Quit Outcomes and Program Utilization by Mode of Entry Among Clients Enrolling in a Quitline. Issue 7 (September 2018)

• Record Type: Journal Article
• Authors: Nair, Uma S.; Reikowsky, Ryan C.; Wertheim, Betsy C.; Thomson, Cynthia A.; Gordon, Judith S.
• Is Part Of: American journal of health promotion. Volume 32:Issue 7(2018)
• Page Start: 1510
• Page End: 1517
• Publication Date: 2018-09
• Subjects: tobacco -- cessation -- quitline services -- provider referrals -- mode of entry; Health promotion -- Periodicals; Health Promotion; Health promotion; Periodicals; Periodicals; 613.05
• DOI: 10.1177/0890117117749366
• Languages: English
• ISSNs: 0890-1171

Abstract

Purpose: To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services. Design: This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016. Setting: The study was conducted at the Arizona Smokers' Helpline. Participants: Enrolled clients completed a 7-month follow-up (N = 18 650). Measures: The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months. Analysis: Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders. Results: Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients. Conclusion: Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.