Okay – so let’s say you DO have the support of policy makers (thanks to Jennifer Singleterry’s tips in last week’s blog). What other partnerships might be important in moving forward with quitline sustainability efforts? Anyone? Anyone? Bueller…

Yes! Public-private partnerships! To tell us a little more about what makes quitlines a powerful tool in building public-private partnerships we asked David Zauche, Senior Program Officer for Partnership for Prevention and also a new addition to NAQC’s Advisory Council, to weigh in. Here is what David had to say:

"How do tobacco cessation quitlines bring value to public-private partnerships (P3’s)? To answer that question it would help to know just how such a partnership is defined. But this is not as easy as it sounds - many definitions exist. A common strain among definitions seems to be:

Public-private partnerships are cooperative ventures between public agencies and the private sector through which the skills and assets of each are shared for the common good. This generally involves an allocation of resources for the delivery of a public service, for which both partners share in the recognition.

P3’s have become very popular in the U.S. in the past two decades, though they have existed for hundreds of years. These partnerships have benefited the public in a variety of sectors including transportation, schools, energy, and urban development. Governments all over the world are dealing with enormous budget shortfalls and they are increasingly turning to P3 models to deliver services. This is certainly true in the health care sector. In fact, P3’s have become a valuable public health tool at the community level.

There are many good examples of successful P3’s that impact public health and some are specific to the tobacco control realm. For example, the Department of Health and Human Services’ (HHS) Million Hearts initiative aims to prevent one million heart attacks and strokes in the next five years, improving Americans’ health and increasing productivity. The CDC’s Thomas Frieden, MD wrote, "Through this public-private partnership, Million Hearts focuses on the areas that will save the most lives. It leverages and aligns current investments and is a great example of getting more health value from our existing health investments.” Many different partners have joined forces including the American Heart Association, the American Medical Association, the American Nurses Association and Walgreens. HHS will target more than $200 million in new and refocused investments to achieve the goals of Million Hearts.

Some other examples:

In Oklahoma, Integris Health partnered with the Oklahoma Hospital Association, the state department of health, and the state tobacco settlement endowment trust to institute a hospital tobacco treatment program. As a result, tobacco-free campuses were established; tobacco cessation assistance is provided to employees and family members; physicians take an active role in helping their patients quit; and patients are referred to 1-800-QUIT NOW for quitline assistance after the hospital intervention.

In Colorado, a Tobacco Cessation and Sustainability Partnership was formed to support health plans in providing evidence-based tobacco cessation interventions and to build a framework to sustain the state’s quitline. These key stakeholders from health plans, state agencies, the clinical community, and the advocacy community engaged in a collaborative process to educate purchasers about the value of providing tobacco cessation benefits.

In Massachusetts, a partnership developed between eight commercial Medicaid health plans and the Massachusetts Department of Public Health. Provider representatives from the health plans delivered a tobacco cessation kit called Quitworks door-to-door to thousands of practices. Patients enrolled in QuitWorks were offered free proactive counseling. The program linked 12,000 health care providers and their patients to proactive telephone counseling

So, back to the original question – why would a quitline make a good partner in public health? Well, there are many reasons.

• Tobacco cessation works. Smokers may have to try and fail before they succeed, but tens of millions of Americans have successfully quit.
• Quitlines work. Effectiveness rates have been documented in the 2008 Public Health Service guideline and elsewhere. But many quitlines face severe financial handicaps which limit hours of operation, services, promotion, reach and, ultimately, even greater success than is currently realized.
• Return on investment. No preventive service – not hypertension treatment, mammography, cholesterol treatment – has a better payoff in health impact and cost effectiveness than tobacco cessation services.

The key to public-private partnerships is shared strengths and benefits. Quitlines will be well-served by increased funding, promotion, reach, and sustainability. But insurers, employers, health systems, and government agencies will also benefit through shared recognition for evidenced-based services delivered, healthier workforces, fewer hospital admissions, and a superior return on investment.”

Quitlines have a long history of serving as the bridge that brings partners together and increasing awareness of the importance of offering cessation assistance. It is a lengthy process to build cost-sharing partnerships with the private sector (and the public one, for that matter!) and one that can have many starts and stops along the way. However, if we are to truly focus on the issue of sustainability and be successful in doing so, we simply must take the first step. Have you?