Tobacco Documents Online

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I I I I I I I I I I I I I health educxtion." Another ttiurier to acccw.ibilit,t• nLtv be rclued to the cost (both direct and indirect) ot stxh program,.- Trend arlal • y':res -tugM, t that cij,arctte amoldng i.• inamoingiy a behavior of t23e lc" edu• cated and aoc+ocronocnlealty <1Laad%-an- taRed aegnient-< o(our aociety." The+e individual.~ mlty have limited financial rr.ourcr• and are pmbabl,v the Iea.st likel,v to enroll in retaation progl•am.s, Accrct mkv be llirther limited by curr rant insurance poticies, which rarely re- imburre for anloldng-ces;aat3on activi- tie$~)I,T A final barrier to the u_.e of cessation progrant~ mz.v be that they are unac- ceptable to certain "gtnent_ of the pop- ulation, including those with the highest srnokinR prevalence t3tea." Blue-collar workers, for axample, mkv not reapond to adwrtisementa and program materi- als that art targeted ~marlly toward white-collar .rorkera Similarl,y, His- panics and blscica may be better asstisted by culttlrall,v <pecific materials. Fflnallr, <moking-ce:wtaon literature is often written at a level beyond the literacy Adlls of many :cmokers."Ihe National Cancer Institute is currently &v~e~aing cessation progtam•t de,dgned apecifical- l,v for minolit,v popula.iott.,° Factors That CofltrlbtJte to Suee.sslul Casution The ttnding that per+ow w ho attempt to quit ulwking on their ow •n are altnwt 1• FK.xe~ 1~IG ~matLvTE, PicmJF, Hatsiv+dnw F.7. F+tri i;X. Da.ia RI1• Ttrnd& ta c}lamtte >~ m the Unhcd Statra the cl+aRiryt tnRu. mc+r of t,.ret<4K and tsa. J,I.YA.IRY`:+61:O.W 2, F1eme JF Fsom AIC, Naouy Tfi, Hatriasxlnau EJ, thti. Rat. 'lrveda tn e*arv-ttt amaidmc tn tho Uaited Ratra: {xujactfaa to tl+eyrnr Wt>0, JAM,I. 1SNR."til;til•lCt• 3. C.et.n Ar Dirrw Co.+tml. Jt1.1w+oy fM HwhA Q*u.tW+M+ ef $~ aR n 1i.rs e~tf1Ms. p+rnx Rnekrdk, Mt US Dept of HeahA and Htr arn `'.Yr±eaa~ 1Rlo. A trl+aet oCtAe Cirytem C.eeet` aL DHt{~Pu~lkatiot+tCDC1:tP.'Y11, t. Hats'a,>anv sJ, tl'eeta Jr, Wltetoalou ?x. et al• QwltlTaC ustaldnR ia tl+~ Usktd ~tr. ia 1~Y. J \Oft ('4w~e~ ~M~f. Itl tM~MI S hettkeTE, Rattiw R,\, flrFrie.o CH, lZ+rk.ke atL Attnt,uus t+f rax•ev.dttt anddnt eewatxn ut• tertt•rttket. h+ a+ed.~cQ traetiee: a saeta•ae.tetiis d 2laxKrVikd jiah..Clafd. R('.Lmco.• RE, LicAtKStdn E• Lmtx+ter+n eflrcts P~ ttC1Ml1CRA1 MMldiV elVwltiM WMMtl,YtA Iy` Aur .IM+ Tfi.. 1R~~.1 C~T:C`L .. IeRawrtttJ L A errtitwl r•n~e.r aad en*lusti,+n e[ ' >lanldne e.v+t.t,nt metLKal+. NNw Hiatll. A1rF t•.iti,eart: JL 1tY.:nrad 1Mfr.e... hf ~ti...!• ty Cl+.ln+l afKA..fa: C`.tMt CtHw awi t1r.wA., 1M1~!! . RetlK.da. lldA US Drft et Hew1tA. F•du- eax~a and N1+tlar~e 1!^l HE\V r"Ne>u,i,in tCPC) \'CRR A CtdeaftsJL AY.bw..l JMl tq(tis.Nn.afeMal+~ t~.Nrf Q.f....lf1t..~Ir, lf !•1ldti. MtlKa1. 11dz t'Q N'gt et He.1tA and 1t.w.aw brae.~ 11tt:• Nakw.l 1Mutrt.o of „A ~t-r ,4A^ v.••.Y,t M+;n twice as like~v to aucrced a.+ xr.wn.s a ho aeck help is not surpriainR given the oh,.erti•ation that eemcion pro- grams ma,V attract the mos t ttronglV addicted amokem The lower sslcce.~s rate alranit per:%otls usinR ce"ation pro- pram•s may be exptaired by the finding that program ts.ers difter frr-n FeraotLs who try to quit on their oa 1-, ;,r, number of prcwious quit attetnpta, number of cigarettes amoked per da;i: tetc2. Postiti - bly, gelf-quitters have mote co.-lhdence in their ability to quit betmll»e they are lens nicotine dependent '<sm per.ons who seek help in quitiing ` Ptsarmaco- logical agents to nronmx• cessation, wch as nicotine gum, have :,een cited as aids to increaae succem''1jOur ur a;i; do not support this conclusion, with few aucce,teRtl quitters in our•tudv report- ing nicotine gum use as n metiwd of cessation. Its limited mz •lrihty at the txme of this aur+w and i; rtvf'or gum uae' hoa•ewr, mav have con~;ril.atted to the low utiGation rate in `1sy •stud,y. Our data also pro.'i& lndir.ct evi- dence of the importance of thc play,st-an in helping smokers to quit. More t]wl ?0% of .ucceeders and rtapeem had been ur* to quit by a dortor (Table Y). In t:ontra.o, only 46% of all amoker. m:r• ver'ed in the Adult Use ot ibb.ceo aut- rtw, had been advi.ed by a doctor to quit •Troking." Moreomrr, our cla:riheation of ce:aation method sras ba..ed e_Xclu- v on the method used to quit and ma,v have undere-Kimated tlx ifnpat•- 1te.hA pol~Ikwuaa:9'„"4KL 10. CAapce.* `~epasoitntit clu+ie.c a c... ibr tAMr abaudontts.t. 4t.vt.19l& 1 i1:1•Ytaa• 11. Coalxa Itx tti.mw. Coatroi• 7Ll.eee Car t. 1l.+R 3/dbab tad liaa 1Y1alaiau ltier Adrh t'+. 4 JU6.mo .A.." RdticW i., 1tk LN Dept d liealtA atit Haatsn Serasee.r 19PA 12- Unt WA, Paraett LN, 6ru'tth Lf•. Relsp+e rata tn adktktn peaarww i t'k« fArye+bl• 1!rl~.i ~i ll C,LC L;arr> ti•nca. S Sti. noa, ptrx, ~C CA.C Isutat.la 3!e>!S, li. Pkra .?; \trtu+a D.C 1Gklta S, Gbddna T, WVliamCAtsoe R, A ca+t+dkd tnl d be.hh ed,uwjon tr w~t7ic~,1. :Rett t~.. x.l. lte4;1: 1:&:1K alC, Nv.: rs 7'; Hatri.n 1S• Pvv%e m, Fkre dten F..t tluu RH. Tt.w& ia ilt,wue s reid++R In t1e Unhed •tas+:.dnrak+ea2 wfeeeftna ur 1m crm.irK. J.' .Y,4 1R&.'lSt~S"Ct 1R. \nr4 rq ; F VkrnWr i;E, .ir..lnet J:C et a1, 'lt+ahirw M,r Norkr aw,t stutevc .ati+re"eeae aM d,woCroph* 1N.ll'fm!'14 •'twl HfthJ. 1!i.`C_Mal:ra q~ 1S, Cw•p+ RD• 1't.wsWte• nad.t:er *res aer3mte naslucurtts• t}a/hrta.zr 4r al'•tS,4fi1: 131 1•l Ckb+di atA. Tlw dMlrke t.« t'.:~tiea d asrFoe. tw akJ I eteetiea iaeett • fnrsc as aa.l.rair devtxett l1.rNwi, iRt4lS'A"t ;51et M Clt.pa.a LC Aaeid t!r!, ttw evanieilY te t..ek Nw-t.~q.r.arl.e+~ fi.a1~. HwtJL1 f11• r..a J%tv 1!!Q? "-w :1. ?L.s. CD. ReM JC tlttirx 1R"t. and the e..d.b.iRr d-r,tltK.dreuts• 1rt.n.tt,1.. Aw J tance of a?l>,vaicianh advice to motivate a smoker to make a quit attempt. Fbr example, if a respondent had been urged by his or her physician several times over a period of years to stop smoking and then quit cold turkey, the respondent would still be categorized as having used an unasaisted method of ce<sation. Recent studies have indicat- ed that, with a little training, physician intervention can &•1gniScantl,y increase the proportion of smokers who success- illll,y quit.r" The National Cancer Insti- tute has summarised these findings in its recent publication, How to Help }owr lbtient:t Stop Smoking.' Value of C.ssat4ott Programs We conclude that ce-.-ation programs play a limited, but imporiant- public health role. They appear particularty to be treating heavy amokefa, the group at highest risk for the dose-dependent morbidity and mortality M"ociated with cigarette amoking. In addition, even though the percentage of persons uning ce&%ation programs is small, the actual number is large. Consider the 17 mil- lion smokers who reported having at- tempted to quit in 1936.' I f 16% of these vnokem used ceaaation programs, the number of par+ons using these methods would exceed 2 million each y'ear. 1Nr .ioA to tlmle CtepAen x,vev., PAn. c.ron lettr+ltanL ud Rklurd Rothenterg,1ID• fortheir aaWdatl<e in prep.rinW and e[•ric.ring the arnva<rspt- h1lkHrottA• IAti?7?~i'~o6. :1. \.tionaa Cancer Itrtkuto. Snroki.q 7Lbetro, a.d Cean. P eq+eat: 1ld3-tfsf Smhu R.poa. Rello.da, Ud: US Dept of He.lth and Human Se+- tietv lnpee... r- Randurt A. Seeial FLwadaJioM of fhowpAt a.J.ktioa: A SariaJ Cagw,h r. Ta.a.Fc EnCie+aod CliHa, NJ: Pr.ntkriHaU inc 14PB, ZL Conten Ibr Di.ew Contral. 1~+ H.atfA Co* • arp..eru qf SlMek;M: Nkof;M. AddiefioM. Rodt- r+Ds, Md: US Dept of HealAt and Htnnan Servkt+: 1lR9• A eePoet of tA. Stintea+Genets119R8, DH HS Fubfjatien lCDC1 rbA10d. a. Reneeiu NL Plurtbt•eioRk npttt+ oteir- eato .nakisY and nkatlne addkttea• V sapi I x'd, ltlelCll tk t s I A-1 tto, :L GuneainRs SR. Haer.n B, Rkiurd RJ, Stein aLJ, Ca.te. TJ• Internbta and rthotine /NnL ldYA 1!liR~k1E63•186A 2L Tenetr.mn P. Fr,vd V. Ha>s.rs1 H, et a!. F•RM•. d uitotbVt#vt*inRltua in tanbtnation wltA RMP com".tMK m the t,nwtbn d sntokine• N S.pt J xrd. lklt;11fi1S•ttl t. Gl7nn TJ. llaelpr AlW. }4dtarek TF• Phyai- cmt•kdthUd anektnR Rwatkn prt,Rr,m: the N.- tfar! Cancer Iwtitute triaL, In: Etvt+aom P, eda. Almaew im CaaerrCoOtot• NeR York. NY: Alan R L1r Inc In peam = Cbrnn TJ• ?1nnkJ HW. Hear to H.tp F•an J1ti..ti Stop S~eknp: ANa„os! Cascer futi• trh M.ar! J6. Phrweraa &Cfx+da, Md: US L4ptctHe.h.h atd Hmn.n Serskw lA&9. Natketl la.tltateh d H.+hA PoWt+tton Al.106L MyttpesClwOpQWtSrtvt.K,-FqpMM 27fi