per pack. As a result, New York has reduced its adult smoking rate to 16.8 percent and its high school smoking rate to 13.8 percent, both well below the national rates of 20.6 percent for adults and 20 percent for high schoolers.

But New York cannot let up in this fight because tobacco use remains the state’s number one cause of preventable death. The sad reality is that 25,400 New Yorkers die annually from smoking- related disease, and more than 20,000 New York kids become regular smokers each year. And health care costs associated with tobacco use in New York State amount to a staggering $8.2 billion annually.

For more information, see web link:
Campaign for Tobacco-Free Kids News Release January 19, 2010


Federal Court Deals Blow to Public Health in Ruling FDA Cannot Regulate E-Cigarettes As Drugs or Medical Devices

In ruling that the U.S. Food and Drug Administration may not regulate electronic cigarettes as drugs or medical devices, U.S. District Judge Richard Leon has ignored decades of precedent and put America's consumers at unnecessary risk. If upheld, Judge Leon’s decision opens a gaping loophole in the protection FDA has provided against the sale and distribution of non-tobacco products that a manufacturer laces with unregulated quantities of nicotine. For years, the FDA has stringently regulated all products containing nicotine when sold to consumers in any form other than a traditional tobacco product because of nicotine's dangerous and addictive impact.

Judge Leon's decision also ignores the common sense distinction that FDA has long drawn between traditional tobacco products that contain nicotine, such as cigarettes, smokeless tobacco, cigars and pipes, and a host of non-tobacco products, ranging from toothpaste to lollipops to water, in which manufacturers have added nicotine, a highly addictive substance.

We urge the government to appeal this ruling in order to protect public health. It is important to note that even if the ruling is upheld, this ruling leaves open the possibility that the FDA can regulate electronic cigarettes under the new law granting the agency the power to regulate tobacco products. Like other consumer products, electronic cigarettes should be regulated to protect public health before they are permitted to be sold to consumers.

Judge Leon's decision came in response to a lawsuit filed by two e-cigarette manufacturers that challenged the FDA's jurisdiction over these products and the agency's attempt to prohibit their importation under the Federal Food, Drug and Cosmetic Act. Electronic cigarettes have not been tested for safety or approved by any government agency for sale in the United States, yet manufacturers have been marketing and selling these products in stores and shopping mall kiosks throughout the U.S., as well as on the Internet.

Electronic cigarettes, which are manufactured primarily in China, pose several serious potential risks to public health. First, there is no credible scientific evidence that these products are safe for human consumption or that they are effective at helping smokers or other tobacco users quit, as some manufacturers have claimed. In contrast to tobacco cessation products that have been approved by the FDA, there are no controls on the amount or potency of the nicotine or other substances in electronic cigarettes. Last year, the FDA announced that a laboratory analysis of electronic cigarette samples found that they contain carcinogens and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze

Second, these products risk deterring current smokers from quitting by providing an alternative source of nicotine in places where smoking is not allowed. They also provide an unproven and unapproved alternative to smoking cessation therapies that have been approved by the FDA as safe and effective. Smokers concerned about their health should utilize approved smoking cessation medications and counseling rather than unapproved products. As the World Health Organization has concluded, until electronic cigarette manufacturers have conducted the necessary scientific studies and gone through the appropriate regulatory process, "WHO does not consider it to be a legitimate therapy for smokers trying to quit."

Third, these products could serve as a pathway to nicotine addiction for children, leading them to smoke cigarettes and use other tobacco products. Electronic cigarettes have been marketed in youth-friendly candy and fruit flavors including bubblegum, cookies and cream, and cola. These products are also readily accessible to youth because they are widely sold in shopping malls and over the Internet and, because they are not traditional tobacco products, they are not subject to age verification laws.

For more information, see web link:
Campaign for Tobacco-Free Kids News Release January 14, 2010


NBC's The More You Know Campaign to Include 1-800-QUIT-NOW

NAQC has learned that NBC Universal's The More You Know anti-smoking messages (3 total) will be incorporated into their public service rotation and aired during primetime and late night starting the week of January 15. All three of the PSA's include 1-800-QUIT-NOW on screen during the 15-second spots.

NBC premiered a Josh Gomez (from Chuck) ad on Friday, Jan 15, during the show Wine Country, a late night slot. A Chris Malonie PSA premiered on Saturday, Jan 16, during Law and Order: SVU and a Brian Williams spot will also run, but that date has not been set. Once the ads premiere, the spots will be put into rotation.

You may view the three anti-smoking spots on The More You Know Web site (http://www.themoreyouknow.com/anti-smoking/).


  • Christopher Meloni's script is as follows: "Imagine living longer. Imagine feeling better. Imagine saving money. Now stop imagining, set a quit date and stop smoking."
  • Joshua Gomez's message states that smoking is deadly, no butts about it.
  • Brian Williams focuses on chemicals and toxins and making a smart choice.

Please contact NAQC at naqc@naquitline.org with any questions.

For more information, see web link:
NAQC Promotion Communiqué Archive January 13, 2010


San Francisco Launches Citywide 'Make Today the Day' Quit Smoking Campaign

At a time when many smokers consider quitting for the New Year, a new campaign is a timely launch of a partnership that joins together mutual public health interests sought by the American Lung Association in California, Healthy San Francisco and the city's Public Health Office in a citywide public awareness campaign aimed to help smokers achieve that goal.

Encompassing 42 poster board and transit sites across San Francisco, the ad campaign is simple and direct -- Make Today the Day -- to decide to quit, and then take the steps necessary to do so.

According to the most recent data available (1999), smoking costs San Francisco $433 million annually in medical and indirect expenses. With that figure certain to be much higher today, the American Lung Association in California and the city of San Francisco believe that quit smoking health promotion is a valuable investment in improving the long-term wellbeing of area citizens and the fiscal health of the city. The statewide costs of smoking are nearly $16 billion annually.

For years, Dr. Mitchell Katz, Public Health Director for the city of San Francisco, has spearheaded a number of tobacco free initiatives. "While prevention and cessation efforts in San Francisco and across the state have reduced the smoking rate, there are still nearly four million people in California who smoke," stated Dr. Katz at a joint news conference held with the American Lung Association at San Francisco's City Hall.

The American Lung Association in California joins the city of San Francisco to kick-off the 'Make Today the Day' campaign to urge people who smoke in San Francisco to quit.

The ad campaign urges smokers to contact their doctor to learn more about the wide selection of resources and treatments -- and, directs people to the American Lung Association for help. People who call the number on the ad (800-586-4872) will reach the American Lung Association's Helpline where they will be connected to a registered nurse or respiratory therapist who will be able to answer their questions and provide them with resources and support.

In addition, smokers can find additional resources to help them quit at the American Lung Association's website, www.californialung.org, including tools, tips on how to talk to your doctor about quitting smoking and stories from smokers who became ex-smokers.

It's widely accepted that smoking is a leading contributor of coronary heart disease, stroke and a host of other cancers and diseases like lung cancer and chronic obstructive pulmonary disease, and that it harms nearly every organ in the body.

For more information, see web link:
PRNewswire January 5, 2010


iPhone Apps to Help Keep 10 New Year's Resolutions

Every year you make them, and every year you break them.

But with the help of your iphone, maybe you'll actually stick to your New Year's resolutions in 2010.

Will power can be hard to come by, but applications that help you lose weight, get fit, quit smoking and accomplish countless other goals are just a click away.

Here are 10 apps that might help you stay on track.

Quit Smoking

Nagging friends can't get you to do it, but maybe an iPhone app will.

My Quitline is a free application that links users to the National Cancer Institute's quitline where you can speak to a live coach. The app also includes a live text feature to get advice on quiting.

Launched in April, it was developed by The George Washington University's School of Public Health and Health Services (SPHHS) and the National Tobacco Cessation Collaborative (NTCC), with support from the National Cancer Institute (NCI).

If you're a results-driven person, check out Quitter. The free application tracks how long you've been smoke free and calculates the amount of money you've saved as a result. Just type in the cost of a pack, the number you smoked each and the day you went cold turkey.

There are also apps to help with losing weight, exercising more, saving money, sleeping more, getting organized, going green, reducing stress, volunteering, and learning something new.

For more information, see web link:
ABC News January 4, 2010


North Carolina Sets Curbs on Smoking

North Carolina turns a new page at the start of 2010 in its long history as a tobacco-growing state as it implements a ban on smoking in bars and restaurants.

"We are keenly aware of the history in our state, but now it's just that -- history," said Betsy Vetter, chair of the North Carolina Alliance for Health, an independent state coalition that, among other things, works to reduce tobacco use.

The law exempts cigar bars and country clubs from the ban. The federal Centers for Disease Control and Prevention doesn't include North Carolina on its list of 21 states plus the District of Columbia with 100 percent smoke-free laws -- meaning smoking is prohibited in all workplaces, restaurants and bars.

Still, the law is a big step for the nation's largest tobacco-producing state, which has long derived a hefty portion of tax revenues from that industry. The state has 255,000 tobacco-related jobs, nearly 40 percent of the nation's total, according to the North Carolina Department of Agriculture and Consumer Services.

"For North Carolina we feel like it's a huge victory," said Amy Barkley, a regional director for the Washington-based Campaign for Tobacco-Free Kids, an advocacy organization.

Later this year, Michigan and Wisconsin will also implement laws banning smoking in workplaces, restaurants and bars.

Among states with new laws on the books for 2010, Illinois, New Hampshire and Oregon have banned the practice of texting while driving. California is the first state to partially prohibit the use of artificial trans fats in restaurants, following a move by several major cities. In Montana, insurance companies are now required to provide coverage for autism spectrum disorders. Same-sex couples are allowed to legally marry in New Hampshire.

North Carolina's no-smoking law was passed and signed by Democratic Gov. Bev Perdue in May after two previous attempts at legislation failed. Sponsors of the bill initially sought a 100 percent smoke-free ban that would include all workplaces, but scaled it back. Smokers can be fined up to $50 for infractions, while bars and restaurants must pay up to $200.

Several North Carolina restaurants and bars said they welcomed the ban. "At least now this way, my customers won't get mad at me about it," said Terry Harvey, owner of Jimmy's Barbecue in Lexington, who contemplated going smoke-free a few years ago, but worried he would lose customers. Earlier this week he put up no-smoking signs and removed ashtrays in his restaurant.

For more information, see web link:
Wall Street Journal January 2, 2010


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