Building a world where young people reject tobacco and anyone can quit 1 Increasing Consumer Demand: The EX- sm Program Cheryl G. Healton, DrPh President and CEO, American Legacy Foundation

Building a world where young people reject tobacco and anyone can quit 2 Background: Legacy Support for Cessation Current Support concept of national portal (Sub-Committee on Cessation) Press event to promote the 10-point plan 1 million subsidy to quitlines (216 drawn down, balance unspent) Millions in co-op cessation support $734K for NAQC Potential $12 million in potential support toward national campaign for cessation Raise further support to underwrite the network of quitlines and the campaign Work to obtain low-cost cessation products through creative purchasing methods

Building a world where young people reject tobacco and anyone can quit 3 Our Latest Effort: EX- sm EX- sm - is a multi-component cessation program designed to reach smokers who are committed to quitting, but don’t know how. EX- sm fulfills one of Legacy’s key missions: To build a world where anyone can quit. EX- sm will be built on partnerships with states and other for-profit and not-for profit organizations.

Building a world where young people reject tobacco and anyone can quit 4 Formative Research The EX- sm brand was created in partnership with GSD&M, a creative development and media planning agency. The EX- sm brand is a result of: –60 in-home interviews with smokers and their families. –31 focus groups with smokers at various stages of considering or trying to quit. –A review of the peer-reviewed and other scientific literature on cessation.

Building a world where young people reject tobacco and anyone can quit 5 The EX- sm Brand Interviews and focus groups revealed that people do not know how to quit. Smokers felt that having a quit plan would break the process into clear manageable steps… making quitting a real possibility. EX- sm advertising attempts to create an emotional connection for smokers between the EX- sm brand and cessation resources.

Building a world where young people reject tobacco and anyone can quit 6 Guiding Principles of the Brand Provide a sense of structure –A comprehensive program smokers can come back to over time. Provide action-oriented content –Smokers need actionable know-how. Avoid language with anti-smoking overtones –Smokers need empathy, not a lecture. Be real/ acknowledge the struggle –Don’t sugarcoat quitting. A plan isn’t going to make it easier, just more achievable.

Building a world where young people reject tobacco and anyone can quit 7 The EX- Name The EX- sm name is strong and appealing. “Become An EX- sm ” communicates a ‘process’ as opposed to an instant fix; and is therefore believable and desirable –“It’s about overcoming” –“That’s what I want to be” –“Clear and straightforward” –“It’s finished, over” –“It has hope – You can transform yourself.”

Building a world where young people reject tobacco and anyone can quit 8 The EX- sm Media Audience: the 20+ Cigarette Per Day Smoker Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. Predominantly White, Suburban, Rural Median Age: 47 Median Income: $48,466 Blue Collar and 41% Not Employed (Retired, Unemployed, Homemakers) High School Education Hard-working, headstrong individuals who speak their minds and don’t feel the need to change for other people

Building a world where young people reject tobacco and anyone can quit 9 Reaching the Audience Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. Research shows that heavy smokers are also heavy consumers of TV, including cable, and radio. Therefore, the right media campaign can be expected to successfully reach this audience at a comparatively affordable price.

Building a world where young people reject tobacco and anyone can quit 10 Primary Program Elements Quit Manual Online quit services Telephonic Fulfillment line/ telephonic counseling Exploring Retail Outlet Distribution Evaluation of pilot program

Building a world where young people reject tobacco and anyone can quit 11 The Quit Book Written by a former smoker, the book helps smokers develop a quit plan that includes one or more effective cessation strategies, particularly counseling, pharmacotherapy and social support.

Building a world where young people reject tobacco and anyone can quit 12 The Website Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as access to the quit manual online.

Building a world where young people reject tobacco and anyone can quit 13 The Telephonic Fulfillment Line Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. This IVR/Voice System will enable callers to request a free, hard copy of the quit manual and will offer the option of being immediately warm-linked to state telephonic counseling.

Building a world where young people reject tobacco and anyone can quit 14 A National Collaboration Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. Legacy envisions EX- sm as a collaborative effort with state Departments of Public Health and others. Because national media buys are far more cost effective than local buys, Legacy hopes to encourage states and others to join with them to purchase national media.

Building a world where young people reject tobacco and anyone can quit 15 Evaluating the EX- sm Pilot Legacy will share a detailed draft evaluation plan with the Alliance Group Evaluation Committee. Legacy will also seek feedback from the Legacy Evaluation Advisory Panel.

Building a world where young people reject tobacco and anyone can quit 16 Draft Plan for Evaluating the Pilot Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. Telephone Survey –RDD phone survey of 2000 adults collected at baseline and 2 follow-ups. Longitudinal data will be collected from consenting smokers reached at baseline. Cohort Study –An in-depth study of three cohorts of smokers: 1) those who receive the Quit Manual, 2) those who engage in telephonic counseling, and 3) those who engage in online quit services to help understand how consumers are using the services. Scanner Data –Will be used to assess changes in pharmacotherapy purchase behavior.

Building a world where young people reject tobacco and anyone can quit 17 Additional Evaluation Mechanisms Developed in partnership with Smokeclinic, the website will offer online cessation services and social support, as well as tips about successful quitting. Tracking and characterizing call volume, online visitors, and dropped calls Varying of Fulfillment Line scripting patterns to determine order effects