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Connections - February 2010
We are pleased to announce the FDA has taken another critical step in implementing its new authority to regulate tobacco products. Today the agency appointed a group of highly qualified scientists and health professionals to its Tobacco Products Scientific Advisory Committee.

The appointed panel includes experts in tobacco control and cessation who understand and support quitlines. One of the key issues to be addressed by the committee is the affect of menthol on youth initiation and cessation. To learn more about this issue, review the Summary of the Second Conference on Menthol Cigarettes (co-sponsored by NAQC).

We will continue to keep members updated on the most recent updates from the FDA as they develop.

Best regards,

Linda Bailey
President & CEO

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Tobacco Control


Final MDS Update Materials Available

The MDS Update process is now complete, and final materials for implementation are available online. Materials include:
  • Introduction
  • Intake questions
  • Intake questions with changes since July 2009 highlighted
  • Follow-up questions
  • Follow-up questions with changes since July 2009 highlighted
  • Comparison of the original 2005 MDS to the 2009 MDS Update
  • Detailed notes on each item, including tips for those asking the questions, as well as tips for analysis and reporting (Annotated Tables)
  • List of common response categories to SI 3 "How did you hear about the quitline” mapping them onto the three major response categories "Media” "Other advertising” and "Referrals”
  • MDS Fact sheet
NAQC and CDC have worked closely to ensure the CDC’s Stimulus Funding reporting requirements for quitlines will contain the same questions as are currently in the 2009 MDS Update. The target implementation date is July 1, 2010, the beginning of each quitline’s fiscal year, or an alternative date that meets the needs and goals of each quitline. Technical assistance for implementation is available by contacting NAQC’s Director of Research, Jessie Saul, at

NAQC’s Advisory Council Meets to Discuss Quality

Members of NAQC’s Advisory Council met on February 11 and 12 to engage in a formal feedback and discussion process focused on the best practices outlined in the issue paper on call center metrics and to build on previous discussions related to monitoring and influencing quality improvement.

The first day of the meeting opened with an author-lead presentation of the quality improvement initiative issue paper (draft version), Call Center Metrics: Best Practices in Performance Measurement and Management to Maximize Quitline Efficiency and Quality. Following the presentation, three primary reviewers presented their feedback to the author and additional comments were taken from the remaining advisory council members in a facilitated discussion. The second day of the meeting was primarily dedicated to clarifying and receiving input on NAQC’s role in achieving the 2015 strategic goals and how we will measure our progress toward those goals.

NAQC remains thankful for the leadership and expertise of this group and the time and energy they continue to dedicate to the quitline community.

February’s Webinar Summary Now Available: Call Center Metrics: Essential Elements for Ensuring Quality

The summary of the recent webinar on call center metrics is now available. We have included highlights from the presentation as well as comments and questions addressed during the discussion. If you participated in the webinar, please take a moment to complete our short evaluation survey.

Thanks so much for your continued support of these important learning sessions. April’s webinar, Improving the Quality of the Counseling Intervention: Strategies for Quitlines is fast approaching. Should you have any ideas for presenters, programs to highlight, or any questions related to this webinar or series, please contact Tamatha Thomas-Haase at

NAQC Releases Annual Report

Moving Quitlines Forward: North American Quitline Consortium Annual Report (2008/2009) is now available. As part of our green initiative, only designated representatives from each member organization were sent printed copies. Hard copies of the report are available upon request.

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Tobacco Control

D.C. Quitline Launches Mobile Research

The American Legacy Foundation's Schroeder Institute for Tobacco Research and Policy has launched an innovative study examining the effectiveness of mobile phone support for the D.C. Tobacco Quitline.
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Quitline Iowa Sees Record Number of Calls

Quitline Iowa saw a record number of calls in January looking for help to quit smoking. Quitline coordinator, Jeremy Whitaker, says over 5,000 people called for help in January. Whitaker says a lot of the calls were driven by the offer of four weeks of free nicotine patches, gum or lozenges for anyone who called in to 1-800-QUIT-NOW. He says they had a great response when they made the same offer last year and were surprised to see an even bigger response this year.
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Quitline Messages That Stress Benefits of Quitting May Improve Smoking Cessation

Smokers who received gain-framed messaging from quitline specialists (e.g., stressing the benefits of quitting) had slightly better cessation outcomes than those who received standard-care messaging (e.g., potential losses from smoking and benefits of quitting), according to a new study published online in the Journal of the National Cancer Institute. Researchers also established that quitline specialists can be trained to provide gain-framed messaging with good fidelity.
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FDA Announces Tobacco Products Scientific Advisory Committee

The U.S. Food and Drug Administration today announced membership and meeting information for the Tobacco Products Scientific Advisory Committee (TPSAC). The Committee, requiredthrough the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act), will provide advice, information, and recommendations to FDA on a wide range of tobacco-related issues.
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ARRA Announces Awards

HHS announced award recipients for one of the four components that make up Communities Putting Prevention to Work—the States and Territories Policy and Environmental Change Initiative. Recipients will receive a total of $119.1 million for the 3 categories of projects: statewide policy and environmental change, special policy and environmental change initiatives, and tobacco cessation through quitlines and media. All 50 states, Washington DC, and Puerto Rico received funding, as well as 6 territories. And, through a supplemental award, additional funding was provided to 13 states to support special initiatives.
fact sheet
media release

NTCC National Priorities Activities Update

At last year’s NTCC Annual Meeting, several long-term, overarching priorities around tobacco cessation were introduced—the Tobacco Cessation Priorities for the Nation. Over the past year, NTCC and partners have been working on various initiatives and activities to address these priorities.
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Local Smoking Cessation Workshops (sponsored by Pfizer)

Smoking cessation workshops, led by tobacco treatment specialists trained by Mayo Clinic, are coming to communities across the country for people who want to learn about quitting smoking. The free, hour-long workshops can accommodate as many as 20 people at a time and include presentations from a former smoker who quit with a prescription treatment option and support. These workshops provide attendees with a non-judgmental environment where they can learn about tools (e.g., plans, treatment options) to help them make a quit attempt.

NOTE: These smoking cessation workshops are being offered by Pfizer, Inc. To view the dates of upcoming clinics in your area or to register, log on to or call 1-888-866-0843.

Two Medicine Combinations Shown Effective for Quitting Smoking

Smokers trying to quit smoking for the holidays have the best chance for success if they take the nicotine lozenge in combination with either bupropion (a pill) or the nicotine patch, according to researchers at the University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI).
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Cessation Services in the States

The most extensive tobacco control programs in the United States, including cessation services, are provided or regulated by the states. Several recent reports offer a snapshot view of the progress that states are making in directly providing cessation services, paying for them, or assuring that other payers cover them. The results fall far short of what is needed to reach the goal set by the Call to ACTTION—expand access to comprehensive tobacco cessation treatment to 50% of smokers by 2015, and 100% by 2020.
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Company Seeks FDA Approval for Tobacco Lozenge

A small company in Virginia says it's the first to apply for special approval from the FDA to certify its tobacco product as a safer alternative to traditional tobacco products. The company, Star Scientific, based in Glen Allen, Va., is seeking a "modified risk" approval for its Ariva-BDL, a wintergreen-flavored, dissolving tobacco lozenge.
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American Cancer Society to Manage New Effort Against Tobacco in Africa

African nations face the highest increase in tobacco use among developing countries. In response, the Bill & Melinda Gates Foundation has given a grant of $7 million over five years to the American Cancer Society to lead and coordinate the African Tobacco Control Consortium, a global coalition of public health-oriented organizations focusing on using evidence-based approaches to stem the tobacco epidemic in Africa.
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Coded to Obey Law, Marlboro Lights Become Marlboro Gold

When it comes to new rules for marketing so-called light cigarettes, tobacco companies plan to honor the letter of the law—but to shade the truth, critics say. Come June, under the new federal tobacco law, cigarette companies will no longer be allowed to use words like "light” or "mild” on packages to imply that some cigarettes are safer than others. But in a move that critics say simply skirts the new rules, tobacco companies plan to use packaging to make those same distinctions: light colors for light cigarettes.
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Defragmenting Healthcare: Science, Medicine and Smoking

The lag between what we know about helping smokers and what we do to help them opens a window into the gaping hole between scientific knowledge and clinical practice. What is the magnitude of the consequences of the smoking addiction on our health care system and why should we be concerned about it?
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Financial Penalties for Tobacco Companies

Six public health groups that have been granted intervenor status in the DoJ lawsuit against the tobacco companies filed a petition asking the U.S. Supreme Court to review the Appeals Court decision restricting the remedies that could be imposed on the tobacco companies as result of their violations of the RICO Act. The Department of Justice also announced it is appealing the decision.
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Legacy and the Ad Council Team Up to Help Smokers "Re-Learn Life Without Cigarettes"

LegacySM and the Ad Council have partnered to help smokers "re-learn" life without cigarettes with EX®, a national quit smoking campaign sponsored by the National Alliance for Tobacco Cessation (NATC), in order to help the 43 million Americans who smoke to finally quit. The campaign is being unveiled in conjunction with New York State's recently renewed membership to the NATC.
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e-Cigarettes Not Subject to FDA Oversight as Drug Delivery Device

In a decision that riled the public health community, a federal judge ruled that the Food and Drug Administration cannot regulate electronic cigarettes as drug delivery devices. The case was prompted when the FDA in September 2008 seized imports of the battery-operated devices that vaporize a nicotine solution for inhalation.
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NIH and FDA Announce Collaborative Initiative to Fast-Track Innovations to the Public

The National Institutes of Health and the U.S. Food and Drug Administration announced a new collaboration on regulatory and translational science via a webcast on February 24, 2010. This new collaboration will help speed the translation of research into medical products and therapies.
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Global Tobacco Report Outlines 21 Challenges for 21st Century

A new American Cancer Society report outlines 21 challenges and needs for global tobacco control, covering the wide range of issues to be addressed and expertise needed to reduce the rising tide of tobacco use worldwide, particularly in the low- and middle-income nations that are the target of the multinational tobacco industry. The report is published early online and will appear in the January/February issue of CA: A Cancer Journal for Clinicians.
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Guam to Increase Tobacco Tax

A law that will go into effect in April will increase Guam's tax on tobacco from $1 per pack of cigarettes to $3, a move that is hoped to raise additional money for the government's Healthy Futures Fund while also reducing the number of smokers on the island.
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American Heart Association Introduces My Life Check: The Simple 7

A recent survey shows 70% of Americans have been told to make lifestyle changes by a doctor or other healthcare professional. No matter what day it is, it’s never too late to make better choices for health. All you need is a goal, a plan, and the desire to live better. The American Heart Association has developed a way for anyone to know where they stand on the road to good health.
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Tobacco Taxes: A Win-Win-Win for Cash-Strapped States

By increasing cigarette taxes by $1 per pack, states could raise more than $9 billion in annual revenue to help close severe budget shortfalls, while also reducing smoking and saving lives, according to a new report released today by a coalition of public health organizations. The poll also found voters far prefer higher tobacco taxes to other options, such as other tax increases or budget cuts, for addressing state budget deficits.
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Operation Cessation: Curbing Military and Veteran Tobacco Use

The U.S. military has a long history with tobacco products. Cigarettes were issued in daily rations throughout World Wars I and II, and even into the Vietnam War. This unhealthy tradition came to a formal end in 1975, and today many military leaders hope that tobacco use will soon be just that—a thing of the past. The Department of Defense (DoD) has launched an online interactive tobacco cessation program that developers hope will help bring military tobacco use rates down.
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ClearWay Minnesota Releases Tobacco Industry Report

ClearWay MinnesotaSM today released Unfiltered: A Revealing Look at Today's Tobacco Industry, a campaign that shines a light on how the tobacco industry has continued to evolve and thrive, despite billion dollar settlements designed to change the way the industry did business in the last decade.
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SBE Council Joins the Coalition to Stop Contraband Tobacco

The Small Business and Entrepreneurship Council announced its membership in the Coalition to Stop Contraband Tobacco, an organization urging the U.S. Congress to pass the Prevent All Cigarette Trafficking (PACT) Act.
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Smoke-Free Air Policy Implementation

The Tobacco Control Network (TCN) Strategies for Smoke-Free Air Policy Implementation Teleconference Series has released the materials associated with its January webinar, Health Benefits of Smoke-Free Air Policies: Taking the Institute of Medicine Report to Heart. This webinar reviews the outcomes and case studies associated with the Institute of Medicine (IOM) Report, Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence.
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UK Releases Tobacco Control Strategy and Regulations for Nicotine Inhaler

The Department of Health for England announced a new strategy for tobacco control including the development of services for gradual cessation over months—recruiting smokers who want to cut down but not quit in the immediately foreseeable future.

In parallel, the MHRA (the UK equivalent of the U.S. FDA) announced an extension to the license for the nicotine inhaler, though the principle applies to all forms of NRT. This extends the license to harm reduction, e.g. for partial substitution of cigarettes in people who are unable or unwilling to stop smoking. The product can be used indefinitely, with no maximum duration of advised use and concurrent with smoking. This extension of the license to harm reduction applies to pregnant women. The agency is consulting on whether to bring other currently unregulated harm reduction nicotine products (e.g., e-cigarettes) under its umbrella.

Confronting a Neglected Epidemic: Tobacco Cessation for Persons with Mental Illness and Substance Abuse Problems

Schroeder SA, Morris CD. Annu Rev Public Health. 2009 Dec. 15 [Epub ahead of print]

This review article examines the existing literature on tobacco cessation for people with mental illness and substance abuse problems, noting this population consumes 44% of all cigarettes, reflecting very high prevalence rates plus heavy smoking by users. Current treatment standard and areas for future progress are also discussed. Expected final online publication date for the Annual Review of Public Health Volume 31 is March 17, 2010. Please visit Annual Reviews to see revised estimates.

"Real-world" effectiveness of reactive telephone counseling for smoking cessation: a randomized controlled trial.

Sood A, Andoh J, Verhulst S, Ganesh M, Edson B, Hopkins-Price P. Chest. 2009 Nov;136(5):1229-36. Epub 2009 Feb 18.

This study evaluated the real-world effectiveness of reactive telephone counseling (tobacco users call in for all contacts, no outbound calls are made) with callers to a helpline run by the American Lung Association chapter of Illinois-Iowa. A control group received only mailed self-help literature, and a study group also received supplemental live reactive telephone counseling. Follow-up was conducted at 1, 3, 6, and 12 months after study enrollment. Quit rates were not statistically different between the two groups at any of the follow-up points. The authors conclude that supplemental live, reactive telephone counseling does not provide greater success in smoking cessation than self-help materials alone.

National Health Interview Survey Results Released

CDC/NCHS, National Health Interview Survey, 1997-June 2009, Sample Adult Core component.

For the period January through June 2009, the percentage of adults aged 18 years and over who were current smokers was 20.4% which was not significantly different from the 2008 estimate of 20.5%. See page 56 of the document for details.

The NSDUH Report: Use of Menthol Cigarettes

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (November 19, 2009). Rockville, MD.

This study examined use of menthol cigarettes. The study shows the levels of menthol cigarette use among Black smokers is more than 4 in 5 (82.6 percent) and remains much higher than White smokers (23.8 percent), Hispanic smokers (32.3 percent) and smokers from other racial and ethnic groups. The study also reported smokers who started smoking in the last year are more likely to use menthol cigarettes (44.6 percent) than long-term smokers (31.8 percent). And among persons who smoked in the past month, the percentage of menthol smokers is rising—from 31.0 percent in 2004 to 33.9 percent in 2008.

Figure 4. Past Month Menthol Cigarette Use Among Past Month Cigarette Smokers Aged 12 or Older, by Race/Ethnicity: 2004 to 2008

Source: 2004 to 2008 SAMHSA National Surveys on Drug Use and Health (NSDUHs).

Reaching Spanish-Speaking Smokers: State-Level Evidence of Untapped Potential for QuitLine Utilization

Burns EK, Levinson AH. Am J Public Health. 2010 Feb 10. [Epub ahead of print]

This study examined the effects of a Spanish-language media campaign on the reach and outcomes among Latino smokers in Colorado. Call volume among Latinos increased 57.6% during the campaign. Callers during the campaign were significantly younger (less than 45 years old), more often Spanish speaking, uninsured, and less educated than callers before the campaign. Program completion and medication use were similar before and during the campaign, and quit rates improved slightly (7-day abstinence: 29.6% vs 41.0%, P=.07; 6-month abstinence: 9.6% vs 18.8%, P=.04). The authors conclude it is possible to increase quitline-supported quit attempts among younger, low socioeconomic status Latinos.

For more information, including a comment by Linda Bailey, NAQC President & CEO, see NAQC’s Newsroom.

The effect of linking community health centers to a state-level smoker's quitline on rates of cessation assistance.

Shelley D, Cantrell J. BMC Health Serv Res. 2010 Jan 25;10:25.

This study examined the effect of a fax referral system linking community health centers (CHCs) with the New York State Quitline on rates of provider cessation assistance. Two comparison CHCs offered usual care (expanded vital sign chart stamp that prompted providers to provide the first 4As), and two intervention CHCs received the chart stamp plus an office-based fax referral link to the quitline. Adherence to the 4As increased significantly over the study period for all CHCs, with no differences between sites. Intervention sites were 2.4 times more likely to provide referrals to the quitline over control sites and 1.8 times more likely to offer medications and/or a prescription. The authors conclude that referral links between CHCs and state quitlines may offer providers a practical method for referring smokers to effective services.

State Preemption of Local Smoke-Free Laws in Government Work Sites, Private Work Sites, and Restaurants --- United States, 2005—2009

Centers for Disease Control and Prevention. MMWR. February 5, 2010 / 59(04);105-108

This report updates previous analysis on smoke-free laws in government work sites, private-sector work sites, and restaurants, and summarizes changes that occurred from December 31, 2004, to December 31, 2009, in state laws that preempt local smoke-free laws for the same three settings. During that period, the number of states preempting local smoking restrictions in at least one of these three settings decreased from 19 to 12. In contrast with the 2005 findings, this decrease indicates progress toward achieving the goal of eliminating state laws preempting local smoking restrictions. Further progress could result in additional reductions in secondhand smoke exposure. For this analysis, preemption was defined as a statute or judicial opinion that prevents local jurisdictions from enacting smoking restrictions that would be more stringent than, or different from, state law.

Using the Postpartum Hospital Stay to Address Mothers' and Fathers' Smoking: The NEWS Study.

Winickoff JP, Healey EA, Regan S, Park ER, Cole C, Friebely J, Rigotti NA. Pediatrics. 2010 Feb 1. [Epub ahead of print]

This study tested the feasibility and acceptability of introducing an intervention to address mothers' and fathers' smoking during the hospitalization after childbirth. Parents of all newborns who were current smokers or recent quitters were assigned to an intervention or control group. Intervention group parents received an in-hospital counseling session, and were offered a fax to their provider and quitline enrollment. 94% had a fax sent to their provider, and 75% accepted quitline enrollment. Increases in abstinence and quit attempts were not statistically significant between the groups, although sample sizes were small. The authors conclude that enrollment of mothers and fathers into treatment services during the immediate postpartum hospital stay are feasible and seem to stimulate quit attempts.

Changes in Tobacco Quitlines in the United States, 2005-2006

Keller PA, Feltracco A, Bailey La, Li Z, Niederdeppe J, Baker TB, Fiore MC. Prev Chronic Dis 2010;7(2). mar/09_0095.htm. Accessed Feb 19, 2010

This study reports changes in quitline services, funding and use from 2005-2006. The study found that by 2006, all 50 states, the District of Columbia, and Puerto Rico had quitlines, and annual mean reach was approximately 1% of US adult smokers (aged 18 years or older). Significant increases were seen in mean quitline reach, mean per capita funding for quitline services, and provision of free cessation medications; otherwise, few changes were seen in quitline services. The authors conclude that, while progress is being made, further research and investment to optimize quitline service delivery and reach are required for quitlines to fulfill their potential of improving health at a population level.

NCI Funds e-Cigarette Study

A study funded by the National Cancer Institute (NCI) is scheduled to be published in an upcoming issue of the journal Tobacco Control. The study extensively monitored nicotine levels in the body and heart rates of participants when using both traditional and electronic cigarettes. Results indicate e-cigarettes are about as successful at delivering nicotine as puffing on an unlit cigarette.
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Menthol Cigarette Update

The Second Conference on Menthol Cigarettes (co-sponsored by NAQC) has concluded that menthol makes it easier for youth to start smoking and may make it harder for smokers to quit.
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CDC Seeks Proven Scientific Leader to Serve as Director of the Office of Smoking and Health

The Centers for Disease Control and Prevention (CDC), through its Office on Smoking and Health (OSH), is the lead federal agency for comprehensive tobacco prevention and control. OSH is a division within the National Center for Chronic Disease Prevention and Health Promotion. Originally established in 1965 as the National Clearinghouse for Smoking and Health, OSH is dedicated to reducing the death and disease caused by tobacco use and exposure to secondhand smoke.
job announcement

ADPH Releases RFA for Online Cessation Services

The Alabama Department of Public Health (ADPH) is seeking competitive applications to operate online cessation services to meet the needs of Alabamians seeking Web-based access to individualized counseling, educational materials, nicotine replacement therapy, and referral to onsite cessation programs. Funding for this 22-month project is from the American Recovery and Reinvestment Act (ARRA) for 2009.

13th Annual Health Education Advocacy Summit

March 6–8, 2010 in Washington, DC
more info

2010 Joint Conference of the Society for Public Health Education and CDC Prevention Research Centers (PRCs) Program

Advocate, Communicate, and Translate to Enhance Research & Practice
April 7–9, 2010 in Atlanta, GA
more info

Society for Behavioral Medicine 2010 Conference

April 7–10, 2010 in Seattle, WA
more info

Promising Practices: Achieving Health and Social Equity in Tobacco Control

April 27–28, 2010 in New Orleans, LA
more info

APPEAL 15th Anniversary Conference

June 3–4, 2010 in San Francisco, CA
more info

20th Anniversary Social Marketing in Public Health Conference

June 11–12, 2010 in Clearwater Beach, FL
more info

11th International Congress of Behavioral Medicine Conference and Call for Abstracts

Translational Behavioral Research: A Global Challenge
August 4–7, 2010 in Washington, D.C.
more info

National Association of Local Boards of Health (NALBOH) 18th Annual Conference and Call for Abstracts

August 5–7, 2010 in Omaha, NE
more info

Seventh National Conference on Quality Health Care for Culturally Diverse Populations

October 18–21, 2010 in Baltimore, MD
more info

APHA Annual Meeting & Exposition

November 6–10, 2010 in Denver, CO
more info

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