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The purpose of the present study was (1) to examine demographic differences between smokers who successfully quit (n = 1809), who relapsed (n = 6548), and who did not attempt to quit (n = 11 102) within the last year, and (2) to examine state-level tobacco policies/programs as predictors of quit success. Data were utilized from the 2014-2015 Tobacco Use Supplement to the Current Population Survey, which were paired with 2014 data on taxation, appropriations, and smoke-free air laws. As compared with smokers who relapsed, those who successfully quit were more likely to be white, married, more highly educated, of higher income, and heavier smokers. Compared with those who did not attempt to quit, those who attempted to quit, regardless of success, were younger and more likely to be Hispanic. State comprehensive smoke-free air laws and tobacco excise taxation significantly predicted quit success. Thus, expansions of these policies should be considered to promote successful quitting.

Background: Many telephone quit lines provide free nicotine replacement therapy (NRT) to smokers who are trying to stop smoking. However, providing free NRT to smokers can be costly., Objective: To compare NRT usage patterns, quit rate, and costs of giving smokers calling a telephone quit line different amounts of free NRT., Design: A 3-group randomized trial was conducted., Setting and Participants: A total of 2806 adult smokers of 10+ cigarettes per day who called the New York State Smokers' Quit Line (NYSSQL) were sent different amounts of nicotine patches for free as follows: (1) a 2-week supply of nicotine patches, (2) a 4-week supply, and (3) a 6-week supply. In addition, all study participants received a free stop smoking guide plus 1 proactive follow-up call attempt conducted 2 weeks after initially contacting the NYSSQL. Of the 2806 enrolled participants, 1682 completed the 7-month follow-up to assess their use of the NRT sent to them and smoking status., Main Outcome Measures: Nicotine patch usage, quit rates, reductions in cigarette consumption, and cost-effectiveness measures., Results: Most respondents (85%) reported using the nicotine patches sent to them, although the amount used varied in direct proportion to the amount sent. The 7- and 30-day nonsmoker prevalence rates measured at 7-month follow-up did not differ significantly between the 3 groups. The cost per attributable quit was also not significantly different between the 3 groups., Conclusion: Sending out more than a free 2-week supply of patches to smokers who contact a quit line is no more effective in achieving smoking cessation than sending just 2 weeks of patches.

Objective: To assess the efficacy of an intervention to encourage the adoption of smoke-free policies among owners and managers of multiunit housing., Design: A pretest-posttest quasi-experimental design was employed., Participants: The study population included 287 multiunit housing operators (MUHOs) from across New York State who were recruited to complete a baseline survey designed to assess policies about smoking in the housing units that they owned and/or managed. Subjects were surveyed between March and July 2008 (n = 128 intervention, n = 159 control) and recontacted 1 year later to complete a follow-up survey (n = 59 intervention, n = 95 control)., Intervention: An informational packet on the benefits of implementing a smoke-free policy was mailed to MUHOs in the New York State counties of Erie and Niagara between March and July 2008. For comparison purposes, a sample of MUHOs located outside of Erie and Niagara counties who did not receive the information packet were identified to serve as control subjects., Main Outcome Measures: Logistic regression was used to assess predictors of policy interest, concern, and implementation at follow-up. Predictors included: intervention group, baseline status, respondent smoking status, survey type, government-subsidy status, quantity of units operated, and average building size, construction type, and age., Results: Multiunit housing operators who received the information packet were more likely to report interest in adopting a smoke-free policy (OR = 6.49, 95% CI = 1.44-29.2), and less likely to report concerns about adopting such a policy (OR = 0.16, 95% CI = 0.04-0.66) compared to MUHOs who did not receive the information packet; however, the rate of adoption of smoke-free policies was comparable between the groups., Conclusion: Sending MUHOs an information packet on the benefits of adopting a smoke-free policy was effective in addressing concerns and generating interest toward smoke-free policies but was not sufficient in itself to generate actual policy adoption.

Background: Previous studies have found that offering additional callback counseling support to smokers calling a telephone quit line increases quit rates. However, what is less certain is the most cost-efficient protocol for offering such a service., Objective: This study compares the efficacy of offering 2 versus 4 counseling callbacks after an initial call from Medicaid/uninsured adult smokers contacting the New York State Smokers' Quit Line (NYSSQL). Outcomes compared are the 7- and 30-day nonsmoker prevalence rates measured at 3-month follow-up and the cost per quit., Design: A 2-group randomized trial was conducted., Setting and Participants: The study population included 1923 adult (18+ years) Medicaid/uninsured current smokers (10+ cigarettes per day) who called the NYSSQL between February and March 2009 seeking help to stop smoking. At the time of the study, the NYSSQL provided Medicaid/uninsured callers with up to 6 weeks of free nicotine medications and up to 4 counseling callbacks. Half the subjects were randomized to standard care with up to 4 counseling callbacks with the remaining subjects offered only 2 counseling callbacks. All participants were sent a minimum of a 2-week supply of nicotine replacement therapy, with some receiving up to 6 weeks. Participants were recontacted 3 months after enrollment in the study to assess smoking status., Main Outcome Measures: Quit rates, total counseling callbacks completed, reductions in cigarette consumption, and cost per quit measures., Results: There was not a significant difference between study groups in the number of callbacks completed. There was also no difference in 7- or 30-day nonsmoker prevalence rates measured after 3 months' follow-up or reported use of the free nicotine replacement therapy between those assigned to either the 2- or 4-callback protocols. The cost per quit was essentially the same in both groups (2 callbacks--$442 per quit vs 4 callbacks--$445 per quit)., Conclusion: There was no advantage in terms of quit success or cost to offering up to 4 callbacks instead of 2 callbacks.

Objective: This study characterized longitudinal changes in cigarette smoking and purchase and cessation patterns among low-income smokers in New York State., Design: Longitudinal tobacco use surveys were conducted in 2002 and 2005. Responses from the 2002 and 2005 surveys were compared among participants who completed both surveys., Setting: New York State., Participants: Adult low-income smokers (n = 274) were recruited from the Department of Social Services office in Erie County, New York, in 2002 and recontacted in 2005., Main Outcome Measures: These included cigarette smoking, cessation and purchase behaviors, awareness and use of the Quitline, and participation in tobacco industry promotions during the 3-year follow-up period., Results: During the 3-year follow-up period, 37 participants (13.5%) stopped smoking. Among smokers, the average number of daily cigarettes smoked decreased from 16.1 to 13.7 cigarettes (P < .01). There were significant increases in the proportion of smokers who reported that they had ever used a stop smoking medication (26.6% to 51.9%), had ever heard of the Quitline (32.5% to 73.0%), or had ever called the Quitline (4.2% to 11.0%). There was an increase in the use of tobacco industry coupons (41.1% to 59.3%)., Conclusions: Findings suggest that state and local tobacco control policies and programs are being increasingly utilized by this population; however, tobacco company price promotions are also being increasingly used, offsetting the public health benefit of the tobacco control policies and programs in this low-income population.

This study compares the participant characteristics, program costs, and outcomes of a Quit & Win contest and a nicotine replacement therapy (NRT) voucher giveaway promotion. Both programs were conducted simultaneously so that smokers could enroll in either one program alone (n = 849 and 690, respectively) or both programs (Combination group; n = 230). A follow-up telephone survey of a random sample of participants was conducted 4 to 7 months after enrollment to evaluate smoking status. At enrollment, participants in the three groups were comparable on most smoking and demographic variables, although Quit & Win participants were, on average, younger than those who signed up to get the NRT voucher. Compared with the characteristics of smokers in the region, those who enrolled in the intervention programs were heavier smokers and had more years of formal education. At follow-up, the self-reported quit rates were similar across the three intervention groups, ranging between 25 percent and 30 percent. The only evidence for a higher quit rate among those in the Combination group was among younger smokers. On a simple estimated cost per quit basis, the Quit & Win (130 dollars) and NRT (179 dollars) voucher interventions appear roughly comparable. In all groups, abstinence rates were higher among lighter smokers (<21 cigarettes per day), participants who did not live with another smoker, and those who were married. Both the Quit & Win and NRT voucher giveaway programs were effective in recruiting smokers to make a quit attempt, although combining both interventions did not generally increase abstinence rates.

This article presents results from two population-based promotions for free cessation products used to induce smokers to call the New York State Smokers'. The first promotion was a press announcement urging smokers to call the quitline to get a voucher for a free 2-week supply of nicotine patches or gum (nicotine replacement therapy [NRT]). The second promotion involved comparing response to two newspaper advertisements for the quitline, one of which offered a free stop smoking guide and one that offered the guide plus a free stop smoking aide called Better Quit (BQ). Responses to each promotion were monitored by tracking the call volume to the quitline-before, during, and after each of the promotions. The NRT voucher promotion increased median call volume 25-fold compared to prepromotion levels, whereas the BQ newspaper advertisement increased median call volume 2-fold compared to a newspaper advertisement for the quitline, which did not offer BQ. A random sample of 732 smokers who received the free NRT voucher were followed up 4 to 6 months later to determine their use of NRT and smoking behavior. Embedded within this follow-up study was a randomized experiment in which half the smokers were mailed a quit kit with BQ included and the other half received just the quit kit. Seventy percent of follow-up survey respondents said that they had redeemed the NRT voucher and used the medication to try to quit smoking. Twenty-two percent reported they were no longer smoking, compared with the 12 percent among a comparison group of quitline callers who had not received the free NRT voucher (odds ratio = 1.77; 95% confidence interval: 1.17-2.68). There was no difference in quit rates between those that were sent the BQ cigarette substitute and those that did not get the BQ. This study shows that offering a free 2-week voucher for NRT is a cost-effective method to increase calls to a stop smoking quitline and may also increase the odds of quitting for those who get the free NRT.

In an effort footline to motivate smokers across New York State to stop smoking, tobacco control programs across the state held 'Quit and Win' incentive-based stop-smoking contests. These contests encouraged smokers to make a quit attempt by offering a chance to win cash prize (usually 1,000 dollars) for successfully stopping smoking for at least 1 month. Between 2001 and 2004, 11 different Quit and Win Contests involving 5,504 adult smokers were sponsored in different communities across New York State. Follow-up surveys were conducted 4 to 6 months after each contest ended to evaluate participants' success in quitting smoking. Expenditures for promoting contests varied from a high of 91,441 dollars to a low of 4,345 dollars, with a median of 25,928 dollars. An average of 0.55 percent of smokers was recruited to join contests across the 11 communities. Among smokers who enrolled in a contest, 9 out of 10 reported making a quit attempt, and between 53 percent and 72 percent reported quitting for the full month of the contest. At 4 to 6 months follow-up, self-reported quit rates (7-day point prevalence) among contestants ranged from 22 percent to 49 percent, with an average of 31 percent. Based on a statewide population survey, 8 of the 11 programs showed quit rates that were significantly higher (P < .001 by Wilcoxon rank-sum test) than the estimated quit rate of 21 percent seen among smokers making a quit attempt in the past year. This study shows that for a relatively modest investment of resources, thousands of smokers can be recruited to make a serious quit attempt, with many remaining smoke-free months later.

In an effort to increase access to evidence-based smoking cessation therapies, regional tobacco control programs in New York State implemented different interventions to make free nicotine patches and gum available to smokers wishing to quit. In one region, eligible smokers were sent a voucher redeemable at a local pharmacy for a 2-week supply of either nicotine patches or gum. In other regions, smokers received either a 1-week supply or a 2-week supply of nicotine patches sent to their home. In New York City, eligible smokers received a 6-week supply of nicotine patches and a follow-up phone call. All of the programs utilized the state's Smokers' Quitline to screen and register eligible smokers for the free medication. The reach of the different programs was evaluated by computing the proportion of eligible smokers within a given area enrolled in the program and tracking call volume to the Quitline before, during, and after the free giveaway promotions. Efficacy was evaluated by a telephone follow-up survey of program participants conducted 4 months after enrollment to measure use of the medications and smoking behavior. The quit rate of program participants was contrasted with the quit rate computed from an earlier follow-up survey of Quitline callers who were not provided nicotine replacement therapy (NRT). Free nicotine patches or gum was sent to 40,090 smokers representing about 2.9 percent of eligible heavy smokers (10+ cigarettes per day) in the state. In each time period and location where free NRT was offered, call volume to the Quitline increased dramatically. Quit rates varied in relationship to the supply of NRT sent to participants, but in all cases was higher than the quit rate observed among smokers not sent NRT (21%-35% vs 12%). The offer of free NRT appears to be a cost-effective method to induce large numbers of smokers to make a quit attempt.

Background: The prevalence of smoking remains higher among the Medicaid population compared with the general population. To reduce this disparity, the majority of state Medicaid programs now provide coverage for smoking cessation pharmacotherapy. The objectives of this study were to (1) assess awareness of this benefit among Medicaid smokers and (2) compare the use of pharmacotherapy among a sample of Medicaid smokers with smokers in the general population of western New York., Methods: This report summarizes findings from two cross-sectional studies conducted in western New York State during 2002 to 2003: (1) Medicaid smokers (n = 1,174) completed an interviewer-administered questionnaire in the Office of Medicaid Management and (2) smokers from the general population (n = 852) completed a telephone survey., Results: The majority of Medicaid smokers (54%) remain unaware of the program benefit providing coverage for smoking cessation pharmacotherapies. Medicaid smokers were much less likely (odds ratio = 0.33, 95% confidence interval = 0.25-0.44) than the general population to report having ever used pharmacotherapies., Conclusions: Highlighting the availability of the smoking cessation pharmacotherapy benefit to Medicaid program participants may be one strategy to enhance quit attempts among this population. Future research should identify other potential barriers to the use of effective pharmacotherapies among poorer smokers.

The objective of this study was to determine the extent to which people avoid smoky restaurants, bars, bowling alleys, casinos, and bingo halls because of secondhand smoke. Data were collected with telephone interviews of a sample of 1,548 randomly selected adults in Erie and Niagara Counties between October 2002 and March 2003. Most nonsmokers (71%) reported that they are bothered by secondhand smoke. Thirty-four percent of nonsmokers and 10% of smokers responded that they had avoided patronizing a smoky establishment in the past 12 months. The places that were most often avoided were restaurants (17%), bars or taverns (13%), and bingo halls (9%).

The objective of this study was to assess the cigarette purchase patterns of smokers in Erie and Niagara Counties following recent increases in the state excise tax for cigarettes. Data were collected with telephone interviews of a sample of 1,548 randomly selected people in Erie and Niagara Counties between October 2002 and March 2003. Purchase patterns were assessed for the 908 smokers in the sample who responded to questions about cigarette purchasing patterns. Thirty-three percent reported that their usual source of cigarettes is from a small store, large store, pharmacy, or vending machine, while 67% reported that their usual source is from an Indian reservation. Only one smoker reported the Internet was a usual source of cigarettes. The average price paid per pack was $4.80 in a small store and $1.91 on an Indian reservation. Price influences smoking behavior; however, the majority of smokers are taking advantage of readily available venues where less expensive, untaxed cigarettes are sold. This may undermine the public health benefit of higher prices and cause lost revenue to state and local governments.

Data from a community-based screening campaign were analyzed to assess compliance with colorectal cancer (CRC) screening guidelines among both average risk adults and those at increased risk because of having a first-degree relative (FDR) with CRC (FDR+). The prevalence of screening compliance was low in both groups. The authors also found that individuals with FDR+ returned a free fecal occult blood test at a slightly higher rate than those without FDR+s. Despite higher screening rates among individuals with FDR+s, interventions may need to target this high-risk group to increase compliance with CRC screening recommendations.

The objective of this study was to assess the economic impact of the Erie County, New York, Clean Air Act on the restaurant industry by examining restaurant employment and payroll statistics. Monthly county-specific data were compared between 1996 (before the law), 1997 (after phase 1, which required 80% of indoor restaurant seating to be smoke-free), and 1998 (after phase 2 which prohibited smoking in 100% of indoor restaurant seating). Erie County's Clean Air Act had no adverse economic impact on its restaurant industry.

A pilot study consisting of 76 compliance checks was conducted in October 1998 in Chautauqua County, New York, by a 15-year-old white female. Half of the merchants were randomized to be checked under a standard protocol whereby the minor was instructed to answer truthfully when asked about her age. The remaining stores were checked under a new protocol that permitted the minor to state that she was 18 years old if asked about her age. It was found that untruthful age reporting during compliance checks has little impact on the overall compliance rate.

This study's objective was to determine the level of compliance with the New York City Smoke-Free Air Act. Three data sources were used: (1) a population-based telephone survey of 251 New York City restaurant owners/managers; (2) independent inspections of the 251 surveyed restaurants; and (3) complaint records from the New York City Department of Health from April 1995 to March 1997. Ninety percent of restaurant owners/managers reported their indoor dining area was smoke-free in compliance with the law. Most New York City restaurants were able to comply with the smoke-free law with relative ease and little expense.

The purpose of this study was to observe trends in the number of restaurants and restaurant employees two years before and two years after the New York City Smoke-Free Air Act took effect in April, 1995. Between April 1993 and April 1997, New York City added 19,347 new restaurant jobs (18% increase) while the rest of the state outside the immediate metropolitan area added 7,423 new jobs (5% increase). The rate of growth in the number of restaurants was comparable among New York City, neighboring counties, and the rest of the state. The data suggest that the New York City Smoke-Free Air Act did not result in job losses for the city's restaurant industry.

This article examines the results of a study to determine if the New York City Smoke-Free Air Act has had an adverse economic impact on the taxable sales receipts from the city's restaurant and hotel industries. The study found that real taxable sales from eating and drinking places and hotels in New York City increased by 2.1 percent and 36.9 percent, respectively, compared with levels two years before the smoke-free law took effect. During the same period, real taxable sales for eating and drinking establishments and hotels in the rest of the state experienced a 3.8 percent decrease and a modest 2.4 percent increase in sales, respectively.

The objective of this study was to determine the extent to which restaurateurs have reported a change in business since the New York City Smoke-Free Air Act took effect. A population-based cross-sectional telephone survey of 434 owners/managers of restaurants located in New York City was conducted by an independent survey firm during November and December 1996. There is no evidence to suggest that the smoke-free law has had a detrimental effect on the city's restaurant business.

On January 10, 1995, New York City's mayor signed into law a bill restricting smoking in most public facilities including restaurant dining areas, workplaces, and sports stadiums. This law was the subject of extensive public debate and was considered quite controversial at the time it was enacted. Passage of the smoking law (known as the New York City Smoke-Free Air Act) helped pave the way for other localities in New York to enact similar restrictions on smoking in public facilities. This article documents the process of enacting the New York City Smoke-Free Air Act.

The objective of this study was to assess consumer response to the New York City Smoke-Free Air Act. The overwhelming majority of respondents reported they were largely unaffected by the law or dined out more frequently since the law took effect; however, there was a small percentage of consumers that reported dining out less frequently. There were few reports of consumers who stopped dining out altogether or left or entered the city with the specific purpose of dining in a place that suited their smoking preference. The New York City Smoke-Free Air Act appears to have had little impact on the dining out patterns of consumers.

This article provides estimates of the prevalence of tobacco, alcohol, and other drug use behaviors of ninth-grade students enrolled in public and parochial schools in Erie County, New York. A computer-scannable survey consisting of 50 questions was completed by 7,891 students in the fall of 1992. Survey findings show that tobacco and alcohol are the drugs used most often by ninth-grade students. Results also indicate that cigarette use is strongly associated with other drug use behaviors such as getting drunk, using marijuana, and other illegal drugs. A report detailing findings from the survey has been widely disseminated to school officials and community leaders throughout Erie County. Our experience in conducting this survey suggests that collecting information on the drug use behaviors of adolescents at the local level is both feasible and worthwhile.