Empowering Quitters: A Year in Review of EX Program’s Impact on Tobacco Addiction

Empowering Quitters: A Year in Review of EX Program’s Impact on Tobacco Addiction

Every day, millions of U.S. adults struggle with tobacco addiction.

At Truth Initiative, we’re on a mission to change this. Our vision is to create a world where young people reject tobacco and anyone can quit.

Inspired by Mayo Clinic’s effective on-site treatment model for tobacco addiction, we partnered with Mayo Clinic to create EX more than 15 years ago. EX is a digital adaptation of Mayo Clinic’s proven approach, making these tools and resources more widely accessible.

As we reflect on 2023, we are so incredibly proud to play a role in helping people literally change their lives by quitting smoking, vaping, and nicotine use. And we’re committed to continue to innovate nicotine addiction treatment, so we can better support those affected by it.

Here are 10 examples of how we’ve made an impact on helping people live free from tobacco in 2023:

  1. Reached and engaged communities at highest risk

    There are dramatic disparities in tobacco use rates. Individuals with lower education levels and mental health conditions, as well as those who are living in poverty or disabled, among certain racial and ethnic groups, and members of the LGBT community use tobacco at disproportionately high rates. We’re committed to serving those communities and partnering with others to help us reach them. This year, for example, almost 5 million Medicaid members are provided EX Program through our partnership with health plans.

Tobacco use among U.S. adults varies by race/ethnicity, education level, annual household income, disability, sexual orientation, and health insurance coverage.

  1. Delivered high-value, evidence-based content on emerging products, such as Zyn

    The tobacco industry and tobacco product landscape are constantly evolving. To meet this challenge, we stay current on the latest data and trends. In response to surges in search traffic related to oral nicotine pouches, like Zyn, we published articles on EX explaining what Zyn/other oral nicotine pouches are, how to quit Zyn/other oral nicotine pouches, and why it is not recommended to use Zyn to quit smoking or vaping. This content rapidly became a featured snippet in Google, demonstrating its value to tobacco users.

The tobacco industry and tobacco product landscape are constantly evolving. To meet this challenge, we stay current on the latest data and trends.

  1. Addressed tobacco as part of a holistic, whole-person approach

    We understand that many social and contextual factors play into how likely it is that someone starts using tobacco and how hard it is to quit. This year, we began publishing new articles and Mayo Clinic blog posts on how social determinants of health and other facets of our users’ lives (such as alcohol/other substance use, financial stress, and living with chronic pain) can make quitting feel so hard. We also provide specific tips to make quitting easier if those are part of a user’s quit journey.

  2. Introduced trauma-based care

    Awareness and training in social determinants of health—and trauma in particular—have become increasingly important in our tobacco cessation work as more people share these experiences. In 2023, our EX Coaching staff developed trauma-informed care protocols to apply across all EX users anchored on the 6 CDC-guiding principles of trauma-informed care. We also published new articles about why experiencing trauma makes quitting feel so hard and ways to make quitting easier for those with a traumatic history.

  3. Sustained a high level of activity in our thriving online community

    Social support is a core component for effective cessation treatment. Our EX Community continues to provide unparalleled peer and expert quit support. EX Community members are online 24 hours a day, 7 days a week, 365 days a year. Every single post garners at least one response, with an average of 12 responses per post (and always within minutes).

sample post from the EX Program community, which provides unparalleled peer and expert quit support.

  1. Expanded opportunities to interact with our beloved EX Coaches

    This past year, the average chat length with an EX Coach was 15 minutes. (Compare this to the average call duration to state quitlines of 11 minutes nationally.) In November 2023 alone, our coaches completed over 1,100 chats. Our EX Coaches are so beloved that this year, we launched the EX Duo app and EX Community virtual events as other ways for members to connect with and learn from them.

members can chat with coaches for advice, motivation, and guidance to make their tobacco cessation journey easier.

  1. Launched Scout, our AI-powered content recommender, to deliver more personalized user experiences

    We launched the first ever AI-recommender engine for tobacco cessation, called EX Scout, in late 2023. It generates tailored content recommendations for users, like the way Netflix recommends movies for its users. The version of Scout that is live on the site today is the first of 3 phases. Subsequent phases, planned for rollout in 2024, will employ increasingly sophisticated machine learning models to provide even more tailored recommendations to boost quitting outcomes.

  2. Enhanced content on connections between mental health and tobacco use

    In usability testing, in the clinical trials we run, and in chats with EX Coaches, topics of stress/anxiety and mental health continue to be a top concern for tobacco users trying to quit. We published 13 Mayo Clinic blog posts this year that addressed different dimensions of stress, anxiety, self-care, and coping strategies.

  3. Connected more individuals with quit medication

    Using quit medication can double a quitter’s odds of success, but nationally, most quitters don’t use it. EX removes common barriers to using medication, and it works. Among clients who follow best practices, 67% of EX users order quit medication, compared to 29% nationally. To further support our users, we published a comprehensive 40+ page guide to all different types of quit medication.

  4. Delivered meaningful outcomes

    Across all tobacco products, there’s only one thing that works for everyone seeking to live tobacco free: trying to quit. If you don’t try, you won’t succeed. Among our clients that apply best practices, we see a 52% quit rate among EX users.

As we move in to 2024, we look forward to continuing to evolve EX Program to reduce tobacco addiction and better support individuals in need. We sincerely appreciate our clients, who amplify the reach of EX Program to deliver on our mission to create a world where anyone can quit.

Interested in seeing how we can strategically partner with you to end smoking, vaping, and nicotine use among your population? See our demo or contact one of our experts to start a conversation today!

Amanda Graham, Ph.D.

Chief Health Officer

Dr. Amanda Graham leads the Innovations Center within Truth Initiative. The Innovations Center is dedicated to designing and building leading digital products for tobacco cessation, including the EX Program. She is internationally recognized as a thought leader in web and mobile quit-smoking interventions and online social networks and has been awarded over $15 million in research funding. She has published over 115 peer-reviewed manuscripts and serves on National Institutes of Health study sections and numerous journal editorial boards. Graham is Professor of Medicine (adjunct) at the Mayo Clinic College of Medicine and Science.

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