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Quit for life: a youth smoking cessation program in Canada

The Quit for Life (Q4L) programme aims to encourage and support smoking cessation among teenage smokers by providing them with information and skills to aid in this process. The programme was developed and implemented in 1993 by Health Canada, In partnership with the Canadian Lung Association and Ciba-Geigy Ltd. A minimal contact, self-help format was chosen to ensure wide availability and accessibility. Teen smokers were consulted at all stages during the development of the Q4L kit. The kit contains such items as a self-help booklet, a tracking form that fits into a cigarette pack and a poster that provides tips on how a "buddy’, a friend or relative can help a smoker through the quitting process. The booklet details five steps in the quitting process:

1. Why Quit? Thinking About Quitting: Both long and short-term health risks associated with smoking are discussed, as is the subject of nicotine addiction.

2. Getting Ready to Quit: Teens are encouraged to understand why they smoke. A number of feelings and situations, which often trigger the need to smoke, are identified. This section also helps teens identify if their smoking is a physical addiction, behavioural addiction, or a combination of the two. Common roadblocks to smoking cessation are discussed.

3. Taking Charge: Teens are encouraged to use the cigarette tracking form as a method of noting their smoking behaviours and to enlist the help of a "buddy". Tips are also given to develop a "survival kit", containing cigarette replacements, such as sugarless gum and low-calorie snacks.

4. Taking the Big Step: Information is provided on two commonly used methods of quitting smoking: Tapering Off and Cold Turkey. A number of coping tips are included in this section.

5. Staying Smoke-free: In the final section in the Q4L program booklet, teens are given advice on short and long-term strategies to remain smoke-free.

The Q4L kit was promoted for three years through a variety of youth-oriented media channels, including television, radio and print media. Promotional materials were also distributed to schools and health agencies throughout Canada. In partnership with the Canadian Dental Association, posters promoting the kit were displayed in dental offices across Canada. A toll-free number was provided where teens could call to order the free kit.

Since 1993, around 100,000 (about 20%) of the estimated eligible teens in Canada requested and were sent a Q4L kit. According to a 1995 evaluation, 92% of teens who received a kit used it in some way. Use of the kit was closely associated with both quit and reduce attempts. Follow-up interviews with teens after both six and 12 months found:

1. 77% of all teens reported a net reduction in the number of cigarettes smoked per day compared to a baseline rate;
   

2. Over 21% of teens reported stopping completely by the time of the first interview (six months) with a further 12% achieving cessation by the second interview (12 months).

Overall, the evaluation of the Q4L programme concluded that the programme has met, and in many aspects exceeded, nearly all expectations. Approximately 20% of all teens indicated significant gains in longer-term cessation. This is particularly positive for a minimal contact; self-help program aimed at teens.

For more information on the Quit 4 Life programme please contact:

Dawn Hachey, Office of Tobacco Reduction Programmes

Email: dawn-hachey.HWC@hc-sc.gc.ca