Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines.
Thursday, March 17, 2016
Posted by: Natalia Gromov
Steven L. Bernstein, June-Marie Rosner, Benjamin Toll,
Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines.
Nicotine Tob Res (2016)doi: 10.1093/ntr/ntw042First published online: February 26, 2016
Quitlines (QLs) are free, effective sources of treatment for tobacco dependence. Although the QL number is toll-free, the use of cellphones as the sole source of telephony may impose an unintended cost, in terms of cell minutes. To quantify the use of cell-only telephony among self-pay or Medicaid smokers, assess their calling plans, and estimate the impact of a typical course of QL counseling. A survey of smokers age >= 18 years visiting an American urban emergency department from April-July, 2013.
773 smokers were surveyed, of whom 563 (72.8%) were low-income, defined as having Medicaid or no insurance. All low-income smokers had at least one phone: 48 (8.5%) reported land-lines only, 159 (28.2%) land-lines and cells, and 356 (63.2%) cells only. Of the cellphone owners, monthly calling plans provided unlimited minutes for 339/515 (65.8%), <250 minutes for 124 (24.1%), and >250 minutes for 52 (10.0%). Another recent trial found that QL users make a median of 1 call lasting 28 minutes, with the 75th and 90th percentiles of calls and minutes at 3 and 4 calls, and 48 and 73.6 minutes, respectively. Thus, robust use of QL services could consume 11-29% of a low-income smoker’s typical 250 monthly cell minutes. Among low-income smokers, cellphones are often the sole telephone. Robust use of the QL may impose a substantial burden on low-income smokers’ calling plans, and therefore deter use of the QL. Exempting calls to QLs from counting against smokers’ plans may help promote QL utilization.
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