February 2007


Research Highlights
Other Cessation News


Research Highlights

Other Cessation News




Correcting the misperceptions about nicotine and NRT

With 2007 less than 2 months old, many of us have already forgotten those promises we made to ourselves on December 31st.  Lose weight.  Save money. Spend more time with family. One of the top resolutions people make every year but fail to realize is to quit smoking.  Smoking cessation success rates are incredibly low whether the attempt is made on January 1st, July 1st or any other day of the year.  NTCC’s work can help to make those attempts a reality and increase successful cessation among tobacco users. NTCC has identified five strategic initiatives for 2007 to promote and support tobacco cessation.

1. Consumer Demand Initiative: Even though most smokers report a desire to quit, many have been slow to adopt products and services proven to help them.  The Consumer Demand Initiative is focused on identifying innovative strategies for increasing the demand for, and the use of, evidence-based tobacco cessation products and services. 

One of the reasons smokers are reluctant to use products like nicotine replacement therapies (NRT) is because of the misperceptions that they have about them. 

  • To help dispel these myths and increase consumer demand, NTCC has developed a fact sheet for use by organizations and professionals that promote tobacco cessation.  The Misperceptions of Nicotine fact sheet will be distributed to partners in a PDF version and a Word version that can be customized for their needs.  This fact sheet will help to ensure that cessation materials contain correct information about nicotine and the role it has in quitting. 

Another way to increase demand for products and services is to develop new options and choices for consumers to assist them in quitting. 

  • This year, AED has teamed with IDEO, a world-renown product design firm, to spur the development and application of new and innovative ideas in tobacco cessation.  Through a grant awarded by the RWJF’s Pioneer Program, organizations will receive funding and apply IDEO’s design process to develop inventive and novel products and services as part of NTCC’s IDEO Design Project.
  • To further disseminate and apply consumer demand concepts and strategies this year, NTCC will be holding its first national consumer demand conference on May 3-4, 2007.  The “Innovations in Building Consumer Demand for Tobacco Cessation Products and Services” conference will convene decision makers and stimulate action on promising ideas and innovations in tobacco cessation products and services. 

2. Health Literacy Initiative:  A multitude of materials and products are available to assist tobacco users in quitting.  But what happens when someone is not able to comprehend the content of the materials or can’t understand how to use the products?  This question touches on an essential issue in health literacy.  Health literacy, which is the ability to obtain, understand, and use health information and services, may be a contributing factor in the lack of use of evidence-based tobacco cessation products and services.  An initial review of some existing materials shows that many of these may not be appropriate for smokers with lower health literacy skills. This year, NTCC has convened a Health Literacy Workgroup to discuss potential ideas on how to address health literacy and tobacco cessation treatment in new and existing products, materials, and activities.

  • To determine the extent and use of low-literacy materials for tobacco cessation, NTCC will collect and catalog existing low-literacy materials and publications on tobacco cessation.  This environmental scan will help NTCC assess how well the field is meeting the needs of lower-literacy smokers who are trying to quit.
  • Although several organizations have released general health literacy recommendations, no specific guidelines currently exist for the development of tobacco cessation materials. Based on existing knowledge, research, and resources, NTCC will work with its members to develop a Health Literacy Guide for organizations to follow in creating low-literacy cessation materials.
  • Non-print forms of media, including radio, television, and multimedia, can be more effective or enhance health message comprehension for low-literate populations.  NTCC and its members will review these materials and learn from the best practices for communicating with low-literate populations. 
  • In addition to these projects, NTCC and its members will create a proposal in response to a recent NIH funding announcement related to research on health literacy concepts & interventions.  This research would help to gain a better understanding of the relationship between cessation and literacy and to inform interventions to address this issue. 

3. New Media Initiative:  Communication has rapidly evolved in the last decade and continues to develop at an accelerated pace.  New media forms including websites, blogs, email, CD/DVDs, mobile phones, and Podcasts have the potential to reach new and expanding audiences. This is an opportunity for NTCC and its partners to determine ways to use these new and emerging technologies to promote tobacco cessation.

Initially, NTCC will review the tobacco cessation content of Wikipedia, an online encyclopedia. Wikipedia is written collaboratively by volunteers, allowing most articles to be changed by almost anyone with access to the Web site. 

  • While research has shown that Wikipedia entries are generally accurate, NTCC has created a Wikipedia taskforce to review and update information on tobacco cessation found there to ensure it is accurate, reliable, and comprehensive. 

4. Provider Outreach Initiative: For many individuals who make resolutions to quit, their health care provider can be an important source of information on tobacco cessation treatment.  In an effort to get more health care providers to take a more active role in promoting cessation with their patients, NTCC will attempt to educate and empower all healthcare professionals, including doctors, nurses, physician assistants, and medical school students, about the important role they can play in tobacco cessation. 

  • In 2007, NTCC will provide and promote a comprehensive web-based list of CME courses for medical professionals that focuses on tobacco cessation and treatment. 
  • NTCC members will also develop an electronic medical records template.  This will encourage physicians and health care professionals to take a more active role in screening their patients for tobacco use.

5. Smoke-free Policies Initiative: Do you live in one of the more than 100 new localities or nine new states that enacted smoke-free laws in 2006?  We hope so. As these policies are implemented, an increased demand for cessation services often is created.

  • NTCC can take advantage of this and develop a smoke-free policy playbook for localities that are implementing smoke-free policies. NTCC will work with its members to create a toolkit to help states prepare for the increased demand for cessation services and manage the greater strain on resources. 
  • In addition to smoke-free initiatives of states, organizations are beginning to adopt smoke-free meeting policies that require large meetings and conferences be held in locations that have enacted smoke-free laws. NTCC will promote existing meeting planning databases and resources to help organizations and companies to plan their meetings and conferences in smoke-free cities.

Through these initiatives, NTCC hopes to make tobacco cessation a reality for the millions that attempt to quit each year. For more information on these initiatives or on the National Tobacco Cessation Collaborative, please contact Todd Phillips at tphillip@aed.org.


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Research Highlights

Use of Cessation Methods Among Smokers Aged 16-24 Years in the US in 2002: Teens not using assisted quit methods to kick the habit

According to data from the 2003 National Youth Smoking Cessation Survey, smokers aged 16–24 years who had ever tried to quit smoking were more likely to make unassisted quit attempts than to use assisted quitting methods.  This study, conducted by the Roswell Park Cancer Institute, found that of the 13 assisted methods recommended by the Public Health Services, only one (talking with a nurse, doctor, or dentist) was used by at least 20% of teens.  Other assisted methods, including calling a quitline, going to a support group and talking with a counselor, were used by less than 5% of this group. The study reported that six of the 11 unassisted methods were used by at least 36% of the respondents.  This includes attempts to quit by decreasing the number of cigarettes smoked (88.3%), not buying cigarettes (56.0%), telling others they no longer smoked (44.5%), and switching to “light” cigarettes (36.1%).

For more information, see web link:
MMWR Weekly December 22, 2006 / 55(50); 1351-1354


Scan of Human Genome May Help Unlock the Genetic Contribution to Tobacco Addiction

Researchers, funded by the National Institute on Drug Abuse, completed the first scan of the human genome to identify genes not previously associated with nicotine addiction.  The findings, published in the online issue of the Journal of Human Molecular Genetics, reinforce the evidence that genetic risk factors contribute to tobacco addiction. The study also focused on genetic variants in previously suspected gene families. Smoking behaviors, including the onset of smoking, smoking persistence (current smoking versus past smoking), and nicotine addiction, cluster in families. Results of this study bring scientists one step closer to understanding why some smokers become addicted to nicotine. Efforts to understand nicotine addiction are important so that new approaches can be developed to reduce tobacco use. Tailoring of smoking cessation medications to an individual's genetic background may significantly increase the efficacy of treatment.

For more information, see web link:
NIDA Researchers Complete Unprecedented Scan of Human
Genome (2006, December 4). NIH News.


Study Finds Going Online Helps Smokers Quit:
Online Support Communities Helped 62 Percent Successfully End the Habit

A study conducted at the University of Maryland’s Robert H. Smith School of Business analyzed the effectiveness of Internet support networks in helping smokers quit.  Despite a body of research examining the effects of social support on quitting smoking, there is limited evidence on the effectiveness of social support provided by online “strangers.”  Given the proliferation of interactive technologies for connecting individuals in electronically mediated environments, it is important to investigate behaviors in these contexts. Researchers investigated how social support provided through an online virtual community influences its members’ smoking cessation behaviors.  They examined the online behavior of 411 Quitnet.com users who were able to get support any time from their quitting partners by visiting the site and posting on the Web forums.
They found that more than 62 percent of respondents reported they successfully abandoned cigarettes after joining a smoking cessation support community. The findings indicate the most effective strategies and offer tips to smokers who want to use an online support community for help quitting.

For more information, see external PDF:
Ma, M & Agarwal, R (2006). With a Little Help from Strangers: Social
Support and Smoking Cessation in Online Communities.


Survey Shows Majority of American Employers Believe They Should Help Employees Quit Smoking  

According to a new survey released by the National Business Group on Health, employers ranked smoking among their top three employee health priorities along with high blood pressure and obesity. Eighty-two percent of employers also thought they should take steps to help employees quit smoking. Most employers believed the best way to encourage smokers to quit is by establishing smoke-free workplaces.  However, more than three-quarters (78 percent) of employees surveyed who work at companies with smoke-free workplaces say the policy is not effective in motivating them to quit. The survey found that employees who smoke most wish that employers would offer access to smoking cessation benefits to help them quit. This key difference between employer and employee perceptions has important implications for the policies employers adopt to help their employees quit smoking.

For more information, see web link:
New National Business Group on Health Survey (2006, December 19). PRNewswire.


State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2005

A study from the Centers for Disease Control and Prevention (CDC) finds that state coverage of proven and effective cessation services for Medicaid recipients is low. Because Medicaid recipients have approximately 38% greater smoking prevalence than the overall U.S. adult population, they are disproportionately affected by tobacco-related disease and disability.  In 2005, 41 states and the District of Columbia offered some sort of coverage for tobacco-dependence treatment including cessation counseling and/or pharmacotherapy while nine states offered no coverage to Medicaid recipients.   The report also found that two-thirds of states (25) required some sort of patient cost sharing which research has found results in decreased use of treatment. Only one state, Oregon, covered all medications approved by the U.S. Food and Drug Administration (FDA) for cessation and all three forms of counseling recommended by Public Health Service clinical practice guidelines. 

For more information, see web link:
MMWR Weekly November 10, 2006 / 55(44);1194-1197


Organization, Financing, Promotion, and Cost of U.S. Quitlines, 2004

A study published in the American Journal of Preventive Medicine finds that tobacco quitlines provide tobacco cessation treatment at a remarkably modest cost. The study, conducted at the University of Wisconsin School of Medicine and Public Health analyzed a survey of the 38 quitlines in operation in 2004 to obtain baseline information about their organization, financing, promotion and cost. The survey, conducted by the North American Quitline Consortium, found that median state quitline operating budgets in 2004 were $500,000 which translates to a median per capita cost of 14 cents and a median cost per adult smoker of 85 cents. In comparison with other medical treatments, the cost is extremely modest when compared with the total economic cost of smoking of $3,931 per year per smoker.

For more information, see web link:
Keller, P et al. (2007).Organization, Financing, Promotion, and Cost of U.S.
Quitlines, 2004. American Journal of Preventive Medicine. 32(1), 32-37.


Nicotine in U.S. cigarettes rising, Harvard study finds

According to a study done at the Harvard School of Public Health, the amount of nicotine that smokers typically inhale per cigarette rose by 11 percent from 1998 to 2005. Researchers analyzed data submitted by major cigarette brands to the Massachusetts Department of Public Health. Nicotine yields rose in cigarettes of each of the four major manufacturers and across all major cigarette market categories. To boost amounts of nicotine inhaled by smokers, cigarette makers intensified the concentration of nicotine in their tobacco and modified cigarette designs to increase the number of puffs per cigarette, the Harvard researchers said.

For more information, see web link
Szep, J Nicotine in U.S. cigarettes rising, Harvard study finds (2007, January 18). Reuters.


In Clue to Addiction, a Brain Injury Halts Smoking

Scientists studying stroke patients reported in the journal Science that an injury to a specific part of the brain called the insula appears to instantly and permanently break a smoking habit. The insula is a prune-size region under the frontal lobes that is thought to register gut feelings and is apparently a critical part of the network that sustains addictive behavior. The findings are based on a small study but it could alter the course of addiction research and help develop new therapies for cessation treatment that focus on this area of the brain.

For more information, see web link:
Carey, B In Clue to Addiction, a Brain Injury Halts Smoking. (2007, January 26).
New York Times.

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Other Cessation News

C-Change and Ad Council partner to promote cancer prevention interventions

C-Change and The Ad Council have partnered to develop and launch a communication strategy that aims at increasing employer health plans’ coverage and employee utilization of cost-effective cancer prevention interventions. The two year initiative will promote the value and ultimate cost-savings associated with the evidence-based prevention and early detection services, including smoking cessation.  The messages will be disseminated to public and private employers, human resources directors, benefits managers, company executives, benefits consultants, and benefits brokers to increase health insurance coverage of the screenings and early detection through employee benefit programs.

Access to cancer prevention services will become increasingly important as the nation’s healthcare cost crises forces employers and insurance providers to make difficult benefits decisions.  A recent report compiled by Milliman consultants, “Cancer Screening: Payer Cost/ Benefit thru Employee Benefits Programs,” demonstrates that covering and promoting established screening recommendations through employer-sponsored programs can be done at a low cost for employee benefit programs.

For more information, see external PDF:
Making the Business Case for Cancer
Prevention and Early Detection, (Fall 2006). e-collaborating


Oprah’s Smoking Challenge Update

Since O, The Oprah Magazine urged its readers to quit smoking in November 2005, hundreds have responded and joined the online quit-smoking community on the message boards. O magazine chose 5 women on the boards who, despite the support, were still smoking. The magazine recruited a professional, Dr. Steven A. Schroeder, professor of medicine at the University of California, San Francisco, and director of its Smoking Cessation Leadership Center. He spoke to the five women on the phone, and suggested a personal cessation plan for each of them, including using nicotine replacement therapy, prescription pharmaceuticals, and behavioral therapy.

For more information, see web link:
O's Smoking Challenge Update, (January 2007). O, The Oprah Magazine


New nicotine product marketed as cigarette alternative

With smoking bans becoming more common, a new nicotine filled hand gel called Nicogel claims to offer a four-hour craving respite.  Billed as a cigarette replacement for times when smoking is inconvenient, over-the-counter Nicogel will be entering the U.S. market on drugstore shelves by the spring.  To some tobacco opponents, a product that focuses more on sustaining than stopping still has health risks. “The most important concern is that using a bridge product like Nicogel may discourage smokers from making a serious attempt at quitting," said Thomas J. Glynn, Ph.D., who spoke for the American Cancer Society. "From a public health perspective that's a very big concern." Some argue that Nicogel hasn't been shown to be effective or safe, unlike nicotine-replacement therapies.  Also, unlike NRT products such as patches, gums, and inhalers that contain pharmaceutical-grade nicotine, Nicogel contains tobacco and therefore could be carcinogenic.

For more information, see web link:
Phend, C. Nicogel in the Hand a Surrogate for Tobacco in the Lungs. (2007, January 12). MedPage Today.


Obama Quitting Smoking with Nicorette

After struggling to quit smoking in the past, Sen. Barack Obama is trying again.  In an interview with the Chicago Tribune, Obama (D-Ill.) said he resolved to quit his cigarette habit over the winter holidays, just weeks before his expected presidential campaign would make photographers and reporters an even more regular part of his life.  He said that although he has never been a heavy smoker, he has quit for periods over the last several years but then slipped back into the habit. On the cusp of a potential presidential bid seemed the right time to quit for good, he said. "I've never been a heavy smoker," Obama told the Chicago Tribune. "I've quit periodically over the last several years. I've got an ironclad demand from my wife that in the stresses of the campaign I don't succumb. I've been chewing Nicorette strenuously."

For more information, see web link:
Tapper, J. Obama to Quit -- Smoking, That Is. (2007, February 7). ABC News.


Oprah Promotes 1-800-QUIT-NOW

AQC learned this week that the March 2007 issue of O, The Oprah Magazine lists 1-800-QUIT-NOW as one of 5 must-have numbers on speed dial. The plug for QUIT NOW appears in the O Zone section of the magazine. Banyan Communications had pitched the number to the magazine in the fall of 2006, when the groundwork for the 1-800-QUIT-NOW promotions campaign began—the promotion's target audience is among the magazine's readership.

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