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North American Quitline Consortium
April 2012

Time-Sensitive News

Canada's Graphic Health Warnings! 
As of March 21, 2012, all cigarettes manufactured in or imported to Canada must have the new warnings.  Retailers have until June 18, 2012 to sell their old inventory before being required to only sell cigarettes with new warnings. We congratulate our colleagues in Canada on their new warnings and look forward to hearing about their experience with increasing call volumes over the next few months!
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Update on the HHS/CDC National Tobacco Education Campaign!
NAQC will be distributing an update on the campaign later today. Congratulations to CDC, NCI, the state quitlines and all others who have been working to make the National Tobacco Education Campaign such a success!

NAQC has included important campaign details and updates on the campaign pages, which can be found here. We will continue gathering information on impact the CDC's National Tobacco Education Campaign had on your quitline's call volume, services and promotion efforts through the NAQC Listserv. Please be sure to continue sharing your successes – especially related to earned media- with us and your colleagues by posting them to NAQC@LISTSERV.NAQUITLINE.ORG.
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Minimal Data Set Updates!
Due to upcoming national promotions of both U.S. and Canadian toll-free quitline numbers, quitlines in both countries are preparing for what could be a dramatic increase in call volume. As quitlines increase their capacity to handle surges in call volume, and make contingency plans, one issue that has come up multiple times is whether and how to streamline collection of Minimal Data Set intake data (as a strategy for decreasing the time for intake). In late 2011 and early 2012, the Minimal Data Set Workgroup met to discuss these issues and make recommendations on ways to streamline MDS. The workgroup’s recommendations are provided in the document available on the NAQC website (click here).

Update for US Quitlines: at the request of state quitlines, the CDC has proposed wording for a new intake question that will help quitlines track the number of tobacco users who contact quitlines as a result of the National Tobacco Education Campaign. The question is not part of the MDS. CDC will be asking US quitlines to report on responses to this question both in aggregate as part of their quarterly Services Survey as well as individual-level data for the national quitline data warehouse. The question wording is: In the past three months, did you hear about 1-800-QUIT-NOW from any advertisements with smokers telling personal stories and tips about living with health problems? 1. Yes; 2. No; 3. Unsure.

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


Research “Coffeebreak” Webinar Cancelled for Today (April 12)!
There will be no research “coffeebreak” webinar today from 2:00-2:30 p.m. ET. Instead, there will be a 60-minute webinar held on Thursday, April 26, from 11 a.m. – Noon Eastern Time (8-9 a.m. Pacific time) on the implications of the recent article published in the British Medical Journal by Ferguson et al. on NRT and quitlines in the UK. For more details, see the announcement below.
NAQC’s “Coffee Break” series is a monthly 30-minute webinar designed to serve as an informal forum to discuss current, upcoming, and potential quitline-related research; facilitate communication and interaction between researchers; and create and support connections between researchers and quitlines. Typically, the presenter gives a 10-15 minute presentation on a newly published research article, a new methodology for conducting research or collecting data, a description of a newly funded study, etc. There are 10-15 minutes at the end of each presentation for questions. The presentation slides and call recordings for past presentations are available here.
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Webinar to Discuss Article on Quitlines and NRT – Thursday, April 26!
NAQC will be hosting a webinar on Thursday, April 26, from 11a.m. – Noon Eastern Time (8-9 a.m. Pacific time) to discuss implications of the recent article by Ferguson et al. published in the British Medical Journal. The article described a 2x2 randomized study conducted in the UK comparing standard quitline care to proactive counseling, and provision of NRT to no NRT. The authors conclude that “offering free nicotine replacement therapy or additional (proactive) counselling to standard helpline support had no additional effect on smoking cessation.”

Presentations will include a summary of the study design and findings, as well as formal responses from Dr. Shu-Hong Zhu (UCSD) and Dr. Bruce Baskerville (University of Waterloo). Strengths and weaknesses of the study, as well as implications for quitlines in a North American context will be discussed. Join us for this important webinar! Members and non-members alike are invited to participate.
» learn more 

Join NAQC Webinar on April 18 on Quitline Service Offering Models: A Review of the Evidence and Recommendations for Practice in Times of Limited Resources!
The first draft of NAQC’s seventh Quality Improvement Initiative Issue Paper, Quitline Service Offering Models: A Review of the Evidence and Recommendations for Practice in Times of Limited Resources, will be delivered to NAQC members for their review on April 13, 2012.  As is the case with each issue paper, NAQC members are being asked to provide feedback on the first draft by participating in oral and/or written comment processes.
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FY2011 Annual Survey Update!
Thank you for your participation in the FY2011 Annual Survey of Quitlines! NAQC staff will be following up with you over the next few weeks if we have any questions about the data you provided. We will be sending you your FY2011 benchmarks, updating the “metrics” section of quitline profiles, and releasing final survey results once the data cleaning process has completed. As always, if you have any questions or concerns, please let us know at

NAQC Conference 2012: Register Today!
NAQC invites all members and others dedicated to improving the effectiveness of and access to quitline services to register for our upcoming conference. NAQC Conference 2012, QUITLINE INNOVATION AND SUSTAINABILITY: Exploring Strategies and Seizing Opportunities in Challenging Times, will take place August 13th and 14th in Kansas City, Missouri as an ancillary meeting to the National Conference on Tobacco or Health. Registration is open until July 27, 2012. Please remember to visit our 20th Anniversary Blog and join in the discussions! 
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Sustaining Quitline Services through Public-Private Partnerships!
NAQC has recently launched a new Public-Private Partnerships page on its website.  The page hosts information and resources to assist states and their partners in building partnerships with private insurers to increase coverage for cessation treatment, including quitline services. The information and resources provided mirrors the NAQC webinar series, “Building Public Private Partnerships” launched in December 2011. The series include:
  • Assessing and  Building Support for Health Plan Coverage for Quitline Services
  • Developing and Implementing a Plan to Expand Health Plans
  • Building Support for Tobacco Cessation Coverage through Promotion, Education, and Return-on-Investment (ROI)
Members are encouraged to visit the page to explore building cost-sharing partnerships in their state.  For more information, please contact Deb Osborne, NAQC, Public-Private Partnerships Manager at
» learn more

Research & Evaluation Listserv – Sign Up Today!
NAQC is happy to announce the creation of a new listserv dedicated to quitline research and evaluation issues. To subscribe to the listserv, please contact Natalia Gromov at
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NAQC Membership Drive!
NAQC’s membership drive for fiscal year 2013 began on February 16. You may take advantage of the early bird renewal special and win a free registration to the NAQC Conference if you renew by May 31st . To avoid lapse in your membership benefits, please submit payment for your dues by July 1, 2012 (payments are accepted in a form of a check, credit card payment, and online renewal). Please refer to the membership page for more information.

Please make sure that you are making the most of your membership with NAQC and making use of important benefits such as the monthly Seminar Series that covers topics such as: Medicaid coverage and reimbursement, development of public-private partnerships, and preparing for the graphic health warnings.

For questions regarding membership, please contact Natalia Gromov at 800-398-5489 ext 701 or
» learn more

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

Tobacco Control
New Report Released: “The Business Case for Coverage of Tobacco Cessation 2012 Update”!
A new report by Leif Associates presents an actuarial assessment of the benefits derived from smoking cessation programs as compared to their cost. Overall, the research indicates that an investment in programs designed to reduce adult smoking will lead to improved health outcomes, resulting in lower health care costs and more affordable health insurance premiums. Given that tobacco cessation is universally included as a covered benefit under the Patient Protection and Affordable Care Act of 2010, and that each private insurer has the choice of which cessation methods to cover, this report attempts to provide a comprehensive study on the costs and benefits of various programs. The results show that over a three-year period, expenditures for smoking cessation programs in the range of $144 to $804 per smoker attempting to quit should be fully offset by health care cost savings in a typical commercial population. In addition, greater cost savings are likely occur within special populations, such as pregnant women and persons with cardiac conditions, and for persons who remain in the health plan longer than the average of three years assumed in the study. This report is a great tool for tobacco control advocates and adds to the growing evidence that tobacco cessation coverage is not only effective, cost-effective as well.
» learn more

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

The combined effect of very low nicotine content cigarettes, used as an adjunct to usual quitline care (nicotine replacement therapy and behavioural support), on smoking cessation: A randomised controlled trial.
Walker N, Howe C, Bullen C, Grigg M, Glover M, McRobbie H, Laugesen M, Parag V, Whittaker R. Addiction. Accepted manuscript online: 30 MAR 2012.
This study examined the combined effect of very low nicotine content (VLNC) cigarettes and usual Quitline care (NRT and counseling) on quitting outcomes in smokers motivated to quit. Smokers who called the quitline were randomized to standard quitline care alone (eight weeks of NRT plus counseling), or standard quitline care with VLNC cigarettes. Results showed that participants in the intervention group were more likely to have quit smoking at six months than the usual care group (7-day point prevalence abstinence 33% vs. 28%, 95% CI=1.01,1.39, p=0.037). The median time to relapse in the intervention group was two months compared to two weeks in the usual care group. The authors conclude that addition of VLNC cigarettes to standard quitline smoking cessation support may help some smokers quit.

Longitudinal changes in weight in relation to smoking cessation in participants of the EPIC-PANACEA study.
Traviera N, Agudoa A, Mayb AM, et al. Preventive Medicine. March-April 2012;54(3-4):183-192.
This study examined the association between smoking cessation and weight change in the European population of the European Prospective Investigation into Cancer and Nutrition-Physical Activity, Nutrition, Alcohol, Cessation of smoking, Eating out of home And obesity (EPIC-PANACEA) project. Data were collected from more than 300,000 participants recruited between 1992 and 2000 in nine European countries. Results showed that smoking cessation tends to be followed by weight gain. However, this weight gain tends to be focused in the first years following cessation. When smokers who quit more than one year prior to recruitment were compared to never smokers, no major differences in annual weight gain were observed. The authors conclude that promoting weight gain control as a part of a quit smoking program may help remove a barrier to smoking cessation.

State Cigarette Excise Taxes – United States, 2010-2011.
Centers for Disease Control and Prevention. MMWR Weekly. March 30, 2012;61(12):201-204.
This study examined state cigarette excise taxes during 2010-2011. Results showed that during that period, eight states increased their cigarette excise taxes ranging from increases of $0.40 to $1.60, and one state decreased its tax. Mean state tax increased from $1.34 in 2009 to $1.46 in 2011. Missouri now has the lowest cigarette excise tax at $0.17 per pack. California, Missouri, and North Dakota are the only states that have not increased their state cigarette excise tax since 2000. State cigarette excise taxes in major tobacco-growing states and bordering southeastern states remain substantially lower than state cigarette excise taxes in the rest of the United States. The major tobacco-growing states typically have higher smoking rates and do not have strong tobacco control policies and interventions in place. For example, in addition to having lower excise taxes, no southern state has a comprehensive state smoke-free law that prohibits smoking in workplaces, restaurants, and bars. In addition to reducing smoking rates, cigarette excise tax increases have been shown to increase state revenue despite consumption declines, increases in the number of smokers quitting, and any increase in smuggling or tax avoidance. During 1990–2000, all states that increased their cigarette excise tax by at least $0.10 per pack also increased cigarette tax revenue.

Excise tax increases can provide a revenue source to fund and expand comprehensive state tobacco control programs. The Institute of Medicine recommends that all states dedicate revenue by statute to fund tobacco prevention programs at the state-specific levels recommended by CDC. However, only one state (South Carolina) that increased its tax in 2010 or 2011 dedicated any revenue from its increase for tobacco prevention, even though such a move has been shown to produce a strong return on investment. For example, when California increased its cigarette excise tax in 1988, approximately $0.05 per pack was dedicated to state tobacco control and prevention programs. During the first 15 years of the California tobacco control program, the state invested $1.8 billion in cigarette excise tax revenue in the program, resulting in $86 billion in health-care cost savings.
Investigating the use of social media to help women from going back to smoking post-partum.
Lowe JB, Barnes M, Teo C, Sutherns S. Aust N Z J Public Health. 2012 Feb;36(1):30-32.
This study examined the social factors that would keep women from relapsing to smoking after delivery of their baby, for those who had quit because they were pregnant. Of the 24 women who participated in pre- and post-partum interviews, isolation was a factor that influenced how they dealt with stress linked to relapse. Results showed that women who lived close to family members with whom they had strong relationships were not as likely to use the computer to interact with relatives and friends. Women without these strong ties in geographic proximity reported using Facebook and other Internet activities to interact with people while they stayed at home with their baby. The authors conclude that the use of electronic media may help facilitate interaction between new mothers, which could prevent isolation and relapse back to smoking after delivery.
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NALBOH Annual Conference Opportunity!
Sponsor and exhibitor opportunities are now available at the National Association of Local Boards of Health 20th Annual Conference in Atlanta, Georgia.  Join your target audience by attending the only national public health conference focused solely on board of health issues and concerns!
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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.
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