Feasibility and Early Outcomes of a Tailored Quitline Protocol for Smokers with Mental Health Condit
Thursday, March 21, 2019
Posted by: Natalia Gromov
Carpenter KM, Nash CM, Vargas-Belcher RA, Vickerman KA, Haufle V.
Feasibility and Early Outcomes of a Tailored Quitline Protocol for Smokers with Mental Health Conditions.
Nicotine Tob Res. 2019 Feb 15. pii: ntz023. doi: 10.1093/ntr/ntz023. [Epub ahead of print]
Adults with mental health conditions (MHCs) smoke at higher rates, are more nicotine dependent, and have more trouble quitting smoking than those without MHCs. About half of smokers who call state-funded quitlines report MHCs, and those with such conditions have cessation rates 8-10% lower than those without MHCs. This paper describes a clinical pilot of a tailored protocol for quitline callers with MHCs. Callers to the Texas Tobacco Quit Line (TXQL) who self-reported MHCs were offered a tailored quitline program, offering up to 12 weeks of combination nicotine replacement (nicotine patch plus gum or lozenge) and seven counseling calls. Characteristics, program engagement, and 7-month outcomes for these pilot participants were compared to callers in the standard TXQL program with and without MHCs not offered the tailored program. Eighty-eight percent of eligible quitline callers accepted enrollment in the tailored pilot. Pilot enrollees (n = 311) had high rates of co-morbidity and serious mental illness, including bipolar disorder (59%). Those in the pilot sample participated in more coaching calls and used more nicotine replacement versus comparison groups. Early cessation outcomes showed numerically higher quit rates for pilot participants than those with MHCs in the standard program, but small sample size and low response rates prevent definitive statements about efficacy. Offering a tailored quitline protocol for callers with MHCs was feasible and acceptable to quitline callers and increased engagement in treatment. A larger study is needed to determine if the protocol increases cessation among this group. Nearly half of all quitline callers report a mental health condition. This clinical quality improvement pilot shows that delivering a tailored tobacco cessation program for smokers with mental health conditions is feasible and acceptable to quitline callers. Participants in the pilot group had higher engagement in treatment, doubling the number of coaching calls received and using more nicotine replacement than comparison groups. Further investigation is needed to determine the effect of this program on cessation rates, although preliminary outcomes are promising.
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