MLMQ_for_MS_May2026_FinalSubmission_REDACTED.pdf

Prepared by:

Alex Hurst Executive Director National Jewish Health 1400 Jackson St., Denver, CO 80206 hursta@njhealth.org

Proposal to Offer Youth and Young Adult Commercial Tobacco and Vaping Cessation

Services in Mississippi mailto:hursta@njhealth.org

Proposal to Offer My Life, My Quit and QuitLogix

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Table of Contents

CORPORATE OVERVIEW

Executive Summary

About National Jewish Health

Our Expertise in Nicotine Cessation Programs

Our Clients

A. PROGRAM OVERVIEW

A.1 Evidence-Based Strategies and Best Practices

Digital-First Service Delivery

Live Text Coaching

Live eCoaching

Hours of Operation

A.2.Culturally and Linguistically Appropriate Program

Coaching Services

Smart Device Application

Interactive Web Program

Automated Interactive Text Messaging

Message Types

Ad Hoc Support: Two-way Online Chat

Services for Non-English Speakers and Hearing- or Speech-Impaired Callers

Intake and Enrollment

A.3 Behavioral Support, Empowerment, Counseling, and Messaging

Coaching Protocol

Stages of Change

Motivational Interviewing

Cognitive Behavioral Therapy

A.4. Program Overview, Quit Dates, and Tips

Participant Eligibility

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B. MESSAGING AND RESOURCES

B.1. Educational Materials

B.1.A. Promotional Materials

Provider Referrals

C. SERVICE REQUIREMENTS AND INFORMATION MANAGEMENT AND DATA SYSTEMS

Regulatory Compliance

Commitment to Quality

Quality Improvement

D. REPORTING

Evaluations

COST PROPOSAL

My Life, My Quit™ and QuitLogix® Young Adult

CONCLUSION

ATTACHMENTS

Attachment 1: Mobile Apps REDACTED

Attachment 2: Website REDACTED

Attachment 3: Education Materials REDACTED

Attachment 4: Promotional Materials REDACTED

Attachment 5: Sample Reports REDACTED

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CORPORATE OVERVIEW

Executive Summary

National Jewish Health is honored to submit this proposal in response to Mississippi State Department of Health’s Invitation for Bids for Youth and Young Adult Cessation Services. We are well-positioned to provide youth and young adults in Mississippi who use nicotine products1 the innovative, evidence-based support they need through our nationally recognized My Life, My Quit™ and QuitLogix® programs.

Founded in 1899 as a nonsectarian, nonprofit hospital, National Jewish Health is leading respiratory care hospital dedicated to respiratory health. Since the first patient was admitted more than 125 years ago, National Jewish Health has expanded its services to include many respiratory, immunologic, and related disorders. As an academic medical center committed to excellence in respiratory health, our mission is "To heal, to discover, and to educate as a preeminent health care institution."

In support of this mission, National Jewish Health launched our evidence-based QuitLogix program in 2002. What began as a telephone-based nicotine cessation program has evolved into a comprehensive, multi-channel digital suite of services, featuring app, text and web programming that is tailored to meet the needs of specific populations including youth and young adults. We continually leverage emerging research and some of the nicotine cessation and prevention industry’s most prominent thinkers to evolve and improve our program to meet the needs of our clients and program participants.

In 2019, we developed the My Life, My Quit program for youth and tailored young adult services within our existing QuitLogix program to further our commitment to local, regional, and national efforts toward nicotine prevention and cessation. Both programs were developed following best practices for cessation, adapted to support youth and young adult developmental needs based on extensive input and feedback from youth, young adults, and subject matter experts. My Life, My Quit is now available in 26 states and has enrolled over

8,500 youth across the country. The QuitLogix Young Adult program is available in 24 states across the country and has enrolled more than 11,000 young adults across phone, web, and text programs.

Our programs work. National Jewish Health has conducted multiple outcome evaluations for My Life, My Quit and QuitLogix and consistently find success rates far exceeding the national

1 All references to “nicotine” shall be understood to include commercial tobacco and vaping products unless otherwise specified. We affirm the sacred purpose of tobacco in American Indian communities. In this proposal, cessation services refer only to commercial tobacco. All references to “tobacco” shall be understood as “commercial tobacco” unless otherwise specified.

4 | P a g e benchmark of 30% for cessation programs set by NAQC. Our 2025 multistate evaluation found at seven months after intake, the 30-day point prevalence responder quit rate for conventional tobacco + Electronic Nicotine Delivery Systems (ENDS) was 67% for My Life, My Quit and 36% for the QuitLogix Young Adult program.

Since the original development of My Life, My Quit and QuitLogix National Jewish Health continues to evolve the programs to meet the changing needs and behaviors of youth and young adults. Enhancements include the launch of a mobile application (app) for My Life, My Quit August 2025 (available in Apple App Store and Google Play Store), and pending launch of the QuitLogix app summer 2026. The apps offered for each program include use of biometric authentication to allow for seamless entry into the program (reducing a commonly cited barrier of passwords for youth and young adults), use of push notifications to support user engagement and re-engagement, and milestone tracking. These innovations are complemented by enhanced behavior change support designed for youth and young adults through the use of videos and in the moment support, content tailored to nicotine products, and activities tailored youth and young adults throughout their quit journey.

Available at no cost to participants, the My Life, My Quit youth program offers:

• Youth-friendly app available in the Apple App Store and Google Play Store, and website (mylifemyquit.com) with vaping and tobacco information, interactive activities for a customized quit plan, in the moment and proactive support through push notifications and ability to seamlessly connect with live text coaching.

• Coaching by phone, live texting, or live online chat, provided by specialized tobacco treatment coaches who understand teens, support quitting, and build relationships to develop healthy futures.

• Dedicated text short code (36072) and toll-free (1.855.891.9989) phone numbers.

• Keyword-interactive text messages tailored by tobacco type and readiness to change for anytime support or countdown to quit.

• Educational materials designed for youth with messages from youth about quitting tobacco or vaping and how to ask for support.

• A watermarked certificate at completion of the program to ensure it cannot be recreated (to support authenticity for mandated participants).

• Online resources for educators, parents, and health professionals.

• Promotional toolkit including free banner ads, at least 3 social media posts, customized flyers, wallet cards and posters featuring Mississippi-brand tag.

• Also included will be our new 2026 MLMQ :15 second video campaign and Toolkit material

• A provider referral program via fax and web.

Available at no cost to participants, the QuitLogix Young Adult program offers:

http://mylifemyquit.com/

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• Access to an evidence based self-guided quit journey via an app. The program allows participants to customize the program to meet their needs and incorporates developmentally appropriate activities and resources to meet the needs of young adults, in the moment and proactive support through push notifications and ability to seamlessly connect with live text coaching.

• Coaching by live texting with tobacco treatment specialists trained by nationally recognized experts in working with young adults.

• Keyword-interactive text messages tailored by tobacco type and readiness to change for anytime support or countdown to quit.

• A Welcome Package with personalized educational materials and the industry renowned My Quit Journey© workbook.

As an academic medical center, we are committed to advancing research and education in the field of nicotine cessation for youth and young adults. Our team of experts continually introduces new technologies and best practices as they become available to inform the ongoing development of My Life, My Quit and QuitLogix.

We look forward to the opportunity to provide the youth and young adults of Mississippi valuable, life-saving nicotine cessation programs. By choosing to partner with National Jewish Health, you are taking an important step toward supporting the health and well-being of your next generation.

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About National Jewish Health

Now in our 125th year as a nonprofit hospital, National Jewish Health is proud to be the world’s leading facility dedicated exclusively to the treatment of patients with respiratory, cardiac, immune, and related disorders. As an academic medical center, we maintain a strong focus on the science of preventing and treating chronic disease and have access to the most cutting-edge respiratory research, including the harms associated with vaping. Patients and families come to National Jewish Health from around the world to receive best-in-class, comprehensive, coordinated care.

Our Expertise in Nicotine Cessation Programs

Drawing on deep expertise in respiratory research and care, nationally recognized disease management programs, and extensive experience in delivering evidence-based nicotine cessation services, National Jewish Health is now the nation’s largest provider of Quitline services. We currently operate in 26 states, have supported more than 2.5 million people since our first Quitline contract in 2002, and consistently achieve one of the highest quit rates in the country. Our continued success is fueled by ongoing innovation, particularly in responding to the evolving nicotine landscape. In 2019, we introduced two purpose-built programs to support younger populations: My Life, My Quit for teens ages 13-17 and QuitLogix Young Adult program for those ages 18-24. Recognizing that youth and young adults turn first to digital platforms for information and help, these programs were created as digital-first models to deliver support in the formats they trust and use most.

My Life, My Quit and QuitLogix program evaluations, conducted in 2025, demonstrated a dedicated program with promotion can increase reach among youth and young adults who use nicotine products. Cessation data are highly encouraging, with quit rates that exceed the national benchmark for Quitline programs. Namely, at seven months after intake, the 30-day point prevalence responder quit rate for conventional tobacco + ENDS (Electronic Nicotine

Delivery Systems) was 67% for My Life, My Quit and 35% for the QuitLogix Young Adult program.

Since the launch of the programs, we have served nearly 8,500 youth and 11,000 young adult participants through our phone, web, and text programs. We are confident that our service has the right mix of experience in coaching, available technology, and promotional partnerships to continue to expand our reach and engagement with youth and young adults seeking assistance to become nicotine-free.

National Jewish Health employs some of the most prominent specialists in respiratory health.

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Our focus on continuous innovation is driven by the needs of our clients and from our mission to integrate new research into practice. As new evidence and best practices emerge, we regularly enhance our services. My Life, My Quit and QuitLogix are overseen by a medical director and clinical director, two industry thought leaders with over 60 years of combined experience in the field of tobacco prevention and cessation. We also collaborate with some of the most prominent partners across the country and engage communities to introduce new knowledge and best practices to our program.

Our Clients

We believe what sets National Jewish Health apart is our dedication and passion for our work in tobacco and vaping cessation. Our cessation programs are staffed by more than 80 devoted professionals including specialized youth coaches who undergo rigorous training, clinical and tobacco control program experts, account management, web development, and data analytics. As a client, you have access to this devoted, highly collaborative team.

Additionally, we pride ourselves on our close working relationships with our clients, who consistently commend our agility in responding to their suggestions and requests, our excellent customer service, and our commitment to continually improve our service offerings. National Jewish Health currently provides My Life, My Quit in 26 states and QuitLogix in 24 states through partnerships with state health departments and funding agencies. We would be pleased to extend this support to youth and young adults in Mississippi.

A. Program Development

A.1. Evidence-Based Strategies and Best Practices

Limited evidence is available on tobacco treatment interventions for youth, particularly when compared with the adult literature. The most recent Cochrane review on tobacco cessation interventions for youth and young adults did not identify any single intervention with clear, statistically significant effects on cessation outcomes. However, most included studies were small, limited in scope, or too heterogenous to allow for meaningful meta-analysis. While pharmacotherapy has not demonstrated clear effectiveness among youth, some behavioral interventions show modest benefit. In particular, motivational interviewing has been shown to be effective in supporting behavior change among youth, including reductions in substance use such as tobacco and nicotine.

Our coaches are highly trained and answer hundreds of calls each day.

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The U.S. Public Health Service Surgeon General’s 2012 report further emphasized key cognitive and psychosocial differences between youth and adults, underscoring the importance of tailoring tobacco treatment interventions for youth. The report identified approaches that address social influences and incorporate cognitive-behavioral and motivational enhancement techniques as among the most effective. In addition, interventions delivered through telephone counseling, internet-based programs, and text messaging showed positive effects for improving cessation outcomes among youth.

Telephone Quitlines are an evidence-based resource recommended by the Clinical Practice Guideline for Treating Tobacco Use and Dependence and highlighted in the 2020 Surgeon General’s report on cessation interventions. Quitlines offer a range of evidence-based services, including proactive multi-session telephone counseling, interactive automated text messaging, and interactive web-based treatment support. Taken together, Quitlines represent an important but underutilized evidence-based resource for supporting youth and young adults in becoming free from nicotine.

Our Quitline programs My Life, My Quit and QuitLogix have been carefully developed to feature only the most promising services for youth and young adult (respectively). Our nicotine cessation services and coaching methods are designed to implement numerous best practices and evidence-based guidelines including:

• Clinical Practice Guideline on Treating Tobacco Use and Dependence: 2008 (DHHS, 2008) and Recommendation Statement (Annals of Internal Medicine, Oct 2015)

• U.S. Preventive Services Task Force Recommendation Statement on Tobacco Smoking Cessation in Adults (2021)

• 2019 Cochrane review, Telephone Counselling for Smoking Cessation

• 2014/2017 Best Practices for Comprehensive Tobacco Control Programs (CDC)

• 2017 Cochrane review, Internet-based Interventions for Smoking Cessation

• 2017 Cochrane review, Tobacco Cessation Interventions for Young People

• 2016 Cochrane review, Mobile Phone-based Interventions for Smoking Cessation

• 2020 Surgeon General Report, Smoking Cessation

• 2016 Surgeon General Report, E-cigarette Use Among Youth and Young Adults

• 2012 Surgeon General Report, Preventing Tobacco Use Among Youth and Young Adults

• Telephone Quitlines: A Resource for Development, Implementation, and Evaluation

(CDC, 2004)

• Youth Tobacco Cessation: A Guide for Making Informed Decisions (CDC, 2004)

• Social Cognitive Theory (Bandura, 1989)

• Cognitive Behavioral Therapy (Beck, 1993)

• Health Behavior Change (Rollnick, Mason, & Butler, 2007)

• Goal-Setting Theory (Locke, 1996)

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• Transtheoretical Model of Change: Stages of Change (Prochaska & Velicer, 1997)

• Motivational Interviewing: Helping People Change, Third Edition (Miller & Rollnick, 2013)

• Relapse Prevention Theory (Marlatt & Gordon, 1985)

• NAQC Best and Promising Practices (2022)

Digital-First Service Delivery

As prefaced above, seamless, no wrong door access to free, live coaching is a core feature of our approach. Also available is a smartphone application (app) to enhance support and accessibility for My Life, My Quit with a complementary QuitLogix app launching Summer 2026.

We do not offer nicotine replacement therapy (NRT) to any participants under 18 years old. If requested, participants are referred to their prescribing health care provider for more information on whether medication can aid their quit attempt. Should the state choose to expand services in the future, subject to interest and available funding, we can offer access to NRT for young adults 18-24 through the QuitLogix app.

Products are available in personalized combinations, and participants can choose a digital package that works for them: live coaching with selected digital services or standalone digital services for participants who may not want to engage in live coaching.

Live Text Coaching

A key innovation in My Life, My Quit and the QuitLogix young adult program includes the ability to engage in coaching using live text messaging directly with a coach. Youth and young adult participants engage in live text coaching by texting COACH to 36072 at any time after they have enrolled in text messages. A live coach responds to every request, and if the participant wishes to engage in a coaching session, they are directed to respond to a short series of screening questions, then engage in a conversation with a coach.

Live eCoaching

National Jewish Health offers live eCoaching chat as a standard digital product to youth enrolled in the My Life, My Quit web program. Participants who are enrolled and logged into their web program profile may request a coaching session using the web-based chat functionality. Coaches document the eCoaching sessions in our case management system, QuitPro, in the same manner they record phone coaching.

Hours of Operation

We are pleased to offer live coaching and digital program services 24 hours a day, seven (7) days per week. These hours are maintained every day of the year with few exceptions to our live coaching program:

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• Closed Thanksgiving and Christmas Day

• Operates with reduced hours (closing at 5:30 p.m. MST and opening at 5:00 a.m.

MST the following day) on Memorial Day, Independence Day, Labor Day, the day after Thanksgiving, and Christmas Eve

See Attachment 1: Mobile Apps for more information.

See Attachment 2: Website for more information.

A.2. Cultural and Linguistic Consideration for Diverse Populations

National Jewish Health invests significant time and energy into properly training each My Life, My Quit and QuitLogix team member. Our core curriculum includes didactic training, live role-plays, side-by-side training, and observation of current staff. Our coaches receive more than 150 hours of training, including our Tobacco Treatment Specialist (TTS) training program accredited by the Council for Tobacco Treatment Training Programs. Additionally, we host a robust continuing education program that offers more than 20 hours of in-service and computer-based learning opportunities each year.

A dedicated and specially trained pool of coaches serve all youth callers to enhance the experience and skills needed for coaches to be responsive to adolescent populations. Dr.

Bonnie Halpern-Felsher, PhD, a nationally recognized expert in cognitive and psychosocial development from Stanford University, developed a tailored coach training on working with adolescents. The training included elements of social learning, as well as cognitive-behavioral and motivational enhancement models for personalized treatment assistance. Because youth are more likely to be required to engage (i.e., involuntary) in treatment, coach training includes use of motivational interviewing to engage youth mandated to seek treatment by the justice system, their educational institution, or by a parent or guardian. While external motivation can result in initial engagement, coaches needed to be able to maintain engagement with individuals with low internal motivation for change. Additionally, Dr. Robin Mermelstein, PhD a renowned expert on young adult smoking patterns and the social and emotional contexts that shape them, developed a specialized coach-training curriculum in partnership with the University of Illinois Chicago. This training focuses on the distinctive factors influencing tobacco use and cessation during young adulthood, such as major life transitions, experimentation with roles and identities, evolving “possible selves,” and the fluid, rapidly changing nature of this developmental period.

QuitLogix coaches receive more than 120 hours of training.

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Our supervisors are also TTS-trained experts and are available in real-time to assist coaches with challenging calls or chats. Coaches participate in bi-monthly mentoring sessions and weekly team huddles with Supervisors. Both programs My Life, My Quit and QuitLogix are overseen by both a Medical Director, Dr. Barry Make, MD, and a full-time Clinical Director, Dr.

Maggie Britton, PhD, who provide support and leadership for our nicotine cessation programs.

Coaching Services

The core of the My Life, My Quit and QuitLogix coaching program includes five proactive coaching sessions conducted by an experienced coach. Enrolled participants can make an unlimited number of inbound contacts, as needed, for up to 90 days after initial intake.

Coaching sessions are personalized for the participant based on their readiness for change and participants receive support from coaches trained to work effectively with young people. Our five-contact protocol aligns with the U.S. Preventive Services Task Force guidelines and the clinical guidelines for treating tobacco use and dependence, which recommend at least four counseling sessions of 10 minutes or more. Our evaluation results highlight the importance of live coaching, with the 30-day point prevalence responder quit rate for conventional tobacco + ENDS was 67% for My Life, My Quit and 35% for the young adult QuitLogix program. The coaching program is highly scalable to any number of participants as it does not have group size limits or curriculum structure constraints common to other youth tobacco cessation programs.

We use a “no wrong door” approach to live coaching for youth, ensuring access through traditional phone-based coaching as well as innovative live text and web-based (eCoaching) support. For young adults, we provide live text-based coaching, with the option to expand additional access pathways as state funding and interest allow. Coaching delivered by text or web mirrors traditional telephone-based services and follows established best practice guidelines for behavior change, supported by robust quality assurance processes. The approach and content are consistent across modalities, including discussions of motivation to quit, development of a quit plan, and strategies for engaging supportive others in the quit attempt.

Smart Device Application

In response to evolving youth engagement patterns, National Jewish Health has expanded My Life, My Quit to include a smart device application that provides on-demand access to cessation support. The app incorporates features such as personalized quit plans, milestone tracking, and interactive activities designed to reinforce behavior change. National Jewish Health will release a complementing QuitLogix app later this summer that will incorporate many of the same features for the young adult population.

To support sustained engagement, the platform leverages push notifications, check-ins, and milestone-based encouragement, ensuring participants receive timely and relevant support throughout their quit journey. These features reflect best practices in digital health engagement and are informed by ongoing user experience research.

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National Jewish Health actively reviews, researches, and monitors technology-based developments, and assesses and offers interactive cessation tools and other innovative technology-based platforms as needed to further expand services and reach. Our focus is always on offering participants the most effective resources to support them in their quit journey.

Interactive Web Program

National Jewish Health offers a My Life, My Quit website available to the public all day, every day of the year. Offering both a web- and phone-based youth tailored Quitline program, as recommended by the Centers for Disease Control and Prevention (CDC) and the North American Quitline Consortium (NAQC), increases reach and engagement among youth.

Interactive web programs are an evidence-based cessation intervention, and our program delivers best practices in web-based interventions such as tailoring the program to readiness for change. We follow best practices outlined in the 2017 Cochrane review that found interactive and tailored web-based cessation programs are effective at increasing smoking cessation with or without supplemental behavioral support.

The My Life, My Quit online web program begins with a dedicated youth-friendly landing page.

The website’s aesthetic is casual, conversational, encouraging, and nonjudgmental. Youth can view infographics, interactive calculators, fact sheets, and links to current state-approved resources when available. Chat functionality is available on the website to quickly connect interested individuals to live My Life, My Quit staff.

Education information targeting the youth audience is available on the program website with information about nicotine and vaping e-cigarettes, as well as other tobacco products. The educational information is designed to encourage youth to consider quitting and enroll in the My Life, My Quit program. The online content closely aligns with the evidence-based clinical quit process that forms the foundation of our coaching program. Site content is authored and approved by our Medical and Clinical Directors and is updated regularly to reflect program changes based on the latest clinical research and program outcomes.

Many adult visitors to the website submit questions or use the online chat function to ask questions about the program, about how to help young people quit, and how they can promote the program to youth. As a result of these queries, we have added several pages of education information for parents, educators, health professionals, and community agencies. Information for parents can be downloaded in Spanish. We also designed and co-branded posters, rack cards, and wallet card files available to print to help promote the program. Providers and educators can submit a referral through the secure web portal.

For individuals ready to take steps toward quitting, the website promotes enrollment in the web program. Participants can enroll in the phone-only, web-only, or combined web-phone program on the website, and select text services. The web and phone programs are seamlessly integrated to enable a single point of entry via the web enrollment form.

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Our Web Program provides an engaging user experience to assist tobacco users on their quit journey through a personalized web experience that complements our coaching process and follows the best available evidence for participants. The site includes interactive exercises, strategies for quitting, quizzes, trackers, and educational information about tobacco use and cessation. Participants can access their dashboard to develop and track their personalized Quit P.L.A.N. The dashboard also provides information about their next scheduled coaching appointment. The program is tailored to each stage of change to further personalize the web-based intervention. Throughout the quitting process, participants are encouraged to check in, assess their progress and document their rewards.

Automated Interactive Text Messaging

National Jewish Health offers youth and young adults an automated interactive text messaging program available as a standalone program by texting “Start my quit” to 36072, or by opting-in during intake or at any time during coaching. My Life, My Quit includes messages tailored to tobacco type and readiness for change.

Text message content includes interactive responses and is sent at various intervals based on a variety of triggers and are adapted by tobacco type, including combustible, smokeless, or electronic tobacco products. Participant’s information recorded in our database is used to automatically generate text messages. Participant information from all sources is accessible to coaches and can be updated online or during a coaching session.

Messages are sent both before and after the participant’s quit date. Participants who have not yet set a quit date can still participate in the program, with messages generated based on enrollment/registration date and triggered on call completion or other benchmarks. We maintain an extensive library of text messages that offer two-way messages to respond to text-for-help which may include keywords such as “CRAVE,” “SLIP,” or “MOOD.” Certain keyword responses also prompt automated video content, reflecting youth and young adults’ preference for engaging with visual rather than text-heavy content. Our text messaging program includes informational and motivational messages, appointment reminders, quit date anniversary messages, and re-engagement messages.

Message Types

• Informational and Motivational Messages are daily texts that contain dynamic informational and motivational content tailored to each participant.

• Process Messages are sent after certain program and system events. They include coaching appointment reminders, disenrollment notifications, and more.

• Count Down Messages are aligned to the participants quit date and provide support and encouragement with quitting. Participants can use keywords to access support anytime, or type COACH to receive live support.

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• Quit Anniversary Messages are based on the participant’s quit date and are sent at 1-, 2-, 3-, 6-, and 12-month anniversaries. The messages congratulate the participant for reaching these important milestones and motivate them to stay tobacco-free.

• Re-engagement Messages are targeted to participants who become unreachable during their enrollment and may or may not have quit and encourage them to re-engage with the program.

Ad Hoc Support: Two-Way Online Chat

At any time on the My Life, My Quit website, youth can easily reach a coach via our website chat functionality. This functionality is available to quickly connect interested individuals to live Quitline staff for answers to their general questions and real-time technical assistance to users needing help with the registration process during operating hours. In addition, a "Contact Us" feature facilitates an inbound participant inquiry to National Jewish Health.

Services for Non-English Speakers and Hearing- or Speech-Impaired Callers

Text and chat coaching, as well as participant education materials, are currently available in English-language only for My Life, My Quit and English and Spanish for QuitLogix. For all other languages, My Life, My Quit provides coaching over the phone to youth using LanguageLine, a reputable translation service that provides real-time phone interpretation between the coach and the non-English speaker at no charge to the caller. This service is available during all hours of operation in more than 200 languages and American Sign Language through video interpretation. We offer TTY (800-261-6259) for youth who are hearing or speech impaired and we encourage use of the online chat system for all participants.

Intake and Enrollment

Youth and young adults who call are welcomed with a warm, empathic, non-judgmental greeting by a coach. Whether by phone, text or chat, or online youth complete the following standard intake and enrollment process:

• Congratulate and engage the participant prior to assessing eligibility.

• Explain and offer all tobacco cessation program options.

• Send the participant a Welcome Package or welcome email.

• Offer the coaching program that includes up to five coaching sessions and unlimited inbound contacts by phone, text or chat.

• Complete the first coaching session, or if not convenient, schedule a time for the first coaching session at the earliest possible date.

• Offer online and automated text messaging programs as additional resources.

A separate brief enrollment process helps youth engage directly in our interactive text messaging program. Youth and young adults can simply text “Start my quit” to 36072 and answer four enrollment questions on age and zip code to verify eligibility, and tobacco type and readiness for change to tailor messages to the individual.

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A.3. Behavioral Support, Empowerment, Counseling, and Messaging

Based on the available literature of best practices for tobacco control with youth and young adults, we conducted a comprehensive review of the National Jewish Health cessation program that provides telephone, text, email, print and web-based treatment services. We identified several adaptations and enhancements to meet the specific needs of young people seeking nicotine treatment assistance and engaged relevant tobacco control experts, and state partners as key stakeholders. To make enhancements, we incorporated input directly from youth and young adults, subject matter experts, and community stakeholders.

The My Life, My Quit program was designed for youth ages 13-17 who want information and support to quit nicotine use, with a strong focus on vaping e-cigarettes, the most commonly used product among teens. The new program name and website (mylifemyquit.com) helped distinguish the program as being for youth, with imagery to reflect the target audience. The QuitLogix Young Adult program offers a developmentally tailored approach for people 18-24, also centered on helping young adults quit vaping and other tobacco products. Stakeholder input facilitated and continues to help refine each program and its components, promotional materials, and coaching content.

Both programs leverage live text messaging functionality to connect youth and young adults directly with a coach (youth also have access to online- and phone-based coaching, which could be extended to young adults in the future, subject to client interest and available funding).

Additional automated, interactive text messages provide motivational and supportive content, triggered by events or specific keywords, as recommended in current evidence-based practices for text-based treatment services. Keywords such as CRAVE, MOOD, SLIP, STRESS, BORED prompt automated video content, reflecting youth and young adults’ preference for engaging with visual rather than text-heavy content.

In addition, a My Life, My Quit phone application is now made available to support smart device users with leveraging the same services available through the web, including a direct access pathway to live text coaching that can be opted into as well. The content includes messages that resonate with young people, informed through focus groups and interviews with youth, as well as adolescent tobacco control experts. The registration and intake processes were substantially reduced from the standard Quitline program by removing adult-oriented questions (e.g., marital status) as a means to facilitate better rapport and a faster transition to coaching. By focusing questions to be developmentally congruent, coaches effectively build rapport with youth and reduce the time it takes to reach coaching content during the call.

Online users reach the intervention pages faster with the shorter online intake form.

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Coaching Protocol

Youth and young adult participants who engage with a coach will receive support from professionals trained in developmentally appropriate engagement strategies, the social influences shaping tobacco use, strategies to strengthen self-efficacy for behavior change, and best practices for working with mandated participants. Live coaching is delivered by phone, online chat, or text messaging, based on participant preference, and may be supplemented with automated text messages and an interactive online program. After five coaching sessions, we mail a printed watermarked completion certificate to ensure it cannot be recreated (to support authenticity for mandated participants). We ensure confidentiality for youth who seek help in accordance with state laws. Incentives can be considered based on state interest and funding availability.

Our coaches collaborate with each participant to develop a personalized quit plan tailored to their circumstances and readiness for change. Sessions are unscripted and conversational, giving coaches the flexibility to focus on what each young person needs in the moment while still guiding them toward meaningful behavior change.

Youth coaching incorporates principles of adolescent cognitive and psychosocial development woven throughout our protocols. Coaches are trained to address the key drivers of nicotine use, such as stress, social pressures, and challenges with emotional regulation. They help youth build practical skills, including identifying and managing triggers, navigating social situations, practicing refusal skills, expressing individuality in healthier ways, asking for support, and addressing concerns like weight gain or peer rejection. For young adults, coaching meets them in the complexity of early adulthood, balancing independence, new experiences, and social expectations. Coaches help them make sense of these influences, find practical alternatives to nicotine, and build momentum toward lasting change. Digital tools complement these conversations with interactive activities that reinforce coping skills, strengthen resilience, and support ongoing progress between sessions.

As the nicotine product landscape evolves, both My Life, My Quit and QuitLogix update their content and coaching protocols to address emerging products, such as nicotine pouches, and increasingly common patterns of poly-use (e.g., vaping in combination with other nicotine products). Coaches are equipped to address common misconceptions, such as comparisons between FDA-authorized nicotine pouches and FDA-approved cessation therapies, and provide clear, evidence-based guidance tailored to each participant’s product use and goals.

Our coaching protocol is grounded in three evidence-based approaches: stages of change, motivational interviewing, and cognitive-behavioral therapy.

Stages of Change

Clinical evidence supports using readiness-based interventions for smoking cessation to assess where a participant is in the behavior change process. The stages of change model (depicted graphically) is a five-stage progression model, recognizing that people move

17 | P a g e through distinct phases when adopting new behaviors. Our coaches use this model to assess each participant’s current state of readiness and tailor interventions accordingly to facilitate movement throughout the change process and support a successful quit attempt.

Motivational Interviewing

Our coaches embody the spirit of motivational interviewing in every interaction, grounding each encounter in partnership, acceptance, compassion, and evocation of each participant’s internal motivation for change. Coaches begin by affirming each participant’s inherent capacity for change and honoring their lived experiences throughout the process. Our coaches use a collaborative, participant-driven approach to develop a personalized quit plan. They draw on motivational interviewing techniques such as reflective listening, empathic responding, open-ended questioning, and permission-based feedback (e.g., Elicit- Advise-Elicit) to help youth progress through their stages of change toward a successful quit.

Cognitive Behavioral Therapy

Youth and young adult nicotine dependence is closely linked with stress, anxiety, depression, and other behavioral health factors. Our coaching approach incorporates supportive, skills-based strategies that acknowledge the interconnected role of tobacco use with behavioral health and help participants develop appropriate coping strategies.

A key component of this approach is Cognitive Behavioral Therapy (CBT), an evidence-based framework shown to be effective in supporting behavior change among youth and young adults. Using CBT principles, coaches help participants explore the connection between thoughts, feelings, and behaviors related to tobacco use, identify patterns, and develop healthier, more effective responses. This collaborative process strengthens self-awareness and supports the development of practical strategies for sustained cessation.

A.4. Program Overview, Quit Dates, and Tips

Participant Eligibility

If you choose to partner with National Jewish Health, My Life, My Quit will be offered to all youth age 13-17 and QuitLogix to young adults age 18-24 in Mississippi. Importantly, youth and young adults who use any type of tobacco product, including combustible, smokeless, and electronic or vaping devices, are eligible to participate in the programs, with services tailored by

18 | P a g e product type. Any participant age 25 or older will be directed to the Mississippi Tobacco Helpline.

Enrollment numbers depend on statewide marketing efforts, engagement strategies, and incentives associated with completed coaching sessions. National Jewish Health provides an initial communication toolkit and materials to market the program using paid banner ads and social media posts. In partnership with our media agency, we offer unique marketing packages encouraging youth and young adults to enroll in services.

National Jewish Health will work with Mississippi to define and implement an eligibility screening process during initial intake calls or using the online form. Once a participant is identified as eligible for coaching, they will remain eligible for the duration of the coaching program, to a maximum of 90 days after their last contact. At the close of a coaching program, participants remain eligible for the online program and can re-enroll in coaching.

B. MESSAGING AND RESOURCES

B.1. Educational Materials

Every phone-registered youth is eligible to receive a Welcome Packet containing the My Quit Journey© interactive workbook and educational materials with relevant information for youth participants. Web-registered participants receive access to the same information throughout the online program. We developed tailored educational information for youth participants who are trying to stop using nicotine. The materials were based on myths common among youth about tobacco use, best practices in youth tobacco control, and materials to support treatment.

All youth participants access the tailored materials that include messages and graphics to aid in treatment. Six information topics for youth participants include: “Stress and Coping,” “Are You a Target?” “It’s Still Commercial Tobacco,” “How Nicotine Works,” “Most Teens Don’t Use Commercial Tobacco,” and “Asking for Help”.

National Jewish Health developed these educational materials to be developmentally appropriate for youth, and they are available in digital or printed format. Our educational materials use graphics and pictures extensively and the content is tightly coupled to the clinical quit process that forms the foundation of our telephone program.

See Attachment 3: Educational Materials for more information.

Electronic nicotine delivery devices, such as vaping devices, are considered tobacco products.

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B.1.A. Promotional Materials

Using the information collected from multiple sources, we developed marketing materials for the My Life, My Quit program for use by states and state partners. The marketing and media toolkit was designed for use in current communication channels, including through local public health and tobacco control agencies, social media promotions, and for paid web banner advertising. Additional program information was designed to create awareness among parents, educators, and health professionals about the program.

Promotional materials about the program for Facebook were oriented towards adults (parents, health and education professionals) while featuring youth-friendly imagery with messages about a new free and confidential tobacco treatment program. These adult-oriented materials were intended to increase awareness about a dedicated program for adolescents in social media channels used by adults.

Promotional materials for youth were designed for Instagram with youth-friendly imagery and messages designed for the social media platform. Each promotional message included the web URL (mylifemyquit.com) and dedicated toll-free number (855-891-9989). Banner ads featuring three different treatment messages gleaned through discussion with youth were created and sent to states to promote the program using paid advertising. Additional messages from the initial focus groups were developed into banner ads for release over the first year of the program.

Beginning in 2020, National Jewish Health worked with a media agency to create the first multi-state youth cessation campaign with a call to action to enroll in My Life, My Quit. The media package now includes three highly impactful message packages including “End the Cycle”, “Detached” and “What Finally Worked”. The package has been used in 12 states helping hundreds of youth enroll in cessation services. National Jewish Health continues to work closely with various media agencies to provide key insights about youth experiences with tobacco cessation to inform new messaging.

See Attachment 4: Promotional Materials for more information.

Provider Referrals

National Jewish Health has implemented a comprehensive and successful referral program for health care professionals and community organizations to easily refer their patients who use tobacco to the Quitline. We accept and process referrals made via eligible Electronic medical record systems, fax through our dedicated fax referral line, through our secure online provider web portal, and live transfer. There is no cost for these services to referring providers. All provider referrals receive outcome reports via fax or secure email back to the referring provider.

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C. SERVICE REQUIREMENTS AND INFORMATION MANAGEMENT

AND DATA SYSTEMS

To enhance our Quitline program and better meet the needs of our participants and state partners, we developed a proprietary case management system, QuitPro. Over the past decade, we have refined QuitPro to power the robust and agile data capture and reporting capabilities that are essential for a Quitline program. This software, developed and maintained internally by the National Jewish Health IST Team, allows for increased flexibility and speed in responding to the changing needs of our state clients such as changing eligibility criteria. QuitPro drives our telephone coaching, online client databases, and texting programs, allowing for collection, storage, security, and access to participant data from inbound and outbound calls, chats, text messages, eligibility and minimal data set intake questions, for all parties who require access, whether for staff on a call or for client reporting purposes. The system is flexible and customized, allowing for quick and easy updates to meet current and future specifications.

Regulatory Compliance

As a hospital, research institution, and contractor for state agencies, National Jewish Health maintains the highest levels of security and privacy to guard protected health information (PHI).

We are committed to complying with Health Insurance Portability and Accountability Act (HIPAA) regulations. Our phone- and internet-based services, including text messaging and email support, are designed and maintained in compliance with HIPAA standards.

All data collection about youth participants and each interaction with our program is compliant with HIPAA regulations. We have specific systems in place to ensure the confidentiality of participant records. The Network Management Team employs firewalls, spam filters, email encryption, data leak prevention systems, anti-virus, network access control measures, log management systems, central authentication systems, and secure file transfer systems. Locally we have policies and procedures in place to address administrative, physical, and technical safeguards required by HIPAA and HITECH regulations.

National Jewish Health systems, including QuitPro, our My Life, My Quit and QuitLogix websites, are HIPAA compliant requiring usernames and passwords for anyone accessing the website. Our system protects against unauthorized third parties accessing participant data or monitoring participant use of the program with https encryption and firewalls to isolate our database servers from the internet.

Recognizing the importance of both security and ease of access, we support modern authentication methods, including optional biometric login (e.g., face ID or fingerprint recognition) to the My Life My Quit phone app (which will be present on the forthcoming QuitLogix app). These features reduce barriers to engagement while maintaining the highest

21 | P a g e standards of data security and privacy, particularly important…