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SpotlightReport Reveals Characteristics of People Who Quit Many effective, evidence-based smoking cessation options are available such as medications, counseling, telephone help lines, and self-help groups. However, even with treatments and services, many people continue to smoke. Understanding the characteristics of those people who are able to quit is important to improving and targeting smoking cessation and outreach efforts. A recent National Survey on Drug Use and Health (NSDUH) report examines smoking cessation rates among individuals who were able to quit during the past year. These were individuals who had smoked on a daily basis at some time in their lives and who smoked any cigarettes during the 13 to 24 months prior to the survey. The survey includes a series of questions about the use of cigarettes and other tobacco products. Respondents (aged 12 or older) are asked whether they ever smoked all or part of a cigarette, when they last smoked a cigarette, and whether they ever smoked cigarettes on a daily basis. The findings show that:
The report also reveals a variation in smoking cessation rates across states. This is most likely due to variations in state policies on smoking, such as smoke-free laws, tobacco taxes, and the level of coverage of smoking cessation treatment in Medicaid programs, state employee health plans, and private insurance regulations.
Despite the well-known health risks of smoking and the availability of cessation treatment and services, many people are unable to quit. In this study, only 1 in 25 people who had been smokers during the year before last were found to have stopped in the next 12 months. The findings in this report suggest the need for targeted efforts, particularly for the populations of smokers where cessation rates were lower, on the availability and effectiveness of smoking cessation services. To download the full report, visit: http://www.oas.samhsa.gov/2k10/172/172SmokingCessationHTML.pdf. Research HighlightsAsthmatic Kids Breathe Easier with Smoke-Free AirFor children with asthma, reducing exposure to environmental tobacco smoke greatly decreases their chances of an asthma flare-up, hospital admission or emergency room visit, a study shows. "We found this to be true when the child's exposure (to second-hand smoke) decreased, even if the decrease did not mean completely eliminating their exposure," Dr. Lynn B. Gerald, of University of Arizona in Tucson told Reuters Health. "Any reduction in environmental tobacco smoke exposure seems to greatly benefit these children." Gerald's team documented the association between changes in environmental tobacco smoke exposure and childhood asthma-related illness in 290 asthmatic children enrolled in a clinical trial of supervised asthma therapy. The average age of the children was 11 years and 80 percent had moderate persistent asthma. At the start of the study, 28 percent of caregivers reported that the child was exposed to second-hand smoke in the home and 19 percent reported exposure to smoke outside the home only. At a follow-up interview, 74 percent of caregivers reported no change in the child's exposure to second-hand smoke, 17 percent reported less exposure, and 9 percent reported increased exposure. According to a report in the medical journal Chest, children who had any decrease in exposure to second-hand smoke over the course of 1 year had fewer episodes of poor asthma control, made fewer respiratory-related trips to the emergency room and were less apt to be hospitalized than children who had the same or increased exposure to second-hand smoke. "We were not surprised by the findings but we were surprised by the magnitude of the benefit that decreasing smoke exposure appeared to have," Gerald told Reuters Health. She said doctors can use this information as another "teaching point" for caregivers and parents of children with asthma. Given that the majority of second-hand smoke exposure in the home is due to parents smoking, "the most effective environmental tobacco smoke reduction strategy may be to provide smoking cessation interventions to parents and possibly other household members," Gerald and her colleagues conclude.
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Big Decline in Heart Attacks If All States Had Smoking BansIf all states banned smoking in restaurants, offices and other public spaces nationwide, the number of Americans suffering from heart attacks would drop by more than 18,000 within the first year, researchers report. "Comprehensive smoking bans have been implemented in some states, but not in every state," noted lead researcher Dr. Mouaz Al-Mallah, co-director of Cardiac Imaging Research at Henry Ford Hospital, in Detroit. Currently, 39 states have some type of public smoking bans, with 26 banning smoking in any enclosed public space, while 11 states have no bans at all. Based on the finding, Al-Mallah said that he would "encourage all states to institute a ban on smoking in public place to protect people from secondhand smoke. Authorities should do everything possible to prevent healthy individuals from being exposed to secondhand smoke, and one of the ways is by passing such laws. " Al-Mallah was scheduled to present the findings at the American Heart Association's annual Quality of Care and Outcomes Research conference in Washington, D.C. For the study, the researchers looked at data from 13 states that do not have laws banning smoking in public places. In states without smoking bans there were 169,043 hospitalizations for heart attack, the researchers found. Based on their calculations of an 11 percent drop in heart attacks if bans were instituted nationwide, there would be 18,596 fewer hospitalizations for heart attack in the first year. In addition, there would be a savings of $92 million in costs of caring for these patients, the researchers said. In 2008, Al-Mallah found that a smoking ban in Michigan would result in a 12 percent drop in heart attacks in that state. Dr. Gregg C. Fonarow, director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles, said that, "smoking and exposure to environmental tobacco smoke are well established and modifiable risk factors for heart attack, stroke and premature cardiovascular death." He said that a number of studies have demonstrated that when communities adopt comprehensive smoking bans, substantial reductions in heart attacks follow. "Adopting a national comprehensive smoking ban would prevent cardiovascular events, reduce death and disability due to cardiovascular disease, and greatly improve the cardiovascular health of this nation," Fonarow said. Another expert agreed, and said that bans' benefits extend to nonsmokers as well by reducing secondhand smoke. "This is another important piece of evidence that smoke-free laws protect health," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids said. "It shows why it is critical that every state pass a comprehensive smoke-free law that protects all workers and applies to all workplaces and public places."
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Online Social Connections Helped Smokers Quit, Study SaysMembers of the online smoking-cessation site QuitNet who made the most connections with other members of the mutual-support community were less likely to smoke, according to a study described as the first formal analysis of a stable, therapeutic online social network designed to assist health-behavior change. Researcher Nathan Cobb, M.D., of the Schroeder Institute for Tobacco Research and Policy Studies and colleagues found that the 7,569 QuitNet participants studied had made connections to an average of more than 13 other members — a relatively low number compared to other social-networking sites like Facebook. However, those connections appeared to be effective: individuals who were most integrated in the social network were more likely to be female, older, longer-term users of QuitNet, and — perhaps most significantly — not smoking. Cobb and colleagues found that QuitNet users were fairly evenly split between recent quitters and individuals who were trying to maintain long-term abstinence from tobacco use. Many had been members of QuitNet for a year or longer. “Because maintaining abstinence after cessation is so difficult and because successful quitters provide valuable information and normative influence within a social network, these findings of heterophily and persistence are reassuring and suggest that evolving networks can become more effective over time,” according to the authors. Women made up 72 percent of all active QuitNet members, the study found, and the most active members in the network had an average age of 49. “This tendency of network members to be female and older is noteworthy in light of the conventional wisdom that the population of Internet users skews in the opposite direction,” the study noted. QuitNet participants made an average of 38.2 visits to the site during the 60-day study period. “These results make it clear that researchers need to have a stable, functioning network before they evaluate or disseminate a network-based intervention,” Cobb told MeYouHealth. The findings were published online May 13, 2010 in the American Journal of Public Health.
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Arizona's Smoking Ban Reduced Hospital Visits, UA Study FindsSince the 2007 state law took effect, admissions for ailments related to secondhand smoke have declined by as much as 33 percent. Two University of Arizona researchers have studied the relationship between Arizona's 2007 law that bans smoking in public places and hospitalization rates for a range of ailments related to secondhand smoke exposure. Their results: Admissions for acute myocardial infarction or AMI, stroke, asthma and angina decreased following the implementation of the ban. Reductions in hospital charges are estimated to total more than $16 million in the first 13 months after the ban. Patricia M. Herman and Michele E. Walsh, both researchers in the UA psychology department, used public data on monthly hospital admissions in Arizona from January 2004 through May 2008 for their analyses. To control for other reasons why hospital admissions change over time, they compared admissions for those primary diagnoses before and after May 1, 2007 – the start date of the smoking ban – to admissions for four diagnoses not associated with secondhand smoke: appendicitis, kidney stones, acute cholecystitis and ulcers. They also compared admissions in Arizona counties with preexisting county or municipal smoking bans – which would be expected to show little effect from the statewide ban – to counties with no previous bans. Their results showed statistically significant reductions in hospital admissions of 13 percent for AMI, 33 percent for unstable angina, 14 percent for acute stroke and 22 percent for asthma in counties with no previous bans over what was seen in counties with previous bans. There were no statistically significant changes seen for diagnoses not associated with secondhand smoke. Their findings are published in the current issue of the American Journal of Public Health.
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National Survey: Parents Deeply Concerned About Alcohol, Smoking, Food Marketing Content on TelevisionToday’s new media landscape brings a longer list of inappropriate television content, including alcohol abuse, smoking and even the marketing of junk food to children, which one survey shows are just as great a concern to parents as violence, sex and profanity. The national survey by the United States Conference of Catholic Bishops (USCCB) aims to understand American parents’ concerns about media’s effect on children, considering that the average youth between the age of 8 and18 spends 30 percent of his or her time on total media watching television – more time spent online or on the phone. According to the report, 84 percent of parents reported that sexual content was something they were concerned or very concerned about; illegal drug use followed at 78 percent; violence at 76 percent; profane language at 74 percent; and alcohol abuse at 70 percent. The majority of parents were also concerned with marketing of junk food to children at 55 percent and smoking at 53 percent. While parents are concerned about various substance abuse portrayals on television, these portrayals have not been traditionally covered by the current ratings systems for parental controls. The survey found:
In light of this research, several groups are asking the Federal Communications Commission (FCC) to update its TV ratings system so that parents can be warned about this type of content before allowing their kids to watch television in the hopes of reducing youth exposure to inappropriate content that might lead to similar behavior. Legacy joined the call-to-action, pointing to a growing body of research showing that smoking images in media, particularly movies, can be more powerful than traditional tobacco ads, accounting for the single largest reason that youth start to smoke. In addition, in 2004, 78 percent of middle school students and 87 percent of high school students reported seeing actors using tobacco on television or in movies.
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Nationwide Study Shows That Adolescent Smoking May Be Influenced by Mothers' Smoking or DepressionA new study reveals that adolescents aged 12 to 17 living with mothers who are current smokers or who have had a major depressive episode in the past year are far more likely to smoke than adolescents not living under these circumstances. The study was sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) as part of its strategic initiative on data and outcomes – an effort to create integrated data systems that help inform policy makers and providers on behavioral health issues. The new study shows that adolescents living with mothers who currently smoke were nearly three times more likely to take up smoking than adolescents living with non-smoking mothers (16.9 percent versus 5.8 percent). Similarly, adolescents living with mothers who have suffered from a major depressive episode in the past year were almost twice as likely to take up smoking as adolescents not living in that situation (14.3 percent versus 7.9 percent). In addition the study revealed adolescents living with mothers who had a major depressive episode and were current smokers were more than four times more likely to smoke than adolescents living with mothers who had neither of these conditions (25.3 percent versus 5.6 percent). More than 1 in 4 (25.6 percent) of adolescents live with mothers who currently smoke and nearly 1 in10 adolescents (9.7 percent) live with mothers who have experienced a major depressive episode in the past year. About 1 in 27 (3.7 percent) of all adolescents live with mothers with both of these conditions. “These findings highlight factors that influence smoking among adolescents. It also suggests that prevention of smoking requires attention to multiple risk factors, including mental illness in the family,” said SAMHSA Administrator Pamela S. Hyde, J.D. “Knowing the factors that contribute to smoking helps to design and implement the best approach towards prevention and well-being.” These new data occur against the backdrop of an overall decline in past month smoking rates among adolescents -- from 13.0 percent in 2002 to 9.3 percent in 2008. Despite this progress, however, an estimated 1.4 million persons aged 11 to 17 started smoking in the in the past 12 months. Adolescent Smoking and Maternal Risk Factors is based on data collected during 2005 to 2007 from SAMHSA’s National Survey on Drug Use and Health which collected samples from 7, 359 mother-child pairs. The full report is available on line at http://oas.samhsa.gov/2k10/166/166SmokingMoms.cfm.
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African American Children Suffer More from Prenatal Tobacco Exposure, Study SuggestsLow-level prenatal tobacco exposure was "associated with deficits in both motor and cognitive development, but only for black children," said Kimberly Yolton, Ph.D., detailing the findings of a study recently presented at the annual meeting of the Pediatric Academic Societies. Researchers studied developmental differences among 242 white and black children, ages 1 and 2, who had been exposed to tobacco smoke prior to birth. Only children of mothers with measurable amounts of the nicotine metabolite cotinine were studied; about 30 percent of the study subjects were smokers or reported exposure to secondhand smoke, but many others still had measurable cotinine in their blood, suggesting that they had been unwittingly exposed to tobacco smoke. Yolton, a researcher at Cincinnati Children's Hospital Medical Center, noted that nicotine concentrations can be 15 times higher in fetal blood than in their mothers' bloodstream.
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Children Living in Apartments with Nonsmoking Adults Still ExposedThe majority of children living in apartments are exposed to secondhand smoke, even when they don't live with smokers. This study from the University of Rochester Medical Center is the first to examine whether housing type is a potential contributor to children's exposure to cigarette smoke. The abstract was presented this morning at the Pediatric Academic Society Meeting in Vancouver, Canada. Among children who lived in an apartment, 84 percent had been exposed to tobacco smoke, according to the level of a biomarker (cotinine) in their blood that indicates exposure to nicotine found in tobacco, and this included more than 9 of 10 African-American and white children. Even among children who lived in detached houses, 70 percent showed evidence of exposure. "We are starting to understand the role that seepage through walls and through shared ventilation may impact tobacco smoke exposure in apartments," said Karen Wilson, M.D., MPH, author of the study and an assistant professor of Pediatrics at the University of Rochester Medical Center's Golisano Children's Hospital. "We see that children are being exposed in ways we are not picking up, and it's important, for their health, that we figure out where this exposure is taking place, and work to eliminate it. Multi-unit housing is one potential source, but a very important one." Previous studies have shown that children with cotinine levels indicating tobacco smoke exposure have higher rates of respiratory diseases, decreased cognitive abilities and decreased antioxidant levels. The study analyzed data from almost 6,000 children between 6- and 18-years-old in a national database (National Health and Nutrition Examination Survey 2001-2006) to see if there was any relationship between their smoke exposure and their housing type. Apartment living was associated with a 45 percent increase in cotinine levels for African American children and a 207 percent increase for white children. About 18 percent of U.S. children live in apartments, and many of these children are living in subsidized housing communities where smoking is more prevalent. Wilson said many parents are trying to limit their children's tobacco smoke exposure by not allowing smoking in their apartments, but they say they can smell tobacco smoke coming from other apartments or from common areas. Last summer, the U.S. Department of Housing and Urban Development released a memo recommending that their housing developments enact smoke-free policies. A smoking ban within multi-unit, subsidized housing could further reduce the tobacco smoke exposure for children and reduce smoking rates among residents.
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Other Cessation NewsMore Smokers in Washington Taking it Outside to Cut Secondhand SmokeThe number of people in Washington who smoke in their homes has dropped 61 percent since 2000, part of growing public awareness of the dangers of secondhand smoke. About 1 in 5 people reported that they smoked in their homes in statewide telephone phone surveys of health issues in 2000, according to the state Department of Health. That dropped to about 1 in 13 in 2008, according to the state Department of Health. “I think the message is really getting across that secondhand smoke really is a danger,” said Annie Peterson, a tobacco prevention specialist for the Snohomish Health District. The decline in smoking rates in homes in Snohomish County over the same period was nearly as great — down nearly 58 percent, according to the Snohomish Health District. People giving up smoking in their homes has dropped about double the rate of people giving up smoking altogether. In December 2005, Washington became the fifth state to prohibit smoking in restaurants, bars and taverns and all other workplaces. Peterson said the health district, which is charged with enforcing the state’s indoor smoking ban in public places, gets almost as many complaints about secondhand smoke as it does of smokers not complying with the state law. “It cuts across all income levels, both rental housing and condos,” Peterson said. Tobacco smoke can seep into nearby rooms or even other living units through light fixtures and electrical outlets, she said. “I hear a lot from people struggling with smoke coming into their apartment,” she said. “It’s a lifestyle compromise that’s happening, getting in the way of people being able to enjoy their space.” The only way to truly prevent smoke from one living unit seeping into a neighbor’s dwelling is to ban indoor smoking in housing units, she said. Senior Services of Snohomish County, a nonprofit housing agency, took that step in July 2008. It has 703 units at 17 locations in Snohomish County. People who want to smoke must leave their building, even when the weather is harsh. An in-home smoking ban will go into effect at the Everett Housing Authority in June of next year.
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South Carolina Legislature Delivers Historic Victory for Kids and Health By Approving Cigarette Tax Increase over Governor's VetoThe South Carolina Legislature delivered an historic victory for the state's kids and health by voting to override Governor Mark Sanford's veto and increase the state's lowest-in-the-nation cigarette tax by 50 cents, to 57 cents per pack. South Carolina has not increased its cigarette tax since 1977, far longer than any other state. The higher cigarette tax is truly a win-win-win solution for South Carolina — a health win that will reduce tobacco use and save lives, a financial win that will help to balance the state budget and fund essential programs, and a political win that polls show is popular with the voters. In another important step forward, the Legislature allocated $5 million of the new cigarette tax revenue to fund programs that prevent kids from smoking and help smokers quit. While still short of the $62.2 million a year recommended by the U.S. Centers for Disease Control and Prevention for such programs, this represents the largest investment South Carolina has ever made in tobacco prevention. We urge state leaders to add to this funding in the future. The evidence is clear that increasing the cigarette tax is one of the most effective ways to reduce smoking, especially among kids. Studies show that every 10 percent increase in the price of cigarettes reduces youth smoking by about 6.5 percent and overall cigarette consumption by about 4 percent. South Carolina can expect the 50 cents cigarette tax increase to prevent 23,300 South Carolina kids from becoming smokers; spur 12,800 current adult smokers to quit; save $529.4 million in future health care costs; and raise $123.4 million a year in new state revenue. Tobacco use is the leading preventable cause of death and disease in South Carolina, claiming 6,100 lives and costing the state $1.1 billion in health care bills each year. Currently 17.8 percent of South Carolina high school students smoke, and 22,400 kids try cigarettes for the first time each year. With South Carolina's increase, the average state cigarette tax will be $1.42 per pack. South Carolina is the fifth state to increase its cigarette tax this year, joining Utah ($1 increase), New Mexico (75 cents), Washington ($1) and Hawai'i (40 cents). Missouri will now have the lowest cigarette tax at just 17 cents a pack, while Rhode Island has the highest at $3.46 per pack. We call on every state to significantly increase the tobacco tax to reduce tobacco use and its devastating health and financial toll, as well as raise much-needed revenue to help close budget shortfalls.
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Graphic Tobacco Warnings Proposed for MA StoresMassachusetts is poised to become the first state in the nation to force retailers to prominently display graphic warnings about the perils of smoking right where cigarettes are sold - at tobacco sales racks and next to cash registers. Images of ominously darkened lungs, damaged brains, and diseased teeth could start appearing before the end of the year in more than 9,000 convenience stores, pharmacies, and gas stations, if a proposal by the state Department of Public Health is approved as expected. Other posters would direct smokers to where they can get help to stamp out their habit. Retailers who refuse to display the signs within 2 feet of tobacco displays and cash registers could face fines of $100 to $300. A retail industry group reacted with dismay, arguing that cramped corner stores are already burdened by too many regulatory dictums. The initiative needs the approval of the state Public Health Council - an appointed panel of doctors, disease trackers, and consumer activists - but board members expressed unequivocal support. Since the 1990s, Massachusetts has been at the vanguard of US efforts to reduce tobacco use, the leading cause of preventable deaths in the United States. The signs are modeled on a nothing-left-to-the-imagination campaign in New York City, where signs showing the health effects of smoking began sprouting in 11,500 shops last December. Massachusetts health authorities provided copies of the New York City posters as an illustration of what their campaign will look like. The campaign is being underwritten by $316,000 in federal stimulus money from the Centers for Disease Control and Prevention, which will allow the state to provide the materials to retailers without charge. Because the posters will be produced by outside vendors, a spokeswoman for the state Department of Public Health said, it conforms to the intent of the stimulus law, providing jobs in a sour economy. Graphic images portraying the damage wrought by smoking have been a hallmark of antismoking campaigns in Europe for years. But, in the United States, admonitions on cigarette packs and at stores have tended to rely on words rather than pictures. The maker of Marlboro and other top-selling brands, Philip Morris USA, said it believes warnings should be uniform nationally and established by the federal government, which has been given expanded authority over tobacco marketing. In New York, the graphic signs have met with little resistance from retailers and consumers, said Anne Pearson, an attorney with the city's Bureau of Tobacco Control.
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HHS Secretary Names Preventing and Reducing Tobacco Use as a Top PriorityU.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius has named preventing and reducing tobacco use as a strategic initiative for HHS. In the “Secretary’s Strategic Initiatives and Key Inter-Agency Collaborations” Sebelius noted that it will require “comprehensive, sustained, and accountable tobacco control efforts based on evidence-based interventions” to lower the current smoking rate of twenty percent in the U.S. Initial actions identified to increase efforts to prevent and reduce tobacco use include:
Increasing efforts in the area of tobacco control is a big step in the right direction to ensure that Americans live healthier lives. To download the PDF version of the “Secretary’s Strategic Initiatives and Key Inter-Agency Collaborations,” visit http://www.hhs.gov/secretary/about/secretarialstrategicinitiatives2010.pdf.
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"Celebrating Smokefree Voices" YouTube Video ContestThe National Cancer Institute’s Smokefree Women team is launching “Celebrating Smokefree Voices,” a YouTube video contest, to capture the quitting experiences and reasons for quitting smoking among women and friends/families across the U.S. The contest launched Monday, May 10th -- the one-year anniversary of http://women.smokefree.gov. Smokefree Women wants to capture the variety of quitting experiences and reasons for quitting smoking among women and friends/families across the nation. Tell them why being smokefree is important to you. There are two categories for video submissions:
There will be three winners in each category with prizes up to $2,000. All video entries must be submitted by June 4, 2010 along with the required video entry form. Contest winners will be announced on July 2, 2010, right before Independence Day, to celebrate freedom (or “independence”) from smoking. Visit http://www.women.smokefree.gov/videocontest.aspx for video contest instructions.
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Kids on the Field? Stub the ButtsSmokers soon will have one less place to puff: Mississippi youth sporting events. Legislation passed during the 2010 session, recently signed into law by Gov. Haley Barbour, prohibits smoking within 100 feet of a facility where people under age 18 are participating in athletic events. It also would prohibit smoking at any indoor youth sporting events. The bill spells out penalties for those who violate the new law, which takes effect July 1. The first offense will result in a warning while a second violation would result in a $75 fine. Fines for ensuing violations are not to exceed $150. Groups in charge of the sports venue could post no-smoking signs and could take action to remove those who violate the smoking ban. The bill does allow a designated smoking area "separate from the fields of activity" to be established. The bill says, "It is the responsibility of all law enforcement officers and law enforcement agencies of this state to ensure that the provisions ... are enforced." Roy Hart, director of the Office of Tobacco Control at the Mississippi State Department of Health, said the legislation is "a step in the right direction." He said statistics indicate 550 Mississippians die each year from secondhand smoke.
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Nicorette's New Campaign to Help Smokers Quit Includes Big ContestNicorette is offering two new ways to help smokers finally quit smoking. A new nicotine lozenge is now available, as well as more internet support. By sharing a smoking story online, participants in Nicorette's latest contest can also get the opportunity to meet Dr. Drew Pinsky. Nicorette's latest item is a "mini lozenge" to help smokers quit. It is a dissolvable lozenge that dissolves three times faster than their previous dissolvable items. These little craving attackers are great, but must be kept away from children or people that can be harmed by nicotine. A recent report from the American Association of Poison Control Centers revealed children are more at-risk of nicotine poisoning if these candy-like lozenges are left in easy to reach places. Centers for Disease Control and Prevention states tobacco use the most preventable cause of death in the U.S. "Each year in the United States, cigarette smoking and exposure to secondhand smoke causes 443,000—or 1 in 5 deaths." A new Nicorette Facebook group is also available for smokers needing to express their problems with stopping. Smokers can share their stories and network to help each other. A contest to meet Dr. Drew face to face and be a guest on his radio show is currently underway. More information can be found at the Nicorette Facebook page or their homepage.
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