1. THE PREMIER TEEN SMOKING CESSATION PROGRAM

2. Developed by American Lung Association and West Virginia University in 1997 and revised in 2009 Based on solid research and developed for teens Recognized by federal agencies: Substance Abuse and Mental Health Service Administration (SAMHSA): evidenced-based model program National Cancer Institute: research-tested intervention program US Office of Juvenile Justice and Delinquency Prevention: model program N-O-T (Not On Tobacco)

3. Overview of N-O-T Designed to help teens: Quit smoking Reduce their tobacco intake Increase healthy lifestyle behaviors Improve life management skills

4. Key Features of N-O-T Based on research and evaluation. Created specifically for youth. Comprehensive facilitator training, including ongoing technical assistance. Gender-sensitive curriculum. Local evaluation component for tracking.

5. N-O-T is for… Teens who smoke or chew Youth who want a group program Those who volunteer to participate

6. Did you know that: Tobacco users have more absences. (Lundborg, P. (2007). Does Smoking Increase Sick-Leaves? Evidence Using Register Data on Swedish Workers. Tobacco Control 16: 114-118.) Smoking causes memory and cognitive impairment in adolescents. (Biological Psychiatry, Vol. 57; pp 56–66 (January 2005)) Teens who smoke are three times more likely than nonsmokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. Smoking is associated with a host of other risky behaviors, such as fighting and engaging in unprotected sex. (MMWR. Preventing tobacco use among young people. pp 36,104. March 11,1994 / 43(RR-4);1-10)

7. Benefits of N-O-T for Your School N-O-T functions as a health education course. N-O-T improves the quality of life for all students and teachers at your school by promoting a tobacco-free environment. Students who participate in N-O-T have fewer behavioral problems and increased attendance.

8. Benefits of N-O-T for Your Students Teens are successful in the N-O-T program because they may quit smoking, reduce smoking, or at least attempt to quit or reduce smoking. They gain a sense of accomplishment and control over smoking. They form friendships with other teens in the program. They build a positive relationship with an adult role model, the facilitator. Their motivation to do well in school often increases. They improve their health not just by reducing their smoking but by increasing their physical activity, managing their stress better, eating better, and learning how to obtain and maintain social support. They save money; they learn how much they spend on cigarettes, and if they quit or reduce smoking, they reap the savings.

9. Nicotine Addiction in Teens Nicotine is the addictive drug in tobacco. –A colorless, poisonous alkaloid derived from the tobacco plant and used in insecticides. Teens become addicted quickly. –6-7 times as addictive as alcohol Effect is immediate Addiction involves physical, psychological, and social dependence.

10. Cigarette Smoking is 6 times more addictive than cocaine or heroin. Jeffrey Wigand Ph.D., MAT, Ph.S.

11. N-O-T Program Components Ten weekly sessions Four optional booster sessions Each session should last at least 45 minutes

12. Overview of Sessions Sessions 1-4 – Preparation Session 5 – Quit Day - Action Sessions 6-10 – Maintenance and Relapse Prevention

13. AMERICAN LUNG ASSOCIATION OF VIRGINIA N–O–T: NOT ON TOBACCO 2003-2007 Virginia N-O-T Participants 2684 teens 1220 QUIT=45%

14. An occupied seat… does not ensure learning is taking place. Addiction to tobacco limits the users time of concentration to 4 minutes

15. Statements from graduates of the N-O-T Program The best thing I think is kids admitting they have problems quitting or that we need to talk it out.ELR (SW Virginia) The N-O-T Program put me in the position to confront the reality that I had to quit.KB (SW Virginia) I really love the N-O-T Program. It made me really think about how it affected me and the people around me and all the consequences that went along with smoking. ND (SW Virginia) My withdrawals are not as bad now, I can wait longer for the next smoke. WBW (SW Virginia) N-O-T is a good program for learning how to quit and how to deal with addiction. JGY (SW Virginia)

16. Statement from a Facilitator of the N-O-T Program I have to say that working in the N-O-T groups has been the highlight of my year. Connie Elkins Facilitator, Tazewell County, VA

17. Any Questions?