North American Quitline Consortium
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New Report Finds More Smokers Calling Telephone Quitlines
But State Budget Cuts Put Progress at Risk
PHOENIX (April 7, 2010)—Record numbers of U.S. smokers are turning to telephone quitlines for help in breaking their addiction, but access to this critical service is being put at risk by state budget cuts, according to a report released today by the North American Quitline Consortium and other public health organizations.
The number of tobacco users calling quitlines—a telephone helpline where smokers can turn for trusted, reliable help when they want to quit—increased 116% between 2005 and 2009, according to the report. Despite this increase in demand, total funding for all U.S. quitlines decreased for the first time ever in Fiscal Year (FY) 2010. The full report, U.S. Quitlines at a Crossroads: Utilization, Budget, and Service Trends 2005-2010, is available at: www.naquitline.org/report. This report was produced with funding from the Robert Wood Johnson Foundation.
Funding has been cut despite the fact that states will collect $25.1 billion in revenue this year from tobacco taxes and legal settlements with the tobacco industry, and more states have already enacted or are considering tobacco tax increases this year. These increases will motivate more smokers to try to quit and provide additional revenue that states can use to fund quitlines and other tobacco prevention and cessation programs.
"At a time when demand for quitlines is at a record level, it is more important than ever to support proven tobacco cessation efforts,” said Linda Bailey, president and chief executive officer of the North American Quitline Consortium (NAQC). "The investment of $2.19 per capita for quitlines, as recommended by the Centers for Disease Control and Prevention,1
is based on sound science and real-world experience. States that made the necessary investments have been able to provide cessation services to the growing number of smokers who want to quit. We commend the states that have committed the necessary funding to quitline services and encourage them to continue this practice."
In late 2009, all publicly-funded quitlines in the U.S. were asked to complete a survey to assess their financial and service capacity. The NAQC-administered survey included questions related to: quitline budgets; changes in budgets over time and their impact; funding sources; promotion and utilization of quitline services; and capacity to provide services to tobacco users. The report shows that while quitlines have made tremendous progress in financial and service capacity, this progress is being put at risk by a seven percent decrease in total funding for all U.S. quitlines in FY 2010.
While federal and state economic conditions are difficult, the resources do exist to fully fund quitlines and comprehensive tobacco control programs consistent with the best practices recommended by the Centers for Disease Control and Prevention (CDC).1
According to a recent report on how states are spending the money collected each year from the Master Settlement Agreement and other tobacco tax revenues, in "Fiscal Year 2010, the states will collect $25.1 billion from the tobacco settlement and tobacco taxes. They will spend just 2.3 percent of it—$567.5 million—on tobacco prevention and cessation programs.”2
Funding can also be raised through a dedicated tax on tobacco products.
The report found that for FY 2009 to FY 2010: 27 states reported quitline funding reductions; 20 experienced reductions in service budgets; 19 states cut back spending on medications; and 25 reduced funding for promotions. While 20 states reported funding increases for quitlines, further analysis found 12 of these states experienced reductions to their overall tobacco control program budgets.
State quitline budgets have continued to decline since this data was collected. As states enact tobacco tax increases this fiscal year to address ongoing budget shortfalls, smokers will undoubtedly turn to quitlines for help. But the services they need may not be available. With reduced funding comes longer hold times for smokers when they call, fewer follow up calls from counselors, and less medication assistance, such as the patch, gum, or lozenge.
"The downward trend in quitline funding is alarming," said C. Tracy Orleans, PhD, senior scientist for the Robert Wood Johnson Foundation. "According to the CDC, more than 40 percent of U.S. smokers try to quit every year, and we know that without assistance most will relapse.1
All smokers and quitters need better knowledge of and access to affordable and effective treatment that can help them live longer, healthier lives.”
Tobacco kills more than 435,000 U.S. residents every year; this represents twice as many deaths as those attributed to alcohol consumption, motor vehicle use, firearms, and illicit drug use combined.3,4
As noted by the CDC, "quitlines are effective in increasing successful quitting and have the potential to reach large numbers of smokers.”1
Also, the U.S. Public Health Service states, "quitlines significantly increase abstinence rates compared to minimal or no counseling interventions” and, "the addition of quitline counseling to medication significantly improves abstinence rates compared to medication alone.”5
The evidence exists to support the investment of a robust, national network of state-run quitlines. Failing to maintain and enhance this investment makes it even more difficult for our nation to meet the national goals of reducing smoking prevalence among adults,6
achieving the associated population and individual health improvements, as well as the budgetary benefits of this prudent investment. Overall, quitlines work—they save both lives and money.NORTH AMERICAN QUITLINE CONSORTIUM
The North American Quitline Consortium (NAQC) is a non-profit organization that strives to promote evidence-based quitline services across diverse communities in North America. By bringing quitline partners together—including state and provincial quitline administrators, researchers, quitline service providers, and national organizations in the United States, Canada, and Mexico—NAQC helps facilitate shared learning and encourages a better understanding of quitline operations, promotions, and effectiveness to enhance overall quitline efforts.1-800-QUIT-NOW
For access to free quit smoking support, including quit coaching, educational materials, and referrals to local resources, call 1-800-QUIT-NOW (1-800-784-8669). This toll-free telephone number connects callers to counseling and information about available quitline services in their states.
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Centers for Disease Control and Prevention. Best Practices for Comprehensive Tobacco Control Programs—2007. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; October 2007. Reprinted with corrections.2
Campaign for Tobacco Free Kids, "A Broken Promise to Our Children: The 1998 State Tobacco Settlement 11 Years Later,” December 9, 2009. See http://www.tobaccofreekids.org/reports/settlements/FY2010/State%20Settlement%20Full%20Report%20FY%202010.pdf (accessed 12/11/09).3
Mokdad AH, Marks JS, Stroup DF, et al. Actual causes of death in the United States, 2000. JAMA 2004;291(10):1238-1245. Correction published in JAMA 2005;293:298.4
Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA 2005;293:1861-1867.5
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008.6
Healthy People 2010. Objectives for Improving Health. Tobacco Use. http://www.healthypeople.gov/document/html/Volume2/27tobacco.htm (accessed 1/28/2010).