The literature was synthesized around five research questions concerning the effectiveness of interventions, strategies to increase consumer demand for cessation treatments and implementation of proven cessation strategies, and the effects of smokeless-tobacco marketing. The results supported the effectiveness of population-based interventions targeted to adolescents and young adults that increased the unit price of tobacco as well as the effectiveness of mass-media campaigns run concurrently with other interventions. Strong evidence was also found to support the effectiveness of telephone cessation support to increase tobacco cessation in adults and of strategies based on the health-care system that used provider reminders, provider education, and multicomponent interventions that include client telephone support (HHS, 2006).

Analysis suggests that persons who have comorbidities should use the tobacco-cessation treatments recommended for the general population, and that cessation treatment for persons who have chemical and nicotine dependence should also include counseling and pharmacotherapy. There are still critical gaps in the evidence base, and improvement in research methods are necessary to fill data gaps.

Fiore (2003) reviewed evidence-based populationwide strategies for a National Action Plan for Tobacco Cessation. The plan would include cessation interventions such as quitlines, supported by a Smokers’ Health Fund created through a proposed $2/pack increase in the federal excise tax on cigarettes. Such new resources could fund a national quitline, a multifaceted counteradvertising media campaign, insurance coverage for tobacco-dependence treatment for 100 million covered people (including all those on Medicare and Medicaid), and a new tobacco research and training infrastructure. The Interagency Committee on Smoking and Health, under the auspices of the Department of Health and Human Services, hoped that such a dramatic new endeavor would also foster strong public–private partnerships involving health insurers, employers, health systems, national quality assurance and accreditation organizations, clinicians, and communities (Fiore, 2003).

WHO published Building Blocks for Tobacco Control: A Handbook in 2004 as part of its Tobacco Free Initiative (WHO, 2004). The WHO Framework Convention on Tobacco Control (FCTC) provided global action, but guidance on the development of national capacity for tobacco control was lacking. The handbook was created to address that need. It describes the need to build national capacity for tobacco control. It lists practical tobacco-control approaches for countries, including defining objectives, developing strategies, drawing up action plans, developing and implementing appropriate policies, developing regulatory



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