NTCC Outreach around the PHS Guideline Update

NTCC was one of 58 organizations that endorsed the U.S. Public Health Service 2008 Clinical Practice Guideline Update: Treating Tobacco Use and Dependence, which was released May 7, 2008 at the American Medical Association Headquarters in Chicago, IL. As part of its Consumer Demand initiative, NTCC plans to conduct a year-long series of outreach activities to promote the Guideline's recommendations on effective treatments for quitting smoking, to both providers and consumers.

This 2008 Guideline makes several new evidence-based recommendations for quitting smoking, and also strengthens previous ones. For this third edition of the Guideline, a panel of 24 experts reviewed more than 8,700 research articles published since 1975 and found that counseling by itself or especially in conjunction with medication can greatly increase a person's success in quitting. The review found that there are now seven medications approved by the FDA as smoking cessation treatments, including the newly recommended nicotine lozenge and varenicline (Chantix). It also highlights - for the first time - the need to address youth smoking, and that counseling is an effective treatment for helping youth smokers quit.

In addition to supplementing the ongoing promotional outreach of the Guideline to providers, NTCC plans to take a new approach to translating the Guideline recommendations for consumers. Research has shown that misperceptions exist among current smokers about effective methods for quitting smoking, and there is a lack of awareness about which treatment options have been shown to be effective. With the recent release of the 2008 Guideline, NTCC will take the opportunity to promote the concept of evidence-based treatments to consumers, in order to increase the demand for - and use of - these treatments.

"We want to ensure that not a single patient leaves a healthcare visit without receiving evidence-based treatment," said Michael C. Fiore, MD, MPH, chair of the Guideline panel.

As part of its consumer outreach efforts, NTCC will work to develop potential tools and materials, including a Web site; a recognizable treatment graphic; a Consumer Reports-style publication that gives an overview of the recommended quitting methods; and a booklet describing the quitting methods in consumer-friendly language, that includes personal success stories for each method.

In addition to these materials, NTCC will explore different ways to reach consumers by integrating the 2008 Guideline with Legacy's EX campaign, state quitlines, pharmaceutical industry outreach, and possible partnerships with pharmacies (Kroger and others); through media outreach, in both traditional and new media formats (social networking sites, Wikipedia), identifying potential tie-in opportunities, including the Great American Smokeout, New Year's, the planned release of the American Journal of Preventive Medicine Consumer Demand journal supplement, and NCTOH 2009; and by developing template materials that NTCC partners can use in their own outreach activities, including op-eds, news articles and press releases.

To obtain a copy of the U.S. Public Health Service 2008 Clinical Practice Guideline Update: Treating Tobacco Use and Dependence or supporting materials, please visit http://www.surgeongeneral.gov/tobacco/default.htm.

For more information on the NTCC outreach around the Guideline, please contact Jessica Nadeau at jnadeau@aed.org.

To view a webcast of the AMA press event, go to the Robert Wood Johnson Foundation website at http://www.rwjf.org/newsroom/activitydetail.jsp?productid=29591&typeid=108.

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Dr. Michael Fiore, professor of medicine at the University of Wisconsin, founding director University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI), and chair of the PHS Guideline panel

Dr. Michael Fiore is currently professor of medicine at the University of Wisconsin and founding director University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI).

Dr. Fiore is a nationally recognized expert on tobacco, providing perspectives to audiences ranging from Good Morning America to the United States Senate. He has written numerous articles, chapters, and books on cigarette smoking and was a co-author and consulting editor of Reducing Tobacco Use-A Report of the Surgeon General (2000).

Dr. Fiore served as chair of the panel that produced the United States Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence, in 2000 which provides a gold standard for healthcare providers. Currently, he serves as Co-Director of a Robert Wood Johnson Foundation National Program Office, Addressing Tobacco in Managed Care.

Dr. Fiore chaired the U.S. Department of Health and Human Services Subcommittee on Tobacco Cessation of the Interagency Committee on Smoking and Health which produced a comprehensive plan for promoting tobacco cessation in the United States. In July 2003, he was one of five national recipients of the Innovators in Combating Substance Abuse Award from the Robert Wood Johnson Foundation.

Dr. Fiore's chief research and policy focus has been to develop strategies to prompt clinicians and health care systems to intervene with patients who use tobacco. As part of this effort, he spearheaded the concept of expanding the vital signs to include tobacco use status. Recent research shows that 70 percent of physicians now ask patients about their smoking status.

Dr. Fiore was Co-Principal Investigator for a five-year NIH-funded Transdisciplinary Tobacco Use Research Center (TTURC) grant designed to understand tobacco dependence in order to prevent relapse to smoking. In September, 2004, he began his role as co-principal investigator of a second, TTURC grant, seeking to examine tobacco dependence treatment and outcomes with an eye to determining the effectiveness of various treatments and matching those treatments to smokers wishing to quit.

After graduating from Bowdoin College, Dr. Fiore completed medical school at Northwestern University in Chicago and his internal medicine training at Boston City Hospital. His postgraduate education included a Masters of Public Health from Harvard University. Dr. Fiore received additional training as an Epidemic Intelligence Service (EIS) Officer for the United States Centers for Disease Control where he also completed a Preventive Medicine residency program at the United States Office on Smoking and Health before coming to the University of Wisconsin-Madison.

Q1: The new 2008 Clinical Practice Guideline - Treating Tobacco Use and Dependence was released at the beginning of May. What was the impetus for this Guideline update?

The 2008 Guideline is an update of the 2000 U.S. Public Health Service Clinical Practice Guideline. Since that document was released eight years ago, the science regarding the treatment of tobacco dependence has advanced. The 2008 Guideline is based upon a review of 8,700 articles and includes more than 50 meta-analyses - more than any that has ever been done on a public-health topic. The underlying impetus for the 2008 Update was to provide clinicians and health systems with the latest evidence on how to effectively treat the No. 1 cause of preventable disease and death in this country.

Q2: What are some of the important differences between the 2000 Guideline and this update?

This 2008 Guideline makes some new evidence-based recommendations and also strengthens previous ones. The new recommendations include:

• Quitline counseling is effective with diverse populations and has broad reach. Therefore, clinicians and health care delivery systems should both ensure patient access to quitlines and promote quitline use.
• Specific motivational strategies designed to encourage the smoker not yet ready to quit to consider a quit attempt.
• The combination of counseling and medication is more effective than either alone. Adding counseling to medication improves outcomes; adding medication to a counseling program improves outcomes. When at all practical, both should be provided.
• With this Guideline Update, nicotine lozenges and varenicline have been added to the list of effective medications for smoking cessation. The list now stands at seven medications and also includes the nicotine patch, nasal spray, inhaler and gum, and bupropion.

In addition, the Update has strengthened some recommendations. These include:

• For smokers with a history of depression, buproprion SR and nortriptyline are effective.
• Counseling and medication are effective with diverse populations, including racial and ethnic minorities, those with limited education or finances, patients with medical or psychiatric co-morbidities, and LGBT patients.
• Tobacco dependence is a chronic condition that often requires repeated intervention to achieve long-term abstinence. Many patients relapse several times before quitting for good. Clinicians should intervene using the recommended treatments in the Guideline Update, regardless of a smoker's past experience with cessation.
• Recommendation for tobacco cessation counseling is strengthened for:
  • Pregnant smokers
  • Adolescents
  • Spit tobacco users
  • Light smokers
  • However, the Guideline does not recommend medication for these four patient populations.

Q3: What are some changes clinicians will need to make to incorporate the new Guideline into their practice?

The goal is to change clinical culture and practice patterns to ensure that every patient who uses tobacco is identified and offered the evidence-based treatments included in the Guideline Update. Clinicians can take advantage of the brief intervention strategies embodied in the 5A's - Ask, Advise, Assess, Assist and Arrange. Likewise, health systems and clinicians need to implement a charting/documentation system that systematically identifies tobacco users so that the clinician can provide evidence-based treatments.

Q4: What are some ways that NTCC partners can help to promote the Guideline?

The NTCC is a vital link in this effort to reduce the harms resulting from tobacco use in this country. It can and should play an important role to encourage health systems and clinicians to adopt the Guideline recommendations. It can also play a central role in alerting smokers to the availability of these evidence-based recommendations.

Q5: NTCC plans to translate the recommendations in Guideline for consumers and conduct outreach over the next year. What is the potential impact of the Guideline update on the consumers?

Over 40% of all smokers in America try to quit every year. Ultimately, the Guideline is directed towards them - how can individuals who want to quit increase their likelihood of success.

Q6: Are there any promising practices on the horizon that were not included in this update?

While acknowledging the importance of this Guideline, we do need to recognize that additional research is needed. Dr. Sue Curry, one of the 24 Guideline panel members and recently named Dean of the University of Iowa College of Public Health, has emphasized the 100 research needs identified in the Guideline. Some of these include treatments for certain populations with high smoking prevalence rates such as those with low socioeconomic status, some American Indian populations and those with psychiatric and/or substance use disorders. Also needed are studies done in real-world clinical settings, the development of innovative and more effective counseling strategies, and the identification of further treatment options for children, adolescents and young adults.

Q7: How did you get involved in tobacco control?

I am a physician and it was so clear to me early on that smoking was incredibly harmful. I trained at the Boston City Hospital -- where so many of the patients were poor and uninsured. These individuals frequently came to the hospital with diseases that were caused by smoking. In part, this led me to focus on prevention. In the 1980s, I began working for the CDC, including spending time at the United States Office on Smoking and Health.

Q8: You are currently director of the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI). Can you tell us a little about UW-CTRI and the work you do?

Founded in 1992, the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI) combines ground-breaking tobacco research with practical application. Our focus is to understand tobacco dependence and translate that understanding into treatments that help smokers successfully quit.

Q9: What has been the most challenging aspect of your work in tobacco control?

Tobacco use exacts an enormous toll on the health of Americans. In many ways, the decades of statistics describing the dangers of tobacco use have inured us to the personal tragedy of tobacco use. If I am able to bring this personal imperative to treating tobacco dependence, I will view my contribution as meaningful.

Q10: What has been the most rewarding aspect of your work in tobacco control?

I am an optimist by nature. I believe it is possible within our lifetimes to essentially eliminate tobacco dependence from our society. It has taken us 50 years to drop the rate of tobacco use from about 45% in the 1950s to about 20% today. My hope is that we will soon succeed in helping all smokers who want to quit to achieve that goal and to prevent another generation of children from becoming addicted to this deadly drug.

To obtain a copy of the U.S. Public Health Service 2008 Clinical Practice Guideline Update: Treating Tobacco Use and Dependence or supporting materials, please visit http://www.surgeongeneral.gov/tobacco/default.htm.

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Free & Clear® Reports Record Breaking Tobacco Quit Rates

Free & Clear, Inc., the national leader in evidence-based tobacco cessation programs delivered via the phone and internet, announced record breaking tobacco quit rates among Quit For Life Program participants during the first quarter of 2008. Results of a follow-up survey of individuals six months after registering with the program showed 44.5 percent were tobacco free, compared with 39.8 percent in the fourth quarter of 2007.

First quarter quit rates are the highest quit rates Free & Clear has achieved in over 20 years conducting the Quit For Life Program, which has helped more than 200,000 people quit tobacco. In addition to the higher quit rates, program satisfaction among participants was 92.8 percent.

Over a dozen of Free & Clear's clients also reported record quit rates during the first quarter. Clients that experienced their highest ever quit rates included Regence, PacificSource, Anthem's Lumenos® product, UPS, Uniform Medical Plan (UMP) and the South Carolina Employee Insurance Program (SCEIP) serving South Carolina state employees. PacificSource reported record results, the company's highest ever. Anthem's Lumenos® product, UPS and SCEIP improved their quit rates by five percentage points, while UMP improved its quit rate by approximately ten percentage points and Regence by approximately 15 percentage points.

"We are extremely pleased with our results during the first quarter," said Dr. Susan Zbikowski, Free & Clear's Vice President of Clinical and Behavioral Sciences. "Not only are our client quit rates the highest we've ever achieved, they are among the highest in the industry. As the recently released Public Health Service Tobacco Guidelines found, combining medication and counseling is the most effective strategy, and an integrated cessation program like the Quit For Life Program can be incredibly successful in helping individuals quit tobacco for good."

The Quit For Life Program helps people overcome their physical, psychological and behavioral addiction to tobacco using an integrated mix of medication support, phone-based cognitive behavioral coaching and web-based learning and social support. A total of 14,428 program participants were eligible for the six month follow-up survey during the first quarter, and 51.4 percent completed the survey. Analysis of client results was limited to those that had at least 75 program participants completing the survey in the quarter.

For more information, see web link:
BusinessWire, May 21, 2008

Smoking is Addictive, But Quitting is Contagious

In a recent study published in the New England Journal of Medicine, researchers discovered that smoking cessation occurs in network clusters. Those who continue to smoke are increasingly pushed to the periphery of social networks.

These are the findings of a massive longitudinal study spanning 32 years. Through reconstructing the social network of 12,067 individuals, researchers from Harvard Medical School and the University of California/San Diego have discovered that smoking cessation occurs in network clusters and is hardly the isolated decision it might feel like to the individual quitter.

These findings support the claim that the most effective means for public health interventions to reduce smoking are through targeting groups, not individuals. Because we are all interconnected in social networks, our health is interconnected.

"We've found that when you analyze large social networks, entire pockets of people who might not know each other all quit smoking at once," says Nicholas Christakis, MD, PhD, professor in Harvard Medical School's Department of Health Care Policy, who, along with U.C. San Diego researcher James Fowler, PhD, authored the study. "So if there's a change in the zeitgeist of this social network, like a cultural shift, a whole group of people who are connected but who might not know each other all quit together."

Over the last few years, Christakis, who is also a professor of sociology in the Faculty of Arts and Sciences at Harvard University, and Fowler have been analyzing data from the Framingham Heart Study (an ongoing cardiovascular study begun in 1948), recreating the social patterns contained within the study data to see how health correlates with an individual's social network.

Last year, they reported on how obesity spreads through social networks. Using the same data, they decided to analyze smoking cessation trends within that same population.

The first and most striking finding was the discovery that, from the larger network perspective, people quit smoking as groups and not as individuals.

"When you look at the entire network over this 30-year period, you see that the average size of each particular cluster of smokers remains roughly the same," says Fowler. "It's just that there are fewer and fewer of these clusters as time goes on."

They also found that while they were able to quantify the person-to-person effects of smoking cessation among married couples, siblings, friends, and coworkers, they also discovered "quitting cascades" that advanced from person-to-person-to-person.

Christakis illustrates this point by describing a small network containing three individual smokers, persons A, B, and C. The first person, A, is friends with B, and B is friends with C, but A and C do not know each other. If C quits smoking, A's chances of not smoking spike 30 percent, regardless of whether or not B smokes. The middle individual, it would appear, might act as a kind of "carrier" for a social norm. Education also seems to matter. We are more influenced by the quitting behavior of other

s if those people are highly educated. To add a further twist, we are also more influenced by others if we ourselves are more educated.

Says Christakis, "We see by this that the educated are not only more influential, but they are also more easily influenced."

The study, which was funded primarily by the National Institute on Aging, appears in the May 22 issue of the New England Journal of Medicine.

For more information, see web link:
New England Journal of Medicine, 2008, Volume 358, Issue 21

Study Suggests Cool Kids Can Kelp Others Avoid Smoking

Getting the cool kids to talk to their peers about the dangers of smoking cut the number of young people who started using cigarettes in one study by nearly 25 percent, British researchers said.

The study published in the journal Lancet took a different approach than most tobacco cessation programs aimed at youths by asking students to nominate others they viewed as influential or leaders to spread the anti-smoking message.

This peer selection proved more effective than conventional programs and greatly reduced the number of students likely to start smoking, the researchers said.

"The important thing this shows is that young people can help each other from taking up the addictive habit of smoking," said Rona Campbell, a health researcher at the University of Bristol who helped lead the study.

"If the program was taken up widely it could cut the recruitment of new smokers significantly."

Worldwide an estimated 10 percent of students aged 13- to 15-years old smoke cigarettes, with the highest rates in European countries at 19 percent, according to the Global Tobacco Surveillance System.

The study involved nearly 11,000 students aged 12 to 13 in 59 schools across western England and Wales. Of these, 29 schools were randomly selected to continue normal anti-smoking programs and the rest tried the new approach.

The researchers asked them to nominate influential students and then invited these popular students to take part in a training program about the risks of smoking and benefits of not starting.

Children who already smoked could take part as leaders so long as they agreed to try to quit. The leaders spread the information gained in the training informally during everyday conversations and interactions with others.

The results were significant. Students in the peer selection group were 23 percent less likely to start smoking after one year and 15 percent less likely after two years than young people in schools with traditional cessation programs.

This would translate into a potential reduction of 43,000 14- to 15-year olds who take up smoking each year, Campbell said.

Studies also show the damage done by smoking takes decades to accumulate, so people who start young have more health risks later.

For more information, see web link:
Reuters, May 9, 2008

Study Suggests Stronger Tobacco Control Policies in States With High Smoking Rates Would be Effective in Reducing Smoking and Saving Thousands of Lives

According to new research findings published in the Southern Medical Journal, if Kentucky fails to implement and enforce strong tobacco control policies more than 17,000 state residents will needlessly die prematurely from smoking over just the next fifteen to twenty years. Kentucky currently has the highest adult smoking rate in the United States. Kentucky also has weak public policies addressing smoking, with a cigarette tax ranked 46th of all states and tobacco control expenditures ranked 39th among states.

Using a model called SimSmoke, researchers from the Pacific Institute for Research and Evaluation (PIRE) studied the effect such policies can have on future smoking prevalence and smoking-attributable deaths in Kentucky. SimSmoke is a computer simulation of tobacco control policy effects developed by David Levy, Ph.D., the study's author and a senior research scientist at PIRE. The model was developed with Ellen Hahn, DNS, Professor from the University of Kentucky College of Nursing and College of Public Health and Director of the Tobacco Policy Research Program, and staff from the Kentucky Governor's Office of Wellness and Physical Activity, Tobacco Prevention & Cessation Program.

The model examined the impact of tobacco control policies specifically recommended in the Healthy People 2010 goals, a set of health objectives for the nation that includes reducing adult smoking prevalence to 12 percent by 2010. If the United States is to make progress toward reaching those goals, states such as Kentucky with high smoking rates must lower those rates.

If current tobacco policies are maintained, the SimSmoke model estimates that about 7,500 adults will die prematurely from smoking this year alone, and that number will increase in future years. However, when the policies recommended by Healthy People 2010 are implemented, as many as 1,100 deaths may be averted in the year 2020 alone. These include raising the state tax to $2.00 per pack, implementing comprehensive smoke-free policies throughout the state, running well-funded, sustained media campaigns, and providing all smokers access to smoking cessation treatments.

"States with effective tobacco control policies significantly impact smoking rates and save lives. This study specifically shows the positive effect these policies can have in states like Kentucky with high smoking rates and weak tobacco control policies," said Levy.

Hahn said, "Of all the tobacco control policies that we simulated for Kentucky, we found that significant increases in tobacco taxes, clean air laws, and media campaigns would have the greatest potential to reduce smoking prevalence by 2010. Cessation treatment, school education, and youth access policies will play a greater role in later years."

Many states have already implemented strong tobacco control policies. However, if we are going to come close to reaching the Healthy People 2010 goals, those states with high smoking rates and weak tobacco will need to implement strong tobacco control policies. "Kentucky, like many of the other states with high smoking rates, has a considerable historical burden of tobacco production to overcome," said Levy. "But states such as California that have stronger policies indicate that the projections found through the study are attainable."

For more information, see web link:
PRNewsWire, May 5, 2008

Smoking Bans May Reduce Youth Smoking Initiation

In a recent study in the Archives of Pediatrics and Adolescent Medicine, researchers found that local smoke-free restaurant laws may significantly lower youth smoking initiation.

To determine whether smoke-free restaurant laws influence the progression from never smoking to early experimentation and early experimentation to established smoking, researchers conducted a 4-year longitudinal study of youth in 301 Massachusetts communities.

Massachusetts youths aged 12 to 17 years at baseline were interviewed in 2001-2002 and then reinterviewed after 2 and 4 years.

Researchers measured overall progression to established smoking (having smoked =100 cigarettes in one's lifetime), transition from nonsmoking (never having puffed a cigarette) to experimentation, and transition from experimentation to established smoking.

The study found that youths living in towns with a strong restaurant smoking regulation at baseline had significantly lower odds of progressing to established smoking compared with those living in towns with weak regulations. The observed association between strong restaurant smoking regulations and impeded progression to established smoking was entirely due to an effect on the transition from experimentation to established smoking.

For more information, see web link:
Archives of Pediatrics and Adolescent Medicine, 2008, Volume 162, Number 5

Smoking and Smoking Cessation in Relation to Mortality in Women

Women who quit smoking reduce their risk of dying from heart disease and tobacco-related cancers. Researchers at the Harvard School of Public Health analyzed data on 105,000 women over 24 years, taken from the Nurses' Health Study, a long-term survey that began at Harvard in 1976.

Stacey Kenfield, lead author of the report, says the data show harm from smoking can be reversed over time to the level of a non-smoker. "For coronary heart disease for example, your risk declines to a non-smokers' risk within 20 years. For all causes it declines at 20 years. For lung cancer it is after 30 years."

Kenfield says scientists observed almost immediate benefits when the women kicked the habit. "We saw a 47 percent reduction in risk for coronary heart disease within the first five years [of quitting] and a 21 percent reduction in lung cancer death within the first five years."

Kenfield says the data also indicate that smoking is more dangerous the younger a woman is when she starts. "If you start before you are 17, you have a 21-fold higher risk than a non-smoker. But if you start after the age of 26 you only have a 9-fold higher risk of dying from lung cancer."

Based on that evidence, Kenfield recommends high schools offer more programs to help students quit. "If you would like to see the whole potential benefit from your cigarette cessation, you really need to quit as soon as possible."

Tobacco is the leading preventable cause of death in the United States. The World Health Organization attributed 5 million deaths to smoking in 2000. That number is expected to climb to 10 million tobacco-related deaths by 2030. Kenfield's study is published in the Journal of the American Medical Association.

For more information, see web link :
Journal of the American Medical Association, 2008, Volume 299, Issue 17

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Campaign for Tobacco-Free Kids Honors Governor Phil Bredesen For Leadership in Protecting Tennesseans from Dangers of Tobacco Use

On May 20, 2008, the Campaign for Tobacco-Free Kids presented Tennessee Governor Phil Bredesen with its highest honor, the Champion Award, for his leadership in the fight to reduce the devastating toll of tobacco use.

The Champion Award recognizes Governor Bredesen's leadership in proposing, championing, and signing into law a "Tennessee Trifecta" of lifesaving legislation last year - a statewide smoke-free workplace law, a 42-cent increase in the cigarette tax, and new funding for tobacco prevention and cessation programs. In the process, Governor Bredesen made Tennessee a leader among traditional tobacco-growing states and an emerging leader nationally in taking a stand against tobacco use.

Governor Bredesen was recognized at the Campaign's annual awards gala, a gathering of more than 400 government, public health, civic and business leaders to celebrate a year of tremendous progress in the fight against tobacco.

"We applaud Governor Bredesen for his leadership and foresight in enacting a comprehensive strategy to combat the No. 1 preventable cause of death and disease in Tennessee - tobacco use," said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. "Thanks to Governor Bredesen, Tennessee is reducing smoking, saving lives, and lowering smoking-caused health care costs - and, in the process, improving the physical and financial health of Tennesseans for generations to come. Because of Governor Bredesen's leadership, Tennessee is setting an example for its neighbors and the nation."

The Champion Award honors extraordinary leadership in the fight against tobacco use, the leading preventable cause of death in the United States. Previous recipients include U.S. Senators John McCain (R-AZ), Edward Kennedy (D-MA) and Tom Harkin (D-IA); John Seffrin, president of the American Cancer Society; Washington Gov. Christine Gregoire; and District of Columbia Mayor Adrian Fenty.

"Too many Tennesseans die each year from preventable tobacco-related illnesses," said Governor Bredesen. "I believe every citizen deserves the right to go to work, earn a paycheck, eat a meal, and provide for their families without risking their health in the process. The initiatives we passed last year represented the biggest step that any tobacco state has taken to reduce the toll of tobacco on the health and lives of its citizens, and it will ultimately mean healthier living for all the people of Tennessee."

For more information, see web link:
Campaign for Tobacco Free Kids Press Release May 20, 2008

Ohio Tobacco Cessation Programs in Jeopardy

A decision by state lawmakers to raid the Ohio Tobacco Use Prevention and Control Foundation Endowment Fund has area health care professionals and social service providers fired up at the prospect that local efforts aimed at keeping youth from smoking and helping adults quit could go up in smoke.

The Ohio General Assembly recently passed legislation abolishing the Ohio Tobacco Prevention Foundation (OTPF), a nonprofit organization created to reduce tobacco use among Ohioans, and authorizing officials to transfer the bulk of the foundation's assets - $230 million - to the state treasury to help fund the governor's economic stimulus package.

The $1.57 billion plan is expected to create 57,000 jobs statewide, said Keith Dailey, spokesman for Gov. Ted Strickland, who unveiled the Building Ohio Jobs proposal during his State of the State address in February.

"The governor called for a jobs stimulus plan (earlier) this year in response to the national economic downturn that has affected every state and cost the nation jobs. Ohio will invest in job-creating industries, in our communities, in our infrastructure and in our workforce. This bipartisan investment will create new jobs during the next five years while laying the foundation for future economic prosperity," Dailey said.

Officials plan to divert the foundation's remaining assets - $40 million - to the Ohio Department of Health to fund anti-tobacco initiatives.

However, local tobacco education, prevention and cessation programs might not see any of that money after the current fiscal year, which ends June 30, said Karie Cook, tobacco prevention grant project coordinator for the Fairfield County Department of Health.

The agency is part of the Southeastern Ohio Regional Tobacco Consortium, made up of the health departments of Fairfield, Vinton, Hocking, Licking, Perry, Pickaway and Ross counties. The seven-county consortium is one of 45 grantees receiving funding from the OTPF.

The $788,709 community grant enables the SEORTC to fund prevention programs such as stand, a youth-led anti-tobacco movement, and LifeSkills, a school-based tobacco education program targeting sixth-graders, and to offer smoking cessation services at local hospitals and county health departments.

Cook said those programs will cease to exist if ODH is unable or unwilling to fund those initiatives beyond June.

"It would be a shame to see those programs go away. The tobacco companies are spending more than $700 million in the state to market their products. There is no comparison," she said.

Kristopher Weiss, a spokesman for the Ohio Department of Health, said the agency - which spends about $2.6 million annually to pay for anti-tobacco initiatives and smoking ban enforcement efforts - remains committed to reducing tobacco use in the state.

"We have been told that there will be about $40 million made available (to reduce tobacco use), but that money hasn't been made available yet. We hope that any funding we do receive will help to enhance those efforts," he said.

ODH is in the process of reviewing existing tobacco programs such as those offered in Fairfield County to determine which, if any, might receive funding beyond the current fiscal year.

For more information, see web link:
The Newspaper Network of Central Ohio, May 19, 2008

Florida Quitline Calls Hit New Record

Florida's Quitline is experiencing heavy call volume from Floridians who are seeking help in overcoming their tobacco addiction. The Quitline broke two records when it recently received a record of 2,600 calls in one day and 150 calls in one minute. The Quitline has received more than 25,000 calls in the first 16 weeks of 2008, exceeding the total for all of 2007. So far this year, 14,682 new participants have received services through the Quitline compared to 4,858 Floridians in 2007.

Cameron Smith, American Cancer Society Quitline Account Manager, credits the television, radio, print, online and billboard advertising efforts of the Tobacco Free Florida campaign for the increase in calls. "We receive calls as early as 5 a.m. when commuters hear about the Quitline on the radio as they are driving to work." All Tobacco Free Florida campaign ads are tagged with the Quitline phone number and offer for free nicotine replacement therapies for cigarette and smokeless tobacco users.

Anyone 18 or older who calls the state's Quitline is eligible to receive free nicotine replacement therapies in the form of patches, lozenges or gum. Floridians with incomes of less than $45,000 a year can get eight weeks of treatment and those with an income of more than $45,000 can get four weeks' worth. Tobacco users who are uninsured can receive additional weeks of treatment with confirmation of uninsured status.

Smith says the people that have the most success at kicking the habit pair the counseling service with the cessation aides. "When tobacco users call the Quitline, they won't just receive patches or gum.

The counselor will integrate the replacement therapies into an individual quit plan to ensure success." The Florida Quitline phone number is 1-877-U-CAN-NOW (1-877-822-6669). Bilingual (English-Spanish) counselors who are specially trained to help tobacco users quit are available twenty-four hours a day, seven days a week. For more information on the Quitline and Tobacco Free Florida, please contact Pam Schultetus at media@tobaccofreeflorida.com or (850) 668-2222.

For more information, see web link:
Tobacco Free Florida News Release, May 15, 2008

DC Council Delivers Victory for Kids and Taxpayers by Doubling the Cigarette Tax to $2 per Pack

The District of Columbia Council has taken a critical step to protect kids and taxpayers from the devastating toll of tobacco use by doubling the District's cigarette tax to $2 per pack.

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 7 percent and overall cigarette consumption by about 4 percent. The District can expect the $1 cigarette tax increase to prevent some 4,100 DC kids alive today from smoking; spur 3,100 DC smokers to quit for good; save 2,100 DC residents from smoking-caused deaths; produce more than $100 million in long-term health care savings; and raise about $11.7 million a year in new revenue.

Tobacco use is the leading preventable cause of death and disease in the District of Columbia, claiming more than 700 lives each year and costing the state $243 million annually in health care bills, including $78 million in Medicaid payments alone. Government expenditures related to tobacco amount to a hidden tax of $605 each year on every DC household. Currently, 9.2 percent of DC high school students smoke, and 500 more kids become regular smokers every year.

With the DC increase, the average state cigarette tax will be $1.16 per pack. Since January 1, 2002, 43 states and the District of Columbia have increased cigarette taxes, some more than once. Ten states and DC now have cigarette taxes of $2 or more.

For more information, see web link:
Campaign for Tobacco Free Kids Press Release May 14, 2008

Anesthesiologists Help Patients Extinguish Smoking Habits

In the United States, an estimated 25.9 million men (23.9 percent) and 20.7 million women (18.1 percent) are smokers. In spite of decades of dire warnings about the dangers of tobacco use, people of all ages continue to use cigarettes and other tobacco products.

In response to the continuing tobacco epidemic, the American Society of Anesthesiologists (ASA) formed a Smoking Cessation Initiative Task Force in 2006. ASA Member David O. Warner, M.D., an anesthesiologist at the Mayo Clinic, heads the nine-person smoking task force on behalf of ASA.

Dr. Warner explains how the ASA initiative differs from the numerous other "Stop Smoking" programs available today. "The focus of the ASA initiative is not only on the long-term benefits of not smoking, but also on the benefits of not smoking as long as possible before and after surgery. Smokers require special consideration when undergoing anesthesia for a surgical procedure, because smoking complicates anesthesia management and increases the risks of complications."

As a component of the Smoking Cessation Initiative, ASA is advocating the Ask -Advise -Refer program. This offers physicians practical advice on how to engage their patients in a conversation about their smoking habits and refer them to helpful expert resources, like the national tobacco quit-line, 1-800-Quit- Now. These quit-lines provide free confidential telephone counseling services that are available to all Americans. The ASA task force has developed a variety of resources to help both anesthesiologists and their patients, which can be found on the ASA Web site at: http://www.asahq.org/patientEducation/smoking_cessation.htm.

For more information, see web link:
American Society of Anesthesiologists News Release, May 9, 2008

New Law Allows Arizona's Medicaid Program to Cover Smoking Cessation Treatments

Arizona governor Janet Napolitano recently signed into law a bill allowing the Arizona Health Care Cost Containment System (AHCCCS) to pay for smoking cessation treatments for enrollees.

Until now, Arizona was one of seven states that did not cover smoking cessation programs through their Medicaid programs.

AHCCCS spends about $316 million a year on smoking-related illnesses, or 14 percent of the system's total costs. If fully implemented, this new measure will make AHCCCS eligible to recover nearly 67 percent of those expenses through federal matching funds.

Legislators say the bill will have no financial impact on the state's general fund. It will provide benefits for nicotine replacement therapies and tobacco use medications approved by the U.S. Food and Drug Administration to eligible Medicaid beneficiaries who want to stop smoking.

John Rivers, president and CEO of the Arizona Hospital and Healthcare Association, lauded the legislation.

"It's good fiscal policy because, over the long haul, it will reduce the amount of money the state will have to pay treating smoking-related diseases," Rivers said. "The Legislature and the governor are to be commended for moving Arizona in the right direction."

It is estimated that 36 percent of Medicaid beneficiaries are smokers. The national average is 21 percent, according to the American Cancer Society and the Centers for Disease Control and Prevention.

Sen. Barbara Leff, R-Paradise Valley, who introduced the bill said she introduced it because the $316 million in medical expenses for smoking-related illness is paid by taxpayers.

"Getting people off tobacco will result in a savings for the state and an improvement in the lives of the people served by AHCCCS," she said.

For more information, see web link:
Phoenix Business Journal, April 30, 2008

Nicotine Patch Inventor Dies

Dr. Murray Jarvik, a pioneer researcher of smoking addition and co-inventor of the nicotine patch, has died. He was 84.

Dr. Jarvik died on May 8 at his home in Santa Monica, California, after a long struggle with congestive heart failure, said Mark Wheeler, a Health Sciences spokesman at the University of California, Los Angeles (UCLA).

In the early 1990s, Dr. Jarvik, a UCLA professor of psychiatry and pharmacology, and Jed Rose, then a UCLA postdoctoral fellow and currently the director of the Center for Nicotine and Smoking Cessation Research at Duke University, invented a transdermal patch that delivers nicotine directly into the body to help smokers fight the urge to light up.

Dr. Jarvik's research into the absorption of tobacco through the skin began with studies of farmhands who harvest it.

When Jarvik and Rose could not get approval to run experiments on human subjects, they decided to test their idea on themselves.

"We put the tobacco on our skin and waited to see what would happen," Jarvik recalled in an article in UCLA Magazine.

"Our heart rates increased, adrenaline began pumping, all the things that happen to smokers."

Dr. Rose, his brother and Dr. Jarvik subsequently published two studies, one in 1984, which reported nicotine could be absorbed through the skin, and a second in 1985, reporting that nicotine under the skin could reduce cravings in smokers.

The three men applied for a nicotine patch patent in 1988; it was granted in 1990.

In 1992, the patch became available in the U.S. by prescription for smoking cessation. It was approved for over-the-counter sale four years later.

"It is strange that people should go to such lengths to burn and then inhale some vegetable matter," Dr. Jarvik wrote in an introduction to a 1977 report for the National Institute on Drug Abuse, "Research on Smoking Behavior." "We must find out what is rewarding about it."

For more information, see web link:
The Press Association, May 10, 2008

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