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North American Quitline Consortium
November 2011


IMPORTANT NEWS-- Update on Ruling Against New Cigarette Warnings!
District Judge Leon has blocked the FDA’s requirement to have the new graphic health warnings appear on cigarette packages by next September; according to the Judge, the warnings should not appear unless the tobacco industry loses its larger lawsuit, which raises questions about the Constitutionality of the warning labels. The larger lawsuit is likely to take at least a few years to wind its way through the courts towards resolution.

Although we had hoped for a more positive ruling from Judge Leon on this issue, the ruling can be appealed by the government. NAQC will join with other tobacco control organizations to encourage the Obama Administration to appeal today’s ruling. If the government appeals the ruling and wins, the new graphic health warnings may appear in September 2012 as planned. In the meantime, please remember that science and the experience of nearly 20 countries that already have graphic health warnings are on our side. We will update you as more information becomes available.
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Announcing New Medicaid Learning Community!
NAQC is hosting a Medicaid Learning Community (MLC)! The MLC will include representatives from 12 states (currently being identified based on readiness and existing infrastructure), with the goal to support shared-learning and dissemination of proven-practices related to effective implementation of the new guideline allowing quitlines as an allowable administrative cost expenditure. To learn more and to find out about other important Medicaid resources and updates, please visit the link below.
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Assistance Available in Developing Public-Private Partnerships!
Developing partnerships with both the private and public health plan sector can help maximize quitline services and establish a level of sustainability. To assist states in developing these partnerships, NAQC has brought Deb Osborne on-board. Deb's work with NAQC this year will focus on 1) establishing a strong foundation of common knowledge among states, provinces and coalitions on how to advance tobacco coverage among public and private insurers, and 2) providing more intensive technical assistance to a small number of states. To learn more about the upcoming work and resources, please click on the link below.
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Update on NAQC FY2011 Annual Survey Process! 
Thanks to everyone who completed the FY2011 budget survey! As of Tuesday, November 8, 58 quitlines have completed their budget surveys. We will be continuing to follow up with those who have not yet completed the survey; your participation is greatly appreciated!
To avoid duplicative requests for information from NAQC and CDC, NAQC will be partnering with the CDC to access much of the data that U.S. quitlines have already provided through CDC’s online services survey. There are a few additional questions that NAQC will be fielding through a Survey Monkey survey in January 2012. We are in the final stages of narrowing down the questions that will be asked on our FY11 “mini-survey” and will send out a PDF of the survey questions as soon as possible in order to give quitlines and service providers a chance to prepare. The questionnaire for provinces will be slightly longer than that for states.
Please contact NAQC’s Director of Research, Jessie Saul, if you have any questions or concerns about the budget survey or the upcoming “mini-survey” in January (jsaul@naquitline.org, 800.398.5489 ext 702). PDF copies of your FY2010 survey responses, as well as your FY2011/12 budget survey responses are also available upon request.

November “Coffee Break” Call on Weekly Patterns in Usage of Tobacco Quit Lines!
The NAQC “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.
The next call will be TODAY (Thursday, November 10), from 2:00-2:30 p.m. Eastern Time (11:00-11:30 a.m. Pacific Time). Morgan Johnson, with the Mondays Campaign, will present on “Weekly Patterns in Usage of Tobacco Quit Lines.” For tobacco cessation in particular, insight into behavioral patterns may be valuable for determining how to optimally time interventions to reach the most people and sustain behavior change.  New evidence suggests that there are consistent weekly cycles in usage of tobacco quit lines.  Studying these cycles may help us streamline quit line programs by more efficiently allocating quit line resources at certain optimal times, as well as showing us when is the best time to promote these programs to capture the most tobacco users.  The presentation will walk participants through the evidence for these weekly patterns and what the results contribute to our knowledge of quit lines and how to improve them.
It is strongly recommended that you test your system in advance of the call time to ensure you can access the webinar features. For more information about the speaker or topic, click here.  Call-in information is available on the NAQC website at http://www.naquitline.org/?page=CallInformation . Presentation slides are posted on the same page.
 The September call featured Dr. Peter Selby (Nicotine Dependence Clinic, Centre for Addiction and Mental Health) presenting on “Web-assisted Tobacco Interventions: Recent Research on Online Support for Smokers Trying to Quit.” The presentation slides and call recording are available here.
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Last Call for NAQC Conference 2012 Planning Workgroup!
Interested in joining the most fun workgroup EVER? Want an opportunity to shape the conference agenda to ensure the best learning opportunity for your colleagues? This is our last call for NAQC Conference 2012 planning workgroup members!
Workgroup members will guide the development of the abstract submission form; score abstract submissions and recommend the final slate of breakout sessions; propose plenary topics and speakers; and provide general guidance on conference planning.
If you are interested in serving on the planning workgroup, please email Tamatha Thomas-Haase at tthomas-haase@naquitline.org to learn more! We’re getting started next month!
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New Issue Paper!
NAQC’s new issue paper, The Use of Quitlines Among Priority Populations in the U.S.: Lessons from the Scientific Evidence, is a systematic review of the scientific evidence regarding cessation services to priority populations(African Americans/blacks (AA/B), American Indian and Alaska Natives (AI/AN), Asian American and Native Hawaiian and Pacific Islanders (API), Hispanic/Latinos (H/L), the lesbian, gay, bisexual and transgender (LGBT) community, and individuals of low socioeconomic status (low SES))with a specific focus on the useeffectiveness and promotion of quitlines.
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Tobacco Control
Upcoming Webinars: State Tobacco Funding Regional Strategy Sessions!
The Campaign for Tobacco-Free Kids and the Tobacco Control Network invite state and local health department staff and advocacy partners to hear the latest news on state tobacco funding, in anticipation of the soon to be released "A Broken Promise to our Children” report. Each session will also showcase an example of how state health departments and advocacy organizations have worked together systematically to raise awareness about the impacts of tobacco control efforts, advocate for sustained tobacco control funding, and defend against budget cuts.
» learn more

Opportunity for State Quitlines to Participate in Research Study!
NAQC would like to make its state quitline members aware of an opportunity to participate in CDC's Comparative Effectiveness Research (CER) Tobacco Cessation project. RTI is excited to announce open enrollment for the CDC's Comparative Effectiveness Research (CER) Tobacco Cessation project. All states and US territories are invited to participate in the Promotion Study of this important project.
» learn more

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New Statistics on Quitting Behavior Among US Adults
In this week’s issue of the CDC journal, Morbidity and Mortality Weekly Report, the Office on Smoking and Health published an article titled “Quitting Smoking Among Adults – United States, 2010.”
CDC analyzed 2010 National Health Interview Survey (NHIS) data to describe U.S. adult smokers’ interest in quitting, quit attempts in the past year, successful recent smoking cessation, and use of evidence-based cessation treatments and services by demographic characteristics.  This report describes the results of that analysis, which found that 68.8% of current smokers want to completely stop smoking, 52.4% of smokers had made a quit attempt in the past year, and 6.2% of smokers had successfully quit within the past year.  Further findings indicate that 48.3% of smokers who saw a health care professional in the past year recalled getting advice to quit and 31.7% of smokers used counseling and/or FDA-approved medications when they tried to quit.
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KIQNIC Team is Developing Tools for Distribution to Quitline Community!

The KIQNIC (Knowledge Integration in Quitlines: Networks that Improve Cessation) project wrapped up its third annual survey in August. Data cleaning is almost complete on the 2011 survey data, and the preliminary figures show that 155 individuals completed the survey. This translates into 85 of 97 (87.6% of) possible organizations participating and 63 of 65 (96.9% of) possible quitlines participating. Principal Investigator Scott Leischow expressed the research team’s gratitude, “We are really thrilled with the high response rate, which is critical to social network analysis projects. This means that we should have a pretty accurate snapshot of information sharing across the quitline community in the past year. It also means that we should be able to provide helpful information back to the quitlines based on the data we collected.”
The research team is collaborating with the NAQC KIQNIC Workgroup to develop tools that will aim to help NAQC members better understand how information about quitline practices is shared throughout the network of quitlines. Workgroup members are also helping the researchers develop additional resources for quitlines based on the data that have been collected. The first of these resources will be released early in 2012, and will be publicized here in Connections and also on the KIQNIC website.
If you would like more information about KIQNIC, or would like to volunteer on the NAQC KIQNIC Workgroup, contact Jessie Saul at jsaul@naquitline.org
Support-person Promotion of a Smoking Quitline: a Randomized Controlled Trial.
Patten CA, Smith CM, Brockman TA, Decker PA, Hughes CA, Nadeau AM, Sinicrope PS, Offord KP, Lichtenstein E, Zhu SH. Am J Prev Med. 2011 Jul;41(1):17-23.
This study examined the efficacy of an intervention designed to help support people promote smoker utilization of the Minnesota QUITPLAN Helpline. The two group randomized design compared the support person intervention (n=267) with a control condition (written materials, n=267). Participants were 91% female, 93% Caucasian, and all were Minnesota residents. The intervention consisted of written materials plus three weekly telephone sessions that provided participants with information and skills needed to encourage their smoker to call the helpline. Results showed that the proportion of calls to the Helpline was significantly greater for smokers linked to support people in the intervention group (16.1%) than in the control group (8.6%). The effect remained even when controlling for support people and smokers who lived together. Among the intervention group, support people completing a greater number of sessions was associated with increased calls to the Helpline. The authors concluded that a support-person intervention is effective at increasing smoker utilization of a Helpline, and that this method has potential for increasing the reach of quitlines by targeting the social network of smokers.

Effectiveness of Over-the-Counter Nicotine Replacement Therapy: a Qualitative Review of Nonrandomized Trials.
Hughes JR, Peters EN, Naud S. Nicotine Tob Res. 2011 Jul;13(7):512-22. Epub 2011 Apr 6.
This paper reviews nonrandomized tests of the effectiveness of over-the-counter (OTC) nicotine replacement therapy (NRT). Studies included in the review were retrospective cohort studies of users vs. nonusers of OTC NRT and studies of quit rates before versus after NRT went OTC or before vs after NRT was given free to telephone quitline callers. Most of the studies found greater quitting among NRT users than non-users, although only about half of the studies found statistically greater quitting among NRT users, and the most rigorous studies did not find greater quitting among NRT users. The authors conclude that further secondary analysis using nonrandomized comparison are unlikely to resolve the issue of OTC NRT effectiveness due to sensitivity, specificity, and selection bias problems.

Helping Smokers with Depression to Quit Smoking: Collaborative Care with Quitline.
Segan CJ, Borland R, Wilhelm KA, Bhar SS, Hannan AT, Dunt DR, Ferretter IT. Med J Aust. 2011 Aug 1;195(3):S7-11.
This study examined the co-management of smoking cessation and depression by the Victorian Quitline and physicians. Smokers’ evaluation and uptake of the co-management services were reported, as well as its relationship to quitting success. Quitline clients disclosing doctor-diagnosed depression (n=227) were followed up at 2 months and 6 months. At 2-month follow-up, 83% thought it was a good idea to involve their doctor in their quit attempt, 74% had discussed quitting with their doctor, and 43% had received comanagement. Quit rates were 37% and 33% at 2 months and 6 months respectively, and 20% achieved sustained abstinence. Among participants who discussed quitting with their doctor, those who received co-management of quitting and depression with the quitline were more likely to make a quit attempt than those who did not receive co-management (78% vs. 63%). Those who received co-management also received more quitline calls (mean 4.6 vs. 3.1). The authors conclude that quitline-doctor co-management of smoking cessation and depression is workable, is valued by smokers, and increases the probability of quit attempts. They also found that quitting smoking did not increase the risk of exacerbation of depression.

Promoting Calls to a Quitline: Quantifying the Influence of Message Theme, Strong Negative Emotions and Graphic Images in Television Advertisements.
Farrelly MC, Davis KC, Nonnemaker JM, Kamyab K, Jackson C. Tob Control. 2011 Jul;20(4):279-84. Epub 2011 Feb 2.
This study examined the relative effectiveness on promoting calls to a smoker’s quitilne of television ads that had different themes, portrayals of negative emotions, and/or use of graphic images. Ads were grouped by their objective (promoting cessation, highlighting the dangers of secondhand smoke, or other), and by their portrayals of strong negative emotions and graphic images. Total target audience rating points (TARPs) (i.e., a rough measure of how many people see an ad) are positively correlated with per smoker callvolume. Cessation advertisements are more effective than SHS ads in promoting calls to the quitline. Ads with graphic images only or neither strong negative emotions nor graphic images are associated with higher call volume. Call volume was not significantly associated with the number of TARPs for ads with strong negative emotions only or with both graphic image and strong emotions. The authors conclude that exposure to television ads is strongly associated with quitline call volume, and both cessation and SHS ads can be effective. The use of strong negative emotions in advertisements may be effective in promoting smoking cessation in the population but does not appear to influence quitline call volume. The authors call for further research to understand the role of negative emotions in promoting calls to quitlines and cessation more broadly among the majority of smokers who do not call quitlines.

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Special Journal Issue on Tobacco Use Patterns Call for Papers!
The Journal of Environmental and Public Health has a call for papers for a special issue on Tobacco Use Patterns. The deadline for submissions has been extended until Friday, December 2, 2011.

The main focus of this special issue will be the compilation of research on the emerging science describing tobacco consumption patterns.  Given the introduction of innovative tobacco products, emerging tobacco use patterns may result in 1) cigarette use and the potential to switch to other tobacco products, 2) combined concurrent use (polytobacco use, dual use), 3) increase in the number of social or occasional smokers, and 4) disparities in tobacco use. The issue editors strongly encourage the submission of analyses using cross-section surveys, longitudinal studies, laboratory or natural experiments, or intervention studies. Potential topics include, but are not limited to: Effects of smoking restrictions on tobacco use patterns, dual use of products, occasional use patterns, tobacco use patterns in low- and middle-income countries, use of new and emerging tobacco products, and effects of socioeconomic disparities on tobacco use.
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In-Person Discussion or Webinar: The Winnable Battle Among America's Armed Forces 
In honor of Veterans' Day, Legacy is hosting a thought-leader discussion focused on smoking in the military and how curtailing tobacco use among military families stands to dramatically improve health, save lives and money in the armed forces. The discussion will take place today, November 10 at noon EST.
» learn more and register

Call for SRNT Pre-Conference Workshop Proposals!
SRNT is accepting proposals for pre-conference workshops to be held in conjunction with the 2012 Annual Meeting in Houston, Texas. Pre-conference workshops will be held on Tuesday, March 13.

SRNT has already accepted one full-day basic science and two half-day treatment workshops.

SRNT will consider proposals for either half-day sessions or full-day sessions. SRNT will charge a registration fee, which will cover coffee breaks, lunch, and A/V; other costs associated with workshops (speaker travel, honoraria, etc.) must be covered by the workshop organizers. 

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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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