Consumer Demand Profile: Chantix, New Addition to the 2008 PHS Guideline

Several new evidence-based recommendations for quitting smoking, outlined in the U.S. Public Health Service's 2008 Clinical Practice Guideline Update: Treating Tobacco Use and Dependence last month, are being promoted to healthcare providers with the goal of reaching consumers. Varenicline (Chantix) is one of the seven medications approved by the FDA as smoking cessation treatments, and it appeared in the recent Guideline update for the first time.

Recently, however, consumer demand for medications proven to help smokers quit has reportedly decreased due to questions surrounding the safety of prescription smoking cessation medications. A recent survey found that these reports have raised safety concerns and caused confusion among a significant percentage of smokers who are aware of the issues, and has left them reluctant to quit. According to the survey, almost half (48 percent) of aware smokers have decided to avoid using medications that help people quit. Two-thirds of aware smokers surveyed (67 percent) incorrectly attributed safety news around a specific prescription cessation medication to other cessation aids, such as over-the-counter (OTC) nicotine replacement therapy.

In light of the reported confusion around prescription cessation medications and the new inclusion of Chantix in the recent Guideline update, Chantix is profiled below.

What is Chantix and how does it work?
Chantix is a prescription pill that contains an active ingredient that binds to the same receptors in the brain as nicotine. Chantix, however, is different from other smoking cessation products in that it contains no nicotine. When the active ingredient binds to and activates the brain receptors, it causes a reduced release of dopamine compared to nicotine, and produces a partial stimulation. This helps reduce the cravings associated with nicotine withdrawal. Chantix also blocks and prevents nicotine from binding to these receptors. So if a person smokes, he or she won't derive the same pleasure from it.

What research has been published on Chantix?
There were two pivotal trials published in 2006 in the Journal of the American Medical Association on which the FDA based its approval of Chantix. Both studies compared Chantix to bupropion (Zyban) and a placebo. The studies found that at end of 12 weeks of treatment, 44% were able to quit smoking with Chantix compared to 30% on Zyban, and 18% with a placebo. New research studies are currently in progress that are looking at the use of Chantix among expanded populations, including people with medical and psychiatric co-morbidities.

What side effects might someone experience from taking Chantix?
In the research studies cited above, the most common side effects reported with Chantix were nausea (30%) and sleep problems (13%), including an increase in dreaming, more vivid dreams, or remembering dreams more often. It should be noted that only 3% of participants discontinued use of Chantix based on the nausea they experienced, and it usually occurred during the first week of use and then tapered off. The rates for other side effects were all comparable between Chantix and the placebo.

How are the makers of Chantix responding to recent concerns and consumer confusion?
NTCC contacted Pfizer, the company that produces Chantix. According to a Pfizer representative, while recent news reports have mentioned side effects of Chantix, ranging from mood changes to suicidal ideation, and for some users not to take Chantix while operating heavy equipment (e.g., commercial trucks/airplanes), consumers should speak with their healthcare provider to learn about the risks and benefits of Chantix.

Although adverse events have been reported, several research studies have found no significant difference in the rates for psychiatric adverse effects between Chantix and the placebo. The process of nicotine withdrawal itself, no matter how it's done, also can cause unpleasant side effects, including insomnia, depression, anxiety, and irritability.

Chantix labeling was updated to include new safety information to inform patients and caregivers that the patient should stop taking Chantix and contact their healthcare provider immediately if agitation, depressed mood, changes in behavior, suicidal ideation or suicidal behavior occur. It also includes the standard warning that all drugs that act within the central nervous system have about taking care while operating heavy equipment.

Despite the recent safety concerns and confusion around prescription cessation medications, the fact remains that smoking and the resulting long-term health effects are still a serious problem. If current smokers continue to smoke, 50% will die from smoking- related illness. Without some sort of quitting treatment or support, 95% of smokers who attempt to quit will fail.

NTCC plans to develop a consumer fact sheet on Chantix that will be posted on the NTCC Web site and distributed to our partners.

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Recent Safety News about Smoking Cessation Therapies Leaving Smokers Confused, More Reluctant to Quit

There has been recent news regarding the safety of a prescription smoking cessation therapy. A new survey found that this news has raised safety concerns and caused confusion among a significant percentage of smokers who are aware of the issues and has left them reluctant to quit. Moreover, the survey shows many smokers are avoiding medication to aid in their cessation efforts.

The public health stakes are high as tobacco use kills five million people a year. The majority of people who try quitting do so without assistance. Less than five percent of people who try to quit on their own (cold-turkey) are successful long-term. This underscores the need to get people help with medication when quitting smoking in order to address this important public health issue. Quitting with assistance can more than double one's chances of success.

According to the survey, 31 percent of smokers aware of the safety issues said the recent news concerning a prescription stop-smoking medication has affected their decision to quit smoking or delayed their attempt. In addition, almost half (48 percent) of aware smokers have decided to avoid using medications that help people quit. This may be a direct result of incorrectly attributing the safety news to other products. In fact, two-thirds of aware smokers surveyed (67 percent) incorrectly attributed the safety news to other cessation aids, such as over-the-counter (OTC) therapeutic nicotine (TN), which are approved as safe and effective by the U.S. Food and Drug Administration (FDA).

"What's concerning about these findings is that the recent safety news is affecting smokers' decisions to quit. What smokers need to understand is the reports do not involve other smoking cessation aids such as over-the-counter therapeutic nicotine," said Dr. Michael F. Roizen, founder of RealAge, Inc., Chief Wellness Officer and chair of the Wellness Institute at the Cleveland Clinic. "The news has unnecessarily fueled misconceptions about other medications that are proven safe and effective. Therapeutic nicotine products are among the most researched medicines and have saved millions of lives by helping smokers safely quit and significantly reduce their exposure to the risks of cancer and other smoking-related diseases.

TN products, such as Nicorette gum®, NicoDerm patch® and Commit lozenge® have been proven to double the chances of quitting and remaining smoke-free long-term and are far safer than continued smoking. Data from more than 110 clinical trials involving over 40,000 participants and extensive consumer use over more than 20 years have established the safety and efficacy profile of TN when used as directed. TN is designed to relieve withdrawal symptoms by safely and gradually reducing dependence on nicotine, using a natural substance that a smokers body is accustomed to, rather than introducing a new chemical. It can be used safely in patients with specific health conditions, such as diabetes, high blood pressure, lung disease, and existing heart disease.

Other findings among smokers aware of the safety news:

• Half aged 18-29 have delayed a quit attempt .
• 40 percent of men surveyed say the recent news has delayed their attempt to quit.
• 56 percent report feeling confused about the differences and similarities among the products available to help quit attempts.
• 81 percent would be interested in a proven stop-smoking therapy not associated with the news reports they have heard.

TN products are available without a doctor's prescription, in flexible dosing options at 35,000 retail outlets across the U.S. so a smoker who wants to quit doesn't have to wait to see a doctor to get help. For more information on how to quit, smokers can visit Way2Quit.com. Way2Quit is a comprehensive smoking cessation resource; it provides useful information to help smokers better understand what it will take to quit and how they can create an individualized quit plan.

Decline in Cigarette Smoking in U.S. Significantly Offset by Increase in Use of Cigars, Snuff, Roll-Your-Own and Other Tobacco Products

While trends in cigarette smoking and sales have declined in the U.S. for the past decade, sales of non-cigarette tobacco products have been on the rise. Researchers from the Harvard School of Public Health, led by Professor Gregory N. Connolly, director of the Tobacco Control Research Program at HSPH, and Hillel Alpert, research associate in the program, sought to compare trends in sales of all tobacco products in the U.S. and found that 30 percent of the recent decline in cigarette sales may be offset by the robust sale of small cigars, snuff and roll-your-own products. Thus, the apparent magnitude of overall decline in tobacco use in the U.S. may be illusory. The comparative research of tobacco sales of all kinds across the past decade is published in the June 11, 2008 issue of the Journal of the American Medical Association. It is the first study to examine concurrent sales of cigarettes and other tobacco products.

The major factor in the apparent switch to non-cigarette products by smokers appears to be price -- with the federal tax on other forms of tobacco 1/10th that of cigarettes -- and the heavy attention given to campaigning against cigarette use but not against other forms of tobacco products in recent years. Price increases have proven to be the single most effective form of curbing tobacco use in the U.S. population. According to the National Cancer Institute, in the U.S. smoking-related illnesses account for an estimated 438,000 deaths each year. An estimated 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) in the U.S. are smokers, according to the American Heart Association.

"Tobacco kills, no matter if it's in a cigarette, a cigar, a snuff can or a roll-your-own," said Connolly. "Lower federal and state taxes on these non-cigarette products is keeping tobacco addiction "affordable" and encouraging preventable disease and death. All forms of tobacco should be taxed equally, and state campaigns to curb tobacco use should address this loophole for death."

Since 1998, tobacco sales in the U.S. have declined by 2 percent a year, which has been hailed as an indicator that smoking itself is on the decline. Overall, cigarette sales declined 18 percent from 21.1 billion packs in 2000 to 17.4 billion packs in 2007. During the same interval sales of other tobacco products increased by 1.10 billion cigarette pack equivalents (CPE's) an estimate based on the products' tobacco and nicotine content (714 million moist snuff, 256 million roll-your-own tobacco, 130 million small cigars). Figures were obtained from The Alcohol and Tobacco Tax and Trade Bureau, the U.S. Department of Agriculture and from The Tax Burden on Tobacco report. Nicotine ratings were obtained from the Massachusetts Department of Public Health filed by tobacco manufacturers under Massachusetts law.

"Cigarette companies are responding to the changing pattern of consumption," write the researchers, "by entering other tobacco markets, including acquisition of major U.S. moist snuff manufacturer Conwood by R.J. Reynolds, and by marketing new snuff and snus products to attract new smokers and new tobacco users." Snus is a moist tobacco powder placed under the upper lip. "Cigars, roll-your-own and smokeless tobacco products are generally priced lower than cigarettes," they write. "The weekly cost for a typical user of a premium moist-snuff brand is 55 percent less than for a typical cigarette smoker. State and federal cigarette taxation policies appear to have been effective in reducing smoking, but small cigars and roll-your-own tobacco are taxed at 5 percent to 10 percent the rate of cigarettes, resulting in prices much less than an equivalent pack of cigarettes. These findings should be considered in future policy decisions meant to curb smoking."

Funding was provided by the American Legacy Foundation. The research letter "Trends in the Use of Tobacco Products 2000 - 2007" appears in JAMA June 11, 2008, Volume 299, Number 22.

For more information, see web link:
Harvard School of Public Health Press Release June 10, 2008

Free & Clear® Analysis Shows Workplace Smoking-Cessation Incentives Work

A healthcare premium differential is just one example of a workplace incentive employers are using to encourage healthy lifestyles and to get employees to quit smoking. Smoking cessation in the workplace is a hot topic in the media, but until now there hasn't been any proof that incentives to encourage people to quit smoking actually improve cessation rates.

Free & Clear, Inc., the national leader in evidence-based tobacco-cessation programs delivered via the phone and internet, announced results of a 2007 analysis of cessation outcomes. The analysis, which was conducted among more than 1,150 participants, found that quit rates of employer programs exceeded 40 percent and that employer programs that included premium differentials and/or other incentives, which are generally incorporated into comprehensive cessation programs, had the highest quit rates, 50 percent higher than clients without incentives.

To date, this is the first real-world evaluation that shows how incentives as part of a comprehensive worksite tobacco-control effort that includes the availability of phone-based counseling, can positively impact quit rates.

"An increasing number of employers are directly funding tobacco-cessation programs," said Dr. Susan Zbikowski, Free & Clear's Vice President of Clinical and Behavioral Sciences. "Employer-funded cessation programs are very successful. The results of this analysis provide evidence that incentives are successful as part of a comprehensive tobacco-control strategy used by employers.

"A number of Free & Clear clients incorporate incentives into their tobacco-cessation programming. Employers focused on providing employees with a comprehensive cessation program generally include a variety of tactics, including policies for a smoke-free worksite, access to free intensive counseling services and medication, premium differentials and other incentives for engaging in, and/or completing, the program.

"Nearly 30 percent of Free & Clear's clients implement some kind of incentive to get people to quit tobacco," said Mary Kate Salley, Free & Clear's Senior Vice President of Client Services. "Given the data we now have showing how much more effective a comprehensive approach can be, other organizations might benefit from incorporating additional tactics such as incentives into their tobacco-cessation strategy.

Free & Clear's Quit For Life® Program helps people overcome their addiction to tobacco using a combination of phone-based cognitive behavioral coaching, medication support and web-based learning and social support. The Quit For Life Program has helped more than 200,000 Americans successfully quit smoking since 2004, translating to over two million years of life added and $1 billion in cost savings. Free & Clear's Quit For Life Program is currently offered by over 200 employer, health plan and government clients.

For more information, see web link:
Businesswire June 9, 2008

New Poll: Voters Strongly Support FDA Regulation of Tobacco, Say It Would Be Important Accomplishment for Congress

A new national poll released finds that voters strongly support legislation to grant the U.S. Food and Drug Administration (FDA) authority over tobacco products and also believe it would be an important accomplishment for Congress. The poll finds that 70 percent of voters support Congress passing the legislation and 73 percent believe passage of the legislation would be an important accomplishment. FDA regulation of tobacco is supported across political lines, geographic regions and even by a majority of smokers. The poll found support from:

• Strong majorities of Republicans (66 percent), Democrats (76 percent) and Independents (67 percent);
• Voters in the Northeast (77 percent), Midwest (72 percent), South (69 percent) and West (63 percent); and
• Current/occasional smokers (62 percent), former smokers (76 percent) and those who have never smoked (72 percent).

"Across the nation, there is broad, bipartisan support for FDA regulation of tobacco products," said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. "There are few issues before Congress on which you'd find such strong consensus across regions and across party lines. Americans agree that it's time for Congress to address the nation's number one preventable cause of death and end the deadly status quo that allows tobacco companies to target our children and mislead the public." Support for FDA regulation of tobacco climbs even higher (81 percent) when voters hear specific provisions of the bill. The poll shows:

• 92 percent support restricting tobacco sales to children by requiring ID checks for younger buyers and fining retailers who sell tobacco to minors.
• 88 percent support restricting tobacco marketing aimed at children such as limiting advertising in magazines with a large percentage of readers under age 18.
• 85 percent support requiring tobacco companies to take measures, when scientifically possible, to make cigarettes less harmful.
• 84 percent support preventing tobacco companies from making claims that some products are less harmful than others unless the FDA determines those claims are true.
• 77 percent support requiring the reduction or removal of harmful ingredients, including nicotine, from tobacco products.

The poll also found that nearly half of the electorate (49 percent) would have a more favorable opinion of Congress if it passes legislation giving the FDA authority over tobacco, while only 12 percent would have a less favorable opinion. Three out of four voters (77 percent) say that it is important that Congress pass the FDA legislation. A report by the Institute of Medicine (IOM) concluded that in order for the United States to dramatically reduce tobacco use as a significant public health problem, it is essential to provide FDA authority over tobacco products. As the IOM concluded, "The time has come for Congress to exercise its acknowledged authority to regulate the production, marketing and distribution of tobacco products

For more information, see web link:
Campaign for Tobacco Free Kids News Release June 6, 2008

Free & Clear® Data Shows Effectiveness of Chantix™ When Used in Combination with Phone-Based Behavioral Counseling

Free & Clear, Inc., the national leader in evidence-based tobacco cessation programs delivered via the phone and internet, released an analysis of data from nearly 8000 participants that shows Varenicline, marketed as Chantix, is an effective tool for quitting tobacco when used in conjunction with intensive phone-based behavioral counseling. An analysis of Free & Clear's Quit For Life® Program data showed that the use of Chantix in combination with behavioral counseling provides the highest average quit rate, as measured six months post-registration (50.11 percent) after 30 days, compared to bupropion SR (43.7 percent), patches (42.8 percent), nicotine gum (45.4 percent) and nicotine lozenge (44.3 percent). Overall satisfaction with the program among participants who used Chantix was 93 percent, a comparable level to participants using other medications.

Quit For Life Program participants who used Chantix completed more counseling calls on average than participants who used alternate medications. The analysis also shows that higher numbers of counseling calls resulted in higher quit rates - participants using Chantix who completed five or more calls had an average quit rate of 61.5 percent, versus 42.1 percent for those taking one to two counseling calls. Participants using medications other than Chantix had a quit rate of 53.4 percent with five or more calls, which dropped to 32.7 percent for one to two calls.

Participants in the Quit For Life Program are responsible for making their own prescription and over-the-counter medication choices after being provided with decision support by their Free & Clear Quit Coach® and discussing treatment options with their physician. Depending on coverage, participants may choose from up to seven different kinds of medications, of which Chantix is one option.

"Free & Clear has one of the largest real-world outcomes databases on Chantix use available; currently one-third of Quit For Life Program participants use Chantix. Since becoming available in 2006, Chantix has become one of the most commonly used medications in the program, even surpassing the previously most common nicotine patch," said Dr. Susan Zbikowski, Free & Clear's Vice President of Clinical and Behavioral Sciences. "According to our analysis, Chantix is an effective tool for tobacco cessation when used in combination with intensive phone-based behavioral counseling.

The U.S. Public Health Service's Clinical Practice Guideline Treating Tobacco Use and Dependence also recommends a combination treatment plan of medication and intensive counseling as the most effective method for quitting tobacco. According to the Guideline, "the combination of counseling and medication is more effective than either alone. Thus, clinicians should encourage all individuals making a quit attempt to use both counseling and medication."

For more information, see web link:
Bussinesswire June 5, 2008

Genes May Play Role in Quitting Smoking

The ability to kick the smoking habit may have a lot to do with genetic make-up, a new study finds.

Researchers have found gene patterns that influence a smoker's response to specific smoking-cessation treatments. The researchers identified several genetic variations that appear to indicate the likelihood of success or failure with nicotine replacement therapy and the smoking-cessation drug bupropion (Zyban).

"There is a significant chunk of evidence that the ability to quit smoking has inheritable components," said lead researcher Dr. George R. Uhl, chief of the molecular neurobiology research branch at the National Institute on Drug Abuse.

"There is no single gene that has variants related to smoking," Uhl said. "There is no gene that even has a large effect. But nevertheless, we have identified a number of different genes that are all contributors to the individual differences in the ability to quit smoking."

The findings were published in the June issue of the Archives of General Psychiatry.

For the study, Uhl's team analyzed the DNA of 550 smokers who were part of smoking-cessation studies. These people had been randomly assigned to receive either nicotine replacement therapy; the antidepressant Zyban, which has been found to help people quit smoking; or a placebo.

The researchers found 41 gene variants linked to smokers who successfully quit using nicotine replacement therapy, and 26 genes that were specific to successful quitting with Zyban.

Uhl said these genetic variants alone aren't enough to predict successful treatment to quit smoking. And, the specific role these genes play still isn't clear, he said. But, the findings do explain why different people respond to different smoking-cessation treatments, Uhl said.

"We are now trying to use this information, in new studies of people who are trying to quit, to see if we can increase the power of the approaches to smoking cessation," Uhl said. "We want to target smokers with what would be the best way to help them quit."

In the future, knowing which smokers are more likely to respond to specific treatments would help tailor treatment to individual needs, Uhl said.

Dr. Norman H. Edelman, scientific consultant to the American Lung Association, said he thinks that using genetic information to help people quit smoking is still far in the future. "There are a lot of powerful tools now that let people go on fishing expeditions for genetic linkages, and you're always going to find something," he said. "The fact that they found the few genes that correlate with whether you're successful in smoking cessation is not surprising. Your ability to quit is going to depend at least somewhat on your genetic background."

There may be value in being able to determine who will respond best to individual treatments, Edelman said.

"I don't think this is going to be used clinically anytime soon, but it's of some interest that they could make a distinction about who responds to which treatments," he said.

For more information, see web link:
The Washington Post, June 3, 2008

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MLB's Marlins, Rays Team Up to Fight Tobacco Use

The Tampa Bay Rays and the Florida Marlins are leading a campaign to educate Florida residents about the hazards of tobacco use. Players from both baseball teams have appeared in anti-tobacco television spots that have aired both in the stadium and on television statewide.

The partnership is a product of Tobacco Free Florida, which has collaborated with FSN Florida/Sun Sports to spread awareness of smoking and smokeless tobacco prevention and cessation.

Tobacco Free Florida is an initiative started by the Florida Department of Health, which has noted an increase in call volume to its Quitline and credits this to the campaign featuring the Rays and the Marlins.

For more information, see web link:
Triangle Business Journal, June 19, 2008

High N.Y. Tax Seen as Kick for Smokers to Quit

New York state is declaring its highest-in-the-nation cigarette tax a success.

The number of calls to the state's Smokers' Quitline quadrupled to nearly 10,000 calls during the week of June 2, when the full $2.75-a-pack tax kicked in, New York Health Commissioner Richard Daines said.

Fewer than 2,300 people called for help during the same week in 2007.

Smokers calling the Quitline (1-866-NY-QUITS) requested nearly 7,900 kits the week the new tax was introduced, compared with 1,722 requested the same time last year.

"Not everyone that tries, quits," Daines said. "We estimate 140,000 New Yorkers will successfully quit smoking. We may have more than a million try to cut down or stop, but this is how you get people to try: give them multiple chances and multiple reasons to stop."

The increase that took effect June 3 sent the tax from $1.25 to $2.75 per pack.

In most of the state, cigarettes range from $6 to $8 a pack, depending on brand and store price. They can cost as much as $10 a pack in New York City, which has its own tax.

New Jersey has the next-highest cigarette tax, at nearly $2.58 per pack. Missouri has the cheapest tax in the nation, at 17 cents per pack, although individual counties and cities can impose an additional tax of 4 cents to 7 cents, according to the Federation of Tax Administrators.

For more information, see web link:
USAToday June 16, 2008

North American Quitline Consortium Releases Policy Playbook

The North American Quitline Consortium (NAQC) has announced a new resource-the NAQC Policy Playbook, an online guide to promoting quitlines during policy changes.

Recognizing the impact of smokefree policies and tax increases on quitline usage, NAQC created the Policy Playbook to assist quitlines and advocates with efforts to promote quitline services during the implementation phase of new smokefree policies and the period leading up to and following a tobacco tax increase.

The project was funded by the Robert Wood Johnson Foundation to strengthen the linkages of quitlines and other tobacco control policy efforts. The Policy Playbook can be accessed on NAQC's Web site at http://www.naquitline.org/playbook/.

For more information, see web link:
NAQC Press Information

North American Quitline Consortium Releases Fact Sheet on Link Between Quitlines and Chronic Disease Programs

The Growing Link Between Quitlines and Chronic Disease, a new fact sheet from the North American Quitline Consortium (NAQC) developed in partnership with the National Association of Chronic Disease Directors (NACDD), features the results of an online survey administered to all state-funded quitlines to learn about current linkages between quitlines and chronic disease programs, rationale for developing linkages, challenges to working together and measured impacts and lessons learned so far.

The development of this fact sheet was supported by the Centers for Disease Control and Prevention, American Legacy Foundation and the National Association of Chronic Disease Directors. The Fact Sheet can be downloaded from NAQC's Web site at http://www.naquitline.org/pdfs/FactSheet-ChronicDisease.pdf.

For more information, see web link:
NAQC Press Information

New York's Two 'Top Docs' Urge New Yorkers to Quit Smoking as New Cigarette Tax Goes into Effect

State Health Commissioner Dr. Richard F. Daines and City Health Commissioner Dr. Thomas R. Frieden jointly urged New Yorkers to quit smoking rather than pay an extra $1.25 per pack in state cigarette tax that took effect on June 3, 2008 . The state tax on a pack of cigarettes now totals $2.75. New York City has an additional $1.50 tax bringing its total tax to $4.25 per pack - the highest cigarette taxes in the nation. Cigarettes will now cost more than $8 in New York City and more than $6 across the rest of the state.

The two health commissioners spoke on June 3, 2008 at the Children's Museum of Manhattan to acknowledge the enormous benefit this measure will have for today's children and for future generations. Cigarette taxes are the most effective way to reduce smoking because higher prices drive people to quit smoking and prevent younger children from starting smoking.

"Today is a great day in New York because this tax increase will save thousands of lives," said Commissioner Daines, citing data that each increase in state or federal cigarette taxes since the 1950s has been associated with a reduction in cigarette consumption. "Young people are particularly sensitive to price increases. If people don't become addicted to cigarettes as teens, they almost never become smokers later in life.

"Raising the price of cigarettes will help thousands of adults quit and prevent many young people from starting smoking," said Commissioner Frieden. "At a pack a day, smoking is now a $3,000 a year habit in New York City. Quitting now will not only improve your health, but it will save money you can use for yourself or your family, whether it's your kids' college fund, a summer vacation, or whatever else you want."

Both departments are running media campaigns encouraging New Yorkers to use the tax hike as motivation to quit smoking. Governor David A. Paterson proclaimed June 3rd as "New York Quits Smoking Day," urging New Yorkers to take advantage of free cessation assistance and nicotine products from the NYS Smokers Quitline. The state health department launched a "Never a Better Time to Quit" campaign targeting New York State's 2.7 million smokers with print and radio ads. The state is also contributing to a $20 million national "Become an Ex" TV ad campaign sponsored by the American Legacy Foundation.

In the city, Mayor Michael R. Bloomberg proclaimed June 3rd "NYC Quits Day" and the city health department launched television, radio and print ads, and special nicotine patch giveaways to urge New Yorkers to quit smoking. The campaign shows New Yorkers what they are giving up to smoke - from shopping sprees and plasma TVs to day care and health insurance. New Yorkers can visit www.nyc.gov/quitjune3 for more information.

According to the Campaign for Tobacco Free Kids, New York can expect the $1.25 cigarette tax increase to prevent more than 243,000 New York kids alive today from smoking; spur 140,000 New York smokers to quit for good; save more than 37,000 New York residents from smoking-caused deaths; produce more than $5 billion in health care savings over the long term; and raise about $265 million this year in new state revenue.

The New York State Smokers' Quitline is prepared for an increase in calls from smokers seeking help with quitting. The Quitline provides free coaching and quit plans, free nicotine patches, gum and lozenges, free tips and information, and free online help. The Quitline phone number is 1-866-NY-QUITS (1-866-697-8487). Residents of New York City can call 311 to be linked to the Quitline. The web address is www.nysmokefree.com.

Commissioners Daines and Frieden also called on health care providers to talk to their patients who smoke and actively encourage and assist them in quitting.

For more information, see web link:
New York State Department of Health Press Release June 3, 2008

Cigarette Sales in Indiana Dive 17.8 Percent after Tax Hike

Since last July, when Indiana started collecting 99.5 cents instead of 55.5 cents on every pack of cigarettes sold, consumption of tobacco products has plummeted 17.8 percent, state health officials recently announced.

From July 2006 to March 2007, about 457 million packs of cigarettes were sold. Over that same period the next year, about 376 million packs were sold.

Officials had hoped that the tax increase would produce such a result.

"This is exactly what we predicted," said Dr. Judith Monroe, state health commissioner. "We've got to remember that smoking is an addiction . . . not just a bad habit."

The change does not necessarily mean fewer people are smoking. Some people may just be cutting back while others may have quit, state health officials said. But in the past, a decrease in consumption of tobacco products preceded a decrease in the prevalence of smoking.

In recent months, smoking cessation programs have seen an increase in interest. People used to be able to enroll immediately in the smoking classes that the Marion County Health Department offers. Now those classes, which have expanded in size and number, are booked at least a month ahead.

"Everything else is going up. Food is more expensive now. Gas is more expensive now, and people say the one thing I can give up now is smoking," said Liza Sumpter, tobacco control program manager.

The state's free tobacco quit line also has been fielding more calls recently, said Karla Sneegas, executive director of Indiana Tobacco Prevention and Cessation.

Last year the line handled about 200 calls a month. Now, with increased promotion, it's receiving about 400 calls a week.

Five years ago, after the state instituted a 40-cents-a-pack tax increase, a similar drop in consumption occurred, from 742 million packs to 617 million, a drop of 16.8 percent.

Smoking rates in Indiana have decreased in recent years, going from 27.3 percent of the adult population in 2005 to 24.1 percent in 2007.

But Indiana remains in the top 10 states in smoking prevalence.

Sneegas said she hopes this news will spur further decline in the rates.

"We fully expect this trend in reduction in smoking to continue," she said. To encourage others to stop smoking, Indiana Tobacco Prevention and Cessation and the Indiana Department of Health will host their second Quit 2 Win contest, a lottery of prizes totaling $5,000 for those who successfully quit smoking.

More than 5,000 people entered last year's contest.

And Monroe wasn't ruling out any further tobacco tax increases in the future.

"Right now there aren't any plans," she said. "But if I'm answering as a public health official, we need to keep using the tools that work."

For more information, see web link:
The Indianapolis Star, June 3, 2008

The Lung Association Calls for Improved Support to Help Smokers Butt Out for Good

Based on the results of its new report entitled Making Quit Happen: Canada's Challenges to Smoking Cessation, The Lung Association is calling for universally accessible smoking cessation supports for all smokers living in Canada. "Excellent work has been done in Canada to identify smoking cessation approaches that work to help smokers quit; however, these approaches aren't equally available to all smokers," said Dr. Anthony D'Urzo, family physician and director of the Primary Care Lung Clinic in Toronto. "Access to support programs, regardless of whether a person is living in a rural, urban or remote area, should be available to everyone who wants to quit, as well as affordable medications, regardless of a smoker's province or territory of residence."

The report reveals that more than 90 percent of the estimated five million current smokers in Canada want to quit and over half (52 percent) would like to be smoke-free within the next six months. For the 79 percent of smokers who have tried to quit, an average of six quit attempts were reported. "Nicotine addiction is complex," says Dr. D'Urzo. "What works for one smoker will not necessarily work for another."

The report also reveals that most family physicians and allied health professionals feel they have a role to play in their patients' smoking cessation. In contrast, however, less than 20 percent of family physicians (18 percent) and allied health professionals (16 percent) are trained in smoking cessation counseling. In addition, while 92 percent of physicians reported speaking to their patients about the need to stop smoking, only 46 percent of patients agree that the topic has been raised by their family doctor. This disconnect is even more pronounced in remote and rural areas where people do not have full access to cessation supports - online, telephone helpline, group and individual counseling.

"Physicians and other health care providers want to help their patients butt out, so providing the right tools and training for intervention is key to helping in the smoker's journey to stay quit," said Dr. D'Urzo.

For more information, see web link:
Canadian Newswire May 28, 2008

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