Programs that successfully assist smokers, regardless of age, in quitting can produce a quicker and probably greater short-term public health benefit than any other component of a comprehensive tobacco control program. Smokers who quit smoking before age 50 cut in half their risk of dying in the next 15 years. In addition, implementation of moderately-priced, effective smoking cessation interventions would more than pay for these interventions within 3 to 4 years through cost savings from reduced tobacco use. One smoker successfully quitting reduces the anticipated medical cost associated with acute myocardial infarction and smoke, for example, by an estimated $47 in the first year and $853 over the next seven years. Smoking cessation is more cost-effective than other commonly provided clinical preventive services, including mammography, colon cancer screening, PAP tests, treatment of mild to moderate hypertension, and treatment of high cholesterol.
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General Cessation
The Tobacco Prevention and Education Program (TPEP) approaches cessation from three vantage points: (1) building capacity, (2) network creation, and (3) cessation support. A capacity-building measure has been the coordination of educational sessions to update interested cessation counselors; session lecturers invited to Hawai'i thus far have been experts from the University of Massachusetts which is recognized as one of the leaders in cessation training. Although no credentialing program for cessation currently exists, core standards and ways to implement them are being developed. Another capacity-building measure is the provision of resources to health care providers and other personnel. Recommended resources include the following:
Networking currently occurs through the Cessation Advisory Group where stakeholders in the cessation area meet monthly to develop a comprehensive cessation plan and network, providing recommendations to the Hawai'i Community Foundation.
Cessation support is provided through the Quit Line which was initiated on July 14, 2005. The process begins with intake where the needs of the client are identified and captured as data. Self-help literature (i.e., Quit Kits) are provided to the client and, if necessary, one-on-one counseling. The Quit Line may also provide nicotine replacement to Medicaid clients or the uninsured. In addition to the Quit Line, a tobacco treatment specialist provides direct services by conducting cessation programs and providing counseling.
Youth Access Prevention
The purpose of youth access prevention is to prevent the sale of tobacco to minors. The program educates merchants and retailers on how to train staff to check customer IDs and to avoid selling tobacco to minors (i.e., those under 18 years of age). TPEP makes available a PowerPoint training presentation to merchants and has developed a training packet to accompany it. The Program has also developed tools (e.g., brochures, calendars, stickers, and buttons) with messages to remind cashiers to check, as well as how to check, the age-appropriateness of tobacco sales. In addition, tobacco stings are conducted monthly, as contracted by TPEP. Following each sting, the names of stores inspected (as well as their outcomes) are published in the newspaper.
