NAQC’s Response to HHS Announcement on Tobacco Control Strategy and Draft FDA Warning Labels
On November 10, HHS announced a new comprehensive tobacco control strategy outlining strategic actions, based on scientific evidence and extensive real-world experience, that will serve as a roadmap for reaching the Healthy People objective of reducing the adult smoking rate to 12% by 2020. The strategy engages all sectors of the public health and health care community and emphasizes the importance of reaching underserved and priority populations. NAQC fully supports the strategy, looks forward to working with HHS and other partners on it, and encourages HHS to commit funding for implementation of the strategy.
At the same event, FDA unveiled its proposed tobacco health warning labels and opened a 60-day comment period on the proposed warning labels and the related proposed rule. FDA recommends increasing the size of the warning label to 50% of the front and back of tobacco packages and to include graphic warnings. Although NAQC supports the use of graphic warnings, Linda Bailey expressed disappointment that the proposed warning labels currently do not include 800-QUIT-NOW. NAQC has long advocated for using the warning labels to provide smokers with a health warning along with resources to help them quit.
The proposed rule contains a section that opens the door for including 800-QUIT-NOW on the warning label – Section 1141.16, Disclosures Regarding Cessation (see pages 64-67). Under this section, FDA proposes that “one or more of the required warnings include specified information about an appropriate smoking cessation resource” and that “the final rule should require that a specified reference to a smoking cessation resource be included in the required warnings.” The section goes on to say that the cessation resource should meet specific criteria designed to ensure that the cessation information, advice and support provided are unbiased and evidence-based. NAQC encourages all members to read this section of the proposed rule from FDA.
Call to Action: NAQC staff will develop draft comments to FDA and circulate these to members and partners for feedback. It will be important to show support for inclusion of 800-QUIT-NOW on the warning labels. Please watch your email for opportunities to take on this issue!
Important dates to remember:
-NAQC draft comments will be circulated by mid-December
-Comments to FDA are due by January 11, 2011
-FDA will issue a final rule in June 2011
-The final rule will become effective in September 2012
To see the proposed rule and warning labels:
NEW Cost-Effectiveness Issue Paper!
Performing cost-effectiveness analyses is an essential element of any quitline’s quality improvement process. This is especially true as budgetary constraints become more important to determining all aspects of service delivery. This issue paper is useful for a wide variety of stakeholders. It:
-document the facts related to the cost of tobacco use;
-provides an overview of methods currently used for cost-effectiveness analysis of quitlines; and
-in general terms, describe approaches and considerations for conducting cost-effectiveness analysis on a specific quitline program.
» view paper
Continuing Education Technical Support Offered by NAQC!
Continuing education is at the core of many professional certifications and licensures held by NAQC members. In order to support the continuing education needs of members, NAQC offers technical support in fulfillment of self-certification* and post-approval** continuing education (CE) credit for participation in NAQC’s annual webinar training series.
If you have participated in the 2010 webinar training series and you would like to request technical support to secure verification of attendance for CE credit, including training session agendas with learning objectives, please contact NAQC at NAQC@naquitline.org.
NAQC is currently working with an accredited provider of CME, CNE, and continuing education contact hours (CECH) for health educators and certified public health administrators to offer certified educational opportunities to these professionals in our upcoming webinar training series and the next NAQC Conference.
*Self-certification - The professional holding the certificate or license keeps track of his/her educational activities; submits list of activities to the certifying or licensing organization annually; and expected to provide proof of attendance.
**Post-approval - Following attendance at a professional development activity, an agenda and proof of attendance is sent to the certifying or licensing organization. The number of CEUs to be approved is determined and recorded for each participant after the educational activity has occurred.
» contact NAQC
December’s Webinar Coming Soon!
On December 8th from 3:30 – 5PM ET and December 10th from 12:30 – 2PM ET, join your colleagues for the final NAQC training webinar in our 2010 series, Cultural Competency Training for Quitline Staff: Improving our Current Practice.
This webinar will highlight an online cultural competency module developed by the California Rural Indian Health Board’s Tobacco Education and Prevention Technical Support Center for quitline counselors titled, National Training for Helpline Counselors to Assist American Indian/Alaska Native Smokers; results from a collaboration between CDC’s National Center for Chronic Disease Prevention and Health Promotion, Division of Reproductive Health and the Office on Smoking and Health to evaluate the use of quitlines among pregnant and postpartum women; and how one service provider approaches continuing education to ensure quality services to all tobacco users.
» register now
NAQC to host quarterly conference calls on quitline-related research
On November 23, NAQC will host its first quarterly conference call on quitline-related research. The call is open to anyone who is interested in quitline-related research and evaluation. Calls will be held quarterly moving forward. Meetings will serve as an informal forum to discuss current, upcoming, and potential quitline-related research. One of the primary functions is to facilitate communication and interaction between NAQC members, as well as to create and support connections between researchers and quitlines. To participate in the first call, please rsvp to Jessie Saul at email@example.com or take a 3-item survey at https://www.surveymonkey.com/s/YQSD7BK to provide background information on current and upcoming research projects, as well as to help NAQC tailor the calls to the needs and interests of participants. A summary of the survey responses will be distributed prior to the first call. Call-in information can be found on the call series web page at http://www.naquitline.org/?page=QuarterlyResearch.
» learn more
FY2010 NAQC Annual Survey Update
The FY2010 NAQC Annual Survey of Quitlines is now open! Login information, survey instructions, Q&A’s, and a recording of the training webinar are all available on the 2010 survey page at http://www.naquitline.org/?page=survey2010. The survey will close on November 19, 2010. For any questions, or to arrange an extension for your survey, please contact firstname.lastname@example.org. Survey results will be available in the spring of 2011. Thank you in advance for your help with this important project!
» learn more
HHS Unveils a New Comprehensive Tobacco Control Strategy
U.S. Department of Health and Human Services unveiled a new comprehensive tobacco control strategy outlining strategic actions, based on scientific evidence and extensive real-world experience, that will serve as a roadmap for reaching the Healthy People objective of reducing the adult smoking rate to 12% by 2020.
ALA Releases Its Annual Report on State Cessation Coverage 2010
On November 9, the American Lung Association released its annual report on state cessation coverage. The new report, Helping Smokers Quit: State Cessation Coverage provides an overview of smoking cessation (quit-smoking) services and treatments offered in each state by public and private health care plans and the impact of the new federal health care law.
CTFK Releases Its Annual Report on November 17. State Materials Available November 16
On Wednesday, November 17, the Campaign for Tobacco Free Kids will release its annual report ranking the states on their funding of tobacco prevention and cessation programs. The report is titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 12 Years Later.” CTFK will post state level data and press releases on its website on Tuesday afternoon (November 16) to help states prepare outreach related to the report. For additional information, contact Meg Riordan at email@example.com.
Re-consider Evidence in Menthol Debate!
The NAACP Legal Defence and Educational Fund, National African American Tobacco Prevention Network and The African American Tobacco Control Leadership Councel Join Legacy® in Urging Groups to Re-consider Evidence in Menthol Debate
WASHINGTON, DC -- As the U.S. Food and Drug Administration (FDA) weighs the evidence on the deadly impact of menthol cigarettes, three African American organizations have spoken out against a potential ban, urging the Tobacco Products Scientific Advisory Committee to consider the negative implications of a ban and to discount any unsubstantiated evidence on menthol. The Congress of Racial Equality (CORE), the National Black Chamber of Commerce (NBCC) and National Organization of Black Law Enforcement Executives (NOBLE) have expressed concerns that evidence to support a ban is inconclusive and a dangerous "black market” for menthol products could develop due to the ban.
Legacy, who was an early proponent of a menthol ban, respectfully disagrees. Legacy joins the NAACP Legal Defense and Educational Fund, Inc., National African American Tobacco Prevention Network (NAATPN) and the African American Tobacco Control Leadership Council (AATCLC) in a collective call to ban menthol as an additive in all tobacco products. (http://www.thedefendersonline.com/2010/10/15/lorillard%E2%80%99s-orwellian-assertion-slavery-is-freedom/).
An estimated 45,000 African Americans die annually due to tobacco related illness. A ban on menthol could result in major improvements in overall public health through lower youth and minority smoking rates and higher adult quit rates.
South Dakota 'Yes' Vote on Smoke-Free Law in Victory for Public Health!
South Dakotans scored a major public health victory when voters overwhelmingly cast their ballots in favor of a comprehensive statewide smoke-free law. The new law will extend a restriction on indoor smoking to include all bars, restaurants, casinos and video lottery establishments, and give every worker the right to breathe smoke-free air on the job.
"South Dakota voters sent a clear message that they want to work in and patronize healthy, smoke-free environments,” said John R. Seffrin, PhD, CEO of the American Cancer Society Cancer Action Network (ACS CAN). "Smoke-free laws benefit everyone – workers can make a living without risking their health, patrons and tourists can enjoy time out without the hazards of secondhand smoke, and bar and restaurant owners can promote healthy environments. Everyone wins.”
People with mental illness can tackle tobacco.
Ashton M, Miller CL, Bowden JA, Bertossa S. Aust N Z J Psychiatry. 2010 Nov;44(11):1021-8.
This study tested a smoking reduction and cessation intervention tailored for people with significant disability associated with mental illness. The intervention was a 10-week group counseling program facilitated by mental health workers and peer workers and was promoted through mental health services, primary care providers, and the Quitline phone service. Of the 183 participants who attended at least one session, 80% reported they did not smoke for at least 24 hours. At 12-months, 17% reported they were not smoking. Cigarette use declined over the course of the study, and maintained reductions at 12 months. Those still smoking at 12 months were very motivated to try to quit (84% reported wanting to try again). The authors conclude that a program tailored to meet the specific needs of people with significant mental illness can be effective at helping many to quit or reduce their tobacco use.
Smoking Characteristics of Adults With Selected Lifetime Mental Illnesses: Results From the 2007 National Health Interview Survey.
McClave AK, McKnight-Eily LR, Davis SP, Dube SR. American Journal of Public Health. AJPH First Look, published online ahead of print Oct 21, 2010.
This study used data from the 2007 National Health Interview Survey to estimate smoking prevalence, frequency, intensity, and quit attempts among US adults who had been diagnosed with selected mental illnesses at some point in their lifetime. Illnesses or conditions included serious psychological distress and self-reported bipolar disorder, schizophrenia, attention deficit disorder or hyperactivity, dementia, or phobias or fears. Results showed that the age-adjusted smoking prevalence of adults with these conditions ranged from 34.3% (phobias or fears) to 59.1% (schizophrenia) compared with 18.3% of adults with no such illnesses. The more conditions that were reported, the higher the smoking prevalence. While quit attempts among those with mental illnesses or conditions were comparable to adults without such conditions, adults with mental illness reported a lower success rate in quitting. The authors conclude that prevention and cessation efforts are needed that target adults with mental illnesses.
Increased smoker recognition of a national quitline number following introduction of improved pack warnings: ITC Project New Zealand.
Wilson N, Weerasekera D, Hoek J, Li J, Edwards R. Nicotine Tob Res. 2010 Oct;12 Suppl:S72-7.
This study examined how new health warning requirements for tobacco packaging in New Zealand changed recognition of a national quitline number. Text-based warnings with the quitline number but without the word “Quitline” were compared to pictoral health warnings that included the word “Quitline” beside the number as well as a cessation message featuring the quitline number and repeating the word “Quitline.” Results showed that recognition of the Quitline number increased from 37% to 61% after the introduction of the new pictoral health warnings. The increase was demonstrated across all age groups, genders, deprivation levels, financial stress, and ethnic groups. The authors conclude that this provides evidence for the value of clearly identifying quitline numbers on tobacco packaging as part of pictoral health warnings.
State Medicaid Coverage for Tobacco-Dependence Treatments --- United States, 2009.
Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report (MMWR). October 22, 2010;59(41):1340-1343.
This study surveyed Medicaid programs in the 50 states and Washington DC to document their 2009 tobacco-dependence treatment coverage. 47 programs offered coverage. Only eight programs offered coverage for all recommended medication and counseling for all Medicaid enrollees, and 16 programs reported coverage for fee-for-service enrollees that differed from that provided for Medicaid managed-care enrollees. Only five states (Indiana, Massachusetts, Minnesota, Montana, and Pennsylvania) reported having policies that require coverage of all recommended pharmacotherapies and individual and group counseling for all Medicaid enrollees. Four states (Connecticut, Georgia, Missouri, and Tennessee) offered no coverage for tobacco dependence treatment. The Affordable Care Act mandates Medicaid coverage of tobacco-dependence treatments for pregnant women beginning October 1, 2010. Coverage of cessation medications for all Medicaid enrollees will be expanded by January 2014 when states can no longer exclude cessation medications from covered benefits.
Targeting African American Nonsmokers to Motivate Smokers to Quit: A Qualitative Inquiry.
Thomas JL, Scherber RM, Stewart DW, Lynam IM, Daley CM, Ahluwalia JS. Health Educ Behav. October 2010;37(5):680-693.
This study examined an innovative approach to motivate African American light smokers to engage in behavior change. Twelve focus groups were conducted to assess attitudes and beliefs about engaging a non-smoker in the home in smoking behavior change efforts. Smokers reported an interest in receiving cessation assistance from a non-smoker in their home. The authors conclude that African American non-smokers living with a smoker may be an appropriate target group to motivate smoking behavior change in smokers.
Smoking Cessation Interventions Among Hispanics in the United States: A Systematic Review and Mini Meta-analysis.
Webb MS, Rodríguez-Esquivel D, Baker EA. Am J Health Promot. 2010 Nov-Dec;25(2):109-18.
This study reviewed smoking cessation interventions targeting Hispanic adults living in the United States that had been evaluated by a randomized controlled trial. Five trials were eligible for inclusion in the analysis. Results showed that smoking cessation interventions were effective (odds ratio, 1.54). The authors conclude that more randomized trials evaluating tobacco interventions in this population are needed, with examination of the effect of cultural specificity and acculturation.
State-Specific Prevalence of Cigarette Smoking and Smokeless Tobacco Use Among Adults --- United States, 2009.
Centers for Disease Control and Prevention. MMWR Weekly. Nov 5, 2010;59(43):1400-1406. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5943a2.htm?s_cid=mm5943a2_e.
CDC analyzed data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to assess state-specific current cigarette smoking and smokeless tobacco use among adults. Cigarette smoking prevalence was lowest in Utah (9.8%), California (12.9%) and Washington (14.9%) and highest in Kentucky (25.6%), West Virginia (25.6%) and Oklahoma (25.5%). Smokeless tobacco use was lowest in DC (2.0%) and highest in West Virginia (17.1%). Smokeless tobacco use was significantly higher among men than women in all 50 states. Among the 13 states in which cigarette smoking prevalence was greatest, seven also had the highest prevalence of smokeless tobacco use: Alabama, Alaska, Arkansas, Kentucky, Mississippi, Oklahoma, and West Virginia. In these states, at least one of every nine men who smoked cigarettes also reported using smokeless tobacco. The authors conclude that clinicians should identify all tobacco use in their patients and advise those who use any tobacco product to quit, and they note that the World Health Organization (WHO) recommends implementing this approach in combination with other measures, including raising excise taxes on tobacco and strengthening smoke-free policies to prevent tobacco-related deaths.
Educating smokers about their cigarettes and nicotine medications.
Bansal-Travers M, Cummings KM, Hyland A, Brown A, Celestino P. Health Educ Res. 2010 Aug;25(4):678-86. Epub 2010 Jan 11.
This study tested the efficacy of educational materials designed to correct misperceptions held by smokers about nicotine, NRT, low tar cigarettes, filters and product ingredients. The experimental group and the control group both received counseling, nicotine patches, and a quit smoking guide. In addition, the experimental group received information about cigarette characteristics mailed in a brand-tailored box. Results showed that while the experimental educational materials were recalled better and contributed to higher levels of knowledge about specific cigarette design features, they did not translate into changes in smoking behavior.
Impact on quit attempts of mailed general practitioner 'brief advice' letters plus nicotine replacement therapy vouchers.
Watson D, Bullen C, Clover M, McRobbie H, Parag V, Walker N. J Prim Health Care. 2010 Mar;2(1):4-10.
This study tested whether the combination of a personalized letter from a health care provider advising that a patient quit smoking and a voucher for one month of nicotine gum prompts tobacco users to make a quit attempt in Auckland, New Zealand. Calls to the Quitline and vouchers redeemed at pharmacies were measured both before and after the intervention. Results showed that calls to the quitline were not significantly higher between the intervention district and the comparison district, but NRT voucher redemptions were significantly higher. Almost 9% of the vouchers that were sent out were redeemed for NRT. The authors conclude that the study shows a promising mechanism to increase the number of supported quit attempts through primary care and call for a larger randomized trial.
Travel Scholarship to the 2011 SRNT Annual Meeting
The Tobacco-Related Health Disparities Network of the Society for Research on Nicotine and Tobacco (SRNT) has established as one of its goals to increase the diversity of its membership. Therefore, SRNT is committed to increasing the diversity of researchers who help to stimulate and generate new knowledge concerning nicotine in all its manifestations -- from the molecular to the societal level. The purpose of the Diversity Travel Scholarship program is to increase the diversity of researchers interested in nicotine and tobacco research by:
The scholarship program is a partnership between the American Legacy Foundation, the National Cancer Institute, the California Tobacco-Related Disease Research Program, and the Society for Research on Nicotine and Tobacco and is administered by the Tobacco-Related Health Disparities Network of SRNT.
» learn more
Request for Nominations for the Interagency Committee on Smoking and Health
The Interagency Committee on Smoking and Health (ICSH) is soliciting nominations of qualified individuals to serve as a public member on this Committee. The ICSH advises the Secretary, Health and Human Services, the Assistant Secretary for Health, and the Director, Centers for Disease Control and Prevention, on the coordination of research, educational programs, and other activities within the Department related to the effect of smoking on human health. The ICSH coordinates these activities with appropriate private entities, other Federal agencies, as well as State and local public agencies.
The ICSH is composed of five public members and twenty-one members appointed by the Secretary from appropriate institutes and agencies of the Department and at least one member from any other Federal agency designated by the Secretary. The five public members, also appointed by the Secretary, are drawn from physicians and scientists who represent private entities involved in informing the public about the health effects of smoking. Federal employees will not be considered for membership.
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BHAF Webinar Announcement
The North American Quitline Consortium and the Smoking Cessation Leadership Center invite you to join the webinar, "Do Quitlines Have a Role in Serving the Tobacco Cessation Needs of Persons with Mental Illnesses and Substance Abuse Disorders?”, with Chad Morris, Ph.D. and Gary Tedeschi, Ph.D., on Thursday, November 18, 2010, at 1pm ET/12 noon CT/11 am MT/10 am PT, 90 minutes.
Dr. Morris is an Associate Professor at the University of Colorado Anschutz Medical Campus and Director of the Behavioral Health & Wellness Program. Dr. Tedeschi is the Clinical Director of the California Smokers’ Helpline at the University of California, San Diego’s Moores Cancer Center.
This presentation will address:
- The rationale for the creation of the national Quitline Behavioral Health Advisory Forum
- Highlights from the Advisory Forum report including:
- The association between tobacco use, behavioral health disorders, and higher prevalence of death and disease
-Current knowledge of quitlines’ effectiveness in serving persons with behavioral health disorders
-Existing evidence and expert opinion regarding quitlines’ screening procedures, treatment, staff training and supervision, evaluation and research, community referral, and policies for best serving the needs of persons with behavioral health disorders
» learn more
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Funding for Connections is provided through a contract from the Centers for Disease Control and Prevention. 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.