1
|
Baker AL, McCarter K, Turner A, Segan C, Castle D, Brophy L, Borland R, Kelly PJ, Bonevski B, Baird D, Filia S, Attia J, Szwec S, Palazzi K, White SL, Williams JM, Wrobel AL, Ireland A, Saxby K, Ghijben P, Petrie D, Sweeney R. 'Quitlink': Outcomes of a randomised controlled trial of peer researcher facilitated referral to a tailored quitline tobacco treatment for people receiving mental health services. Aust N Z J Psychiatry 2024; 58:260-276. [PMID: 37353970 PMCID: PMC10903138 DOI: 10.1177/00048674231181039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
OBJECTIVE The aim of this study was to test the effectiveness of a tailored quitline tobacco treatment ('Quitlink') among people receiving support for mental health conditions. METHODS We employed a prospective, cluster-randomised, open, blinded endpoint design to compare a control condition to our 'Quitlink' intervention. Both conditions received a brief intervention delivered by a peer researcher. Control participants received no further intervention. Quitlink participants were referred to a tailored 8-week quitline intervention delivered by dedicated Quitline counsellors plus combination nicotine replacement therapy. The primary outcome was self-reported 6 months continuous abstinence from end of treatment (8 months from baseline). Secondary outcomes included additional smoking outcomes, mental health symptoms, substance use and quality of life. A within-trial economic evaluation was conducted. RESULTS In total, 110 participants were recruited over 26 months and 91 had confirmed outcomes at 8 months post baseline. There was a difference in self-reported prolonged abstinence at 8-month follow-up between Quitlink (16%, n = 6) and control (2%, n = 1) conditions, which was not statistically significant (OR = 8.33 [0.52, 132.09] p = 0.131 available case). There was a significant difference in favour of the Quitlink condition on 7-day point prevalence at 2 months (OR = 8.06 [1.27, 51.00] p = 0.027 available case). Quitlink costs AU$9231 per additional quit achieved. CONCLUSION The Quitlink intervention did not result in significantly higher rates of prolonged abstinence at 8 months post baseline. However, engagement rates and satisfaction with the 'Quitlink' intervention were high. While underpowered, the Quitlink intervention shows promise. A powered trial to determine its effectiveness for improving long-term cessation is warranted.
Collapse
Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
- IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Catherine Segan
- Cancer Council Victoria, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, ON, Canada
| | - Lisa Brophy
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, VIC, Australia
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute (FHMRI), College of Medicine & Public Health, Flinders University, Bedford Park, SA, Australia
| | - Donita Baird
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Sacha Filia
- Cancer Council Victoria, Melbourne, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, NSW, Australia
| | - Stuart Szwec
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Kerrin Palazzi
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | | | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Anna L Wrobel
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Andrew Ireland
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Karinna Saxby
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Peter Ghijben
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Bourne DE, Williams R, Osbahr L, Roemhildt M, Villanti AC. Implementation of Quitline Financial Incentives to Increase Counseling Sessions Among Adults Who Use Menthol Tobacco Products. Health Promot Pract 2024; 25:167-169. [PMID: 37118924 PMCID: PMC10611895 DOI: 10.1177/15248399231171143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Since 2017, the Vermont Tobacco Control Program (VTCP) has worked to reduce the impact of flavored tobacco products on Vermonters. With the proposed U.S. Food and Drug Administration (FDA) rules banning menthol cigarettes and flavored cigars and proposed legislation banning sales of all menthol and flavored tobacco products in Vermont, VTCP prioritized resources to support cessation among Vermonters who use menthol tobacco products. In March 2021, VTCP began offering a tailored quitline protocol for adults who use menthol tobacco, including financial incentives, for completed coaching sessions. From March 2021 to May 2022, 66 quitline callers enrolled in the menthol incentive protocol, representing 8% of all quitline callers and 25% of participants in the state's quitline incentive programs. A greater proportion of callers in the menthol incentive program completed three or more quitline calls (58% vs. 38%) and enrolled in phone and text support (61% vs. 32%). Quitline callers enrolled in any incentive protocols (menthol, Medicaid/uninsured, or pregnant) were more likely to request one or two forms of nicotine replacement therapy (NRT). Quitlines remain an effective, evidence-based method of tobacco cessation, especially in reaching vulnerable populations. Given the targeted marketing of menthol brands to Black and African American populations, LGBTQ+ populations, youth, and neighborhoods with lower incomes, addressing menthol cigarette use is key to improving health equity and health of Vermonters. Early data indicates that the use of financial incentives can increase engagement with a state quitline among menthol tobacco users through greater completion of cessation coaching calls, enrollment in text message support, and NRT usage.
Collapse
Affiliation(s)
| | | | - Lisa Osbahr
- Vermont Department of Health, Burlington, VT, USA
| | | | - Andrea C. Villanti
- Rutgers Center for Tobacco Studies, New Brunswick, NJ, USA
- Rutgers School of Public Health, Piscataway, NJ, USA
| |
Collapse
|
3
|
Martinez SA, Hasan A, Boeckman LM, Beebe LA. Oklahoma Tobacco Helpline Utilization and Outcomes by Diabetes Status. J Public Health Manag Pract 2023; 29:142-150. [PMID: 36715593 PMCID: PMC9897470 DOI: 10.1097/phh.0000000000001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
CONTEXT Diabetes and cigarette smoking are major causes of morbidity and mortality. Individuals with type 2 diabetes (T2D) who smoke are at an increased risk of smoking- and diabetes-related morbidity and mortality. OBJECTIVE We examined utilization patterns, satisfaction, and tobacco cessation outcomes among persons with T2D to determine whether the Oklahoma Tobacco Helpline is an equally effective intervention for tobacco users with T2D compared with those without diabetes. DESIGN This study was a retrospective cohort design using registration and follow-up data from a state tobacco quitline. SETTING We examined Oklahoma Tobacco Helpline registration data from July 2015 to June 2021 to compare Helpline utilization among individuals who self-reported a previous diagnosis of T2D compared with those not reporting a diagnosis of diabetes. PARTICIPANTS Oklahoma Tobacco Helpline registrants enrolled in a call program, either the single- or multiple-call program, who reported diabetes status at baseline. We compared tobacco use history, program enrollment, and services received for individuals self-reporting T2D with those without diabetes. MAIN OUTCOME MEASURES We compared 30-day point-prevalence abstinence at 7 months and evaluated program satisfaction. RESULTS Registrants with T2D were more likely to receive a higher intensity of services including the number of coaching calls and the amount of nicotine replacement therapy. At 7-month follow-up, 32.3% of registrants with T2D and 35.1% of those without diabetes reported 30-day point-prevalence abstinence, but the differences were not statistically significant. CONCLUSIONS While findings demonstrate similar effectiveness, more research is needed to better understand why the prevalence of tobacco use remains high among individuals with T2D and how to improve cessation in this population.
Collapse
Affiliation(s)
- Sydney A Martinez
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | | | | |
Collapse
|
4
|
Cassidy DG, Wang XQ, Mallawaarachchi I, Wiseman KP, Ebbert JO, Blue Star JA, Aycock CA, Estevez Burns R, Jones JR, Krunnfusz AE, Halbert JP, Roy NM, Ellis JM, Williams JB, Klesges RC, Talcott GW. Tobacco quitline performance: Comparing the impacts of early cessation and proactive re-engagement on callers' smoking status at follow-up at 12 months. Tob Induc Dis 2023; 21:24. [PMID: 36798676 PMCID: PMC9923459 DOI: 10.18332/tid/159125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION While tobacco Quitlines are effective in the promotion of smoking cessation, the majority of callers who wish to quit still fail to do so. The aim of this study was to determine if 12-month tobacco Quitline smoking cessation rates could be improved with re-engagement of callers whose first Quitline treatment failed to establish abstinence. METHODS In an adaptive trial, 614 adult smokers, who were active duty, retired, and family of military personnel with TRICARE insurance who called a tobacco Quitline, received a previously evaluated and efficacious four-session tobacco cessation intervention with nicotine replacement therapy (NRT). At the scheduled follow-up at 3 months, callers who had not yet achieved abstinence were offered the opportunity to re-engage. This resulted in three caller groups: 1) those who were abstinent, 2) those who were still smoking but willing to re-engage with an additional Quitline treatment; and 3) individuals who were still smoking but declined re-engagement. A propensity score-adjusted logistic regression model was generated to compare past-7-day point prevalence abstinence at 12 months post Quitline consultation. RESULTS Using a propensity score adjusted logistic regression model, comparison of the three groups resulted in higher odds of past-7-day point prevalence abstinence at follow-up at 12 months for those who were abstinent at 3 months compared to those who re-engaged (OR=9.6; 95% CI: 5.2-17.8; Bonferroni adjusted p<0.0001), and relative to those who declined re-engagement (OR=13.4; 95% CI: 6.8-26.3; Bonferroni adjusted p<0.0001). There was no statistically significant difference in smoking abstinence between smokers at 3 months who re-engaged and those who declined re-engagement (OR=1.39; 95% CI: 0.68-2.85). CONCLUSIONS Tobacco Quitlines seeking to select a single initiative by which to maximize abstinence at follow-up at 12 months may benefit from diverting additional resources from the re-engagement of callers whose initial quit attempt failed, toward changes which increase callers' probability of success within the first 3 months of treatment. TRIAL REGISTRATION This study is registered at clinicaltrials.gov (NCT02201810).
Collapse
Affiliation(s)
- Daniel G. Cassidy
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Xin-Qun Wang
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| | - Indika Mallawaarachchi
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| | - Kara P. Wiseman
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| | - Jon O. Ebbert
- Mayo Clinic Comprehensive Cancer Center, Mayo Clinic, Rochester, United States
| | - John A. Blue Star
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Chase A. Aycock
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Rosemary Estevez Burns
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - John R. Jones
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Andrea E. Krunnfusz
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Jennifer P. Halbert
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| | - Natalie M. Roy
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Jordan M. Ellis
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States
| | - Juinell B. Williams
- Department of Psychology, East Carolina University, Greenville, United States
| | - Robert C. Klesges
- Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| | - Gerald W. Talcott
- Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio, Lackland AFB, Texas, United States,Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, United States
| |
Collapse
|
5
|
Chu S, Tong Z, Zhang Y, Ye X, Liu Z, Chen H, Bai J, Li F, Li X, Wang H, Wang R, Wang X, Li J, Liang S, Nong Y, Wang X, Wang A, Zhang D, Jing H, Feng L, Liang L. Usage, acceptability, and preliminary effectiveness of an mHealth-based integrated modality for smoking cessation interventions in Western China. Tob Induc Dis 2023; 21:07. [PMID: 36721862 PMCID: PMC9865639 DOI: 10.18332/tid/156828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Many smokers have not accessed professional smoking cessation assistance due to limited smoking cessation services. We developed a novel mHealth-based integrated modality for smoking cessation (WeChat + Quitline modality, WQ modality) and applied it to a large public welfare project (China Western-QUIT Program) in western China. This study evaluated the usage, acceptability, and preliminary effectiveness of the WQ modality in the population of western China. METHODS A prospective cohort study was conducted between April and August 2021. Smokers or their relatives were recruited through online advertisements and medical staff referrals. After using the services of the WQ modality for one month, the self-reported awareness, use, and satisfaction with each service among the participants were collected by a telephone interview. We also evaluated the self-reported 7-day point prevalence of abstinence (PPA) and quit attempt rate among baseline current smokers. The usage data of each service were downloaded from quitline and WeChat platforms. RESULTS Of the 17326 people from western China using the WQ modality, the largest number of users was WeChat official account (11173), followed by WeChat mini program (3734), WeChat group (669), and quitline (541 inbound calls, 605 outbound calls). At one month follow-up, over 70% of participants who completed the baseline survey (n=2221) were aware of WeChat-based services, and over 50% used them. However, the awareness rate (11.1%) and utilization rate (0.5%) of quitline were relatively low. The median satisfaction scores across all services were 9 out of 10 points (IQR: 8-9). Among the baseline current smokers (n=1257), self-reported 7-day PPA was 41.8% (526/1257), and another 225 smokers (17.9%) reported making a quit attempt. CONCLUSIONS The WQ modality could be well used and accepted, and it has great potential to motivate and aid short-term smoking cessation in smokers from western China.
Collapse
Affiliation(s)
- Shuilian Chu
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yuntao Zhang
- Department of Respiratory Medicine, People’s Hospital of Lhasa Tibet, Lhasa, Tibet Autonomous Region, China
| | - Xianwei Ye
- Department of Pulmonary and Critical Care Medicine, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Zhiyan Liu
- Department of Respiratory and Critical Care Medicine, Xi'an Third Hospital, Xi'an, China
| | - Hong Chen
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jing Bai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Fengsen Li
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, China
| | - Xiaoping Li
- Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Zunyi, Zunyi, China
| | - Huaizhen Wang
- Hospital Management Office, Kashgar Prefecture Second People’s Hospital, Kashgar, China
| | - Rui Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuefeng Wang
- Department of Respiratory and Critical Care Medicine, Xining Second People’s Hospital, Xining, China
| | - Jiachen Li
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Siqiao Liang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Ying Nong
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xin Wang
- Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University, Urumqi, China
| | - Ahong Wang
- Department of Respiratory and Critical Care Medicine, Kashgar Prefecture Second People’s Hospital, Kashgar, China
| | - Di Zhang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hang Jing
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lin Feng
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Lirong Liang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Khan A, Green K, Medlin L, Khandaker G, Lawler S, Gartner C. Impact of the '10,000 lives' program on Quitline referrals, use and outcomes by demography and Indigenous status. Drug Alcohol Rev 2022; 41:1499-1509. [PMID: 35830355 PMCID: PMC9796440 DOI: 10.1111/dar.13499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/12/2022] [Accepted: 05/04/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In November 2017, Central Queensland Public Health Unit launched the '10,000 Lives' initiative to reduce smoking prevalence in Central Queensland. The program partnered with local champions and other programs (e.g. 'Deadly Choices') to promote the use of smoking cessation services (e.g. Quitline) in Central Queensland. This study assesses the program's impact on Quitline use by participant demographics and Indigenous status. METHODS We compared the number of referred individuals who participated in and completed the Quitline program, and quit smoking during 26-months before (July 2015 to August 2017) and after (November 2017 to December 2019) the '10,000 Lives' launch. We conducted an interrupted time series analysis of monthly referrals to and use of Quitline for Aboriginal and Torres Strait Islander peoples. RESULTS Overall, 3207 individuals were referred to Quitline during the 26-months-post-launch compared to 1594 during 26-months-pre-launch period of '10,000 Lives'. The number of referred individuals who completed Quitline program increased by 330.7% and quit smoking by 308.3% in post-launch period. The increase was substantially higher among aged 45+ years, females and Aboriginal and Torres Strait Islander peoples. The result for referrals and use of Quitline was validated by interrupted time series analysis for Aboriginal and Torres Strait Islander peoples. DISCUSSION AND CONCLUSIONS The '10,000 Lives' collaborative approach to partner with local champions and targeted smoking cessation programs was effective in increasing the use of Quitline and smoking cessation among all demographic groups, including Aboriginal and Torres Strait Islander peoples. This approach can be used in other regions to address higher smoking prevalence.
Collapse
Affiliation(s)
- Arifuzzaman Khan
- School of Public HealthThe University of QueenslandBrisbaneAustralia,Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Kalie Green
- Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Linda Medlin
- Aboriginal and Torres Strait Islander Health and WellbeingCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Gulam Khandaker
- School of Public HealthThe University of QueenslandBrisbaneAustralia,Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Sheleigh Lawler
- School of Public HealthThe University of QueenslandBrisbaneAustralia
| | - Coral Gartner
- School of Public HealthThe University of QueenslandBrisbaneAustralia
| |
Collapse
|
7
|
Shete M, Shete A. Applied Artificial Intelligence for Tobacco Cessation in the Era of COVID-19: A Perspective. Asian Pac J Cancer Prev 2022; 23:2551-2552. [PMID: 36037106 DOI: 10.31557/apjcp.2022.23.8.2551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Indexed: 11/25/2022]
Abstract
COVID-19 has affected many health services including Tobacco cessation measures. To continue with the strategies used for the de-addiction of tobacco, we need to adapt to the changing times. The use of Artificial Intelligence will help dental health care professionals to reach a larger population, effectively implement measures for tobacco cessation, and meticulous follow-up of patients.
Collapse
|
8
|
Hart JT, Boeckman LM, Beebe LA. Unique cessation tools in the box: Quitline utilization and effectiveness trends among a large sample of tobacco users reporting mental health disorders. Front Psychiatry 2022; 13:869802. [PMID: 35928774 PMCID: PMC9343758 DOI: 10.3389/fpsyt.2022.869802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
It is estimated that the prevalence of smoking among adults with MHDs ranges between 40-60%, as compared to about 17% among those without an MHD. In addition, smokers with MHDs smoke more cigarettes, are more nicotine dependent, and experience more difficulty quitting, compared to other smokers. The uniquely high smoking prevalence among the MHD population is a serious public health concern; unfortunately, a majority of individuals experiencing difficulty receive no treatment. The US Public Health Service guidelines, as well as the National Cancer Institute, strongly recommend quitlines as an evidence-based treatment strategy to reduce barriers to cessation treatment, especially among smokers with MHDs; however, the literature is sparse on quitline engagement trends and associated outcomes for quitline participants with MHDs. This study sought to contribute to this gap with the largest sample to-date of MHD-endorsing tobacco quitline (Oklahoma Tobacco Helpline, OTH) participants. From 2015 to 2020, ~65,000 registrants (45-50% of total registered participants) with the OTH identified as having one or more MHDs in addition to their tobacco use. This study tested for the presence of significant differences between groups with and without MHDs (as well as within the MHD-identified group) on program enrollment selections, the intensity of engagement with chosen services, NRT utilization, and quit rates. It also tested for the existence of differences and moderating effects of demographic variables associated with the comparison groups. Statistically significant differences were found between these two groups with regard to: sex, age, racial identity, education level, annual income and insurance status. Significant differences were also found with tobacco use patterns reported by individuals (e.g., timing and daily use amounts). Differences in quitline program selection were demonstrated, such that the MHD-endorsing sample were more likely to participate and agree to the most robust service available. Significantly higher rates of service intensity (number of services engaged) were demonstrated, and MHD individuals were also significantly more likely to receive NRT as a part of their treatment. This study suggests a simplistic "more is better" quitline services approach may suffer in effectiveness because it neglects barriers common to this population. Important information is provided on these unique variables associated with MHD-endorsing individuals trying to quit their tobacco use. These results can help tobacco quitlines conceptualize the unique difficulties experienced by individuals with MHDs and then tailor their approach to respond supportively and constructively to this high need group.
Collapse
Affiliation(s)
- Jonathan T Hart
- Stephenson Cancer Center and Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Lindsay M Boeckman
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Laura A Beebe
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| |
Collapse
|
9
|
McCarter K, McKinlay ML, Cocks N, Brasier C, Hayes L, Baker AL, Castle D, Borland R, Bonevski B, Segan C, Kelly PJ, Turner A, Williams J, Attia J, Sweeney R, Filia S, Baird D, Brophy L. The value of compassionate support to address smoking: A qualitative study with people who experience severe mental illness. Front Psychiatry 2022; 13:868032. [PMID: 36276321 PMCID: PMC9583161 DOI: 10.3389/fpsyt.2022.868032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 09/14/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION People experiencing severe mental illness (SMI) smoke at much higher rates than the general population and require additional support. Engagement with existing evidence-based interventions such as quitlines and nicotine replacement therapy (NRT) may be improved by mental health peer worker involvement and tailored support. This paper reports on a qualitative study nested within a peer researcher-facilitated tobacco treatment trial that included brief advice plus, for those in the intervention group, tailored quitline callback counseling and combination NRT. It contextualizes participant life experience and reflection on trial participation and offers insights for future interventions. METHODS Qualitative semi-structured interviews were conducted with 29 participants in a randomized controlled trial (intervention group n = 15, control group n = 14) following their 2-month (post-recruitment) follow-up assessments, which marked the end of the "Quitlink" intervention for those in the intervention group. Interviews explored the experience of getting help to address smoking (before and during the trial), perceptions of main trial components including assistance from peer researchers and tailored quitline counseling, the role of NRT, and other support received. A general inductive approach to analysis was applied. RESULTS We identified four main themes: (1) the long and complex journey of quitting smoking in the context of disrupted lives; (2) factors affecting quitting (desire to quit, psychological and social barriers, and facilitators and reasons for quitting); (3) the perceived benefits of a tailored approach for people with mental ill-health including the invitation to quit and practical resources; and (4) the importance of compassionate delivery of support, beginning with the peer researchers and extended by quitline counselors for intervention participants. Subthemes were identified within each of these overarching main themes. DISCUSSION The findings underscore the enormity of the challenges that our targeted population face and the considerations needed for providing tobacco treatment to people who experience SMI. The data suggest that a tailored tobacco treatment intervention has the potential to assist people on a journey to quitting, and that compassionate support encapsulating a recovery-oriented approach is highly valued. CLINICAL TRIAL REGISTRATION The Quitlink trial was registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines.
Collapse
Affiliation(s)
- Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Melissa L McKinlay
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Nadine Cocks
- Research, Advocacy and Practice Development, Mind Australia, Heidelberg, VIC, Australia
| | - Catherine Brasier
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Laura Hayes
- Research, Advocacy and Practice Development, Mind Australia, Heidelberg, VIC, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Catherine Segan
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Alyna Turner
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Jill Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - John Attia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Sacha Filia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Donita Baird
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia
| | - Lisa Brophy
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
10
|
Baker AL, McCarter K, Brophy L, Castle D, Kelly PJ, Cocks N, McKinlay ML, Brasier C, Borland R, Bonevski B, Segan C, Baird DE, Turner A, Williams JM, Forbes E, Hayes L, Attia J, Lambkin D, Barker D, Sweeney R. Adapting Peer Researcher Facilitated Strategies to Recruit People Receiving Mental Health Services to a Tobacco Treatment Trial. Front Psychiatry 2022; 13:869169. [PMID: 35722563 PMCID: PMC9199858 DOI: 10.3389/fpsyt.2022.869169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/26/2022] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION One of the most challenging aspects of conducting intervention trials among people who experience severe mental illness (SMI) and who smoke tobacco, is recruitment. In our parent "QuitLink" randomized controlled trial (RCT), slower than expected peer researcher facilitated recruitment, along with the impact of COVID-19 pandemic restrictions, necessitated an adaptive recruitment response. The objectives of the present study were to: (i) describe adaptive peer researcher facilitated recruitment strategies; (ii) explore the effectiveness of these strategies; (iii) investigate whether recruitment strategies reached different subgroups of participants; and (iv) examine the costs and resources required for implementing these strategies. Finally, we offer experience-based lessons in a Peer Researcher Commentary. METHODS People were included in the RCT if they smoked at least 10 cigarettes a day and were accessing mental health support from the project's two partnering mental health organizations in Victoria, Australia. The majority of people accessing these services will have been diagnosed with SMI. Recruitment occurred over 2 years. We began with peer facilitated recruitment strategies delivered face-to-face, then replaced this with direct mail postcards followed by telephone contact. In the final 4 months of the study, we began online recruitment, broadening it to people who smoked and were accessing support or treatment (including from general practitioners) for mental health and/or alcohol or other drug problems, anywhere in the state of Victoria. Differences between recruitment strategies on key participant variables were assessed. We calculated the average cost per enrolee of the different recruitment approaches. RESULTS Only 109 people were recruited from a target of 382: 29 via face-to-face (March 2019 to April 2020), 66 from postcards (May 2020 to November 2020), and 14 from online (November to December 2020 and January to March 2021) strategies. Reflecting our initial focus on recruiting from supported independent living accommodation facilities, participants recruited face-to-face were significantly more likely to be living in partially or fully supported independent living (n = 29, <0.001), but the samples were otherwise similar. After the initial investment in training and equipping peer researchers, the average cost of recruitment was AU$1,182 per participant-~US$850. Face-to-face recruitment was the most expensive approach and postcard recruitment the least (AU$1,648 and AU$928 per participant). DISCUSSION Peer researcher facilitated recruitment into a tobacco treatment trial was difficult and expensive. Widely dispersed services and COVID-19 restrictions necessitated non-face-to-face recruitment strategies, such as direct mail postcards, which improved recruitment and may be worthy of further research. CLINICAL TRIAL REGISTRATION The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. The trial sponsor was the University of Newcastle, NSW, Australia.
Collapse
Affiliation(s)
- Amanda L Baker
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Kristen McCarter
- School of Psychological Sciences, College of Engineering, Science and Environment, University of Newcastle, Callaghan, NSW, Australia
| | - Lisa Brophy
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia.,Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - David Castle
- Centre for Complex Interventions, Centre for Addiction and Mental Health, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Nadine Cocks
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - Melissa L McKinlay
- Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Ron Borland
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Cancer Council Victoria, Melbourne, VIC, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute (FHMRI), College of Medicine & Public Health, Flinders University, Bedford Park, SA, Australia
| | - Catherine Segan
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Donita E Baird
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Alyna Turner
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,School of Medicine, IMPACT, Institute for Innovation in Physical and Mental Health and Clinical Translation, Deakin University, Geelong, VIC, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Erin Forbes
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Laura Hayes
- Research, Advocacy and Policy Development, Mind Australia Limited, Heidelberg, VIC, Australia
| | - John Attia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - David Lambkin
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Daniel Barker
- Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
11
|
Jawed A, Jassal M. Hard to Reach or Just Not Enough? A Narrative Review of Inpatient Tobacco Cessation Programs in Pediatrics. Int J Environ Res Public Health 2021; 18:13423. [PMID: 34949029 DOI: 10.3390/ijerph182413423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022]
Abstract
Caregiver smoking is a significant risk factor for children with acute and chronic diseases. Hospitalization presents an opportunity to explore caregiver smoking as a modifiable risk factor during a time of crisis when the motivation to change could be heightened. To date, there has not been a published review on inpatient smoking cessation interventions in pediatrics that focus on supporting caregivers of hospitalized children. The goals of this review were to identify and assess the reach and efficacy of tobacco cessation strategies implemented across inpatient units in pediatrics and mother-baby units. This review also proposes clinical and research implications along with program-building recommendations that can help inform future practice in tobacco cessation. A narrative review of the literature identified 14 peer-reviewed studies that described smoking cessation interventions between 2002 and 2021. There were five randomized controlled trials, seven prospective studies, and one retrospective study. The primary kinds of interventions were counseling to heighten caregiver contemplation to quit (n = 12), provision of Nicotine Replacement Therapy (NRT) medications (n = 7), and follow-up with the local Quitline (n = 12). A diverse range of deliverers implemented interventions across studies. Variation in defining quit attempts along with tobacco reduction and cessation outcomes contributed to mixed findings across studies.
Collapse
|
12
|
Seitz CM, Ward KD, Kabir Z. Quitline Information Included on Cigarette Packaging: An Assessment of Country Adherence to WHO FCTC Guidelines, 2007 to 2018. Int J Environ Res Public Health 2021; 18:12193. [PMID: 34831948 PMCID: PMC8625675 DOI: 10.3390/ijerph182212193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this study is to evaluate country adherence to the World Health Organization's (WHO) Framework Convention on Tobacco Control (FCTC) guidelines in terms of including quitline information on cigarette packaging. Data were gathered from the WHO's Global Health Observatory database. The study included countries that were signatories to the FCTC, had a toll-free quitline, and required health warnings on cigarette packaging. Countries were then classified by income level according to the World Bank. From 2007 to 2018, the number of countries that established a quitline increased from 34 to 60. During the same timeframe among those countries, the number of countries that included information about the quitline on cigarette packaging increased from 5 to 37, with a larger proportion (79%) of high-income countries promoting their quitlines on cigarette packaging compared to middle-income (45%) countries. Although there was an increase in adherence to the WHO FCTC guidelines, there is still a need for several countries to include quitline information on cigarette packaging.
Collapse
Affiliation(s)
- Christopher M. Seitz
- Department of Health & Exercise Science, Appalachian State University, Boone, NC 28608, USA
| | - Kenneth D. Ward
- Division of Social and Behavioral Sciences, The University of Memphis School of Public Health, Memphis, TN 38152, USA;
| | - Zubair Kabir
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland;
| |
Collapse
|
13
|
Stich C, Lasnier B, Lo E. Improving smoking cessation support for Quebec's smokers: an evaluation of Quebec's telephone quitline. Health Promot Chronic Dis Prev Can 2021; 41:222-229. [PMID: 34427420 PMCID: PMC8428720 DOI: 10.24095/hpcdp.41.7/8.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Quitlines are an important and widespread intervention that support smokers in their efforts to quit smoking and engage them into treatment services. Quebec's quitline, called "la ligne J'ARRÊTE", has been in operation since 2002. The objectives of this study were to evaluate treatment reach, provide a description of caller characteristics and to provide results on cessation outcome measures for Quebec's smoking cessation quitline. METHODS We collected data at intake, assessing new caller volume, caller characteristics and treatment reach. We used a one-group quasi-experimental design to assess 30-day and six-month quit rates, at six-month follow-up. Intake data were collected for 1292 new quitline callers, 18 years of age and older, over a one-year period. RESULTS Results indicated that the service reached 9 in 10 000 Quebec smokers. With respect to the total population of smokers in Quebec, the quitline reached proportionately higher numbers of smokers who were women, were 55 years of age and older and had a high school diploma or less. At follow-up, the 30-day point prevalence abstinence rate was 26.7%, while the six-month prolonged abstinence rate was 18.8%. CONCLUSION These results indicate that the quitline contributed to helping callers quit smoking. They are in line with findings for other quitlines in Canada and the United States. However, quitline reach is comparatively limited, suggesting that additional investment in promotional efforts and research into ways of recruiting underserved populations into the service would increase public health impact.
Collapse
Affiliation(s)
| | - Benoit Lasnier
- Institut national de santé publique du Québec, Montréal, Quebec, Canada
| | - Ernest Lo
- McGill University, Montréal, Quebec, Canada
- Institut national de santé publique du Québec, Montréal, Quebec, Canada
| |
Collapse
|
14
|
Gupta R, Bhatt G, Narake S, Udawat H, Goel S. Outcomes of integrating quitline methodology in tobacco cessation delivered through a model tobacco treatment clinic of a private sector hospital at Rajasthan, India. Indian J Public Health 2021; 65:287-290. [PMID: 34558492 DOI: 10.4103/ijph.ijph_151_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
India despite progress in tobacco cessation delivery in government sector has lagged in private health sector. Adopting a two-fold approach of intensive intervention-based counseling with (or without) pharmacotherapy; and prescheduled proactive follow-ups over the subsequent year, this study reports 337 tobacco patients, each followed for a period of 1 year. It observed a quit rate (QR) of 40.9% for total abstinence at 1 year but with a drop of 15.9% when patients were followed up, up to 6 months (49.6%) versus 6-12 months (34.7%). The pharmacotherapy did not benefit to whom it was prescribed (196 [58.2%] patients; QR: 34.7%) versus the rest to who it was either not prescribed or was declined (141 [41.8%] patients; QR 49.6%). Countrywide tobacco cessation clinics (TCCs) may be established in private sector hospitals, and the component of quitline methodology of making proactive calls may be integrated to improve QR in India.
Collapse
Affiliation(s)
- Rakesh Gupta
- President, Rajasthan Cancer Foundation & Honorary Consultant, Tobacco Cessation; Department of Deaddiction, Santokba Durlabhji Memorial Hospital and Medical Research Institute, Jaipur, Rajasthan, India
| | | | - Sameer Narake
- Senior Statistician, Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
| | - Harsh Udawat
- Senior Consultant, Departments of Gastroenterology and Deaddiction, Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
| | - Sonu Goel
- Professor of Health Management, Department of Community Medicine, School of Public Health, PGIMER, Chandigarh, India
| |
Collapse
|
15
|
Flocke SA, Seeholzer E, Lewis SA, Gill IJ, Rose JC, Albert E, Love TE, Kaelber D. 12-Month Evaluation of an EHR-Supported Staff Role Change for Provision of Tobacco Cessation Care in 8 Primary Care Safety-Net Clinics. J Gen Intern Med 2020; 35:3234-3242. [PMID: 32705473 PMCID: PMC7661631 DOI: 10.1007/s11606-020-06030-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
SIGNIFICANCE Guidelines urge primary care practices to routinely provide tobacco cessation care (i.e., assess tobacco use, provide brief cessation advice, and refer to cessation support). This study evaluates the impact of a systems-based strategy to provide tobacco cessation care in eight primary care clinics serving low-income patients. METHODS A non-randomized stepped wedge study design was used to implement an intervention consisting of (1) changes to the electronic health record (EHR) referral functionality and (2) expansion of staff roles to provide brief advice to quit; assess readiness to quit; offer a referral to tobacco cessation counseling; and sign the referral order. Outcomes assessed from the EHR include performance of tobacco cessation care tasks, referral contact, and enrollment rates for the quitline (QL) and in-house Freedom from Smoking (FFS) program. Generalized estimating equations (GEE) methods were used to compute odds ratios contrasting the pre-implementation vs. 1-, 3-, 6-, and 12-month post-implementation periods. RESULTS Of the 176,061 visits, 26.1% were by identified tobacco users. All indicators significantly increased at each time period evaluated post-implementation. In comparison with the pre-intervention period, assessing smoking status (26.6% vs. 55.7%; OR = 3.7, CI = 3.6-3.9), providing advice (44.8% vs. 88.7%; OR = 7.8, CI = 6.6-9.1), assessing readiness to quit (15.8% vs. 55.0%; OR = 6.2, CI = 5.4-7.0), and acceptance of a referral to tobacco cessation counseling (0.5% vs. 30.9%; OR = 81.0, CI = 11.4-575.8) remained significantly higher 12 months post-intervention. For the QL and FFS, respectively, there were 1223 and 532 referrals; 324 (31.1%) and 103 (24.7%) were contacted; 241 (74.4%) and 72 (69.6%) enrolled; and 195 (80.9%) and 14 (19.4%) received at least one counseling session. CONCLUSIONS This system change intervention that includes an EHR-supported role expansion substantially increased the provision of tobacco cessation care and improvements were sustained beyond 1 year. This approach has the potential to greatly increase the number of individuals referred for tobacco cessation counseling.
Collapse
Affiliation(s)
- Susan A Flocke
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA.
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA.
| | - Eileen Seeholzer
- Center for Health Care Research and Policy, The MetroHealth System, Cleveland, OH, USA
| | - Steven A Lewis
- Center for Health Care Research and Policy, The MetroHealth System, Cleveland, OH, USA
| | - India J Gill
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA
- Departments of Medicine and Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Jeanmarie C Rose
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA
| | - Elizabeth Albert
- Center for Community Health Integration, Case Western Reserve University, Cleveland, OH, USA
| | - Thomas E Love
- Center for Health Care Research and Policy, The MetroHealth System, Cleveland, OH, USA
- Departments of Medicine and Population & Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - David Kaelber
- Center for Health Care Research and Policy, The MetroHealth System, Cleveland, OH, USA
- Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USA
| |
Collapse
|
16
|
Gonzales K, Berger AM, Fiandt K. Federally qualified health center use of the Nebraska Tobacco Quitline. Tob Prev Cessat 2020; 5:43. [PMID: 32411905 PMCID: PMC7205051 DOI: 10.18332/tpc/113354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/22/2019] [Accepted: 10/24/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Promoting cessation services like quitlines is important to reduce tobacco-related morbidity and mortality. A critical need exists to improve clinical staff’s awareness of tobacco quitlines and reduce barriers in recommending and referring tobacco-using patients. The purpose was to obtain information on the use of the Nebraska Tobacco Quitline (NTQ) by Federally Qualified Health Center (FQHC) clinical staff at FQHC settings with tobacco-using patients. Specific aims were: 1) identify FQHC clinical staff and setting characteristics that influence current tobacco cessation assessment and interventions, and 2) identify barriers and facilitators that influence future use of NTQ by FQHC clinical staff and settings. METHODS This study recruited participants from seven FQHC settings. All FQHC provider and non-provider clinical staff were recruited to complete a Clinical Staff Survey. The Medical Director, Associate Medical Director, or Nurse Manager at each FQHC was asked to provide setting information through the Setting Survey. Descriptive statistics were used to report percentages and qualitative data were analyzed using pattern coding. RESULTS The main findings include insufficient awareness and insufficient perceived effectiveness of NTQ, non-providers reporting a limited role in tobacco cessation efforts beyond assessment of tobacco use, and the lack of supportive setting processes for intervention use. CONCLUSIONS Targeted efforts are needed to increase awareness and perceived effectiveness of NTQ, for role expansion for non-providers, and to add Electronic Health Record (EHR) prompts and e-referral capability to increase cessation interventions including NTQ referrals. Future research is suggested to better understand patient-specific barriers in using NTQ.
Collapse
Affiliation(s)
- Kelly Gonzales
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska, United States
| | - Ann M Berger
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska, United States
| | - Kathryn Fiandt
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska, United States
| |
Collapse
|
17
|
Krebs P, Sherman SE, Wilson H, El-Shahawy O, Abroms LL, Zhao X, Nahvi S, Shelley D. Text2Connect: a health system approach to engage tobacco users in quitline cessation services via text messaging. Transl Behav Med 2020; 10:292-301. [PMID: 32011721 DOI: 10.1093/tbm/ibz033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mobile technology has created the opportunity for health systems to provide low cost tobacco cessation assistance to patients. The goal of the present study was to examine the feasibility and effectiveness of an intervention (Text2Connect) that uses text messages to offer proactive connection to the New York State Smokers' Quitline. The electronic health record at two urban health systems was queried for patients who were current smokers and who had an outpatient visit between March 2015 and February 2016. Smokers (N = 4000) were sent an informational letter. Those who did not opt out (N = 3719) were randomized to one of 6 message sequences in order to examine the effect of theoretically informed message frames on response rates. Participants were sent a series of text messages at baseline and at 1 month and were asked to reply in order to be contacted by the state quitline (QL). After removing 1403 nonworking numbers, texts were sent to 2316 patients, and 10.0% (205/2060) responded with a QL request. Almost one quarter (23.6%, 486/2060) replied STOP and 66.4% (1369/2060) never responded. QL request rates were significantly higher when response efficacy messages were not used (p < .001). There were no differences by message framing on STOP requests (p > .05). The Text2Connect intervention was well accepted with a minority opting out. A 10% QL response rate is noteworthy given that only 5-7 brief outreach text messages were used. Results indicate that simple self-efficacy-focused messaging is most effective at supporting response rates.
Collapse
Affiliation(s)
- Paul Krebs
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Scott E Sherman
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Hannah Wilson
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Omar El-Shahawy
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Lorien L Abroms
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Xiaoquan Zhao
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Shadi Nahvi
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Donna Shelley
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| |
Collapse
|
18
|
Beebe LA, Boeckman LM, Klein PG, Saul JE, Gillaspy SR. They Came, But Will They Come Back? An Observational Study of Re-Enrollment Predictors for the Oklahoma Tobacco Helpline. Am J Health Promot 2019; 34:261-268. [PMID: 31878792 DOI: 10.1177/0890117119890789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Although quitlines reach 1% to 2% of tobacco users annually, additional efforts are needed to increase their impact. We hypothesized that offering less intensive services would increase the rate of re-enrollment in any service, as well as re-enrollment in more intensive services. This study describes the enrollment patterns and identifies re-enrollment predictors for Oklahoma Tobacco Helpline (OTH) participants. DESIGN This study used a comparative observational design. SETTING The setting for this study was the OTH, a telephone-based cessation program funded by the Oklahoma Tobacco Settlement Endowment Trust. The OTH participants could select either a multicall telephone-based cessation program (MC) or one or more individual services (IS), including a 2-week nicotine replacement therapy (NRT) starter kit, e-mail or text-based support, and a printed quit guide. PARTICIPANTS A total of 35 648 first-time adult OTH participants eligible for the multicall program from October 2015 through September 2018 were included. MEASURES Demographic and tobacco use variables and initial quitline service selection were collected at intake. Additional service utilization was tracked for 6 months following initial registration. ANALYSIS Pearson chi-square and t tests were used to test for significant differences between groups. Multinomial logistic regression was used to examine predictors of re-enrollment. RESULTS Individual services were more frequently selected (n = 17 266) than MC (n = 14 326), despite all users being eligible for MC. A much higher proportion of IS registrants re-enrolled than MC registrants (16% vs 3%, P < .0001) Among the IS cohort, those who received an NRT follow-up call were 14.7 times more likely to re-enroll in IS, and 7.8 times more likely to re-enroll in MC, than those who were not reached by phone. CONCLUSIONS Access to free NRT without a telephone-coaching requirement is a draw for tobacco users, especially those with lower income and the uninsured. The results suggest the value of increasing use of nonphone services in an effort to increase interest in quitting and reach.
Collapse
Affiliation(s)
- Laura A Beebe
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Lindsay M Boeckman
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Paola G Klein
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jessie E Saul
- North American Research & Analysis, Inc, Hudson, WI, USA
| | - Stephen R Gillaspy
- Department of Pediatrics, College of Medicine, University of Oklahoma Health Sciences, Oklahoma City, OK, USA
| |
Collapse
|
19
|
Ngo CQ, Phan PT, Vu GV, Pham QTL, Chu HT, Pham KTH, Tran BX, Do HP, Nguyen CT, Tran TT, Ha GH, Dang AK, Nguyen HTL, Latkin CA, Ho CSH, Ho RCM. Impact of a Smoking Cessation Quitline in Vietnam: Evidence Base and Future Directions. Int J Environ Res Public Health 2019; 16:ijerph16142538. [PMID: 31315240 PMCID: PMC6678836 DOI: 10.3390/ijerph16142538] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/06/2019] [Accepted: 07/12/2019] [Indexed: 01/27/2023]
Abstract
Smoking is considered the most critical modifiable factor with regard to lung cancer and remains a public health concern in many countries, including Vietnam, which is among those countries with the highest tobacco consumption rates in the world. This study has examined the impact of national telephone counselling for smoking cessation and has identified the factors associated with the impact of the quitline among male callers in Vietnam. A randomized cross-sectional survey of 469 smokers who sought smoking cessation services via the national quitline was performed from September 2015 to May 2016. The primary outcomes were measured by a self-reported quit rate at the time of assessment, 7 day point prevalence abstinence (PA), 6 month prolonged PA, service satisfaction, and level of motivation. Among the participants, 31.6% were abstinent, and 5.1% of participants successfully stopped smoking and did not need to seek quitline support. Most of the clients were satisfied with the quality of service (88.5%), felt more confident about quitting (74.3%), and took early action via their first quit attempt (81.7%); 18.3% reported a more than 7 day abstinence period at the time of survey. The primary reasons for smoking relapse were surrounding smoking environments (51.6%) and craving symptoms (44.1%). Future smoking cessation efforts should focus on improving the quality of quitline services, client satisfaction, and developing a tailored program and counseling targeting smokers with specific characteristics, especially ones experiencing chronic diseases.
Collapse
Affiliation(s)
- Chau Quy Ngo
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
| | - Phuong Thu Phan
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
| | - Giap Van Vu
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam
| | | | - Hanh Thi Chu
- Respiratory Center, Bach Mai Hospital, Hanoi 100000, Vietnam
| | - Kiet Tuan Huy Pham
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Huyen Phuc Do
- Center of Excellence in Health Services and System Research, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Tung Thanh Tran
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
| | - Giang Hai Ha
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Anh Kim Dang
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Huong Thi Lan Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam
| | - Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Cyrus S H Ho
- Vietnam Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
| |
Collapse
|
20
|
Park J, Minh LN, Shin SH, Oh JK, Yun EH, Lee D, Lim MK. Influence of new tobacco control policies and campaigns on Quitline call volume in Korea. Tob Induc Dis 2019; 17:21. [PMID: 31582932 PMCID: PMC6751995 DOI: 10.18332/tid/104674] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION While tobacco control policies have been adopted and enforced, and anti-smoking campaigns have been conducted, the evaluation of their impact on tobacco quitting is lacking in Korea. Therefore, the effectiveness of tobacco control policies and mass media campaigns to encourage use of the Quitline were evaluated by monitoring call volume on Quitline, which has been in operation since 2006, in Korea. METHODS Tobacco control policies and mass media campaigns, from 1 January of 2007 to 31 December of 2016, were assessed from the review of government documents and the history of law and regulation changes. The corresponding period incoming call volumes of the Quitline were assesed. The average monthly call volume, when policies and anti-smoking advertising were implemented, was compared with that of the whole year or baseline years (2007 and 2008). RESULTS Peak call volume occurred in 2010 when the Quitline was directly promoted on television. The call volume in the month the TV campaign aired was 5.5 times higher than the average monthly call volume in the year 2010. A relatively gradual rise in call volume was found from 2013 to 2016 when the tobacco control policies and campaigns, such as Quitline number included on cigarette packs, a fear-oriented anti-tobacco campaign on mass media, and a tax increase on tobacco was implemented, were introduced sequentially. In that period, the average monthly call volume was about five times higher than in 2007 and 2008. CONCLUSIONS Continuous efforts to contribute to tobacco control policies and campaigns by the promotion of the Quitline is a most effective approach to raise quitting attempts. Based on the Korean experience, Quitline data may be useful for assessing the impact of tobacco control policies and campaigns in Asian Pacific countries.
Collapse
Affiliation(s)
- Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Luu Ngoc Minh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Sang Hwa Shin
- Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - E Hwa Yun
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Duckhyung Lee
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.,Division of Cancer Prevention, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| |
Collapse
|
21
|
Sweeney R, Moodie M, Baker AL, Borland R, Castle D, Segan C, Turner A, Attia J, Kelly PJ, Brophy L, Bonevski B, Williams JM, Baird D, White SL, McCarter K. Protocol for an Economic Evaluation of the Quitlink Randomized Controlled Trial for Accessible Smoking Cessation Support for People With Severe Mental Illness. Front Psychiatry 2019; 10:618. [PMID: 31551827 PMCID: PMC6735263 DOI: 10.3389/fpsyt.2019.00618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 08/01/2019] [Indexed: 01/10/2023] Open
Abstract
Introduction: Smoking is a major cause of disease burden and reduced quality of life for people with severe mental illness (SMI). It places significant resource pressure on health systems and financial stress on smokers with SMI (SSMI). Telephone-based smoking cessation interventions have been shown to be cost effective in general populations. However, evidence suggests that SSMI are less likely to be referred to quitlines, and little is known about the effectiveness and cost effectiveness of such interventions that specifically target SSMI. The Quitlink randomized controlled trial for accessible smoking cessation support for SSMI aims to bridge this gap. This paper describes the protocol for evaluating the cost effectiveness of Quitlink. Methods: Quitlink will be implemented in the Australian setting, utilizing the existing mental health peer workforce to link SSMI to a tailored quitline service. The effectiveness of Quitlink will be evaluated in a clustered randomized controlled trial. A cost-effectiveness evaluation will be conducted alongside the Quitlink clustered randomized controlled trial (RCT) with incremental cost-effectiveness ratios (ICERs) calculated for the cost (AUD) per successful quit and quality adjusted life year (QALY) gained at 8 months compared with usual care from both health care system and limited societal perspectives. Financial implications for study participants will also be investigated. A modeled cost-effectiveness analysis will also be conducted to estimate future costs and benefits associated with any treatment effect observed during the trial. Results will be extrapolated to estimate the cost effectiveness of rolling out Quitlink nationally. Sensitivity analyses will be undertaken to assess the impact on results from plausible variations in all modeled variables. Discussion: SSMI require additional support to quit. Quitlink utilizes existing peer worker and quitline workforces and tailors quitline support specifically to provide that increased cessation support. Given Quitlink engages these existing skilled workforces, it is hypothesized that, if found to be effective, it will also be found to be both cost effective and scalable. This protocol describes the economic evaluation of Quitlink that will assess these hypotheses. Ethics and dissemination: Full ethics clearances have been received for the methods described below from the University of Newcastle (Australia) Human Research Ethics Committee (H-2018-0192) and St Vincent's Hospital, Melbourne (HREC/18/SVHM/154). The trial has been registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12619000244101). Participant consent is sought both to participate in the study and to have the study data linked to routine health administrative data on publicly subsidized health service and pharmaceutical use, specifically the Medicare Benefits and Pharmaceutical Benefits Schemes (MBS/PBS). Trial findings (including economic evaluation) will be published in peer reviewed journals and presented at international conferences. Collected data and analyses will be made available in accordance with journal policies and study ethics approvals. Results will be presented to relevant government authorities with an interest in cost effectiveness of these types of interventions.
Collapse
Affiliation(s)
- Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
| | - Amanda L Baker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Ron Borland
- The Cancer Council Victoria, Melbourne, VIC, Australia.,School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australian
| | - David Castle
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Catherine Segan
- The Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Alyna Turner
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,Barwon Health, Geelong, VIC, Australia
| | - John Attia
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Peter J Kelly
- Illawarra Institute for Mental Health, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Lisa Brophy
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Mind Australia, Melbourne, VIC, Australia
| | - Billie Bonevski
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, United States
| | - Donita Baird
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Sarah L White
- The Cancer Council Victoria, Melbourne, VIC, Australia
| | - Kristen McCarter
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
22
|
Baker AL, Borland R, Bonevski B, Segan C, Turner A, Brophy L, McCarter K, Kelly PJ, Williams JM, Baird D, Attia J, Sweeney R, White SL, Filia S, Castle D. "Quitlink"-A Randomized Controlled Trial of Peer Worker Facilitated Quitline Support for Smokers Receiving Mental Health Services: Study Protocol. Front Psychiatry 2019; 10:124. [PMID: 30941063 PMCID: PMC6434698 DOI: 10.3389/fpsyt.2019.00124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 02/19/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction: Although smokers with severe mental illnesses (SSMI) make quit attempts at comparable levels to other smokers, fewer are successful in achieving smoking cessation. Specialized smoking cessation treatments targeting their needs can be effective but have not been widely disseminated. Telephone delivered interventions, including by quitlines, show promise. However, few SSMI contact quitlines and few are referred to them by health professionals. Mental health peer workers can potentially play an important role in supporting smoking cessation. This study will apply a pragmatic model using peer workers to engage SSMI with a customized quitline service, forming the "Quitlink" intervention. Methods: A multi-center prospective, cluster-randomized, open, blinded endpoint (PROBE) trial. Over 3 years, 382 smokers will be recruited from mental health services in Victoria, Australia. Following completion of baseline assessment, a brief intervention will be delivered by a peer worker. Participants will then be randomly allocated either to no further intervention, or to be referred and contacted by the Victorian Quitline and offered a targeted 8-week cognitive behavioral intervention along with nicotine replacement therapy (NRT). Follow-up measures will be administered at 2-, 5-, and 8-months post-baseline. The primary outcome is 6 months continuous abstinence from end of treatment with biochemical verification. Secondary outcomes include 7-day point prevalence abstinence from smoking, increased quit attempts, and reductions in cigarettes per day, cravings and withdrawal, mental health symptoms, and other substance use, and improvements in quality of life. We will use a generalized linear mixed model (linear regression for continuous outcomes and logistic regression for dichotomous outcomes) to handle clustering and the repeated measures at baseline, 2-, 5-, and 8-months; individuals will be modeled as random effects, cluster as a random effect, and group assignment as a fixed effect. Discussion: This is the first rigorously designed RCT to evaluate a specialized quitline intervention accompanied by NRT among SSMI. The study will apply a pragmatic model to link SSMI to the Quitline, using peer workers, with the potential for wide dissemination. Clinical Trial Registration: Trial Registry: The trial is registered with ANZCTR (www.anzctr.org.au): ACTRN12619000244101 prior to the accrual of the first participant and updated regularly as per registry guidelines. Trial Sponsor: University of Newcastle, NSW, Australia.
Collapse
Affiliation(s)
- Amanda L Baker
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Ron Borland
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Billie Bonevski
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Catherine Segan
- Cancer Council Victoria, Melbourne, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alyna Turner
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.,IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Brophy
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.,Mind Australia Limited, Melbourne, VIC, Australia.,School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Melbourne, VIC, Australia
| | - Kristen McCarter
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Peter J Kelly
- Illawarra Health and Medical Research Institute and the School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Jill M Williams
- Division of Addiction Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
| | - Donita Baird
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - John Attia
- Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Rohan Sweeney
- Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | | | - Sacha Filia
- Cancer Council Victoria, Melbourne, VIC, Australia
| | - David Castle
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Department of Psychiatry, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| |
Collapse
|
23
|
Ngo CQ, Chiu RG, Chu HT, Vu GV, Nguyen QN, Nguyen LH, Tran TT, Nguyen CT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Correlated Factors with Quitting Attempts Among Male Smokers in Vietnam: A QUITLINE-Based Survey. Int J Environ Res Public Health 2018; 16:ijerph16010084. [PMID: 30598002 PMCID: PMC6339115 DOI: 10.3390/ijerph16010084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/18/2018] [Accepted: 12/18/2018] [Indexed: 12/11/2022]
Abstract
Despite its decreasing prevalence, cigarette smoking remains the second leading cause of preventable death worldwide. In Vietnam, despite recent smoking cessation efforts, the prevalence of tobacco consumption remains high, particularly among males. In this study, we aim to evaluate the self-efficacy in quitting smoking (i.e., quitting confidence), intention to quit, and identifying associated factors among both rural and urban Vietnamese male populations. A cross-sectional study was conducted on 321 patients (52.7% urban and 47.4% rural inhabitants) who utilized QUITLINE services of Bach Mai Hospital (Hanoi, Vietnam). Socio-economic status, smoking history, cigarette usage data, and intent to quit were assessed. Baseline data were correlated with quitting confidence, to identify significant associated factors. The majority (75.9%) of participants were in the planning phase of cessation, yet 90.8% lacked complete confidence in their quitting ability. Older age, fewer cigarettes per day and previous quitting attempts were associated with quitting confidence (p < 0.05) and plans to quit (p < 0.05). Older smokers and previous quitters were more confident in their ability to quit in the near future and more likely to have made plans to quit. Future smoking cessation efforts should focus on improving self-efficacy, particularly among younger and newer smokers.
Collapse
Affiliation(s)
- Chau Quy Ngo
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Ryan G Chiu
- College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA.
- Center of Excellence in Health Service and System Research, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Hanh Thi Chu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Giap Van Vu
- Department of Internal Medicine, Hanoi Medical University, Hanoi 100000, Vietnam.
| | - Quang Nhat Nguyen
- Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Long Hoang Nguyen
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Tung Thanh Tran
- Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam.
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Carl A Latkin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore 119074, Singapore.
| | - Roger C M Ho
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 700000, Vietnam.
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.
| |
Collapse
|
24
|
Jarman KL, Kowitt SD, Queen TL, Ranney LM, Kim K, Jones EE, Donovan E, Goldstein AO. Do Smokers Recall Source or Quitline on Cigarette Constituent Messages? TOB REGUL SCI 2018; 4:66-82. [PMID: 31414036 PMCID: PMC6693861 DOI: 10.18001/trs.4.6.7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The Food and Drug Administration (FDA) is required under the Family Smoking Prevention and Tobacco Control Act to communicate the risks of tobacco use to the public. Little research exists about methods to communicate the constituents of tobacco in a media campaign. This research examines specific strategies to increase effectiveness of a media campaign for cigarette smoking adults about tobacco constituents by including engagement text about smoking cessation and FDA as the source of the campaign. METHODS In an eye tracking study of 211 current cigarette smokers, participants randomly viewed 4 cigarette constituent messages that varied engagement text for quitting (benefits of quitting and quitline number, presence, absence) and by FDA source (presence, absence). After the eye tracking session, participants were asked about recall of the national quitline number and the source of message. RESULTS Participants in conditions with engagement text were significantly more likely than those in the no engagement conditions to recall the national quitline number. Few participants saw or recalled the FDA source. CONCLUSIONS Engagement text for smoking cessation on constituent communication campaign messages significantly increases recall of the quitline, an important resource for smokers.
Collapse
Affiliation(s)
- Kristen L Jarman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Sarah D Kowitt
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Tara L Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Leah M Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - KyungSu Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ellen E Jones
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily Donovan
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Adam O Goldstein
- Director of Departmental Advancement, Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| |
Collapse
|
25
|
Cornish D, Park K, Avery M. Tobacco cessation outcomes: The case for milestone-based services. Tob Prev Cessat 2018; 4:33. [PMID: 32411859 PMCID: PMC7205149 DOI: 10.18332/tpc/97284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/05/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study focuses on a Midwest State's tobacco quitline. The purpose was to understand possible relationships between services provided and cessation rates. METHODS The data examined in this study came from aggregated intake/treatment data and follow-up interview data. The overall response rate was 22.9%. Measures included quit rate, quit duration, length of services, number of services, stage of change, confidence to quit, and source of referral. RESULTS The dataset included 1452 cases; 77% enrolled in services only once, 17% enrolled twice and 6% enrolled three or more times. Use of medication was higher among those who quit [χ2(1)=7.1, p=0.009, Cramer's V=0.07] than among those who did not. Use of e-cigarettes was lower among those who quit at the time of follow-up [χ2(1)=31.5, p<0.001, Cramer's V=0.15]. Respondents who had quit at the time of the follow-up were significantly more likely to have reported a higher confidence to quit at intake [χ2(1)=24.1, p<0.001, Cramer's V=0.13]. Among those who improved their stage of change during treatment, 35% had quit at follow-up, compared with 18% among those who did not improve. CONCLUSIONS Study findings related to stage of change and associations between confidence and cessation may have meaningful implications. Cessation success may depend on what is accomplished during treatment and the intersection of clients' motivation, satisfaction, confidence, and cessation status at the end of treatment.
Collapse
Affiliation(s)
- Disa Cornish
- Department of Health, Recreation, and Community Services, University of Northern Iowa, Cedar Falls, Iowa, United States
| | - Ki Park
- Center for Social and Behavioral Research, University of Northern Iowa, Cedar Falls, Iowa, United States
| | - Mitchell Avery
- Center for Social and Behavioral Research, University of Northern Iowa, Cedar Falls, Iowa, United States
| |
Collapse
|
26
|
Hudmon KS, Corelli RL, de Moor C, Zillich AJ, Fenlon C, Miles L, Prokhorov AV, Zbikowski SM. Outcomes of a randomized trial evaluating two approaches for promoting pharmacy-based referrals to the tobacco quitline. J Am Pharm Assoc (2003) 2018; 58:387-394. [PMID: 29779983 PMCID: PMC8838875 DOI: 10.1016/j.japh.2018.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 04/05/2018] [Accepted: 04/07/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To evaluate the long-term impact of 2 promising intervention approaches to engage pharmacy personnel (pharmacists, technicians) in referring patients who want to quit smoking to the tobacco quitline. DESIGN Randomized trial. SETTING Community pharmacies in Connecticut (n = 32) and Washington (n = 32). INTERVENTION Two intervention approaches were evaluated: academic detailing (AD), which involved on-site training for pharmacy staff about the quitline, versus mailed quitline materials (MM). MAIN OUTCOME MEASURES Changes in the overall percentage of quitline registrants who reported hearing about the quitline from any pharmacy during the 6-month baseline monitoring period versus the 12-month intervention period, and between-group comparisons of a) the number of quitline registrants who reported hearing about the quitline from one of the study pharmacies during the 12-month intervention period, and b) the number of quitline cards and brochures distributed to patients during the first 6 months of the intervention period. RESULTS The percentage of quitline callers who reported having heard about the quitline from a pharmacy increased significantly, from 2.2% during the baseline monitoring period to 3.8% during the 12-month intervention (P < 0.0001). In addition, comparisons controlled for seasonal effects also revealed significant increases in referrals. Across all 64 pharmacies, 10,013 quitline cards and 4755 brochures were distributed. The number of quitline cards distributed and the number registrants who reported hearing about the quitline from a pharmacy did not differ by intervention approach (AD vs. MM), although AD pharmacies distributed more quitline brochures (P = 0.022). CONCLUSION Brief cessation interventions are feasible in community pharmacies, and the 2 approaches evaluated for engaging pharmacy personnel were similarly effective and collectively led to meaningful increases in the number and proportion of all patients who called the quitline. Involvement of community pharmacy personnel in tobacco cessation presents a significant opportunity to promote quitline services by connecting patients with an effective publicly available resource.
Collapse
|
27
|
Zhang L, Malarcher A, Babb S, Mann N, Davis K, Campbell K, Schauer G, Alexander R, Debrot K, Rodes R. The Impact of a National Tobacco Education Campaign on State-Specific Quitline Calls. Am J Health Promot 2018; 30:374-81. [PMID: 27404646 DOI: 10.1177/0890117116646344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The ads from the first federally funded national tobacco education campaign, Tips From Former Smokers (Tips), considerably increased quitline calls nationwide. This study evaluates the effect of Tips on state-specific quitline calls. DESIGN Precampaign, during-campaign, and postcampaign comparison; regression modeling. SETTING All fifty states as well as the District of Columbia. SUBJECTS Calls to state quitlines. INTERVENTION Tips. MEASURES Tips campaign exposure was measured by gross rating points (GRPs). Calls to quitline's 1-800-QUIT-NOW were assigned to markets in each state based on their area codes. ANALYSIS Multivariate regression was used to assess the relationship between calls to state quitlines and media market-level Tips GRPs, while controlling for market and area code characteristics. RESULTS Nationally, every 100 Tips GRPs per week at the market level was associated with an average of 45 additional quitline calls in each area code (β = 44.65, p < .001). Tips GRPs were associated with significant increases in quitline calls in 46 states and the District of Columbia, of which 11 experienced effects significantly larger than the national average and 5 experienced significantly smaller effects. We were unable to detect statistically significant effects of GRPs on call volumes for four states. Graphically, call volumes in those states followed Tips GRPs. CONCLUSION The Tips campaign significantly increased calls to quitlines for almost all the states. These findings underscore the effectiveness of national tobacco media campaigns for reaching state audiences.
Collapse
Affiliation(s)
- Lei Zhang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ann Malarcher
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Steve Babb
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nathan Mann
- RTI International, Research Triangle Park, NC, USA
| | - Kevin Davis
- RTI International, Research Triangle Park, NC, USA
| | | | - Gillian Schauer
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert Alexander
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen Debrot
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Robert Rodes
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
28
|
Abstract
AIMS AND OBJECTIVES To evaluate an educational programme about nurses' role in tobacco dependence treatment, and its webcast component, on the long-term impact of increasing the frequency of nurses' self-reported changes in practice related to delivery of smoking cessation interventions. BACKGROUND Healthcare professionals' knowledge about evidence-based tobacco dependence treatment using the 5As framework (Ask about tobacco use, Advise users to quit, Assess willingness to quit, Assist in making a quit plan and Arrange for follow-up, including referral to a quitline) is essential to increase smoking cessation rates in the United States. DESIGN A 6-month pre-post design. METHODS A convenience sample of nurses (N = 283) from Kentucky and Louisiana was provided access to the webcast and printed toolkit. Responses from those who completed an online survey at baseline, and at 3 or 6 months postimplementation of the educational programme were included in an analysis of changes in the consistent (always/usually) delivery of the 5As plus referral to the quitline. RESULTS After 3 months, the intervention had a significant impact on increasing nurses' reports of consistently providing the 5As to patients who smoked, which was largely sustained at 6 months. Nurses who viewed the webcast were three times more likely to refer smokers to a quitline at 3 months; and four times more likely at 6 months than those who did not. CONCLUSIONS An online educational programme, plus printed toolkit about tobacco dependence treatment increased nurses' delivery of smoking cessation interventions over time. This study provided preliminary evidence that including a webcast in a nurse-targeted educational programme could significantly increase the proportion of nurses who referred smokers to a quitline beyond the benefit of access to printed materials and web-based resources. RELEVANCE TO CLINICAL PRACTICE Distance learning is a feasible mechanism for enhancing nurses' involvement in tobacco dependence treatment and promoting evidence-based clinical practice.
Collapse
Affiliation(s)
- Linda Sarna
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Stella A Bialous
- School of Nursing, University of California, San Francisco, San Francisco, CA, USA
| | - Marjorie Wells
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jenny Brook
- David Geffin School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
29
|
Sherman SE, Krebs P, York LS, Cummins SE, Kuschner W, Guvenc-Tuncturk S, Zhu SH. Telephone care co-ordination for tobacco cessation: randomised trials testing proactive versus reactive models. Tob Control 2017; 27:78-82. [PMID: 28190003 DOI: 10.1136/tobaccocontrol-2016-053327] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/28/2016] [Accepted: 01/04/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We conducted two parallel studies evaluating the effectiveness of proactive and reactive engagement approaches to telephone treatment for smoking cessation. METHODS Patients who smoked and were interested in quitting were referred to this study and were eligible if they were current smokers and had an address and a telephone number. The data were collected at 35 Department of Veterans Affairs (VA) sites, part of four VA medical centres in both California and Nevada. In study 1, participants received multisession counselling from the California Smokers' Helpline (quitline). In study 2, they received self-help materials only. Patients were randomly assigned by week to either proactive or reactive engagement, and primary care staff were blind to this assignment. Providers gave brief advice and referred them via the electronic health record to a tobacco co-ordinator. All patients were offered cessation medications. OUTCOME Using complete case analysis, in study 1 (quitline), patients in the proactive condition were more likely than those in the reactive condition to report abstinence at 6 months (21.0% vs 16.4%, p=0.03). No difference was found between conditions in study 2 (self-help) (16.9% vs 16.5%, p=0.88). Proactive outreach resulted in increased use of cessation medications in both the quitline (70.1% vs 57.6%, p<0.0001) and the self-help studies (74.5% vs 48.2%, p<0.0001). CONCLUSION Proactive outreach with quitline intervention was associated with greater long-term abstinence. Both studies resulted in high rates of medication use. Sites should use a proactive outreach approach and provide counselling whenever possible. TRIAL REGISTRATION NUMBER NCT00123682.
Collapse
Affiliation(s)
- Scott E Sherman
- VA NY Harbor Healthcare System, New York, New York, USA.,Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Paul Krebs
- VA NY Harbor Healthcare System, New York, New York, USA.,Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Laura S York
- Department of Veterans Affairs, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Sharon E Cummins
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, California, USA
| | - Ware Kuschner
- VA Palo Alto Healthcare System, Palo Alto, California, USA.,Department of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Sebnem Guvenc-Tuncturk
- Department of Pulmonary and Critical Care Medicine, VA Palo Alto Healthcare System, Palo Alto, California, USA
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California San Diego School of Medicine, San Diego, California, USA
| |
Collapse
|
30
|
Segan CJ, Baker AL, Turner A, Williams JM. Nicotine Withdrawal, Relapse of Mental Illness, or Medication Side-Effect? Implementing a Monitoring Tool for People With Mental Illness Into Quitline Counseling. J Dual Diagn 2017; 13:60-66. [PMID: 28067594 DOI: 10.1080/15504263.2016.1276657] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine-dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal. OBJECTIVE The aim of this research was to examine the acceptability and feasibility to quitline counselors of implementing structured assessments of nicotine withdrawal and common medication side effects in people with mental illness who are quitting smoking using a telephone smoking cessation service. METHODS Monitoring involves administering (once pre-cessation and at each contact post-cessation) (1) the Minnesota Nicotine Withdrawal Scale, assessing eight symptoms: anger, anxiety, depression, cravings, difficulty concentrating, increased appetite, insomnia, and restlessness and (2) an adverse side effects checklist of 5 to 10 symptoms, for example, dry mouth and increased thirst. Following a 1-day update training in mental health, quitline counselors were asked to offer these assessments to callers disclosing mental illness in addition to usual counseling. Group interviews with counselors were conducted 2 months later to examine implementation barriers and benefits. RESULTS Barriers included awkwardness in integrating a new structured practice into counseling, difficulty in limiting some callers to only the content of new items, and initial anxieties about how to respond to changes in some symptoms. Benefits included the ability to provide objective feedback on changes in symptoms, as this identified early benefits of quitting, provided reassurance for clients, and provided an opportunity for early intervention where symptoms worsened. CONCLUSIONS Structured monitoring of withdrawal symptoms and medication side effects was able to be integrated into the quitline's counseling and was valued by counselors and clients. Given evidence of its benefits in this limited pilot study, we recommend it be considered for larger-scale adoption by quitlines.
Collapse
Affiliation(s)
- Catherine J Segan
- a Cancer Council Victoria , Melbourne , Australia.,b Centre for Health Policy, School of Population and Global Health, University of Melbourne , Australia
| | - Amanda L Baker
- c School of Medicine and Public Health, University of Newcastle , Callaghan , Australia
| | - Alyna Turner
- c School of Medicine and Public Health, University of Newcastle , Callaghan , Australia.,d IMPACT SRC, Faculty of Health, Deakin University , Geelong , Australia
| | - Jill M Williams
- e Priority Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School , New Brunswick , NJ
| |
Collapse
|
31
|
Sheffer C, Brackman S, Lercara C, Cottoms N, Olson M, Panissidi L, Pittman J, Stayna H. When Free Is Not for Me: Confronting the Barriers to Use of Free Quitline Telephone Counseling for Tobacco Dependence. Int J Environ Res Public Health 2015; 13:ijerph13010015. [PMID: 26703662 PMCID: PMC4730406 DOI: 10.3390/ijerph13010015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/27/2015] [Accepted: 10/30/2015] [Indexed: 11/16/2022]
Abstract
Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%-2% of smokers. We used community-based participatory methods to develop a survey instrument to assess barriers to use of the quitline in the Arkansas Mississippi delta. Barriers were quitline specific and barriers to cessation more broadly. Over one-third (34.9%) of respondents (n = 799) did not have access to a telephone that they could use for the quitline. Respondents reported low levels of knowledge about the quitline, quitting, and trust in tobacco treatment programs as well as considerable ambivalence about quitting including significant concerns about getting sick if they quit and strong faith-based beliefs about quitting. These findings suggest quitlines are not accessible to all lower socioeconomic groups and that significant barriers to use include barriers to cessation. These findings suggest targets for providing accessible tobacco use treatment services and addressing concerns about cessation among lower income, ethnic minority, and rural groups.
Collapse
Affiliation(s)
- Christine Sheffer
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
- Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Sharon Brackman
- Fay W Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA.
| | - Charnette Lercara
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Naomi Cottoms
- Walnut Street Works, Inc., Helena-West Helena, AR 72342, USA.
| | - Mary Olson
- Walnut Street Works, Inc., Helena-West Helena, AR 72342, USA.
| | - Luana Panissidi
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Jami Pittman
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| | - Helen Stayna
- Sophie Davis School of Biomedical Education, City College of New York, New York, NY 10031, USA.
| |
Collapse
|
32
|
Abstract
PURPOSE OF REVIEW Smoking remains the leading cause of preventable morbidity and mortality. Our review highlights research from 2013 to 2015 on the treatment of cigarette smoking, with a focus on heart patients and cardiovascular outcomes. RECENT FINDINGS Seeking to maximize the reach and effectiveness of existing cessation medications, current tobacco control research has demonstrated the safety and efficacy of combination treatment, extended use, reduce-to-quit strategies, and personalized approaches to treatment matching. Further, cytisine has gained interest as a lower-cost strategy for addressing the global tobacco epidemic. On the harm reduction front, snus and electronic nicotine delivery systems are being widely distributed and promoted with major gaps in knowledge of the safety of long-term and dual use. Quitlines, comparable in outcome to in-person treatment, make cessation counseling available on a national scale, though use rates remain relatively low. Employee reward programs are gaining attention given the high costs of tobacco use to employers; sustaining quit rates postpayment, however, has proven challenging. SUMMARY Evidence-based cessation treatments exist. Broader dissemination, adoption, and implementation are key to addressing the tobacco epidemic. The cardiology team has a professional obligation to advance tobacco control efforts and can play an important role in achieving a smoke-free future.
Collapse
Affiliation(s)
- Judith J Prochaska
- aStanford Prevention Research Center, Department of Medicine, Stanford University, Stanford bDepartments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, California, USA
| | | |
Collapse
|
33
|
Abstract
The tobacco addiction treatment field is progressing through innovations in medication development, a focus on precision medicine, and application of new technologies for delivering support in real time and over time. This article reviews the evidence for combined and extended cessation pharmacotherapy and behavioral strategies including provider advice, individual counseling, group programs, the national quitline, websites and social media, and incentives. Healthcare policies are changing to offer cessation treatment to the broad population of smokers. With knowledge of the past and present, this review anticipates what is likely on the horizon in the clinical and public health effort to address tobacco addiction.
Collapse
Affiliation(s)
- Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California 94305;
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering & Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, California 94143;
| |
Collapse
|
34
|
Toll BA, Martino S, O'Malley SS, Fucito LM, McKee SA, Kahler CW, Rojewski AM, Mahoney MC, Wu R, Celestino P, Seshadri S, Koutsky J, Hyland A, Cummings KM. A randomized trial for hazardous drinking and smoking cessation for callers to a quitline. J Consult Clin Psychol 2015; 83:445-54. [PMID: 25419583 PMCID: PMC5996380 DOI: 10.1037/a0038183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study evaluated whether tobacco quitline telephone coaches can be trained to counsel hazardous-drinking smokers to improve smoking cessation success and to limit or abstain from alcohol use. METHOD Smokers (N = 1,948) who called the New York State Smokers' Quitline and reported hazardous drinking (exceeding sex-specific weekly limits [14 drinks for men, 7 drinks for women] or meeting/exceeding daily drinking limits [5 drinks for men, 4 drinks for women] at least once in the past year) were randomized to receive either brief motivational counseling to limit or abstain from alcohol plus an alcohol reduction booklet added to standard care (Alcohol + Tobacco Counseling; ATC), or only smoking cessation counseling plus a smoking cessation booklet added to standard care (Tobacco-Only Counseling; TOC). RESULTS Acceptable coach adherence was achieved. The intention-to-treat (ITT) analysis showed that ATC was associated with a significantly higher rate of smoking abstinence at 7-month follow-up (13.5%) compared with TOC (10.3%; p = .03). The respondent analysis (ATC= 26.2%; TOC = 20.4%) paralleled the ITT findings. When controlling for treatment condition, participants who did not report any heavy drinking were significantly more likely to quit smoking than those who reported any heavy drinking (OR = 1.87, 95% CI [1.29, 2.71]; p = .001). CONCLUSIONS A brief alcohol intervention plus standard care via a telephone quitline resulted in significantly higher smoking cessation rates for hazardous-drinking callers. Given that quitline coaches were trained to provide the intervention with acceptable adherence, the potential to extend this intervention for wide-scale implementation and impact is promising.
Collapse
Affiliation(s)
| | - Steve Martino
- Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare Center
| | | | | | | | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavior and Social Sciences, Brown University School of Public Health
| | | | | | | | - Paula Celestino
- Department of Health Behavior, Roswell Park Cancer Institute
| | | | - James Koutsky
- Department of Health Behavior, Roswell Park Cancer Institute
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Cancer Institute
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina
| |
Collapse
|
35
|
Danaher BG, Severson HH, Zhu SH, Andrews JA, Cummins SE, Lichtenstein E, Tedeschi GJ, Hudkins C, Widdop C, Crowley R, Seeley JR. Randomized Controlled Trial of the Combined Effects of Web and Quitline Interventions for Smokeless Tobacco Cessation. Internet Interv 2015; 2:143-151. [PMID: 25914872 PMCID: PMC4405799 DOI: 10.1016/j.invent.2015.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Use of smokeless tobacco (moist snuff and chewing tobacco) is a significant public health problem but smokeless tobacco users have few resources to help them quit. Web programs and telephone-based programs (Quitlines) have been shown to be effective for smoking cessation. We evaluate the effectiveness of a Web program, a Quitline, and the combination of the two for smokeless users recruited via the Web. OBJECTIVES To test whether offering both a Web and Quitline intervention for smokeless tobacco users results in significantly better long-term tobacco abstinence outcomes than offering either intervention alone; to test whether the offer of Web or Quitline results in better outcome than a self-help manual only Control condition; and to report the usage and satisfaction of the interventions when offered alone or combined. METHODS Smokeless tobacco users (N= 1,683) wanting to quit were recruited online and randomly offered one of four treatment conditions in a 2×2 design: Web Only, Quitline Only, Web + Quitline, and Control (printed self-help guide). Point-prevalence all tobacco abstinence was assessed at 3- and 6-months post enrollment. RESULTS 69% of participants completed both the 3- and 6-month assessments. There was no significant additive or synergistic effect of combining the two interventions for Complete Case or the more rigorous Intent To Treat (ITT) analyses. Significant simple effects were detected, individually the interventions were more efficacious than the control in achieving repeated 7-day point prevalence all tobacco abstinence: Web (ITT, OR = 1.41, 95% CI = 1.03, 1.94, p = .033) and Quitline (ITT: OR = 1.54, 95% CI = 1.13, 2.11, p = .007). Participants were more likely to complete a Quitline call when offered only the Quitline intervention (OR = 0.71, 95% CI = .054, .093, p = .013), the number of website visits and duration did not differ when offered alone or in combination with Quitline. Rates of program helpfulness (p <.05) and satisfaction (p <.05) were higher for those offered both interventions versus offered only quitline. CONCLUSION Combining Web and Quitline interventions did not result in additive or synergistic effects, as have been found for smoking. Both interventions were more effective than a self-help control condition in helping motivated smokeless tobacco users quit tobacco. Intervention usage and satisfaction were related to the amount intervention content offered. Usage of the Quitline intervention decreased when offered in combination, though rates of helpfulness and recommendations were higher when offered in combination. TRIAL REGISTRATION Clinicaltrials.gov NCT00820495; http://clinicaltrials.gov/ct2/show/NCT00820495.
Collapse
Affiliation(s)
- Brian G. Danaher
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | | | - Shu-Hong Zhu
- Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA USA
| | - Judy A. Andrews
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - Sharon E. Cummins
- Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA USA
| | | | - Gary J. Tedeschi
- Moores Cancer Center, University of California, San Diego, 9500 Gilman Drive, MC 0905, La Jolla, CA USA
| | - Coleen Hudkins
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - Chris Widdop
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - Ryann Crowley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| | - John R. Seeley
- Oregon Research Institute, 1776 Millrace Drive, Eugene, OR 97403, USA
| |
Collapse
|
36
|
Bush TM, Levine MD, Magnusson B, Cheng Y, Chen X, Mahoney L, Miles L, Zbikowski SM. Impact of baseline weight on smoking cessation and weight gain in quitlines. Ann Behav Med 2014; 47:208-17. [PMID: 24048952 PMCID: PMC3960374 DOI: 10.1007/s12160-013-9537-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The use and effectiveness of tobacco quitlines by weight is still unknown. PURPOSE This study aims to determine if baseline weight is associated with treatment engagement, cessation, or weight gain following quitline treatment. METHODS Quitline participants (n = 595) were surveyed at baseline, 3 and 6 months. RESULTS Baseline weight was not associated with treatment engagement. In unadjusted analyses, overweight smokers reported higher quit rates and were more likely to gain weight after quitting than obese or normal weight smokers. At 3 months, 40 % of overweight vs. 25 % of normal weight or obese smokers quit smoking (p = 0.01); 42 % of overweight, 32 % of normal weight, and 33 % of obese quitters gained weight (p = 0.05). After adjusting for covariates, weight was not significantly related to cessation (approaching significance at 6 months, p = 0.06) or weight gain. CONCLUSIONS In the first quitline study of this kind, we found no consistent patterns of association between baseline weight and treatment engagement, cessation, or weight gain.
Collapse
Affiliation(s)
- Terry M Bush
- Alere Wellbeing, 999 Third Avenue, Ste 2100, Seattle, WA, 98104, USA,
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Abstract
This study assesses the impact of an academic detailing quitline promotional outreach program on integration of patient referrals to the quitline by fax in healthcare settings and quitline utilization in Ontario, Canada. The study employed a mixed methods approach for evaluation, with trend analysis of quitline administrative data from the year before program inception (2005) to 2011 and qualitative interviews with quitline stakeholders. Participants in the qualitative interviews included academic detailing program staff, regional tobacco control stakeholders and quitline promotion experts. Quantitative outcomes included the number of fax referral partners and fax referrals received, and quitline reach. Trends in proximal and distal outreach program outcomes were assessed. The qualitative data were analysed through a process of data coding involving the constant comparative technique derived from grounded theory methods. The study identified that the outreach program has had some success in integrating the fax referral program in healthcare settings through evidence of increased fax referrals since program inception. However, organizational barriers to program partner engagement have been encountered. While referral from health professionals through the fax referral programs has increased since the inception of the outreach program, the overall reach of the quitline has not increased. The study findings highlight that an academic detailing approach to quitline promotion can have some success in achieving increased fax referral program integration in healthcare settings. However, findings suggest that investment in a comprehensive promotional strategy, incorporating academic detailing, media and the provision of free cessation medications may be a more effective approach to quitline promotion.
Collapse
Affiliation(s)
- Maritt Kirst
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada M5T 3M7
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON, Canada M5T 3M7
| |
Collapse
|
38
|
Tzelepis F, Paul CL, Walsh RA, Wiggers J, Duncan SL, Knight J. Predictors of abstinence among smokers recruited actively to quitline support. Addiction 2013; 108:181-5. [PMID: 22928579 PMCID: PMC3563228 DOI: 10.1111/j.1360-0443.2012.03998.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 10/12/2012] [Accepted: 06/19/2012] [Indexed: 11/26/2022]
Abstract
AIMS Active recruitment of smokers increases the reach of quitlines; however, some quitlines restrict proactive telephone counselling (i.e. counsellor-initiated calls) to smokers ready to quit within 30 days. Identifying characteristics associated with successful quitting by actively recruited smokers could help to distinguish those most likely to benefit from proactive telephone counselling. This study assessed the baseline characteristics of actively recruited smokers associated with prolonged abstinence at 4, 7 and 13 months and the proportion achieving prolonged abstinence that would miss out on proactive telephone counselling if such support was offered only to smokers intending to quit within 30 days at baseline. DESIGN Secondary analysis of a randomized controlled trial in which the baseline characteristics associated with prolonged abstinence were examined. SETTING New South Wales (NSW) community, Australia. PARTICIPANTS A total of 1562 smokers recruited at random from the electronic NSW telephone directory. MEASUREMENTS Baseline socio-demographic and smoking-related characteristics associated with prolonged abstinence at 4, 7 and 13 months post-recruitment. FINDINGS Waiting more than an hour to smoke after waking and intention to quit within 30 days at baseline predicted five of the six prolonged abstinence measures. If proactive telephone counselling was restricted to smokers who at baseline intended to quit within 30 days, 53.8-65.9% of experimental group participants who achieved prolonged abstinence would miss out on telephone support. CONCLUSIONS Less addicted and more motivated smokers who are actively recruited to quitline support are more likely to achieve abstinence. Most actively recruited smokers reported no intention to quit within the next 30 days, but such smokers still achieved long-term abstinence.
Collapse
Affiliation(s)
- Flora Tzelepis
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.
| | | | | | | | | | | |
Collapse
|
39
|
Fucito LM, Latimer AE, Carlin-Menter S, Salovey P, Cummings KM, Makuch RW, Toll BA. Nicotine dependence as a moderator of a quitline-based message framing intervention. Drug Alcohol Depend 2011; 114:229-32. [PMID: 21036492 PMCID: PMC3044773 DOI: 10.1016/j.drugalcdep.2010.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 10/18/2022]
Abstract
High nicotine dependence is a reliable predictor of difficulty quitting smoking and remaining smoke-free. Evidence also suggests that the effectiveness of various smoking cessation treatments may vary by nicotine dependence level. Nicotine dependence, as assessed by Heaviness of Smoking Index baseline total scores, was evaluated as a potential moderator of a message-framing intervention provided through the New York State Smokers' Quitline (free telephone based service). Smokers were exposed to either gain-framed (n=810) or standard-care (n=1222) counseling and printed materials. Those smoking 10 or more cigarettes per day and medically eligible were also offered a free 2-week supply of nicotine patches, gum, or lozenge. Smokers were contacted for follow-up interviews at 3 months by an independent survey group. There was no interaction of nicotine dependence scores and message condition on the likelihood of achieving 7-day point prevalence smoking abstinence at the 3-month follow-up contact. Among continuing smokers at the 3-month follow-up, smokers who reported higher nicotine dependence scores were more likely to report smoking more cigarettes per day and this effect was greater in response to standard-care messages than gain-framed messages. Smokers with higher dependence scores who received standard-care messages also were less likely to report use of nicotine medications compared with less dependent smokers, while there was no difference in those who received gain-framed messages. These findings lend support to prior research demonstrating nicotine dependence heterogeneity in response to message framing interventions and suggest that gain-framed messages may result in less variable smoking outcomes than standard-care messages.
Collapse
Affiliation(s)
- Lisa M. Fucito
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT 06511
| | - Amy E. Latimer
- Queen’s University School of Kinesiology and Health Studies, Kingston, ON K7L3N6
| | | | - Peter Salovey
- Yale University, Department of Psychology, New Haven, CT 06511
,Yale Cancer Center, New Haven, CT 06511
| | - K. Michael Cummings
- Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, NY 14263
| | | | - Benjamin A. Toll
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT 06511
,Yale Cancer Center, New Haven, CT 06511
| |
Collapse
|
40
|
Ortiz AP, Díaz-Toro EC, Calo WA, Correa-Fernández V, Cases A, Santos-Ortiz MC, Mazas C, Mejía L, Wetter DW. Characteristics of smokers accessing the Puerto Rico Quitline. P R Health Sci J 2008; 27:213-219. [PMID: 18782965 PMCID: PMC2763363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND In 2004, the Puerto Rico Department of Health implemented the Puerto Rico Quitline (PRQ), a proactive, telephone-based smoking cessation counseling program. This study examines the demographic and smoking-related characteristics of the individuals served by the PRQ. METHODS Analyses included PRQ participants registered from December 2004-December 2005. PRQ call rates and rate ratios (RR) were calculated overall, among smokers, and stratified by relevant covariates. Associations between sex and relevant characteristics of PRQ participants were compared using regression models. RESULTS Call rates per 100,000 smokers in PR were lower among men than women (RR = 0.50, 95% CI = 0.44-0.56), and higher among all age groups > or = 25 years of age as compared to those aged 15-24 years (RRs = 4.34-8.14) and among smokers living in the San Juan metropolitan area relative to smokers residing outside the metropolitan area (RR = 1.45, 95% CI = 1.29-1.63). Mass media was the most common way in which participants learned about the PRQ (> 70%), with only 2-3% of callers reporting a physician's referral as the source of their information about the PRQ. With respect to reasons for quitting, men were less likely than women to report concern about a child's health (OR = 0.62, 95% CI = 0.46-0.84) and cigarette odor (OR = 0.64, 95% CI = 0.41-0.99). Meanwhile, men were more likely (OR = 1.39, 95% CI = 1.01-1.91) to report the influence of other smokers as a barrier during quitting. CONCLUSIONS PRQ promotion and outreach efforts should target populations underserved by the PRQ including male, young adult, and non-metropolitan area smokers. Initiatives that link the PRQ with primary care providers in promoting smoking cessation should be encouraged.
Collapse
Affiliation(s)
- Ana Patricia Ortiz
- Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico.
| | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Winickoff JP, Park ER, Hipple BJ, Berkowitz A, Vieira C, Friebely J, Healey EA, Rigotti NA. Clinical effort against secondhand smoke exposure: development of framework and intervention. Pediatrics 2008; 122:e363-75. [PMID: 18676523 PMCID: PMC2774730 DOI: 10.1542/peds.2008-0478] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this work was to describe a novel process and present results of formative research to develop a pediatric office intervention that uses available systems of care for addressing parental smoking. METHODS The scientific development of the intervention occurred in 3 stages. In stage 1, we designed an office system for parental tobacco control in the pediatric outpatient setting on the basis of complementary conceptual frameworks of preventive services delivery, conceptualized for the child health care setting through a process of key interviews with leaders in the field of implementing practice change; existing Public Health Service guidelines that had been shown effective in adult practices; and adaptation of an evidence-based adult office system for tobacco control. This was an iterative process that yielded a theoretically framed intervention prototype. In stage 2, we performed focus-group testing in pediatric practices with pediatricians, nurses, clinical assistants, and key office staff. Using qualitative methods, we adapted the intervention prototype on the basis of this feedback to include 5 key implementation steps for the child health care setting. In stage 3, we presented the intervention to breakout groups at 2 national meetings of pediatric practitioners for additional refinements. RESULTS The main result was a theoretically grounded intervention that was responsive to the barriers and suggestions raised in the focus groups and at the national meetings. The Clinical Effort Against Secondhand Smoke Exposure intervention was designed to be flexible and adaptable to the particular practices' staffing, resources, and physical configuration. Practice staff can choose materials relevant to their own particular systems of care (www.ceasetobacco.org). CONCLUSIONS Conceptually grounded and focus-group-tested strategies for parental tobacco control are now available for implementation in the pediatric outpatient setting. The tobacco-control intervention-development process might have particular relevance for other chronic pediatric conditions that have a strong evidence base and have available treatments or resources that are underused.
Collapse
Affiliation(s)
- Jonathan P. Winickoff
- MGH Center for Child and Adolescent Health Policy, Boston, MA,MGH Tobacco Research and Treatment Center, Boston, MA
| | - Elyse R. Park
- MGH Tobacco Research and Treatment Center, Boston, MA
| | - Bethany J. Hipple
- MGH Center for Child and Adolescent Health Policy, Boston, MA,MGH Tobacco Research and Treatment Center, Boston, MA
| | - Anna Berkowitz
- MGH Center for Child and Adolescent Health Policy, Boston, MA
| | - Cecilia Vieira
- MGH Center for Child and Adolescent Health Policy, Boston, MA,MGH Tobacco Research and Treatment Center, Boston, MA
| | - Joan Friebely
- MGH Center for Child and Adolescent Health Policy, Boston, MA,MGH Tobacco Research and Treatment Center, Boston, MA
| | - Erica A. Healey
- MGH Center for Child and Adolescent Health Policy, Boston, MA,MGH Tobacco Research and Treatment Center, Boston, MA
| | | |
Collapse
|