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ACA and Quitlines

Funding and sustainability  is critical for achieving NAQC’s mission to increase access to and the quality of quitline services. In the U.S., the Affordable Care Act (ACA) has made cessation services, including quitlines, more accessible to smokers who would like to quit and has provided opportunities to increase the visibility of quitlines among the public and policymakers as well as support policy activities that improve access to services. Following are highlights of NAQC's work in this area.


Communicating with Our Members & Partners

Thought papers on the impact of the Affordable Care Act (ACA) on quitlines(2017).  These thought papers explore four topics that are especially important for the quitline community and set out consensus goals and next steps for the quitline community.

Making the Case for Quitlines

Employer Fact Sheet (2017). This fact sheet, titled  Staying Competitive in the Marketplace: Helping Employees Become Tobacco Free – is intended as a resource for states to use in making the case for quitlines to employers.

Making the Case for Quitlines: A Toolbox for Communicating with the Media, Policy makers and the Public (2010). This toolbox to help quitlines better communicate with the media, policy makers and the public about the importance of their work. The toolbox includes two new fact sheets and a repository of innovative materials developed by state quitlines.

Repository of Innovative State Quitline Materials

Conference Call - Stimulus Funding for U.S. Quitlines
On September 2, 2009, NAQC convened a conference call with its members to discuss the likelihood of up to $45 million in funding from the stimulus package being allocated to state quitlines and preparations that should be undertaken to prepar for the funding. If you were unable to attend this call, or would like to access the many resources referenced during the call, you can do so via the following documents:

Relevant NAQC Issue Papers

NAQC Issue Papers aim to provide critical knowledge on important quitline topics and guidance for decision-making. NAQC has recently published several new  Issue Papers impacting quitline funding and sustainability:

Quitlines in the U.S.: An Exploration of the Past and Considerations for the Future(2014)

This paper outlines the current status of state quitlines and describes how, as a result of an extremely dynamic political and funding landscape and the opportunity of the Affordable Care Act, quitlines should move forward to improve efficiency and become leverage points for broader cessation initiatives with new and existing partners. The paper illuminates best and promising practices for integrating quitlines into the broader healthcare landscape and informs decisions on strategic planning, determining specific goals and objectives of a state quitline and sustainability planning for the future.

Recommendations found in the Executive Summary express NAQC’s priorities for moving toward the future vision for quitlines defined by NAQC in collaboration with its members, leadership and partners. As NAQC celebrates its 10 year anniversary, the quitline community remains committed to ensuring that tobacco users are encouraged to quit, that high-quality cessation services are readily available to all who want to quit, and that we stand ready to move collectively toward a future vision of the role we will play in this critical effort.
view issue paper (PDF 881KB)
view executive summary (PDF 346KB)

Quitline Service Offering Models: A Review of the Evidence and Recommendations for Practice in Times of Limited Resources


This paper aims to present evaluation and research data used to guide decision-making on ways to invest limited funding for quitline services most effectively in an easy-to-use format and to make recommendations for most effectively using limited resources when determining quitline service offering options. Specifically, the paper addresses the following questions:

1) How effective are different service offering models regarding quitline utilization, tobacco abstinence rates, and costs? Are there points at which the return on investment diminishes in terms of amount of counseling (attempted and completed) and medication provided?
2) What impact does the provision of medications through quitlines have on reach and quit rates? Which mechanisms for dosing and delivery of medications are most cost-effective and/or provide other efficiencies?
3) Is there evidence to support the use of advanced technologies (web, interactive voice response [IVR] and texting) to expand quitline service offerings? Are these approaches cost-effective? What other efficiencies are achieved?

view issue paper(PDF 717KB)
view executive summary(PDF 464KB)
view recommendations for research(PDF 383KB)
view options table(PDF 323KB)

Assessing the Cost-Effectiveness of Quitline Programs (2010)

Performing cost-effectiveness analyses is an essential element of any quitline’s quality improvement process. This is especially true as budgetary constraints become more important to determining all aspects of service delivery. This issue paper:
-documents the facts related to the cost of tobacco use;
-provides an overview of methods currently used for cost-effectiveness analysis of quitlines; and  
-in general terms, describes approaches and considerations for conducting cost-effectiveness analysis on a specific quitline program

view issue paper (PDF 125KB)
view table 1 (PDF 7.36KB)
view table 2 (PDF 7.14KB)
view table 3 (PDF 6.67KB) 

Tobacco Cessation Quitlines - A Good Investment to Save Lives, Decrease Direct Medical Costs and Increase Productivity (2009)

Tobacco use is the single most preventable cause of death and disease in the U. S., causing approximately 438,000 deaths each year. Quitlines are telephone-based tobacco cessation services that help tobacco users quit through a variety of services, including counseling, medications, information and self-help materials. Quitline effectiveness is documented by numerous research studies. Through the leadership of state and federal governments, quitlines have become increasingly popular in the U.S. due to their centralization, cost-effectiveness and ability to reach tobacco users in rural and urban areas. With state budget cuts on the rise, the ability of quitlines to provide evidence-based tobacco cessation services is under threat. Yet, without adequate, sustained funding for quitlines, tobacco use prevalence is unlikely to decline. This NAQC Issue Paper makes the case for quitline investment and sustainability.

The Role of Reimbursement and Third Party Financial Support in Sustaining Quiltines (2008)

An emerging issue related to quitline sustainability is third-party reimbursement for quitline services. As part of a grant from the Robert Wood Johnson Foundation (RWJF), NAQC developed an issue paper on third-party reimbursement of quitlines to serve as a resource to NAQC members and tobacco control partners. Due to differences in healthcare financing in the U.S. and Canada, this project focuses solely on U.S. quitlines. This paper assesses the current practices of quitlines with regard to third-party reimbursement and other forms of financial support, provides an overview of the opportunities for obtaining third party support and sets next steps for garnering third-party financial support for quitlines.  
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