Quitline Promotion to Medicaid Members who Smoke: Effects of COVID-19-specific Messaging and a Free
Thursday, November 17, 2022
Posted by: Natalia Gromov
Tong EK, Cummins SE,
Anderson CM, Kirby CA, Wong S, Zhu SH.
Quitline Promotion to
Medicaid Members who Smoke: Effects of COVID-19-specific Messaging and a Free
Patch Offer.
[published online ahead of print, 2022 Oct 29]. Am J Prev Med.
2022;S0749-3797(22)00466-4. doi:10.1016/j.amepre.2022.09.009
Introduction. People
who smoke are at increased risk of serious COVID-19-related disease but have
had reduced access to cessation treatment during the pandemic. This study
tested 2 approaches to promoting quitline services to Medicaid members who
smoke at high rates: using COVID-19-specific messaging and offering free
nicotine patches. The hypotheses were that both would increase enrollment.
Methods. A
California Medicaid mailing from October 2020 to January 2021 (N=7,489,093)
included 4 versions of a flyer following a 2 × 2 design comparing generic with
COVID-19-specific messaging and a no-patch with free-patch offer. The main
outcome measure was quitline enrollments. Quit outcomes (attempted quitting,
quit ≥7 days, quit ≥30 days) were assessed at 2 months. A subsequent free-patch
offer was sent to all members (N=7,577,198) from April 2021 to June 2021. Data
were collected in 2020-2021 and analyzed in 2022.
Results. The
first mailing generated 1,753 enrollments. Response rates were 0.023% and
0.024% for generic and COVID-19-specific messaging, respectively (p=0.538), and
0.006% and 0.041% for no-patch and free-patch offers, respectively, the latter
being 6.7 times more effective than the former (p<0.0001). Quit outcomes
were comparable across conditions. The subsequent free-patch offer generated
3,546 enrollments at $40.28 per enrollee.
Conclusions. In
a Medicaid mailing during COVID-19, offering free patches generated more than 6
times as many quitline enrollments as offering generic help. COVID-19-specific
messaging was no more effective than generic messaging. Offering free patches
was highly cost-effective. Medicaid programs partnering with quitlines should
consider using similar strategies, especially during a pandemic when regular
health care is disrupted.
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