A Comparative Review of the Effectiveness Trial of N-O-T in Alabama

Abstract

The American Lung Association’s Not On Tobacco (N-O-T) program is federally recognized as an accessible and effective option for teen smoking cessation. The program is the most widely used teen smoking cessation program in schools and communities across the U.S. Over a decade of research demonstrates the program’s solid evidence base, with overwhelmingly positive findings for both smoking cessation and reduction. A recent publication detailing a Not On Tobacco trial in Alabama reported low impact and negative findings. Given the program’s widespread use across the country, it is important to understand differential outcomes between the Alabama study and past Not On Tobacco studies, and to explore what we can learn from these differences. The current manuscript: (1) details and compares the methodological differences between the Alabama study and previous Not On Tobacco efficacy and effectiveness studies in other states, (2) explores important issues surrounding the analysis of teen smoking cessation outcomes, and (3) provides guidance for future research for Not On Tobacco and other teen smoking cessation interventions.