West Virginia Prevention Research Center

Not On Tobacco (N-O-T)

A burning cigarette.

For many years, West Virginia had one of the nation’s highest teen smoking rates. In the mid-1990’s, the WVPRC collaborated with the American Lung Association - West Virginia and national partners to develop a theory-based smoking cessation program specifically designed for teens throughout the state and nation. This program, called Not-On-Tobacco (N-O-T), has been a part of West Virginia’s public health efforts since.

N-O-T consists of ten weekly group sessions delivered by trained facilitators. To date, more than 700 teachers, counselors and community members were trained to deliver the program in West Virginia. With more than 10 years of research and evaluation behind it, N-O-T reached more than 300,000 teens nationwide between 2000 and 2009. It is available in 48 states and several countries. However, West Virginia continues to be a premiere N-O-T state where we continue to develop new and innovative methods to deliver and disseminate N-O-T to teens. In West Virginia (2010-2011), at the three-month follow-up:

  • 30% of teen smokers who completed the N-O-T program reported quitting smoking, and
  • 67% of those who completed the program but could not quit reported a reduction in smoking.

N-O-T participants report among the highest quit rates for any smoking cessation program currently available to teens. Teens in N-O-T also report higher motivation, better grades, fewer absences and better relationships with teachers.

Even with these promising results, many teens in West Virginia lack access to N-O-T. Competing health priorities, time constraints and administrative challenges unique to schools and communities often make it difficult to train facilitators and implement the program. To try to address these issues, researchers at WVU, ALA WV and state and community partners worked together to create a new model to disseminate the N-O-T program throughout West Virginia.

This model utilizes a highly experienced ALA WV Master Trainer as the state coordinator to provide program oversight and regional coordinators representing 5-6 West Virginia counties who are familiar with local youth, schools and organizations in the identified counties. Along with WVU Research Team members, the state and regional coordinators work as a team to help address any challenges facilitators face and offer encouragement and support for program facilitation.

Not-On-Tobacco partnered with WVU Extension Service to recruit exceptional Youth Development Agents to serve as regional coordinators for the identified counties.

Regional coordinators are essential to the program’s success. Their responsibilities include:

  • Recruiting teachers, counselors, coaches and community leaders to work as facilitators
  • Training facilitators in the Not-On-Tobacco modules and research protocols
  • Conducting periodic check-ins and assessments for research purposes
  • Offering support and troubleshooting for facilitators during program implementation
  • Working with school administrators and community organizations to gain support for the program
  • Working with West Virginia University and American Lung Association staff to track progress and report to the funding agency
  • Reporting to the West Virginia University Extension Service to coordinate with their strategic plan for Youth Services

Currently, we are testing the new dissemination model in two regions and have the opportunity to work with innovative and energetic WVU Extension Agents. In the coming months, we hope to expand our reach and bring this effective and vital program to West Virginia youth smokers.