as the NHIS.4 Although not part of the core items, information on healthcare provider advice on, and assistance with, quitting and information on the use of evidence-based treatments are available as part of the cancer-control supplement to the NHIS. However, the NHIS surveys include only the civilian, noninstitutionalized US population and exclude the military population, although dependents of active-duty service members may be included.

With regard to the availability of effective behavioral treatment through a national quitline network, the North American Quitline Consortium tracks the number of services and types of telephone counseling available through state quitlines. Members of the consortium also contribute information about quitline use and the characteristics of quitline callers through their minimal dataset (NAQC, 2008).

In addition to collecting specific information about tobacco-cessation services offered by health-care providers, evaluation of comprehensive tobacco programs has been undertaken and can serve as a model for future program evaluations. The NCI reviewed the effectiveness of the state tobacco-control programs that had participated in the federal ASSIST program described in Appendix A (Gilpin et al., 2006). The Robert Wood Johnson Foundation has also assessed state tobacco-control programs ( Public dissemination of these evaluations can help to engage outside participants in program improvement, encourage transparency in program processes, and permit cross-program comparisons to determine best practices for tobacco control. Program evaluations also help to identify needed policy changes and can support leadership initiatives for program enhancements. CDC has developed a set of key outcome indicators for evaluating comprehensive tobacco-control programs that may be used by DoD and VA to monitor progress and determine the success of their programs. Outcome indicators are presented for achieving three program goals that are applicable to both DoD and VA populations: preventing tobacco-use initiation, eliminating nonsmokers’ exposure to secondhand smoke, and promoting quitting (CDC, 2009b).

Finding: Periodic and public evaluation of tobacco-control programs, based on performance metrics and other surveillance tools help provide the necessary information to


The NHIS is conducted annually, but detailed tobacco questions are asked only as part of the cancer supplement; the supplement was last administered in 2005. It is available online at (accessed on March 10, 2009).

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