Innovations in Building Consumer Demand for
Tobacco Cessation Products and Services

Summary of Main Themes

December 7-8, 2005, Washington, DC

Introduction

Tobacco cessation represents one of the nation’s most perplexing health challenges. Many smokers report a desire to quit, but each year only about one in four smokers makes a quit attempt of at least one day. Smokers have also been slow to adopt proven cessation products and services in their attempts to quit smoking.

The first of two Consumer Demand Roundtables was held December 7-8, 2005 to address this challenge. The Roundtables include invited experts in tobacco control and other fields. The first Roundtable was designed to present information about the current state of cessation in this country, and to begin discussion of recommendations for increasing consumer demand for cessation products and services. At a second Roundtable meeting in February, these invited experts will continue their discussions with the intention of formulating a set of conclusions and recommendations to the field.

Funded by the Robert Wood Johnson Foundation, American Legacy Foundation, Centers for Disease Control and Prevention, National Cancer Institute, National Institute on Drug Abuse, and American Cancer Society, the purpose and goals of these roundtables are three-fold:

• To generate new ways of thinking about increasing demand for evidence-based tobacco cessation products and services.
  
• To achieve major breakthroughs in the use of tobacco cessation products and services to increase the public health or population impact.
  
• To identify and catalyze feasible innovations in R&D, product design, research funding, practice and policy that could significantly improve the use and impact of current evidence-based treatments within the next 3 years.

The first meeting brought together experts from multiple disciplines to examine cessation products/services, treatment delivery systems, marketing efforts, and the effect of policy, among other topics. The participant list, agenda, presentations, and background reading are available at http://csmbc.aed.org/consumerdemand.

Summarized here are the key themes discussed at the meeting. Special emphasis is placed on the breakout sessions, during which several recommendations and innovations were proposed for further discussion at the second meeting.

Main Themes from Meeting Discussion

To increase the appeal and use of evidence-based tobacco cessation products and services, the roundtable participants suggested the following:

Change the way we communicate to smokers about cessation.

• Currently, we often present information to smokers, assuming that these are facts that they should know. Instead there is a need to research what smokers want to know about quitting, and what would motivate them to attempt to quit. This information should be used to change the focus of cessation messages and strategies, telling smokers what they want to know. It should also help identify what types of incentives would increase smoker interest in a quit attempt.
  
• We need to correct commonly-held misperceptions that nicotine causes cancer, leading to the under-use of NRTs.
  
• We need to de-medicalize communication with smokers. Smokers don’t see quitting as a health behavior but rather as a personal decision to change their lifestyle. Therefore, marketing should focus on lifestyle benefits as well as health benefits.
  
• Smokers are averse to the term “counseling.” We need to offer them “coaching.”
  
• Consumers do not necessarily understand how to quit or what it will be like to quit. Communication with smokers should acknowledge that quitting is a journey—not a one-time event. This would provide the appropriate perspective on the process they should expect to engage in, and help them put in perspective “setbacks” (not failures) along the way.
  
• Smokers want to be in control. Presenting a range of effective options to them as well as explaining the benefits of combining certain options to increase effectiveness will allow them to tailor their own quit journey and help them feel in control. Therefore, one option should not be promoted in isolation.
  
• The use of credible celebrities to talk about quitting as a journey should be explored for its value in increasing motivation to use services.

Build ongoing relationships with consumers to reach them repeatedly before, throughout, and beyond their quit journey.

• We are trying to influence an audience that we do not have direct channels to reach. Smokers can be reached directly --and often--where they purchase tobacco products; tobacco companies establish connections through promotions and reconnect with coupons and other offers. There is no equivalent “point of purchase” to repeatedly encourage them to attempt quitting.
  
• Once a smoker attempts to quit, we should find ways to connect to them throughout their journey to encourage quit attempts and maintain cessation once achieved.
  
• Creating a “landing” page/portal would open an inter-active forum for people trying to quit who want to exchange their stories and experience with others following a similar “journey.”
  
• We need to establish accessible systems to work with smokers to identify the “best fit” among cessation options and refer them to effective products and services.
  
• We need to address co-morbid conditions (e.g., depression) and work with appropriate treatment (e.g., psychiatrists, psychologists, dentists, physician assistants, etc.) to reach and motivate these smokers.

Establish databases of smokers and reconnect with them periodically.

• A database of smokers attempting to quit could serve as a tool to connect with smokers and former smokers throughout their journey. Databases could be used to manage direct mail efforts and other channels to promote the many effective options available to smokers and to allow them to track and understand their own quitting journey.
  
• Creating profiles of smokers in such databases would permit the use of tailored messages to fit their quit situation and help move them through successful cessation and maintenance.

Work to develop new or improved products/services that would be more attractive and successful.

• Involve consumers to identify the types of products/services they will want to use. Then, a redesign of products/services could potentially result in more motivation and cessation success.  

• Smokers do not always understand what options are available to them. “Re-brand” cessation to promote all effective options instead of segmenting promotional resources to promote individual products and services.
  
• A toolkit could be produced to help sponsors of products and services re-brand in tailored but compatible ways
  
• Work to identify barriers to using products and services (including cost barriers) and how to reduce or eliminate these barriers (e.g., couponing and rebates).

• Policy changes often create a” bump” in cessation attempts. Coordinating promotional and other activities to take advantage of these opportunities could increase this effect, if preparedness ensures that increased demand for products and services can be met.
  
• We can use and build upon existing infrastructures and advocacy networks, such as the Campaign for Tobacco Free Kids, to take advantage of such policy initiatives.
  
• As state budgets increase, there can be opportunities to increase resources devoted to cessation efforts. Also there is a need to advocate for the earmarking of new funds raised through new policies (e.g., excise taxes) to cessation efforts.
  
• Simply employing a broad reach to “smokers” may be ineffective, failing to recognize that different incentives and motivations will be effective with different types of smokers.
  
• We should address healthcare disparities and identify whether there are different, specific barriers to quitting that must be tackled to aid these populations.

• The marketplace is confusing to smokers. There are more ineffective cessation products/services on the market than there are effective cessation aids. We need to help the consumer identify which are effective.
  
• An organization or group of organizations could establish criteria and provide a ‘seal of approval’ to increase the competitiveness of effective cessation aids.

• Enduring leadership is needed to move this issue forward and to begin to make changes in products and services as well as their marketing. Without collective leadership, these recommendations will not be implemented; we’ll need leadership from many sectors and stakeholders for this to be a successful endeavor.

These ideas and areas of innovation discussed at the first roundtable will be re-considered at the second roundtable, to be held on February 1-2, 2006, in Washington, DC.