May/June 2009


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




Research Presented at SRNT 2009 Dublin Highlights New Treatment Developments and Specific Populations

The 2009 Joint Conference of SRNT and SRNT-Europe was held in Dublin, Ireland on April 27-30, 2009 ( Emerging research presented during the three-day conference highlights potential new approaches to enhancing the effectiveness of current cessation treatments and services and to improving cessation outcomes for certain populations.

New Developments in Treatment

Personalized Treatment with Therapeutic Nicotine Helps Smokers Quit
Research presented at a symposium during SRNT shows that optimizing therapeutic nicotine products through new uses can significantly enhance efficacy while offering more ways of quitting.

Studies discussed at the symposium analyzed the efficacy of using therapeutic nicotine in different ways:

  • prior to quitting,
  • while reducing cigarette consumption,
  • in combination with other therapeutic nicotine products, and
  • to prevent relapse after successfully quitting.

Additional research assessed:

  • the use of therapeutic nicotine treatment among smokers who have not made a commitment to quit, showing that approaching quitting smoking by gradual reduction may be an effective method for this group of smokers.

"A 'one size fits all' approach to helping smokers quit is becoming a thing of the past. Recent studies have found new ways for therapeutic nicotine to reach a broader population of smokers," said researchers.

For more information, see PRNewswire April 28, 2009

Nicotine Patch Plus Lozenge Gives Highest Smoking Cessation Rate
Another study presented at the conference also highlights using therapeutic nicotine in combination with other therapeutic nicotine products. According to the study smoking cessation rates are highest when nicotine patches are combined with nicotine lozenges.

Patients were randomized to 1 of 6 different pharmacotherapy options: bupropion; nicotine lozenge; nicotine patch; bupropion + nicotine lozenge; nicotine patch + nicotine lozenge; or placebo. All participants received six 10 to 20 minute individual counseling sessions.

  • At 8 weeks, cessations rates versus placebo remained significant high with patch + lozenge (53.6 percent), bupropion + lozenge (50.4 percent), and patch alone (44.7 percent).
  • At 6 months, however, only the patch + lozenge group retained a highly significant rate of cessation over placebo (40.1 percent vs. 22.2 percent).

For more information, see Doctor’s Guide April 29, 2009

Higher-Dose Nicotine Patches More Effective for Highly Dependent Smokers
While a combination of nicotine patches with lozenges increased cessation rates in one study, another study found higher-dose nicotine patches may be more effective for certain smokers. Abstinence rates increased among highly dependent smokers when they are given a higher-dose nicotine patch

The double-blind study included 480 smokers who were randomized to receive either nicotine patch treatment of 21 mg/day or 42 mg/day beginning 2 weeks prior to the target quit date.

  • Abstinence tended to be greater for highly dependent smokers receiving 42-mg nicotine patch treatment (22 percent vs. 17 percent on 21 mg), with the opposite trend in low-dependence smokers (28 percent with 21 mg/15 percent with 42 mg).

"Identifying [high-dependence smokers] offers a wonderful opportunity for adapting treatment potentially and heading off a failed quit attempt by offering an alternative or more intensive treatment," said researchers.

For more information, see Doctor’s Guide May 1, 2009

Treatments in Specific Populations

Adding Mood Management to Telephone Counseling Boosts Smoking Cessation Success Rates in Depressed Patients
Prior research has shown that cessation attempts in smokers with past major depression histories fail considerably more often than in other smokers. One study presented at SRNT showed that adding a mood management component as an adjunct to telephone counseling boosts smoking cessation success rates.

A control group received telephone counseling by trained counselors in 8 sessions with the first 30-minute session occurring prior to the smoking quit date. The active treatment group received similar counseling, but with 2 additional sessions before the quit date aimed at teaching mood management (MM) skills.

  • At 6 months, the prolonged abstinence rate was significantly higher in the MM group at 30.5 percent, compared with 22.3 percent among controls.
  • Findings were similar at 12 months for prolonged abstinence (23.9 percent vs. 14.0 percent).

For more information, see Doctor’s Guide April 29, 2009

Telephone-Based Smoking Cessation Interventions Effective in High-Risk, Underserved Pregnant Women
Another high-risk population is pregnant women. Smoking rates are higher among underserved pregnant women who are less likely to receive ongoing prenatal care and even less likely to be exposed to repeated smoking cessation messages. Final results from the New England Smoking Cessation/Reduction in Pregnancy Trial (SCRIPT) show that telephone-based smoking cessation interventions aimed at high-risk, low-income, pregnant women can be effective.

SCRIPT included 1,065 pregnant women smokers randomized to 1 of 3 protocols. All received a Quick Kit, comprised of A Pregnant Woman's Guide to Quit Smoking and a video, Commit to Quit. The first group received Quick Kit only; the second protocol added enrollment in a lottery called Quit & Win, which awards a prize worth $100; and the third also added 3 motivational interview phone calls.

Adjusted quit rates at 32 weeks' gestation were:

  • 17.2 percent for Quick Kit only,
  • 12.5 percent for Quick Kit + Quit &Win, and
  • 18.7 percent for Quick Kit + Quit &Win + motivational interview.

"This shows that while the monetary incentive was ineffective, reinforcing the core methods of brief counseling with tailored interventions can produce an additional increment of cessation," said researchers.

For more information, see Doctor’s Guide April 30, 2009

Computer-Based Smoking Cessation Program Effective for Patients Undergoing Surgery
A computer-based, comprehensive, smoking cessation-care strategy for surgical patients is feasible, effective, and inexpensive, according to findings presented at SNRT.

Researchers developed a strategy that directed patients to a computer program assessing smoking status, with carbon monoxide monitoring as the confirmatory measurement. The computer provided cessation counseling with motivational and cognitive behavioral therapy components.

Staff members were prompted to provide reinforcement and advice, NRT prior to admission, and post-discharge referral to a telephone Quitline.

  • After 3 months of follow-up, continued cessation was achieved by 18 percent in the intervention group and 5 percent of controls.
  • Improved stage of change was reported significantly more in the intervention group among smokers/heavy smokers (42 percent vs. 43 percent) than in the control group (25 percent vs. 22 percent).

The cost of care delivery considered inexpensive in comparison to other forms of cessation counseling and treatment, and was offset by short-term reductions in complications, length of stay, and readmission rates, said researchers.

For more information, see Doctor’s Guide May 2, 2009

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Research Highlights

Childhood Secondhand Smoke Effects Persist

The effects of exposure to secondhand smoke in childhood may persist for decades, a researcher said here.

In a large cohort of nonsmokers, early signs of emphysema were noticeable on CT scans among those who had lived with one or more smokers in childhood, according to Gina Lovasi, Ph.D., of Columbia University.

Those signs -- a significant increase in the number of "air-like spaces" -- were not accompanied by any clinical symptoms, Dr. Lovasi said at the annual meeting of the American Thoracic Society.

"We do see a difference" in the structure of the lung, Dr. Lovasi told reporters, "but it's important to note that we didn't see a difference in lung function."

Still, the finding suggests that the "damage from early childhood tobacco exposure may persist into adulthood," she said.

Dr. Lovasi said the effects of secondhand tobacco smoke are well known, but it remains unclear how long they persist. To help clarify the issue, she and colleagues turned to the Multi-Ethnic Study of Atherosclerosis, or MESA.

In that study, healthy participants provided medical and personal histories and blood samples, and agreed to medical examinations and CT scanning of the chest.

While the primary goal of the study is to examine atherosclerosis, the CT scans of the heart also included large parts of the lungs, she said.

The CT scans of 1,781 nonsmokers, average age 61, were analyzed to determine the proportion of the lungs that was "air-like" and the amount that was tissue.

"Air spaces are normal," Dr. Lovasi said, "but large airspaces can cause a problem."

The study found:

  • 17 percent of participants had lived with two or more smokers in childhood, while 30 percent had lived with one, and 52 percent had not lived with a smoker.
  • In those who had lived with two or more smokers, the proportion of air-like spaces was 20 percent, compared with 18 percent in those who had lived with one and 17 percent in the remaining participants.

Although the difference in relative air-like space between the groups was small on average, Dr. Lovasi noted that individual values ranged from 1 percent to 60 percent.

The study was limited because it represents a single point in time, Dr. Lovasi said. Also, the historical data is largely based on self-reporting.

For more information, see web link:
MedPage Today, May 20, 2009


Study: Smoking Bans Don’t Cause Job Losses in Bars, Restaurants

Smoking bans do not significantly affect employment in bars and restaurants, according to research released by the University of Minnesota and Ohio State University.

That result runs contrary to the arguments made by bar and restaurant owners as they’ve fought such bans at state legislatures and city halls across the country.

According to a press release, the researchers tracked employment in bars and full-service restaurants in 10 Minnesota cities, using state-mandated reporting data from the Minnesota Department of Employment and Economic Development. Limited-service restaurants were not included because they rarely sell alcohol. The cities had various forms of workplace smoking bans, including some that excluded bars.

The study found no significant short- or long-term effects on employment in any of the communities during the 45-month period. Communities that totally banned smoking in public places had nine fewer restaurant and bar workers per 10,000 residents than cities with partial bans and only two fewer workers than cities with no bans at all. The researchers said those numbers were not statistically relevant.

“This study shows that partial smoking bans, which we know do not adequately protect employees, have no economic advantage for hospitality businesses over full bans,” said Jan Forster, one of the researchers and a professor in the division of epidemiology and community health at the University Of Minnesota School Of Public Health, in the press release.

The study is published by the Society for Prevention Research in the June edition of Prevention Science and backed by a grant from ClearWay Minnesota, a Bloomington-based nonprofit that aims to reduce tobacco use and exposure to second-hand smoke.

For more information, see web link:
St. Paul Business Journal, May 19, 2009


Attitudes Toward Tobacco Industry Linked To Smoking Behavior

A new study by UCSF researchers concludes that media campaigns that portray the tobacco industry in a negative light and that appeal to young adults may be a powerful intervention to decrease young adult smoking.

The study sheds light on the relationship between attitudes toward the tobacco industry and smoking behaviors of young adults aged 18 to 25 years, the age group with the highest smoking rate among any in the United States.

The study is the first to link attitudes about the tobacco industry to smoking attitudes and behavior among a national sample of young adults, according to the research team. To determine attitudes, the researchers asked respondents how strongly they agreed or disagreed with three statements: Taking a stand against smoking is important to me; I want to be involved with efforts to get rid of cigarette smoking; and I would like to see cigarette companies go out of business.

The researchers found that those who agreed with those statements and supported action against the tobacco industry were one-third as likely to be smokers as those who did not support action against the tobacco industry. Among current smokers, those who had a negative attitude towards the tobacco industry were over four times more likely to plan to quit smoking than smokers who did not support action against the tobacco industry.

The results show a national impact of the “tobacco industry denormalization” approach, which educates the public about deceptive practices of the tobacco industry in order to influence individuals’ decisions about smoking, according to the research team.

The UCSF study measured attitudes of 1,528 people in the 18-25 age range through questions covering attitudes toward the tobacco industry, support of action against the industry, social groups, receptivity to advertising, depression, alcohol use, and other factors associated with smoking.

Pamela Ling, MD, MPH, lead author of the study and assistant professor of general internal medicine at UCSF attributes negative attitudes toward tobacco companies to the success of the advertising campaigns that slant against the industry. The study breaks new ground in examining attitudes in a national young adult sample that had previously been evaluated only in California, she noted.

For more information, see web link:
ScienceDaily, May 6, 2009


Cigarette Smoke May Rob Children of Needed Antioxidants

Children exposed to cigarette smoke have lower levels of antioxidants, which help the body defend itself against many biological stresses.

A University of Rochester Medical Center study looked at the levels of antioxidants versus the amount of smoke exposure in more than 2,000 6 and 18 years old in the 2003-2004 National Health and Nutrition Examination Survey (NHANES). The study, which was presented at the Pediatric Academic Society Meeting in Baltimore, shows that secondhand smoke exposure is associated with lower levels of antioxidants in children.

"We don't know enough yet to say that this group of children need supplements to make up for the antioxidants they're losing, but it's always wise to feed children an abundance of fruits and vegetables high in antioxidants and other healthy nutrients," said Karen Wilson, M.D., M.P.H., a senior instructor of Pediatrics at the University of Rochester Medical Center and the study's author.

Antioxidants are believed to play an important role in protecting the body's cells against free radicals, which can damage cells. Free radicals are produced during many body processes including when we use oxygen and respond to infections. It is not completely understood how antioxidants work together to neutralize free radicals, but scientists continue to discover more antioxidant compounds, including those examined in the study – vitamins E and C, folate and beta-carotene.

Children's exposure to tobacco smoke was determined by the level of cotinine in their blood (cotinine is a byproduct of metabolizing tobacco smoke). The higher the level of cotinine in a child's blood, the lower the antioxidant level, after controlling for diet and supplements. The study also looked at vitamins that were not antioxidants and found that these compounds did not seem to be reduced with smoke exposure.

For more information, see web link:
EurekAlert, May 4, 2009


Lung Cancer Risk Higher In Smoking Women Than Men

Women who smoke tobacco may be more susceptible than are men to the cancer causing effects of tobacco. Researchers studied women who smoked significantly less than men did, finding that women who smoke tobacco are diagnosed with lung cancer at a younger age. The findings show that women are more vulnerable to carcinogens in tobacco.

The findings were presented at the European Multidisciplinary Conference in Thoracic Oncology (EMCTO), Lugano, Switzerland. Swiss researchers studied 633 patients referred for lung cancer treatment between 2000 and 2005. The researchers found that women are more vulnerable to the effects of tobacco, leading to lung cancer.

Dr Enriqueta Felip from Val d'Hebron University Hospital in Barcelona, Spain says, "In the early 1900s lung cancer was reported to be rare in women, but since the 1960s it has progressively reached epidemic proportions, becoming the leading cause of cancer deaths among women in the United States.”Several case-control studies seem to suggest that women are more vulnerable to tobacco carcinogens than men."

Other study findings show that women survive longer than men do after being diagnosed with lung cancer. The average survival for men is 2.1 years, and for women 4.7 years. Women survive longer than men better surgery to remove cancerous lung tumors, a finding that the scientists say is positive, despite the findings that women are more susceptible to lung cancer.

Lung cancer is the leading cause of cancer deaths among women in the United States, surpassing breast cancer, yet women may not be as aware that they are more vulnerable to lung cancer.

The new study found that women are diagnosed with lung cancer at a much younger age than men are. This leads researchers to believe that women are more susceptible to lung cancer compared to men.

For more information, see web link:
EMaxHealth, May 4, 2009


Smokers Get Help with the Use of Electronic Health Record

Although the dangers of smoking are well known, tobacco still remains the number one cause of preventable death in the United States. The US Public Health Service recommends that physicians ask all patients about their tobacco use and connect them to cessation services, but there are still many patients who are never asked about their smoking habits. Researchers at Brigham and Women’s Hospital (BWH) have found that by enhancing the electronic health record, physicians were more likely to document a patient’s smoking habit and that access to cessation counseling was improved. This research is published April 27, 2009 in the Archives of Internal Medicine.

“As the use of the electronic health record expands, so does the opportunity to use it to improve patient care and delivery. In our study, we found that an enhancement in the electronic health record is a successful tool to remind clinicians to ask patients about smoking status and refer smokers for cessation counseling” said Jeffrey Linder, MD, MPH, a physician and researcher at BWH and lead author of the study.

Linder and colleagues developed an electronic health record enhancement to increase documentation of smoking status, the prescription of tobacco treatment medications and referral of patients to tobacco treatment counseling. This study was performed in 26 primary care practices which were randomized to be intervention practices and have the enhancement implemented in their electronic health record system or be a control practice without the enhanced electronic medical record. Over a period of nine months, more than 315,000 patient visits were made to the participating practices.

Researchers found that documentation of a patients smoking status in the health record was improved in all participating practices, but intervention practices had a higher increase, a 17 percent increase compared to 11 percent in control practices. They also found that in practices with the intervention, patients who were documented smokers at the start of the study were more likely to be non-smokers at the end of the study (a 3.4 percent increase in documented non-smokers) when compared to practices without the enhancement in the medical record. Researchers note that this finding may be due to improved overall documentation. They also found the enhancement did not change the number of patients who were prescribed cessation medication, but did find that documented smokers at the intervention practices were over 10 times more likely to make contact with a smoking cessation counselor. Making contact with cessation counseling roughly doubles a smoker’s odds of successfully quitting.

“Tobacco use is the leading preventable cause of death in the United States and more research is needed to maximize the utilization of health information technology to streamline tobacco treatment efforts by clinicians,” said Linder.

For more information, see web link:
Brigham and Women’s Hospital Press Release April 27, 20099


Smokers 'Need Anger Help to Quit'

Smokers should be given anger management lessons to help them give up smoking, a study suggests.

University of California tests on 20 people found nicotine helped calm aggression, but it was more likely from people not wearing nicotine patches.

Researchers hypothesized smokers were more likely to be people prone to anger and said tackling this could be a vital part of smoking cessation services.

Researchers got the participants to play a computer game - once wearing a nicotine-replacement patch and once using a dummy patch, the Behavioral and Brain Functions journal reported.

After each round, the players could give their opponent a burst of unpleasant noise at a duration and volume set by them.

The study found that when the participants were not wearing the nicotine patch they were more likely to react with aggression.

The researchers believe nicotine affects the part of the brain responsible for emotion.

They said the smokers who struggled to quit were more likely to be the ones who found it hard to remain calm, and ended up turning to a cigarette to soothe them.

One in four people currently smokes in the UK - a figure that has remained fairly constant in recent years after decades of falling rates.

Lead researcher Jean Gehricke said: "Novel behavioral treatments like anger management training may aid smoking cessation efforts in anger-provoking situations that increase withdrawal and tobacco cravings."

For more information, see web link:
BBCNews, April 23, 2009


Panel Sees Role for Smoking in Breast Cancer

Smoking causes lung cancer and is implicated in a dozen other cancers, but scientists have generally dismissed its importance in breast cancer, saying it plays little role, if any.

Now, a Canadian panel of experts is challenging the widely held view.

In a report issued recently, the panel asserted that evidence from new studies strongly suggests that smoking increases the risk of breast cancer, and warned that girls and young women faced special risks from exposure to smoke. For them, even exposure to secondhand smoke during this critical period of development may increase the risk of breast cancer later in life, the report said.

The report found strong evidence that secondhand smoke contributed to premenopausal breast cancer, but did not find enough support to say it increased the risk of postmenopausal breast cancer.

The perspective is a sharp dissent from the consensus among most scientists that there is not enough consistent evidence to determine whether smoking plays a causal role in breast cancer. The International Agency for Research on Cancer said in a 2004 report that it found little or no link between active smoking and breast cancer, and the surgeon general’s office said in 2006 that there was insufficient evidence to say secondhand smoke caused breast cancer.

“One message women have gotten in the past is that ‘you must go for a mammogram, because we can do nothing to prevent breast cancer.’ That’s absolute nonsense,” said Dr. Anthony B. Miller, a member of the panel and associate director for research of the Dalla Lana School of Public Health at the University of Toronto. “You can be more physically active. You can eat a good diet and avoid becoming overweight. Do not drink heavily — and do not smoke.”

For young women, Dr. Miller said, “the message is, Not only will you increase your risk of lung cancer — you know that — what we’re telling you is you’ll also increase your risk for getting breast cancer. In many respects, that is a more personalized message.”

Epidemiologists are sharply divided on the issue, but several who were not involved in the panel’s work said the evidence was still not in.

“I think the jury is still way out,” said Dr. Michael J. Thun, a former vice president of epidemiology and surveillance research for the American Cancer Society. “It’s been a big mystery why smoking doesn’t cause breast cancer. It’s definitely plausible. The issue is, what’s the level of the evidence? That’s where the disagreement exists. The hypothesis itself is a good one.”

The panel did not try to quantify how many excess breast cancers are caused by exposure to smoke, but the report pointed to several new studies suggesting that women who start to smoke when they are young increase their risk of breast cancer by 20 percent, and that many years of heavy smoking increase risk up to 30 percent.

For more information, see web link:
The New York Times, April 23, 2009



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Other Cessation News

Appeals Court Largely Upholds Ruling Vs Tobacco Companies

A federal appeals court largely upheld a landmark ruling which found that the tobacco industry violated federal racketeering laws by engaging in a decades-long scheme to deceive the public about the dangers of smoking.

The court affirmed most remedies that a trial judge imposed against tobacco companies in 2006, which included restrictions on tobacco marketing and a requirement that the industry make corrective public statements about the health effects and addictiveness of smoking.

The appeals court, however, rejected the government's request for additional penalties against cigarette makers.

Among other things, the government and anti-smoking groups wanted to force the tobacco industry to fund a $10 billion national smoking-cessation campaign.

The appeals court also affirmed an earlier ruling that the government couldn't force the tobacco companies to forfeit up to $280 billion in profits.

In a unanimous 92-page ruling, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit said there was ample evidence to conclude that the tobacco industry intended to deceive the public about the dangers of smoking.

The court said the tobacco companies "knew about the negative health consequences of smoking, the addictiveness and manipulation of nicotine, the harmfulness of secondhand smoke, and the concept of smoker compensation, which makes light cigarettes no less harmful than regular cigarettes and possibly more."

The court also said the government had adequately proven that the tobacco industry was likely to commit future racketeering violations unless restrictions were imposed.

Defendants in the case included Altria Group Inc.'s (MO) Philip Morris subsidiary, Reynolds American Inc. (RAI), British American Tobacco PLC (BTI) and Lorillard Inc. (LO).

Matthew Myers, the president of the Campaign For Tobacco-Free Kids, said the ruling was a "tremendous victory for public health" but said the court's refusal to allow additional remedies was disappointing.

The long-running case dates back to 1999, when the Clinton administration alleged that nine tobacco companies and two related trade associations engaged in a 50-year conspiracy to deceive the public about the dangers of smoking. A nine-month trial took place in 2005.

In a 2006 opinion that logged 1,653 pages, U.S. District Court Judge Gladys Kessler ordered a variety of marketing, sales and advertising restrictions on the tobacco industry, including an order that barred cigarette makers from promoting brands as "light" or "low tar."

For more information, see web link: May 27, 2009


New Resource for Smokers Who Want to Quit

The American Lung Association has launched a new resource for smokers who want help quitting. The State Tobacco Cessation Coverage Database contains state-by-state information about what help is available for smokers, including information on Medicaid coverage, state employee health plan coverage, insurance mandates for cessation, quitlines, and ALA programs for each state. These data include details of coverage, like barriers to accessing treatment, as well as the sources for each data point. The database is updated continuously with the most current information. This online database has a customizable search function and is updated continuously. To access the database, please visit

For more information, see web link:
American Lung Association Web site May 18, 2009


Florida, Hawaii and Mississippi Celebrate Tobacco Tax Victories

In recent days, policy-makers in Florida, Hawaii and Mississippi have enacted into law tax increases for cigarettes and other tobacco products, protecting kids and taxpayers in those states from the devastating toll of tobacco use. Once these cigarette tax increases have taken effect, the average state cigarette tax will be $1.27 per pack and the average federal-state cigarette tax will be $2.27 per pack. In support of these state efforts, RWJF funded public opinion polls on attitudes toward tobacco tax increases, public education media campaigns as well as strategic and technical assistance provided through its grantee, the Campaign for Tobacco-Free Kids.

In Hawaii, the Legislature has approved and Gov. Linda Lingle has signed a 60-cent increase to the cigarette tax, bringing the total cigarette tax to $2.60 per pack beginning July 1. The state cigarette tax will further increase by 20 cents per pack annually in July 2010 and July 2011, reaching a total of $3 per pack. The Hawaii Legislature also voted to override the governor’s veto of legislation to also increase the tax on most other tobacco products.

The Mississippi Legislature has approved a 50-cent increase in its cigarette tax, bringing the total cigarette tax to 68 cents per pack. Gov. Haley Barbour signed this into law on May 13. This is the first increase in the Mississippi cigarette tax since 1985.

The Florida Legislature has approved a $1 cigarette tax increase as part of the state budget, which is now before Gov. Charlie Crist for his signature. The $1 cigarette tax increase, which would be the first such increase since 1990, would bring the cigarette tax in Florida to $1.34 per pack. The Florida Legislature also voted to increase the tax on most other tobacco products.

The Campaign for Tobacco-Free Kids estimates that the cigarette tax increases in Florida, Hawaii and Mississippi combined will:

  • Prevent 186,800 kids from becoming smokers
  • Spur 112,600 adult smokers to quit
  • Prevent 89,400 premature smoking-caused deaths
  • Save $4.3 billion in long-term health care costs
  • Raise more than $740 million a year in revenue.

For more information, see web link:
Robert Wood Johnson Foundation Press Release May 15, 2009


North Carolina, Wisconsin Lawmakers Pass Smoking Bans

Bars and restaurants in both North Carolina and Wisconsin are poised to go smoke-free after their state Legislatures passed bans. Both North Carolina Gov. Beverly Perdue and Wisconsin Gov. Jim Doyle have said they support the measures.

Twenty-two states and the District of Columbia have prohibited smoking in bars and restaurants since New York City passed its landmark ban in 2003, and four more — Montana, Nebraska, South Dakota and Virginia — will do so by the end of the year. Florida, Idaho and Nevada ban smoking in restaurants, but not bars.

The North Carolina House's 62-56 vote marked yet another step away from the legacy of tobacco in a state that is still the nation's top producer by sales. Last year, North Carolina farmers produced $686 million worth of tobacco, nearly half the value of the entire U.S. output.

"It is definitely a historic move," said Betsy Vetter, a spokeswoman for the American Heart Association's North Carolina chapter. "We think this will protect a large portion of the population from secondhand smoke and that's quite an accomplishment for public health."

Their law would allow fines of up to $50 for smokers who keep puffing after being asked by an establishment's managers to stop, but the law can only be enforced by a local health director and not police. Hospitality owners or managers could be fined up to $200 after being warned twice to enforce the smoking rules.

In Wisconsin, lawmakers voted for a bill that marked an uneasy truce between the Wisconsin Tavern League, which has opposed past attempts at smoking regulations, and anti-smoking and health groups.

The ban, which takes effect July 2010, would apply in almost all workplaces. Smokers in violation would face fines of up to $250. Bar owners could set up outdoor smoking areas within a reasonable distance of the establishment. Owners who don't try to stop smokers would get a warning and then face a $100 fine for subsequent violations.

For more information, see web link:
The Associated Press, May 14, 2009


Cigarette Sales Slide to Record Low in Oregon

A report released by the Oregon Tobacco Prevention and Education Program showed that cigarette sales have dropped to their lowest level ever, falling from nearly 55 to almost 50 packs per capita in the fiscal year ending June 2008.

"Over this last year, we've seen a decrease in consumption, so that's exciting," said Cathryn Cushing, spokeswoman for the state Public Health Division. "We've seen an increase in the number of folks who've quit smoking, and that's exciting, too, but there's still a lot of work to do."

The report is encouraging on the home front, with 89 percent of households banning smoking, a 2 percent increase last year.

That slight uptick is important now that Oregon has banned smoking in most workplaces, including bars and restaurants, said Dr. Mel Kohn, director of public health in Oregon.

"Now that we have a Smokefree Workplace Law, the main place that people get exposed to secondhand smoke is at home," he said. "I am encouraged by the fact that people realize that this is a hazard and are trying to avoid getting exposed and exposing their children."

Oregon has tracked a dramatic drop in smoking among young people since 1996, but still every day 48 children in Oregon pick up their first cigarette, Kohn said.

Dr. Kohn said the decline in smoking among adults -- which has dropped to 17 percent -- should help further reduce youth smoking.

"Kids model the behavior that they see around them," he said. "With them having less exposure to smoke in the environment -- that's all going to make it less attractive for kids to be smoking, but this is a constant kind of battle that has to be waged."

The faltering economy has probably helped curb smoking, Kohn said. The federal cigarette tax also went up earlier this year.

Though many smokers have quit, the death rate has remained stubbornly flat, accounting for about 22 percent of the 30,000 Oregonians who die every year.

For more information, see web link: May 12, 2009


Ohio's Adult Smoking Rate Declines to 20.1 Percent

According to the Center for Disease Control's (CDC's) Behavioral Risk Factor Surveillance System survey, the adult smoking rate for Ohio in 2008 dipped to 20.1 percent, the lowest for Ohio in the history of the survey. The rate for 2007 was 23.1 percent. The dip in the smoking rate follows years of policies, funding, and programs meant to curb smoking among adults and youth. Unfortunately, threats to policies and cuts to funding and programs make it unlikely that smoking rates in Ohio will continue to decline.

"We know that funding nationally-recognized, science-based tobacco prevention and cessation programs along with strong smoke-free public places laws and tobacco taxes is a combination proven to successfully reduce smoking rates, and it's worked here in Ohio," said Shelly Kiser, director of advocacy for the American Lung Association. "But now our smoke-free public places law is under attack. Funding has been cut, programs have been slashed, and we're falling behind on tobacco tax rates. We're likely to see smoking rates start to go up again."

According to the CDC, research has shown that increasing the price of tobacco products, implementing strong smoke-free public places policies, and funding programs for cessation and prevention have proven effective in reducing smoking rates.

Last year, the Governor and legislature took most of the funding for tobacco prevention and cessation programs for an economic stimulus bill, putting the majority of in-school prevention programs, youth anti-tobacco groups, community coalitions, and cessation help for tobacco users who want to quit out of business. In addition, the SmokeFreeOhio law has been under attack as a number of legislators have introduced bills to weaken it. Ohio ranks 24th for its cigarette tax, and its tax on non-cigarette products is less than half of the cigarette tax. Also, the smoke-free prison grounds policy is to be repealed in both the Governor's and the House's versions of the budget.

"Stopping our successful tobacco prevention and cessation programs now is like a winning team giving up mid-season; we will lose everything we worked so hard for," said Cresha Auck-Foley, Director of Advocacy for the American Heart Association. "The governor and the legislature need to be proactive about strong tobacco policy, remembering than over 100 Ohioans die every other day from smoking."

The Behavioral Risk Factor Surveillance System survey can be accessed at:

For more information, see web link:
Read Media May 11, 2009


DOD Officials Promote 'World No Tobacco Day'

May 31, is World No Tobacco Day, sponsored by the World Health Organization. This year, for the first time, the Department of Defense is endorsing the observance of WNTD by encouraging servicemembers to participate. The effort is part of DOD's multiyear tobacco cessation campaign, Quit Tobacco--Make Everyone Proud.

"Freedom from tobacco addiction is not a sacrifice; it's a way to live our lives to honor those who gave us our freedom," said Capt. David Arday, a physician and U.S. Public Health Service officer and chairman of the DOD Alcohol and Tobacco Advisory Committee. "This is a great opportunity for servicemen and women to connect to others on their installation, across the country and around the globe in a worldwide event to take a public stand and make a personal commitment in the fight against tobacco."

Health promotions staff members at installations are encouraging their patients and clients to sign the online pledge at and accept the challenge to become tobacco free on WNTD.

There are free promotional and informational items available to order or download online to help stage events, plus specially designed e-cards visitors can send to encourage friends and family to give up tobacco. Military personnel also can use the e-card to announce their intention to quit.

The campaign headquarters at offers the latest high-tech ways to connect with others on the road to becoming tobacco free. The site has launched a Twitter page at, and anyone who signs up can follow the site's activities and news, including tobacco and other related health information.

Visitors can take advantage of other social networking opportunities, such as being a friend at MySpace, tuning in to the videos and making comments at the YouTube page and becoming a fan of the campaign's Facebook page. On Facebook, there's a new feature that allows users to announce to others they've quit and to congratulate friends and family who've make the commitment to quit tobacco.

For those who want their own private area to concentrate on tobacco cessation, the campaign Web site offers users "My Quit Space," where they can create a customized quit plan and calendar. Blogging options include starting a private blog or publishing it for others to read and make comments.

The site has gone mobile, which is perfect for the enlisted community. Users can point their mobile browsers to, the new mobile ucanquit2 Web site, to find cessation programs across America to help them quit tobacco and access important tobacco cessation news.

For more information, see web link:
Air Force Link, May 11, 2009


No Safe Bets for Casino Workers: NIOSH Study Shows Casino Workers Face Toxic Conditions

A new report from the National Institute for Occupational Safety and Health (NIOSH) shows workers in Las Vegas casinos are exposed to dangerous levels of secondhand smoke at work. NIOSH recommends making casinos 100 percent smokefree to ensure indoor air within casinos is safe for workers to breathe.

In 2005, blackjack dealers working in three Las Vegas casinos stepped forward and filed a NIOSH workplace Health Hazard Evaluation (HHE) request asking NIOSH to investigate secondhand tobacco smoke in their workplaces. NIOSH responded with a research team that conducted indoor air quality tests and biomarker assessments on 124 card dealers in Bally's, Caesars Palace, and Paris casinos on the Las Vegas strip.

Researchers found secondhand smoke components in the air including nicotine, 4-vinyl pyridine, solanesol, benzene, toluene, p-dichlorormethane, and formaldehyde. In addition, urinary testing of workers after their shifts indicated cancer-causing toxins in secondhand smoke were absorbed into workers' bodies. The NIOSH report authors concluded that the "best means of eliminating workplace exposure to [secondhand smoke] is to ban all smoking in the casinos."

Cynthia Hallett, Executive Director of Americans for Nonsmokers' Rights, said, "Casino workers deserve the same rights as other workers, including the right to a healthy safe workplace, free from toxic secondhand smoke. After the release of this report, we hope to see casino workers protected by strong smokefree workplace laws throughout the country."

Nevada's current smokefree workplace law does not cover the gaming areas of casinos. In fact, Nevada legislators are now considering rolling back the state's smokefree workplace law even further. Hallett added "If anything, these results should convince Nevada lawmakers to strengthen their state law to include the gaming floors of casinos, not roll it back to expose more workers to toxic secondhand smoke."

For more information, see web link:
PRNewsWire, May 6, 2009


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Funding Opportunities

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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