September 2009


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




NTCC Takes Steps to Address National Tobacco Cessation Priorities, Plans Activities for 2009-2010

Workgroups convened this month to discuss and plan activities to address NTCC’s national tobacco cessation priorities for the nation, specifically around the four priorities for which NTCC is leading:

  1. Increase consumer demand for evidence-based tobacco cessation treatments and services.
  2. Link tobacco control public policy changes to increase cessation and treatment use and demand.
  3. Promote the inclusion and use of tobacco control and cessation content in electronic health records (EHRs).
  4. Increase national, state and local longitudinal surveillance of tobacco-use cessation, including quitting motivation and behaviors, treatment beliefs and use, services, and policies.

These and other priorities were introduced and addressed at NTCC’s 2009 Annual Meeting. NTCC partner organizations are moving forward activities to address the remaining priorities, all of which can be found on The outcomes of the recent NTCC workgroup discussions are summarized below, including the initial action steps that NTCC will undertake to work toward addressing these four priorities over the next year.

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

NTCC has been managing ongoing Consumer Demand related activities. These include the IDEO Innovation Kit, the Supplement to the American Journal of Preventive Medicine, and the PHS Guideline Consumer Card. One of the next steps the workgroup considered is dissemination of these products. Workgroup members suggested several ideas for dissemination of the Innovation Kit and journal supplement including highlighting in an issue of the e-newsletter, putting on the NTCC web site, and promoting at conferences. For the PHS Guideline consumer card, members had many ideas for dissemination including point-of-purchase distribution at pharmacies or other places where cessation products are sold, adding the card in the Helpers Quit Kit (which will be piloted in New Jersey soon), and engaging HRSA to distribute at HRSA-supported health centers. In addition:

  • NTCC will conduct a survey of members to obtain other ideas for promotion of these new products.
  • The workgroup will convene in a few months when the products are ready to discuss more about dissemination and distribution.

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

Several potential activities were discussed at the annual meeting. One of these was to further strengthen and promote The site could be expanded to include NAQC materials, TFK webinar materials, insights and strategies from states that have implemented new policies, and information on how states can do additional surveillance before and after policy changes. Another potential activity suggested at the annual meeting was to identifying and promote a “response team” for states to speak with experts or peers in other states to ask questions regarding policy changes.

  • For, the next steps are to identify key elements related to cessation that are missing and find out what is the process for getting information added to the site. The site will be reviewed to see what is missing and how to best integrate cessation information throughout the site.
  • NTCC will contact experts about a template of pre-approved questions or a list of measures for conducting additional surveillance that states could include in existing surveys.
  • NTCC will contact individuals, including representatives from TFK, CDC, Legacy, NAQC, and states, about their interest and availability to participate in a response team.

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

At the annual meeting, several potential activities for this priority were identified. Before these activities could get underway, it was determined that NTCC and its partners should focus on information gathering in order to expand the workgroup. Next steps include:

  • NTCC will identify other organizations that are working on this issue. NTCC will send an email to partners to gather information and will then create a master list of stakeholders.
  • NTCC will then collect from these stakeholder organizations a short description of what activities they are doing related to EHR.
  • An update is needed on the status of the stimulus funds set aside to support EHRs. NTCC will reach out to partners to see if anyone has contacts with the EHR Czar Dr. David Blumenthal of Harvard.
  • Once these steps are complete, NTCC will schedule the next call with all stakeholders to discuss and plan activities.

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

This priority has been the hardest to make progress one due to the fact that surveillance is expensive and existing resources aren’t enough to support it. However, several feasible activities were identified by the workgroup to address this priority.

  • One idea is to do a small pilot project focused on a very important cessation topic that requires longitudinal data. The findings from this pilot could then be used to show potential funders how useful and important it is to have longitudinal data. NTCC will determine if any grant funding is available for a pilot.
  • Another suggestion was to conduct a literature review of existing cohort studies that have increased our understanding of cessation. The findings from this review could show potential funders that what has been learned from this type of data could not have been learned from cross-sectional data alone. NTCC will identify resources (possibly students or fellows at NCI or CDC) to conduct this.
  • Another possibility is to determine if it is feasible for the FDA to build surveillance into their new tobacco control activities. NTCC partners will reach out to contacts at the FDA to explore this option.

For more information on these priorities, or to participate in a workgroup, please contact Jessica Rowden at

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Research Highlights

Public Smoking Bans Cut Heart Attack Rates: Studies

Smoking bans in public places can significantly reduce the number of heart attacks, two U.S. research teams reported.

One team found smoking bans in the United States, Canada and Europe had an immediate effect that increased over time, cutting heart attacks by 17 percent after the first year and as much as 36 percent after three years, they reported in the journal Circulation.

A second team found such bans reduced the annual heart attack rate by 26 percent. Their report in the Journal of the American College of Cardiology estimates a nationwide ban in the United States could prevent as many as 154,000 heart attacks each year.

Both research teams said the findings support the adoption of widespread bans on smoking in enclosed public places to prevent heart attacks and improve public health.

"Public smoking bans seem to be tremendously effective in reducing heart attack and, theoretically, might also help to prevent lung cancer and emphysema, diseases that develop much more slowly than heart attacks," said Dr. David Meyers of the University of Kansas School of Medicine, who led the study in the Journal of the American College of Cardiology.

"Even breathing in low doses of cigarette smoke can increase one's risk of heart attack," he said.

Smoking bans have been enacted in countries all over the world. In the United States, 32 states ban smoking in public places and workplaces, and many cities and other localities do, too.

Meyers and colleagues analyzed data from 10 studies on smoking bans in the United States, Canada and Europe to compare rates of heart attacks before and after public smoking bans.

They found women and younger people were most likely to benefit, possibly because they often work in or frequent bars and restaurants where smoking is common, Meyers said.

James Lightwood of the University of California-San Francisco, who worked on the study in Circulation, said prior studies have been inconsistent in their findings, but their analysis found that smoking bans had a compelling effect.

"This study adds to the already strong evidence that secondhand smoke causes heart attacks, and that passing 100 percent smoke-free laws in all workplaces and public places is something we can do to protect the public," Lightwood said.

For more information, see web link:
Reuters September 21, 2009


Secondhand Smoke Damages Liver

The dangers of inhaling secondhand smoke are accumulating. A study published in the Journal of Hepatology found that long-term exposure to secondhand smoke can cause nonalcoholic fatty liver disease in mice.

Fatty liver disease -- which is an abnormal buildup of fat in the liver -- is a growing problem in the United States. It can be caused by chronic, heavy drinking. But in nonalcoholics, it's most often linked to obesity. The condition can lead to liver dysfunction and is thought to contribute to metabolic syndrome and cardiovascular disease.

Researchers at UC Riverside exposed mice to secondhand cigarette smoke for a year in the lab. They found the smoke affected two key substances that regulate fat metabolism. The smoke inhibited the activity of a kinase (adenosine monophosphate kinase) which then caused an increase of a protein called sterol regulatory element-binding protein that leads to more fatty acid production in the liver.

Identifying these two molecules could give researchers new targets to develop drugs that can reverse fat buildup in the liver, said the lead author of the study, Manuela Martins-Green.

More studies are needed to confirm the relationship between tobacco smoke and liver injury in humans, said Drs. Arian Mallat and Sophie Lotersztajn, in an editorial accompanying the study.

[F]indings from a large survey of U.S. adolescents indicate that passive and active smoke exposure are strong independent predictors of the presence of the metabolic syndrome. These observations indirectly suggest that tobacco use may indeed enhance non-alcoholic fatty liver disease, the hepatic hallmark of the metabolic syndrome.

People with fatty liver disease should stop smoking and avoid secondhand smoke, they said.

For more information, see web link:
LA Times September 11, 2009


Multiple Factors Impact Adolescent Smoking Risk

There is no one-size-fits-all explanation for why teenagers take up smoking, hint findings of a Canadian study.

Therefore, focusing on one single risk factor is not likely to help adolescents resist peer pressure to smoke, or help advance the understanding of why young people smoke, Dr. Jennifer O'Loughlin and colleagues report in the American Journal of Epidemiology.

O'Loughlin, at the University of Montreal in Quebec, therefore suggests that efforts to prevent smoking should take into account "individual-level factors such as age, self-esteem, alcohol use, and academic success." Those involved should also bear in mind "contextual factors such as smoking in parents and friends, and school smoking policies," she told Reuters Health in email correspondence.

Her group investigated how numerous factors altered smoking initiation among 877 students (half male), who were pushing 13 years of age at the start of the study and had never smoked.

Every 3 months for the next 5 years, the researchers surveyed students' smoking habits and other factors potentially linked with starting to smoke. During this period, 421 (48 percent) of the students started smoking, and 87 (21 percent of these) took up daily smoking.

Living in a single-parent family and poor academic performance in school all increased smoking risk. Using alcohol and other tobacco products upped risk nearly 3- and 5-fold.

Having siblings and friends who smoked raised an adolescent's risk for smoking about 2- and 3-fold. Having a parent or teachers and school staff who smoked increased the risk of beginning to smoke by about half or more.

Feeling the need for a cigarette raised smoking risk 6-fold. Adolescents who felt stressed, acted impulsively, and showed susceptibility to tobacco advertising were also more likely to begin smoking.

By contrast, gender, parents' education, feelings of depression, worry about weight or being overweight, seeking novel experiences, physical activity or playing sports, and television watching were some of the factors not linked with increased risk.

Prevention and cessation programs that target social, home, and school smoking, as well as tobacco advertising, may have a positive impact on adolescent smoking, O'Loughlin and colleagues surmise. They call for further investigations into factors linking alcohol use and smoking, and genetic variables tied to smoking risk.

For more information, see web link:
Reuters September 11, 2009


Doctors Fear Asking Mentally Ill To Quit Smoking

People with mental illnesses such as depression and anxiety are the heaviest smokers in the country, but their doctors are afraid to ask them to quit. They assume that if their patients try to quit smoking, their mental disorders will get worse.

That is a myth, according to Brian Hitsman, a tobacco addiction specialist and assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. He also is a member of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

This population's tobacco use and dependence need to be treated, he said. Hitsman has designed and published the first comprehensive, evidence-based plan for psychiatrists, psychologists and other mental health providers to help their patients quit smoking. His paper appeared in a recent issue of The Canadian Journal of Psychiatry.

"These doctors and mental health specialists focus on their patients' psychiatric health and lose track of their physical health," said Hitsman, who is a health psychologist. "Tobacco cessation gets a lot of attention, but we leave out a population that smokes the majority of all the cigarettes."

Between 40 to 80 percent of people with mental illness are daily smokers, depending on the disorder, compared to less than 20 percent of people who don't have problems with mental illness, according to research. The mentally ill also smoke more cigarettes per day -- often up to two packs. They have a disproportionately high rate of tobacco-related disease and mortality, such as cardiovascular disease or cancer, with a correspondingly heavy financial burden to the health-care system.

The mentally ill receive tobacco treatment on only 12 percent of their visits to a psychiatrist and 38 percent of their visits to a primary care physician, Hitsman said.

Doctors erroneously believe mental disorders will worsen if they take away a person's tobacco. "Not a single study shows that symptoms get worse," Hitsman said. He examined 13 randomized clinical trials that measured psychiatric symptoms during smoking cessation treatment. Seven studies showed that psychiatric symptoms actually improved during smoking cessation treatment, and six showed no changes.

There is evidence from a few studies, however, that when mental health providers insert smoking cessation treatment into the mental health treatment plan, they can help their patients quit or cut down.

"They find if you take advantage of the relationship with the counselor and insert smoking cessation counseling into treatment that you enhance quit rates," Hitsman said.

His tobacco cessation plan combines cognitive behavioral therapy, pharmacotherapy and motivational counseling to help the patient quit. Hitsman also has identified several treatment medications that may further facilitate quitting for this population.

People with mental disorders do have a harder time quitting than the general population, Hitsman acknowledged, but said newer studies show it is possible to enhance the chance of success with this approach. Even if patients simply reduce their smoking, they are much more likely to quit successfully at a later date.

For more information, see web link:
ScienceDaily September 9, 2009


Secondhand Smoke Levels Higher in Cars Than in Bars or Restaurants

The concentrations of secondhand smoke are significantly higher in cars than concentrations generally measured in bars, restaurants and other public places that allow smoking, according to a study by researchers at the Johns Hopkins Bloomberg School of Public Health.

The study is among the first to measure smoking in cars under real-world driving conditions and was published online Aug. 24, ahead of print, in Tobacco Control.

For the study, researchers monitored the air in the cars of 17 smokers and five nonsmokers. “Two air monitors were placed in each car for a 24-hour period,” said study author Miranda Jones, a master’s student at the Bloomberg School, who conducted the study as part of her Diversity Summer Internship Program.

The cars were driven as the participants commuted to and from work for at least 30 minutes. The median air concentrations measured were 9.6 µg/m3 (micrograms per cubic meter). After one to three cigarettes, airborne concentrations of nicotine were 72 times higher than in smoke-free cars. After adjusting for factors such as air conditioner use, vehicle size, window opening and sampling time, there was a 1.96-fold increase in air nicotine concentrations per cigarette smoked.

Study participants also were surveyed on their knowledge of and attitudes regarding health risks of secondhand smoking and relevant regulations/legislation.

“Fifty-three percent of the smokers surveyed said that being unable to smoke in the car would help them to quit smoking altogether,” Jones said.

Ninety-three percent of smokers agreed that motor vehicles should be smoke-free on a voluntary basis, but only 7 percent of smokers agreed that vehicles should be smoke-free by regulation. All of the study’s participants–smokers and nonsmokers–agreed that smoking in the car posed a health risk to passengers.

“Involuntary exposure to secondhand smoke accounts for thousands of cases of respiratory, cardiovascular and cancer deaths in the U.S. every year,” said study author Ana Navas-Acien, assistant professor in the Bloomberg School’s Department of Environmental Health Sciences and the Institute for Global Tobacco Control. “While some states have smoke-free regulations, the high air nicotine concentrations measured in this study support the urgent need for smoke-free education campaigns and legislative measures banning smoking in motor vehicles when passengers, especially children, are present,” she said.

For more information, see web link:
Johns Hopkins University Gazette September 7, 2009


Small Amount Of Smoking Increases Risk Of Cardiovascular Disease

Even small amounts of smoke — such as from smoking a few cigarettes a day, inhaling someone else’s tobacco smoke or breathing polluted air — increase the risk of death from cardiovascular disease (CVD), researchers report in Circulation: Journal of the American Heart Association.

In an analysis of prospective data on more than 1 million adults, researchers found that the exposure-response relationship was steepest at relatively low levels of exposure. The risk continued to increase, but leveled off with increasing levels of smoking.

The major findings were:

  • The largest incremental boost in risk of CVD death came with smoking three or less cigarettes a day, which increased the risk by about 64 percent.
  • Those smoking 8-12 cigarettes per day (about a half pack) had a 79 percent increased risk of CVD death.
  • Those smoking 18-22 cigarettes per day (about a full pack) had approximately a 100 percent increased risk of CVD death.
  • Breathing moderate to high levels of ambient air pollution and secondhand smoke, with estimated exposures at far less than smoking one cigarette a day, still increased risk of CVD death by approximately 20 percent to 30 percent compared to those without exposure.

“The evidence in this integrated analysis suggests that there are no apparent safe levels of exposure to cigarette smoke or ambient air pollution,” said C. Arden Pope III, Ph.D., Mary Lou Fulton Professor at Brigham Young University in Provo, Utah. “This may be due to the fact that even with relatively low levels of smoke there are adverse biologic responses such as inflammation, increased platelet activation and altered cardiac function.”

Researchers collected data from the American Cancer Society Cancer Prevention Study II (ACS CPS-II) and integrated it with studies of secondhand smoke and air pollution. The large ACS CPS-II data set allowed researchers to pinpoint excess risk of cardiovascular death associated with relatively small increments of cigarette smoking while controlling for other risk factors such as education, marital status, body mass, alcohol consumption, occupational exposures and diet.

Researchers plotted relative risks of cardiovascular death from increments of cigarette smoking along with comparison estimates for secondhand smoke and air pollution over estimated inhaled doses of fine particulate matter.

“Past studies have established that active cigarette smoking exposes human lungs to extremely large amounts of fine particulate matter and is a major independent contributor to cardiovascular disease,” Pope said. “Our analysis illustrates that it doesn’t require extreme exposure to have significant cardiovascular effects. Even passive exposures to ambient air pollution and secondhand smoke contribute to significant increases in cardiovascular mortality.”

Reasonable efforts should be made to avoid secondhand smoke, and public policy must improve air quality — both of which will have a positive impact on public health — Pope said.

“A critical finding of our study is that smoking is unhealthy even at small amounts,” Pope said.

“Reducing the amount one smokes does some good, but the biggest benefits come from stopping completely.”

For more information, see web link:
EmaxHealth September 1, 2009


Secondhand Smoke Worsens Outcome of Acute Coronary Syndrome

Environmental exposure to tobacco smoke - a known risk factor for myocardial infarction and other acute coronary syndromes (ACS) - can also worsen prognosis after ACS, according to a new study.

"These findings suggest that, by reducing exposure to secondhand smoke, smoke-free legislation may not only reduce the incidence of cardiovascular events, but may also improve prognosis in those who suffer them," Professors Jill P. Pell and Sally Haw write in a featured editorial published with the study in the September issue of Heart.

Professor Pell, head of the Public Health and Health Policy Section at University of Glasgow, UK, is also the lead author of the study. She and her colleagues examined the impact of secondhand smoke exposure on survival after ACS in 1,261 never-smokers admitted to nine Scottish hospitals over a 23-month period.

A total of 132 (10.5 percent) of these never-smokers had a spouse or partner who smoked.

According to the investigators, 50 patients (4 percent) died within 30 days of the index ACS admission and another 35 (3 percent) required readmission for myocardial infarction, yielding a total of 85 adverse events (7 percent).

There was a significant trend in the frequency of all-cause deaths by cotinine band, the researchers report, from 10 deaths (2.1 percent) in never-smokers with serum cotinine levels no higher than 0.1 ng/mL, to 22 (7.5 percent) in those with cotinine levels greater than 0.9 ng/mL (p < 0.001).

This trend persisted after adjustment for potential confounders, with the result that a cotinine level greater than 0.9 ng/mL was associated with an adjusted odds ratio for mortality of 4.80, they note.

"The same dose-response was observed for cardiovascular deaths and death or myocardial infarction," they report.

"These results further strengthen the argument for protecting non-smokers from environmental tobacco smoke," Professor Pell noted in an email to Reuters Health.

"Tobacco control measures, such (as) the comprehensive smoke-free legislation recently implemented in the United Kingdom, need to be adopted worldwide," she said.

For more information, see web link:
RT for Decision Makers in Respiratory Care August 28, 2009


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Other Cessation News

Government of Canada Announces Funding for Tobacco Cessation Programs for Industries With Higher Than Average Smoking Rates

The Honourable Rona Ambrose, federal Minister of Labour, announced funding for a project administered through The Lung Association, Alberta & NWT that is designed to reduce tobacco use among employees who work in industries with higher than average smoking rates.

"The Government of Canada is proud to be working with The Lung Association, Alberta & NWT and its partners to help curb cigarette smoking among employees in industry sectors that have been traditionally hard to reach," said Minister Ambrose. "I look forward to seeing the progress that is made on this front in the months and years ahead."

Funding from the announcement will go towards the Smart Steps...towards a smoke-free life project. Although the Smart Steps program is designed for all employees in workplaces across Alberta, the project will focus on helping employees who work in industries with higher than average smoking rates quit smoking. The project hopes to reach young adults who work in retail, construction, transportation as well as the oil and gas sector with on-site tobacco cessation programming and personalized action plans to help them quit. Funding for this project will help deliver smoking cessation workshops in 25 additional workplaces located in seven cities across Alberta.

"We are thrilled about the funding support from Health Canada. It shows the government's commitment to tobacco reduction and the health of all Canadians," said Tony Hudson, The Lung Association, Alberta & NWT's President & CEO, "Today's investment by the federal government will ensure that our organization can provide workplaces across the province with an effective cessation program that will empower Albertans to quit smoking. This is an exciting moment for The Lung Association, and Albertans who want to breathe easier."

Smoking remains the most preventable cause of disease and premature death in Canada. More than 37,000 people die prematurely each year in Canada due to tobacco use and more than 830 non-smokers died in Canada from second-hand smoke. Given these statistics, Health Canada is pleased to have contributed $184,071 to the Smart Steps...towards a smoke-free life project.

For more information on Health Canada's tobacco control efforts, please visit

For more information, see web link:
MarketWire September 24, 2009


Utah Smokers at a Record Low: 9.1 Percent

A record low number of adult Utahns — 9.1 percent — use tobacco, according to a new annual report released by the state Department of Health.

Tobacco use has declined by 33 percent since 1999, the year that an anti-smoking campaign funded by the Master Settlement agreement with cigarette manufacturers that were sued nationwide went into effect.

Public health administrators credit the reduction in use to the public awareness campaign underwritten by the settlement, the Tobacco Prevention and Control Program and the TRUTH marketing campaign. The report also credits local public health departments and partner public service agencies in communities statewide for the decrease.

The addition of a new $1 per-pack federal cigarette tax, plus the nearly constant anti-tobacco drumbeat surrounding a push to increase the state's tobacco tax during this past legislative session has probably had a ripple effect on the decline of smoking, health officials said.

The state effort to increase the state's per-pack tax to $2 failed, mainly because many lawmakers had promised constituents they would not support any new taxes. But the message of proponents seemed to stick: Nonsmokers pay $500 per year to help offset care provided to smokers who get sick, often chronically and seriously, from their habit.

The total cost of tobacco-related illnesses amount to $369 million in medical expenses, according to the new report, with an additional $300 million in lost workplace productivity from those who smoke.

In other words, each percentage point reduction in the state's smoker percentage amounts to $315 million in future health-care costs.

And the state has 85,000 fewer smokers because of the public education efforts, said David Sundwall, executive director of the state Department of Health, adding the number is "equal to half the population of Salt Lake City."

Interest in quitting is significantly up as well, according to the report. Calls about smoking cessation programs through local public health agencies is up by 36 percent compared to calls made in the 2008 fiscal year, and 60 percent of those inquiries were made by people saying they wanted to quit within the coming month.

Despite the decline, nearly 190,000 Utahns still smoke and 1,150 die each year because of their addiction.

For more information, see web link:
Deseret News September 21, 2009


HHS Prevention and Wellness Initiative, Including Tobacco Control, Is Smart Investment in America's Health

The Communities Putting Prevention to Work initiative announced by the U.S. Department of Health and Human Services, which includes support for strategies to reduce tobacco use, is a smart investment in the nation's health that will save lives, prevent disease and help reduce health care costs. This investment, made possible by the American Recovery and Reinvestment Act of 2009, will also create jobs and strengthen the nation's public health infrastructure, which will help build stronger, healthier communities.

The HHS initiative will provide a total of $650 million for evidence-based prevention and wellness strategies that reduce tobacco use, increase physical activity, improve nutrition and decrease obesity. In the first part of this initiative, HHS Secretary Kathleen Sebelius announced that communities and tribes can apply for $373 million in grants to address these public health challenges under the leadership of the U.S. Centers for Disease Control and Prevention (CDC).

We urge communities and tribes applying for these grants to include evidence-based strategies and programs that are proven to reduce tobacco use and exposure to secondhand smoke. There are few public health measures that have a stronger evidence base than the programs and policies that have significantly reduced tobacco use in states and communities across the country. Research and experience have demonstrated conclusively that comprehensive tobacco prevention and cessation programs reduce tobacco use, save lives and save money by reducing tobacco-related health care costs.

In California, adult smoking rates were reduced by 35 percent after implementation of its pioneering Tobacco Control Program, and a recent study found that the state's program saved $86 billion in health care costs between 1989 and 2004. Maine has seen smoking rates decline by 71 percent for middle schools students and 64 percent for high school students since 1997, preventing more than 26,000 young people from smoking and saving the state $416 million in future health care costs. New York City, which has one of the nation's most comprehensive efforts to reduce tobacco use, reduced adult smoking by 26 percent between 2002 and 2008, resulting in 350,000 fewer smokers.

Preventing disease is a critical component of reforming the nation's health care system. The new HHS initiative is an important down payment on prevention and sends a powerful message that preventing disease should be valued as much as treating it. Now it is critical that health care reform build on this initiative by including funding for prevention and coverage of smoking cessation services.

For more information, see web link:
Campaign for Tobacco Free Kids News Release September 17, 2009


NYC Seeks Ban on Smoking in Parks and Beaches

When New York City’s smoking ban took effect in 2003, cigarette and cigar puffers were driven outdoors.

But soon the outdoors — or at least much of it — may no longer be an option.

The city’s health commissioner, Dr. Thomas A. Farley, announced that the Bloomberg administration would seek to ban smoking in city parks and beaches.

Such bans are still rare, though growing in number. A number of municipalities — particularly in California — have banned smoking in outdoor parks, playgrounds and beaches. In 2007, Los Angeles extended its smoking ban, which already covered beaches and playgrounds, to include municipal parks. Later that year, Chicago banned smoking at its beaches and playgrounds, though smoking is still allowed in many parks. This year, California lawmakers took up a measure to prohibit smoking in all state parks and parts of state beaches.

The New York City proposal would affect more than 1,700 parks, playgrounds and recreational facilities, as well as the city’s seven beaches, which span 14 miles of shoreline.

Dr. Farley said the ban — which officials said may require the approval of the City Council, but could possibly be done through administrative rule-making by the city’s Department of Parks and Recreation — was part of a broader strategy to further curb smoking rates, which have fallen in recent years. The strategy would include, among other things, increasing local, state and federal taxes on tobacco and urging organizations and businesses in the city to reject financing and sponsorship from the tobacco industry.

Mayor Michael R. Bloomberg, who smoked as a young man, faced furious criticism from restaurant and bar owners in 2002 when, in his first year in office, he reached a deal with the City Council on legislation banning smoking in virtually every indoor area. (Smoking had already been banned in most restaurants in 1995.)

But the ban has since gained widespread acceptance and been credited with helping to drive down the smoking rate in the city to 16.9 percent in 2007, from 21.5 percent in 2002.

The proposal to ban smoking in parks and beaches drew praise from public health advocates and criticism from one of the nation’s biggest tobacco manufacturers.

“The issues with secondhand smoke are very real and the majority of the population today doesn’t want to be breathing in tobacco smoke, whether indoors or outdoors,” Dr. David A. Kessler, who was commissioner of the Food and Drug Administration from 1990 to 1997, said in a phone interview. “While undoubtedly some will think this is going too far, 10 years from now, we’ll look back and ask how could it have been otherwise. It’s not only us, but our kids in these parks and beaches.”

Cheryl G. Healton, president and chief executive of the American Legacy Foundation, the smoking prevention group that was created as part of the 1998 master settlement between the tobacco industry and 46 state governments, also applauded New York City’s move.

“There is no redeeming value in smoking at beaches or parks,” she said in a statement. “Anyone who has sat behind someone smoking a stogie can tell you that. The health risks are real. Secondhand smoke is deadly. Cigarette butts — especially those that are still burning — are a hazard to children who might step on them and are toxic to sea life.”

For more information, see web link:
New York Times September 14, 2009


Colorado Medicaid Adds to Smoking Cessation Support

The Colorado Department of Health Care Policy and Financing announced that Medicaid has increased how often smoking cessation medications may be prescribed to help clients quit smoking. This common sense policy change results in improved health for clients and decreased Medicaid costs by decreasing hospitalizations and provider visits.

The expanded benefit gives providers the option to prescribe up to two, 90-day drug therapy treatments each year to aid in smoking cessation. This is an increase from a 90-day drug therapy per lifetime. Studies show that it takes an average of seven attempts to quit smoking and the health and economic benefits outweigh the cost of medications. In order to receive the benefit, a client must get a prescription from their physician that indicates the client’s intent to enroll in counseling.

Tobacco use is the single leading cause of preventable illness and death in the United States. Each year, more than 430,000 Americans – including 4,700 Coloradans – die prematurely from smoking-related diseases. Today, 17.6 percent of adults in Colorado use tobacco.

“There are over 470,000 clients receiving benefits through Medicaid and 34 percent of the adults in the Medicaid program use tobacco,” states Dr. Sandeep Wadhwa, state Medicaid director. “The last time the nation smoked at this rate was in 1977. Clients enrolled in Medicaid use tobacco almost twice the rate of other Coloradans. By providing additional tools for clients to achieve their smoking cessation goals, the probability of success increases significantly. Colorado Medicaid’s goal is to improve the health and functioning of our clients in a cost-effective manner. Increasing the pharmacological options for providers to help clients quit smoking supports this goal.”

The Department and the Governor’s Office thank the Tobacco Cessation Sustainability Partnership, TCSP, for all of their invaluable help in developing this new policy. The TCSP includes representatives of the American Cancer Society, American Heart Association, American Lung Association, Chaffee County Public Health, Colorado Association of Health Plans, Business Health Forum, Colorado Clinical Guidelines Collaborative, Colorado Department of Public Health and Environment, Colorado Medical Society, Colorado Tobacco Education and Prevention Alliance, National Association of Hispanic Nurses, Colorado, National Jewish Health and the University of Colorado Denver Center for Behavioral Health and Wellness.

For more information, see web link:
Colorado Department of Health Care Policy and Financing Press Release September 10, 2009


Washington State Smoking Rates Dip to All-Time Low

New statistics from the Washington State Health Department suggest that the state's smoking rate has dropped for the sixth consecutive year, giving the state the sixth lowest adult smoking rate in the United States, the Associated Press reports.

According to the survey, Washington's smoking rate has declined to 15.3 percent, representing a 16.5 percent reduction from 2008 figures and helping the state achieve ahead of schedule its goal of reducing the state's smoking rate to 16.5 percent or lower by 2010. According to a release, the nation's average smoking rate is 18.4 percent. The health department attributes the decline to its comprehensive Tobacco Prevention and Control Program.

Since launching in 2000, the program has reduced the state's smoking rate by more than 30 percent, representing about 295,000 fewer smokers. The state has now established a new goal of reducing the adult smoking rate to 14 percent or lower by 2013. To achieve the goal, the state is refocusing its smoking prevention and cessation efforts on populations that continue to smoke at higher rates, including those from lower-income or lower-educational backgrounds. Specifically, the health department will target such populations through programs such as Women, Infants, and Children and Head Start.

In addition, the health department will continue to run its Dear Me campaign, which features state residents who smoke writing a letter to themselves about their struggle to quit. The campaign directs viewers to the Washington State Tobacco Quit Line or to for free smoking cessation support.

For more information, see web link:
RWJF Public Health Digest September 8, 2009


Campaign Salutes Avis and Budget Rent-A-Car for Going Smoke-Free

Avis Rent-A-Car's famous advertising slogan "We Try Harder" was never more apt than it is right now. The Campaign for Tobacco-Free Kids applauds Avis Budget Group, Inc. for its announcement that beginning October 1st, 2009, all Avis and Budget rental vehicles in the United States and Canada will be smoke-free.

By prohibiting smoking in its entire North American rental fleet, Avis will not only be saving on cleaning costs, it will be making renting a car a healthier and far more pleasurable experience for its customers.

In ridding Avis and Budget rental cars of the 4000 chemicals, including over 60 carcinogens, in secondhand smoke, Avis is protecting the rights of all of its customers to breathe clean air. A recent study by researchers at the Johns Hopkins Bloomberg School of Public Health concluded that concentrations of secondhand smoke are significantly higher in cars than concentrations generally measured in bars, restaurants and other public places that allow smoking. In addition, residues from secondhand smoke can remain on cushions and fabrics long after secondhand smoke has cleared.

Avis Budget Group Inc. obviously cares about its customers .They do Try Harder. We hope Avis's announcement will spur other rental car companies to follow Avis's lead and make their rental fleets smoke-free as well. It will make renting a car a far healthier and far more pleasurable experience for all consumers.

For more information, see web link:
Campaign for Tobacco-Free Kids Press Release September 3, 2009


Connecticut Cigarette Tax Increase Delivers Victory for Kids and Taxpayers

Connecticut's leaders have taken decisive action to protect the state's kids and taxpayers from the devastating toll of tobacco use by increasing the state cigarette tax by $1 to $3.00 per pack, making it the second highest state cigarette tax in the nation (Rhode Island's tax is $3.46 per pack). Connecticut is also increasing its tax rates on most other tobacco products, but they still remain shamefully low compared to the state's exemplary new tax rate on cigarettes. Increased tobacco taxes are a win-win-win solution for Connecticut and every other state — a health win that will reduce tobacco use and save lives, a financial win that will raise revenue to help alleviate budget shortfalls, and a political win that polls show is popular with the voters.

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 more than six percent and overall cigarette consumption by about 4 percent. Connecticut can expect the $1 cigarette tax increase to prevent 24,000 Connecticut kids from becoming addicted adult smokers; spur 10,000 current adult Connecticut smokers to quit for good; save more than 10,500 Connecticut residents from future smoking-caused deaths; lock in more than $520 million future health care savings; and raise about $60 million a year in new state revenue. The tobacco tax increases take effect on October 1.

By failing to raise taxes on other tobacco products to match its new cigarette tax, Connecticut's legislators have chosen not to take advantage of a golden opportunity to raise a lot more money; money that could be used to increase funding for the state's tobacco prevention program and to help provide cessation assistance through the state's Medicaid program. Connecticut continues to be one of the last states to not provide any cessation coverage for its Medicaid recipients, and is still near the bottom of all the states with regard to tobacco prevention funding.

With Connecticut's tax increase, the average state cigarette tax is now $1.34 per pack. Connecticut is the second state with a cigarette tax of $3 or more, Rhode Island being the first. Fourteen states and the District of Columbia will now have cigarette tax rates of $2 per pack or more, and 26 states and DC have cigarette tax rates of $1 per pack or more. South Carolina remains the lowest-tax state with a cigarette tax of only seven cents per pack. Only four states have failed to raise their cigarette tax since 2000: California (1999), Missouri (1993), North Dakota (1993) and South Carolina (1977).

For more information, see web link:
Campaign for Tobacco Free Kids News Release September 2, 2009


American Legacy Foundation® Remembers Senator Edward M. Kennedy: A Crusader for Public Health

Statement by Cheryl G. Healton, Dr PH, President and CEO

Senator Edward M. Kennedy was a towering figure in the United States Senate for more than 40 years, fighting for many important issues, but top among them were public health and social justice.

Senator Kennedy fully understood the public health epidemic of tobacco use and fought at every opportunity to protect Americans from this devastating epidemic, which is the nation’s number-one preventable cause of death.

Despite his own health struggles this year, Senator Kennedy shepherded the Family Smoking Prevention and Control Act through the United States Senate, which after nearly a decade of work, gave the U.S. Food and Drug Administration the authority to regulate tobacco. His commitment to advancing this legislation was unyielding, even as he battled cancer himself.

Senator Kennedy was also instrumental in the passage of the State Children’s Health Insurance Program Reauthorization Act. This historic piece of legislation, which increased the federal tobacco tax, will have direct life saving benefits, since as the price of cigarettes increases, the number of smokers decreases.

Senator Kennedy’s commitments to making positive change in this country related to tobacco prevention and cessation cannot be overstated and are a prominent part of his legacy. Countless lives are being saved as a result of these recent pieces of legislation and his valiant efforts were critical to their passage. The American Legacy Foundation’s Board of Directors and staff convey their condolences to the Senator’s family, staff and colleagues as the nation mourns his passing.

For more information, see web link:
American Legacy Foundation News Release August 26, 2009


Joint Commission: Most U.S. Hospitals Will Be Smoke-Free in 2009

A new Joint Commission report published in the journal Tobacco Control suggests that an estimated 60 percent of U.S. hospitals will have smoke-free campuses by the end of the year, AHA News Now reports.

Supported by the Robert Wood Johnson Foundation's Substance Abuse Policy and Research Program and the Flight Attendant Medical Research Institute, researchers from the Joint Commission and Detroit-based Henry Ford Health System's Center for Health Promotion and Disease Prevention surveyed 1,916 Joint Commission-accredited hospitals on their current smoking policies and future plans.

The researchers found that, while only 3 percent of hospitals adopted a smoke-free campus in 1992, when the Joint Commission introduced standards requiring accredited hospitals to prohibit smoking within the hospital, more than 45 percent had made their campuses smoke-free by February 2008. Another 15 percent of hospitals were actively taking steps to become smoke-free campuswide. According to the study, nonteaching and nonprofit hospitals were more likely to have smoke-free campuses by February 2008, and private, nonprofit facilities were three times more likely than for-profits to have adopted smoke-free campus policies. The researchers found little relationship, however, between smoke-free hospital campuses and the rate at which hospitals provided smoking-cessation counseling across all patient populations, although hospitals with smoke-free campuses were more likely to provide counseling to patients with acute myocardial infarction, heart failure and pneumonia.

Noting that the study presents the "first systematic evaluation of hospitals" on the issue of smoke-free campuses, the associate director of the Joint Commission's Department of Health Services Research adds that, "from a public health perspective, the benefits of stricter anti-smoking policies are well established." Specifically, the report cites statistics from the Centers for Disease Control and Prevention showing that indirect and direct costs stemming from smoking-related illnesses total approximately $193 billion annually and that cigarette smoking is the leading preventable cause of death in the United States. In addition, cigarette smoking and secondhand smoke result in roughly $96.8 billion in annual productivity losses for the nation

For more information, see web link:
RWJF Public Health Digest August 21, 2009


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