Topic: Alcohol/Drugs/Tobacco
Target Population: Adolescents
Sector: Community-Based, School-Based
This program is for adolescents who smoke daily.
Not On Tobacco® (N-O-T), a voluntary community- or school-based program, is designed to help adolescents stop smoking and vaping by addressing a variety of issues, such as increasing self-control, decreasing exposure to social pressure, and promoting strategies for coping with nicotine withdrawal.
N-O-T has been evaluated in several studies. This program was found to significantly increase rates of smoking cessation among a rural teen population in North Carolina at a 15-month follow-up when compared with a control intervention. Another evaluation found significant results at the post-test but not at 6- or 12-month follow-ups. A final study demonstrated significant results at a 5-month follow-up, but no additional follow-ups were conducted. In this study, N-O-T was more effective for females compared with males.
The N-O-T program intends to break nicotine dependency in youth. Sessions focus on topics such as understanding nicotine addiction, managing stress, preventing relapse, coping with external pressures, realizing the importance of physical activity, strengthening self-control, and developing interpersonal skills.
The sessions are delivered in gender-differentiated groups of 6 to 10 participants. A trained same-gender teacher, school nurse, counselor, or facilitator leads the sessions, which include group activities, discussions, maintaining a journal, and role-playing. Four optional booster sessions are available.
More than 150,000 teens have participated in the N-O-T program since it was first implemented in 2004.
This program is led by certified, trained adults and online 7-hour facilitator training is available. Re-certification is required every 3 years. Please visit https://www.lung.org/quit-smoking/helping-teens-quit/not-on-tobacco for more information.
Considerations for implementing this program include recruiting a facilitator and ensuring they complete training, locating space to hold sessions, acquiring participant buy-in, and obtaining implementation materials.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing N-O-T, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
The program is implemented in 10-weekly 50 minute sessions. Four optional booster sessions are also available.
Implementation materials are required. Please use details in the Contact section for more information.
To move N-O-T to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation should be performed demonstrating positive effects lasting at least one year from the beginning of the program or at least six months from program completion.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact the N-O-T program by email NOT@Lung.org, or contact the American Lung Association by phone 1-800-586-4872, or visit https://www.lung.org/quit-smoking/helping-teens-quit/not-on-tobacco
Dino, G., Horn, K., Goldcamp, J., Fernandes, A., Kalsekar, I., & Massey, C. (2001). A 2-year efficacy study of Not On Tobacco in Florida: An overview of program successes in changing teen smoking behavior. Preventive Medicine, 33(6), 600-605. https://doi.org/10.1006/pmed.2001.0932
Dino, G. A., Horn, K. A., Goldcamp, J., Maniar, S. D., Fernandes, A., & Massey, C. J. (2001). Statewide demonstration of Not On Tobacco: A gender-sensitive teen smoking cessation program. The Journal of School Nursing, 17(2), 90-97. https://doi.org/10.1177/105984050101700206
Horn, K. A., Dino, G. A., Kalsekar, I. D., & Fernandes, A. W. (2004). Appalachian teen smokers: Not On Tobacco 15 months later. American Journal of Public Health, 94(2), 181-184. https://doi.org/10.2105/AJPH.94.2.181
Kohler, C. L., Schoenberger, Y. M., Beasley, T. M., & Phillips, M. M. (2008). Effectiveness evaluation of the N-O-T smoking cessation program for adolescents. American Journal of Health Behavior, 32(4), 368-379. https://doi.org/10.5993/AJHB.32.4.4
Anesetti-Rothermel, A., Noerachmanto, N., Horn, K., & Dino, G. (2012). Beyond reach and effectiveness: Evaluating the Not-On-Tobacco (N-O-T) program in West Virginia from 2000 to 2005. Health Promotion Practice, 13(4), 506-514. https://doi.org/10.1177/1524839910386183
Blank, M. D., Ferris, K. A., Metzger, A., Gentzler, A., Duncan, C., Jarrett, T., & Dino, G. (2017). Physical activity & quit motivation moderators of adolescent smoking reduction. American Journal of Health Behavior, 41(4), 419-427. https://doi.org/10.5993/AJHB.41.4.6
Dino, G. A., Horn, K. A., & Meit, H. (1998). A pilot study of Not On Tobacco: A stop smoking programme for adolescents. Health Education, 98(6), 230-241. https://doi.org/10.1108/09654289810238168
Dino, G. A., Horn, K. A., Goldcamp, J., Kemp-Rye, L., Westrate, S., & Monaco, K. (2001). Teen smoking cessation: Making it work through school and community partnerships. Journal of Public Health Management and Practice, 7(2), 71-80. https://doi.org/10.1097/00124784-200107020-00010
Dino, G., Horn, K., Abdulkadri, A., Kalsekar, I., & Branstetter, S. (2008). Cost-effectiveness analysis of the Not On Tobacco program for adolescent smoking cessation. Prevention Science, 9(1), 38-46. https://doi.org/10.1007/s11121-008-0082-0
Horn, K., Branstetter, S., Zhang, J., Jarrett, T., O'Hara Tompkins, N., Anesetti-Rothermel, A., ... Dino, G., (2013). Understanding physical activity outcomes as a function of teen smoking cessation. Journal of Adolescent Health, 53(1), 125-131. https://doi.org/10.1016/j.jadohealth.2013.01.019
Horn, K., Dino, G., Gao, X., & Momani, A. (1999). Feasibility evaluation of Not On Tobacco: The American Lung Association's new stop smoking programme for adolescents. Health Education, 99(5), 192-207. https://doi.org/10.1108/09654289910294714
Horn, K., Dino, G., Kalsekar, I., & Mody, R. (2005). The impact of Not On Tobacco on teen smoking cessation: End-of-program evaluation results, 1998 to 2003. Journal of Adolescent Research, 20(6), 640-661. https://doi.org/10.1177/0743558405274891
Horn, K., McGloin, T., Dino, G., Manzo, K., Lowry-Chavis, L., Shorty, L., ... Noerachmanto, N. (2005). Quit and reduction rates for a pilot study of the American Indian Not On Tobacco (N-O-T) program. Preventing Chronic Disease, 2(4), A13-A13.
Massey, C. J., Dino, G. A., Horn, K. A., Lacey-McCracken, A., Goldcamp, J., & Kalsekar, I. (2003). Recruitment barriers and successes of the American Lung Association's Not-On-Tobacco program. The Journal of School Health, 73(2), 58-63. https://doi.org/10.1111/j.1746-1561.2003.tb03573.x
Reed, D., Jarrett, T., Farley, J., Richards, T., McDonald, D., & Dino, G. (2016). Lessons of partnership: Successes and challenges associated with the dissemination of the Not-On-Tobacco program within cooperative extension service framework. Journal of Youth Development, 11(1), 77-87. https://doi.org/10.5195/jyd.2016.435
