Tobacco Quitline Performance: Comparing the Impacts of Early Cessation and Proactive Re-engagement o
Friday, March 17, 2023
Posted by: Natalia Gromov
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 Feb 15;21:24. doi: 10.18332/tid/159125. PMID: 36798676;
PMCID: PMC9923459.
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.
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