Unique Cessation Tools in the Box: Quitline Utilization and Effectiveness Trends among a Large Sampl
Thursday, August 18, 2022
Posted by: Natalia Gromov
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. Published 2022 Jul 19.
doi:10.3389/fpsyt.2022.869802
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.
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