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North American Quitline Consortium

June 2014

For quick navigation, please click on the titles below of the topics featured in this month's issue of Connections
  Time-Sensitive News


IMPORTANT - LESS THAN 24 HOURS LEFT TO VOTE! Election of NAQC’s Board of Directors Closes This Week!
Thank you for those who have already cast their votes for the new Board members for FY15! Every vote counts, so please take a few minutes to cast your vote before 5 pm ET on Friday, June 13. If you need assistance with finding your voting portal information, please contact Natalia Gromov at 800-398-5489 or Only organizational representatives are able to vote in the election. 

IMPORTANT: NAQC Membership Drive Is Underway!
Thanks to all NAQC members who have already renewed their memberships for 2014/2015!  Many of you have reached out to us asking for an extension of the membership renewal deadline and to accommodate your requests, we have extended the deadline from July 1 to August 31. To avoid interruption in your membership services, please submit your membership dues (payments are accepted in a form of a check, credit card payment, and online renewal) prior to 5 pm ET on August 31

Staff looks forward to working with you to advance the quitline community. For questions regarding membership, please contact Natalia Gromov at 800-398-5489 ext. 701 or

IMPORTANT! The Perfect Storm:  Support  for  Engaging  Public and Private Insurers  in Covering Quitline Costs!
Engaging public and private insurers to cover quitline costs is an important strategy for increasing the availability of cessation services. In the 2014 CDC Best Practices for Comprehensive Tobacco Control Programs,  CDC encourages states to work with employers and health plans to cover the cost of quitline services  for their  employees and members.   CDC further demonstrated their support in the recent Funding Opportunity Announcement for states, suggesting states consider hiring  full time staff for the purposes of developing  quitline cost sharing  partnerships.

Recently, the Department of Labor, Health and Human Services and the Treasury released FAQs about the Affordable Care Act Implementation - answering questions to assist in the understanding of the new law (see question #5).   These questions included clarification on what health plans and insurers are expected to provide for tobacco cessation coverage.   This clarification  can assist states in  educating health plans and employers on what constitutes comprehensive tobacco cessation coverage and how quitlines can assist them in complying with the law.

The NAQC Public-Private Partnership Initiative  strives to educate and support  states and their partners on how to effectively engage private and public payers to cover the cost of quitline services. If you are interested in exploring, initiating or are in the midst of partnership development and would like assistance with your efforts, please  feel free to contact Deb Osborne, NAQC Public-Private Partnership Manager at

Additionally, please visit the NAQC Public-Private Partnership web page located at   The web page hosts many resources including  staff orientation resources, scopes of work for hiring FTE for partnership development, employer educational materials and  sample stakeholder presentations and much more.   If you can’t find what you are looking for, please contact Deb Osborne at the email address noted  above.

New Postings:
  • Implementation of tobacco cessation coverage under the Affordable Care Act: Understanding how private health insurance policies cover tobacco cessation treatments
  • Power Point Presentation: “ Public-Private Partnerships: Sustaining and Expanding Access to Quitlines”
  • Colorado Letters to Employers and Health Plans (regarding: surveying, meetings, limiting quitline services)
  • Sample SOW for Public-Private Partnership Staff: Colorado Tobacco Cessation Policy Specialist Announcement

IMPORTANT! Upcoming NAQC Resources on e-Cigarettes! 

  • NAQC will share a new publication on e-cigarettes with members in September. The publication will synthesize the research literature on e-cigarettes as well as current practices among QLs  in order to address the most pressing questions for QLs, including: What messages should we be sharing with QL callers about e-cigarette use and dual use? What messages should we be sharing about the importance of quitting e-cigarettes? What approach should QLs take with those who want to quit e-cigarettes? How should we categorize callers who quit cigarettes but continue to use e-cigarettes?
  • In the fall, NAQC will convene a work group to develop standard intake and follow-up questions for the MDS regarding e-cigarettes and electronic nicotine delivery systems (ENDS).
  • The FY13 Annual Survey of Quitlines has questions regarding e-cigarette/ENDS that will yield some important data on quitline protocols when the survey findings are presented in the fall. 
    If you have any questions or are looking for resources, please contact us at

 Find more NAQC News in our Newsroom or go back to top.

Time-Sensitive News

NAQC has prepared a variety of educational webinars in the next coming months on topics ranging from texting to relapse prevention; from pregnant women to the Asian Smokers’ Quitline.  Please find the topics and dates below and don't forget to register!
June 19
1:30-3PM ET
PPP Webinar - Expanding Cessation Coverage and Supporting State Quitline Capacity - Engaging Brokers and Leveraging the HHS Guidelines and Premium Differentials
June 26
12:30 – 2PM ET
Integration of Tobacco Cessation Medications in State and Provincial Quitlines: Evidence, Current Practice and Recommendations for Progress
July 16
12:30 – 2PM ET
Linking Quitlines with Internet Cessation Programming, Text Messaging and Social Networks  
July 23
12:30 – 2PM ET
Quitline Services to Pregnant and Postpartum Women: the Evidence, the Practice and the Outcomes
August 27
12:30 – 2PM ET
The Asian Smokers’ Quitline
September 17
12:30 – 2PM ET
Innovations in Relapse Prevention: A Discussion of Strategies and Solutions 
» learn more

DEADLINE - July 8!  RFP for Nevada State Quitline Services!
A copy of the solicitation and any associated documents may be obtained by following the link and clicking on 'Bidding Opportunities' and then select the document(s) with the Solicitation ID (3126). It is recommended you check the Purchasing Division website regularly to ensure you do not miss any procurement opportunities.
» learn more

Find more Time-Sensitive News in our Newsroom or go back to top.

Tobacco Control

The QuitConnect project, lead by Jim Thrasher, and Scott Strayer, is finalizing the QuitConnect website platform and working with our partners at Roswell Park Cancer Institute to recruit quitline callers to participate.  A subset of callers to the New York State Quitline will be contacted via email or text, and receive one of 5 different invitation messages.  The QuitConnect team will then test which messages are the most successful in getting smokers to register and gain access to additional quitting resources and research opportunities.  The QuitConnect launch is planned for Mid-June.  More information about QuitConnect is available at  If you have any questions, please contact Mark Macauda, study coordinator, at
» learn more

State-Specific Data for Father's Day!
Father’s Day is this Sunday, June 15. Consider taking advantage of this special day to raise awareness about the impact of tobacco use on men and families in your community, as well as spark interest in and support for your tobacco control activities.
To help you in this effort, CTFK has updated its fact sheets on smoking among men and celebrating a smoke-free Father’s Day (see materials at the link below). These materials include state-specific information—including smoking rates for men, smoking-attributable deaths and health care costs—that can be used for press releases, op-eds, LTE’s, etc. The data also can be used to publicize or support your other current or planned tobacco control efforts.
» learn more

New Resources to Promote the 2014 Surgeon General's Report on Smoking and Health!
The 2014 Surgeon General’s report, The Health Consequences of Smoking—50 Years of Progress, is now available as an eBook. The Full Report, Supplemental Evidence Tables, and Executive Summary are available in ePUB (compatible with Apple’s iBooks, Barnes & Noble’s Nook, and many others) and MOBI (Amazon Kindle) formats for your mobile electronic device.
Download them for free at

Several products associated with the 2014 Surgeon General Report are available in Spanish. You can find all the products on the Surgeon General Spanish Resources webpage.   
» learn more

Find more Tobacco Control in our Newsroom or go back to top.

Translational Behavioral Medicine. Online First March 2014.
Using the Electronic Health Record to Connect Primary Care Patients to Evidence-based Telephonic Tobacco Quitline Services: A Closed-loop Demonstration Project.
Robert T. Adsit,  Bradley M. Fox, MD, Thanos Tsiolis, Carolyn Ogland, MD, FAAP, Michelle Simerson, CMA, Linda M. Vind, BS, Sean M. Bell, MBA, Amy D. Skora, BS, Timothy B. Baker, PhD, Michael C. Fiore, MD, MPH, MBA,
The purpose of this case study is to develop and evaluate a secure, closed-loop EHR referral system linking patients visiting healthcare clinics with a state tobacco quitline. A regional health system, EHR vendor, tobacco cessation telephone quitline vendor, and university research center collaborated to modify a health system’s EHR to create an eReferral system. Modifications included the following: clinic workflow adjustments, EHR prompts, and return of treatment delivery information from the quitline to the patient’s EHR. A markedly higher percentage of adult tobacco users were referred to the quitline using eReferral than using the previous paper fax referral (14 vs. 0.3 %). The eReferral system increased the referral of tobacco users to quitline treatment. This case study suggests the feasibility and effectiveness of a secure, closed-loop EHR-based eReferral system.
Addiction. 2014 Jun;109(6):995-1002.
The Freeze on Mass Media Campaigns in England: A Natural Experiment of the Impact of Tobacco Control Campaigns on Quitting Behaviour.
Langley T, Szatkowski L, Lewis S, McNeill A, Gilmore AB, Salway R, Sims M.

This study measured the impact of the suspension of tobacco control mass media campaigns in England in April 2010 on measures of smoking cessation behaviour. DESIGN: Interrupted time series design using routinely collected population-level data. Analysis of use of a range of types of smoking cessation support using segmented negative binomial regression. MEASUREMENTS: Use of non-intensive support: monthly calls to the National Health Service (NHS) quitline (April 2005-September 2011), text requests for quit support packs (December 2007-10) and web hits on the national smoking cessation website (January 2009-March 2011). Use of intensive cessation support: quarterly data on the number of people setting a quit date and 4-week quitters at the NHS Stop Smoking Services (SSS) (quarter 1, 2001 and quarter 3, 2011). FINDINGS: During the suspension of tobacco control mass media spending, literature requests fell by 98% [95% confidence interval (CI) = 96-99], and quitline calls and web hits fell by 65% (95% CI = 43-79) and 34% (95% CI: 11-50), respectively. CONCLUSIONS: The suspension of tobacco control mass media campaigns in England in 2012 appeared to markedly reduce the use of smoking cessation literature, quitline calls and hits on the national smoking cessation website.
Can J Public Health. 2014 Feb 3;105(2):e97-e102.
Electronic Cigarettes in Canada: Prevalence of Use and Perceptions Among Youth and Young Adults.
Czoli CD, Hammond D, White CM.

The goal of this study was to examine the prevalence and perceptions of electronic cigarette use among Canadian youth and young adults. METHODS: A sample of 1,188 youth and young adults age 16-30 years were recruited from an online panel of Canadians in 2012. After viewing an image of an e-cigarette, respondents answered questions regarding their use and perceptions of e-cigarettes. RESULTS: Close to half of respondents (43.4%) had seen e-cigarettes advertised or for sale. A total of 16.1% reported trying an e-cigarette (5.2% nonsmokers, 18.9% former smokers, and 34.5% current smokers), and 5.7% reported use in the past 30 days (0.8% non-smokers, 1.4% former smokers, and 15.0% current smokers). Compared to non-smokers, former smokers and current smokers were more likely to have tried e-cigarettes (OR=4.25 and OR=9.84, respectively), and current smokers were more likely to have tried e-cigarettes than former smokers (OR=2.32). Current smokers were also more likely to be current users of e-cigarettes than both former smokers (OR=15.15) and non-smokers (OR=4.43). Smokers were interested in trying e-cigarettes to help them quit smoking (80.4%), and as a long-term replacement for cigarettes (77.8%).
Am J Prev Med. 2014 Apr 28. pii: S0749-3797(14)00107-X.
E-Cigarette Awareness and Perceived Harmfulness: Prevalence and Associations with Smoking-Cessation Outcomes.
Tan AS, Bigman CA.

This study describes the prevalence and correlates of e-cigarette awareness and perceived harmfulness among U.S. adults and analyze whether these variables are associated with smokers' past-year quit attempts and intention to quit. METHODS: Data were obtained from the Health Information National Trends Survey (HINTS 4 Cycle 2), conducted from October 2012 to January 2013. Data analyses were performed from June to August 2013. RESULTS: Overall, 77% of respondents were aware of e-cigarettes. Of these, 51% believed e-cigarettes were less harmful than cigarettes. Among those who were aware of e-cigarettes, younger, more educated respondents and current smokers (compared with former and non-smokers) were more likely to believe that e-cigarettes were less harmful. Awareness and perceived harm were not associated with smokers' past year quit attempts or intention to quit. CONCLUSIONS: Overall e-cigarette awareness increased whereas the proportion of smokers who perceived less harm of e-cigarettes declined compared with earlier surveys. However, awareness and perceived harm of e-cigarettes did not show evidence of promoting smoking cessation at the population level.
Am J Prev Med. 2014 May 21. pii: S0749-3797(14)00174-3.
Factors Associated with E-cigarette Use: A National Population Survey of Current and Former Smokers.
Giovenco DP, Lewis MJ, Delnevo CD.

Few national surveys document the prevalence of e-cigarette use in the U.S. The existing metric to assess current use likely identifies individuals who have recently tried an e-cigarette but do not continue to use the product. PURPOSE: To document the prevalence of e-cigarette ever use, current use, and established use in a nationally representative survey of current and former cigarette smokers in the U.S. METHODS: A random sample of current and former cigarette smokers completed a web-based survey in June 2013 (n=2,136). Data were analyzed in November 2013. Multivariate logistic regression identified demographic and smoking-related factors associated with each use category. RESULTS: Almost half of respondents had tried e-cigarettes (46.8%), but prevalence of established use remained low (3.8%). Although trial of e-cigarettes was highest among daily smokers, the odds of being an established e-cigarette user were greater for former smokers (OR=3.24, 95% CI=1.13, 9.30, p<0.05). Furthermore, e-cigarette preference and use patterns varied among ever, current, and established users. Established users reported using rechargeable e-cigarettes, having a regular brand, and using e-cigarettes at home and in the workplace at much higher levels than the "current use" metric captures. CONCLUSIONS: Improved survey measures for e-cigarette use are needed. The identification of established e-cigarette users may provide insight to product features or other individual factors that are associated with sustained use of e-cigarettes.
BMC Res Notes. 2014 May 5;7(1):282.
Quitters Referring Smokers: A Quitline Chain-referral Pilot Study.
DeLaughter KL, Volkman JE, Phillips BD, Houston TK.
Telephone counseling Quitlines can support smoking cessation, but are under-utilized. We explored the use of smoker peer-referrals to increase use of a Quitline in Mississippi and Alabama. FINDINGS: Collaborating with the Alabama and Mississippi Quitline, we piloted peer-referrals to Quitlines. Successful 'quitters' who had used the Quitline were contacted at routine follow-up and recruited to participate as a peer-referrer and refer their friends and family who smoked to the Quitline. Peer-referrers completed a training session, received a manual and a set of Quitline brochures a peer-referral forms. These peer-referral forms were then returned to the Quitline telephone counselors who proactively called the referred smokers. Of the initial potential pool of 96 who quit using the Quitline, 24 peer-referrers (75% Women, 29% African-American, and high school graduates/GED 67%) were recruited and initially agreed to participate as peer-referrers. From 23 new referrals, three intakes (100% Women, 66% African-American) were completed. Of the initial pool of 96, 4 (4%) actively participated in referring friends and family. Quitline staff and peer-referrers noted several barriers including: time-point in which potential peer-referrers were asked to participate, an 'overwhelming' referral form to use and limited ways to refer. CONCLUSIONS: 'Quitters' were willing to agree to peer-refer. We identified several areas to improve this new method for increasing awareness and access to support systems like the Quitline for smokers who want to quit.
J Consult Clin Psychol. 2014 Jun;82(3):482-91.  
A Method for Assessing Fidelity of Delivery of Telephone Behavioral Support for Smoking Cessation.
Lorencatto F, West R, Bruguera C, Michie S.

This study aimed to evaluate fidelity of telephone-delivered behavioral support. Method: A treatment manual and transcripts of 75 audio-recorded behavioral support sessions were obtained from the United Kingdom's national Quitline service and coded into component behavior change techniques (BCTs) using a taxonomy of 45 smoking cessation BCTs. Interrater reliability was assessed using percentage agreement. Fidelity was assessed by comparing the number of BCTs identified in the manual with those delivered in telephone sessions by 4 counselors. Fidelity was assessed according to session type, duration, counselor, and BCT. Differences between self-reported and actual BCT use were examined. Results: Average coding reliability was high (81%). On average, 41.8% of manual-specified BCTs were delivered per session (SD = 16.2), with fidelity varying by counselor from 32% to 49%. Fidelity was highest in pre-quit sessions (46%) and for BCT "give options for additional support" (95%). Fidelity was lowest for quit-day sessions (35%) and BCT "set graded tasks" (0%). Session duration was positively correlated with fidelity (r = .585; p < .01). Significantly fewer BCTs were used than were reported as being used, t(15) = -5.52, p < .001. Conclusions: The content of telephone-delivered behavioral support can be reliably coded in terms of BCTs. This can be used to assess fidelity to treatment manuals and to in turn identify training needs. 
Find more Research in our Newsroom or go back to top.


Pfizer Provides E-coupons for Chantix!
Pfizer is making an e-coupon available for use by quitlines. Quitlines may email the coupon to any smokers who are trying to quit and who would like to use varenicline. For additional information, please contact Shah, Niralee by email ( or by phone at 212-733-1283.

Save the Date - June 18-21, 2014 - Social Marketing Conference!
June 18-21, 2014, Clearwater Beach, FL.  The Training Academy is a two day workshop that provides an overview of the social marketing approach and its distinctive features. This year’s theme is Health Equity – abstracts that fall into this category will get special attention.
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Save the Date - June 27-27, 2014 - 2014 Texas Tobacco Summit!
2014 Texas Tobacco Summit will be commemorating the 50th Anniversary of the first Surgeon General’s report, Smoking and Health: Report of the Advisory Committee to the Surgeon General.  The summit is hosted by MD Anderson Cancer Center in Houston.   Please mark the following dates on your calendar: Thursday, June 26th and Friday, June 27th, 2014. 

The goal of the summit is to inform, educate and foster a dialogue among traditional and non-traditional, statewide and national tobacco control organizations working towards the elimination of tobacco use and exposure across the state of Texas. This summit will serve as a key step towards maximizing synergy, minimizing duplication of efforts, complementing each other’s work, and creating a platform to share information and tools with one another.

Registration information will be forthcoming.   As you consider who you may want to send to represent your organization, please keep in mind seating will be limited to 150 people.  
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Geographic Health Equity Symposium on July 25, 2014!
Geographic Health Equity Symposium is a free event taking place in Orlando, FL  and is hosted by the Geographic Health Equity Alliance. The flyer with additional information is located at the link below. 
» learn more

Find more Announcements in our Newsroom or go back to top.

Funding for Connections is provided solely through a cooperative agreement from the Centers for Disease Control and Prevention (1U58DP004967-01). We thank them for their support of this publication. Information and links are provided solely as a service to NAQC members and partners and do not constitute an endorsement of any organization by NAQC, nor should any be inferred.
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