Not On Tobacco® (N-O-T)

Tragically, about 95% of today's tobacco users started using before the age of 21. E-cigarettes have escalated this problem, with over 5,700 kids starting to vape every day, according to the CDC. Not On Tobacco® (N-O-T) seeks to address this growing problem by giving all teens the resources they need to break nicotine dependency and find healthier outlets.

Unlike other cessation programs which simply modify adult curriculum, N-O-T was designed with teenagers in mind and addresses issues that are specifically important to them. The program takes a holistic approach with each session using different interactive learning strategies based on Social Cognitive Theory of behavior change that can then be applied and practiced in everyday life and encourages a voluntary change for youth ages 14 to 19.

This program is approved for WV Expanded School Mental Health.

Last reviewed: 2023

Intended Outcomes:

  • Help teens quit smoking
  • Reduce the number of cigarettes smoked if unable to quit
  • Increase healthy lifestyle behaviors
  • Improve life skills
  • Better grades
  • Higher motivation
  • Fewer absences
  • Better relationships with teachers
  • Fewer school tobacco use policy violations

Continuum of Care:
Indicated Prevention

Topic Areas:
Behavioral Health/Mental Health, Physical Health, Substance Use

Teen/Adolescent (13-18)

Geographic Locations:
Rural, Urban

Delivery Settings:
Community-Based, School-Based

Cultural Considerations:
Limited research found involving diverse populations

This program is intended for tobacco users between the ages of 14-19.

There is no minimum credential requirement to implement this program.


Is Training Required?
Yes, see developer info

Who can provide the required training?
Please see the following link to register for the online on-demand facilitator training course:

Program Costs (materials, training, etc.):
Yes, refer to program website

Program/Practice Website:

Relevant Published, Peer-Reviewed Research:

Blank MD, Ferris KA, Metzger A, Gentzler A, Duncan C, Jarrett T, Dino G. Physical Activity and Quit Motivation Moderators of Adolescent Smoking Reduction. Am J Health Behav. 2017 Jul 1;41(4):419-427. doi: 10.5993/AJHB.41.4.6. PMID: 28601101; PMCID: PMC5546298.

Branstetter, S. A., Blosnich, J., Dino, G., Nolan, J., & Horn, K. (2012). Gender differences in cigarette smoking, social correlates and cessation among adolescents. Addictive Behaviors, 37(6), 739.

Dino G, Horn K, Goldcamp J, Fernandes A, Kalsekar I, Massey C. A 2-year efficacy study of Not On Tobacco in Florida: an overview of program successes in changing teen smoking behavior. Prev Med. 2001 Dec;33(6):600-5. Review. PubMed PMID: 11716656.

Dino, G., Kamal, K., Horn, K., Kalsekar, I., & Fernandes, A. (2004). Stage of change and smoking cessation outcomes among adolescents.
Addictive Behaviors, 29(5), 935-940.

Horn K, Branstetter S, Zhang J, Jarrett T, Tompkins NO, Anesetti-Rothermel A, Olfert M, Richards T, Dino G. Understanding physical activity outcomes as a function of teen smoking cessation. J Adolesc Health. 2013 Jul;53(1):125-31. doi: 10.1016/j.jadohealth.2013.01.019. Epub 2013 Apr 9. PMID: 23578440.

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), 1814.

Horn, K., Fernandes, A., Dino, G., Massey, C. J., & Kalsekar, I. (2003). Adolescent nicotine dependence and smoking cessation outcomes. Addictive Behaviors, 28(4), 769776.

Horn, K., Noerachmanto, N., Dino, G., Manzo, K., & Brayboy, M. (2009). Who Wants to Quit? Characteristics of American Indian Youth Who Seek Smoking Cessation Intervention. Journal of Community Health, 34(2), 153-63.

Joffe A, McNeely C, Colantuoni E, An MW, Wang W, Scharfstein D. Evaluation of school-based smoking-cessation interventions for self-described adolescent smokers. Pediatrics. 2009 Aug;124(2):e187-94. doi: 10.1542/peds.2008-2509. Epub 2009 Jul 27. PMID: 19651564.

Kohler, C. L., DrP.H., Schoenberger, Yu-Mei M,PhD., M.P.H., Beasley, T. M., & Phillips, Martha M, PhD,M.P.H., M.B.A. (2008). Effectiveness Evaluation of the N-O-T Smoking Cessation Program for Adolescents. American Journal of Health Behavior, 32(4), 368-79.

Additional Sources:

Supported By Research

WV Rating:
Supported by Research
»WV Ratings Info

Rationale for Rating:

Research on Not On Tobacco® (N-O-T) showed generally positive results. However, some studies demonstrated mixed results. The research was limited to certain demographics. In several well-designed studies, participants reported a significant decrease in tobacco use.

Contraindications or Concerns:
None identified

Other Registries/Ratings

The California Evidence-Based Clearinghouse for Child Welfare:
Not On Registry

Blueprints for Healthy Youth Development:
Not On Registry

Clearinghouse for Military Family Readiness:
Not On Registry

Office of Juvenile Justice and Delinquency Prevention Model Programs Guide:
Not On Registry

Washington State Institute for Public Policy:
Not On Registry