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From: kbrown@healthedcouncil.org
Date: Fri, 09/24/04

NNTPP LISTSERV

NNTPP is a program of the Health Education Council

Friday September 24, 2004

In this edition:

1) Ten Policy Changes That Could Curb Tobacco Addiction

2) Effectiveness of a Quit and Win Contest with a Low-Income Population

3) Addressing Tobacco among Individuals with a Mental Illness or an Addiction

4) Upcoming Events

1) Ten Policy Changes That Could Curb Tobacco Addiction

The Robert Wood Johnson Foundation

http://www.rwjf.org/news/special/curbTobacco.jhtml

At least 10 percent of U.S. smokers would quit and 3 million premature deaths would be prevented if 10 policy changes were instituted nationwide.

So says a federally appointed panel that culled available scientific evidence on tobacco addiction and how to curb it. The panel's report, "A National Action Plan for Tobacco Cessation," includes six recommendations from the Department of Health and Human Services, and four recommendations to achieve the end through public-private partnerships.

The federal recommendations include:

A national tobacco quit line
An extensive media campaign
Coverage for counseling and medications in benefits for all federal beneficiaries
A new 10-year research agenda to improve long-term quit rates and help tailor therapies for certain groups (such as pregnant women)
Training and education about tobacco dependence treatments for every clinician in the country
A $2 federal excise tax on each pack of cigarettes

These recommendations, which the panel suggests should go into effect by fiscal year 2005, would cost more than $5 billion each year. Funding would come from the $2-per-pack tax. Half of the estimated $28 billion in annual revenue generated by the tax will be earmarked for programs that help people to quit smoking or prevent them from starting.

By comparison, in 2001, the six largest tobacco companies spent $11.2 billion on advertising and promotions. (See details.)

The panel, established by Department of Health and Human Services Secretary Tommy Thompson, was a subcommittee of the department's Interagency Committee on Smoking and Health (ICSH). It was led by Michael C. Fiore, M.D., M.P.H. director of the University of Wisconsin Medical School's Center for Tobacco Research and Intervention, and a director of the Foundation-funded national program Addressing Tobacco in Managed Care. The group's task was to craft a set of bold, evidence-based recommendations to promote tobacco cessation.

The group met five times between October 2002 and January 2003. In February 2003, the group's report was unanimously endorsed by the ICSH and was sent to Secretary Thompson. The report appears in the Feb. 9, 2004, issue of the American Journal of Public Health.

2) Effectiveness of a Quit and Win Contest with a Low-Income Population

Hahn EJ, Rayens MK, Chirila C, Riker CA, Paul TP, Warnick TA.

Prev Med. 2004 Sep; 39 (3):543-50.

Background: In a two-group quasi-experimental study, we evaluated the impact of a quit and win contest on quitting among low-income tobacco users and identified contest elements used by successful quitters. Low-income tobacco users have been largely untouched by tobacco cessation approaches. Methods: A volunteer sample of 248 low-income tobacco users were recruited from quit and win contest registrants (treatment group). A random sample of 290 low-income tobacco users who had not entered the contest were recruited using random digit dialing (control group). Telephone interviews were conducted with both groups at baseline, 3, 6, and 12 months. Seven-day point prevalence measured self-reported quitting and urine cotinine assessed confirmed quitting. Results: On average, quit and win study participants were 3.5 times more likely than controls to self-report quitting and 12.8 times more likely to demonstrate confirmed quitting after controlling for baseline differences in stage of change, age, education, and marital status. The use of specific contest elements was not related to successful quitting. Conclusions: The overall quit rates in the treatment group were higher than those in the control group. The results are promising given that low-income tobacco users are generally less likely to succeed in quitting.

3) Addressing Tobacco among Individuals with a Mental Illness or an Addiction

Williams JM, Ziedonis D.

Addict Behav. 2004 Aug;29 (6):1067-83.

Tobacco dependence among individuals with a mental illness or an addiction is a tremendous problem that goes largely ignored. Studies of genetics, neuroimaging, and nicotinic receptors support a neurobiological link between tobacco use and alcohol dependence, drug dependence, schizophrenia, depression, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders. This paper summarizes the recent literature on this topic and discusses how treatment for tobacco can no longer be ignored in mental-health and addiction-treatment settings. More research is needed as well as a national organized effort to address tobacco in this large segment of smokers.