1. New technology and Quitlines Andrew Stripp Project Manager European Network of Quitlines

2. Contents of Discussion Case for new technology Policy Rationale Review of literature Reach New and emerging technologies

3. Case for new technology in health Like other sectors of our economy and even cultural/social life, the case for new technology in health is promoted because: – New technologies will improve efficiencies in delivery (the cost reduction argument) – The patient experience of service (customer satisfaction) will be enhanced – Outcomes will become better (Efficacy of service) and when combined with reach (reach x efficacy), impact will be large

4. Case for new technology in health – Monitoring and reporting (control element) will be improved, especially self-assessment and self-reported follow ups CRMs enhance data quality – Environmental impact lowered (electronic PDF vs Printed) – Human relationships improved (social networking, community of practice and expert patient networks)

5. E-Health E-health is included as part of the wider European Commission’s Public Health Agenda. This includes: tools and services, using information and communication technologies (ICTs) that can improve prevention, diagnosis, treatment, monitoring and management. can benefit the entire community by improving access to care and quality of care and by making the health sector more efficient. Source: http://ec.europa.eu/health/ehealth/policy/index_en.htmhttp://ec.europa.eu/health/ehealth/policy/index_en.htm

6. EU Health technology assessment (HTA) This is an EU initiative that is concerned with the application of scientific knowledge in health care and disease prevention. Health technology assessment (HTA) is a multidisciplinary process that summarizes information about the medical, social, economic, and ethical issues related to the use of health technology in a systematic, transparent, unbiased, robust manner. Its aim is to inform the formulation of safe, effective, health policies that are patient focused and seek to achieve best value. HTA must always be firmly rooted in research and the scientific method Source http://ec.europa.eu/health/technology_assessment/policy/index_en.htmhttp://ec.europa.eu/health/technology_assessment/policy/index_en.htm

7. WHO FCTC The WHO Framework Convention on Tobacco Control (WHO FCTC) is the first treaty negotiated under the auspices of the World Health Organization. It was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February 2005. It has since become one of the most widely embraced treaties in UN history and, as of today, has already 172 Parties. Source: http://www.who.int/fctc/en/http://www.who.int/fctc/en/

8. Guidelines to Article 14 Demand reduction measures concerning tobacco dependence and cessation

9. Summary of main points: Tobacco use is highly addictive (general pop. level education) Utilise the pre-existing evidence base Treatment should be accessible and affordable (Quitlines) Treatment should be inclusive Monitor and Evaluate Active partnership with civil society Protect from all commercial and vested interests (tobacco industry) Value of sharing experience (ENQ) Central role of health-care systems

10. A basic infrastructure needs to be established in the first instance, before considering new technology as a potential part of an intervention programme. This includes country guidelines based on scientific and evidence based approaches (accounting for national circumstances). Points 51 and 52

11. Cochrane Review Internet intervention programmes that provide individually tailored information and support may be more effective than a static website. The Internet may have an additional benefit when used alongside other interventions, such as nicotine replacement therapy (NRT) or other pharmacotherapy. Innovative smoking cessation intervention delivered via the Internet may be more attractive to young people and females who smoke, and less attractive to smokers reporting depression. More evidence is needed to determine if programmes delivered over the Internet can help people to stop smoking. Civljak M, Sheikh A, Stead LF, Car J. Internet-based interventions for smoking cessation. Cochrane Database of Systematic Reviews 2010, Issue 9

12. Basic Research Public Awareness Values Legislation & Policy Intervention Programmes Where does new technology fit?

14. How should we use new technology? There is a growing body of research to suggest that new technology has additional benefits, such as increased reach, alongside more traditional methods of smoking cessation. New technology and technical innovations can and should be considered within a quitline setting. New and innovative approaches should be employed once a basic infrastructure is established.

15. - Interactive websites - Tailor-made programmes - E-Counselling - Viral Media - Skype - Text Messaging and SMS alerts - Applications (I-phone and Android) Tools already being used

16. The shift in technology Technology has moved a long way from it’s beginnings. Mobile technology has become more accessible at a population level (coverage, 3G and cheaper) and much more advanced in it’s applications.

17. Are computers redundant? Will there only be room for super smart devices in the future? The shift in technology

18. Awareness and Discovery Mobile search SMS from advertising Mobile display advertising Web to mobile tools Click to call Awareness and Discovery Mobile search SMS from advertising Mobile display advertising Web to mobile tools Click to call Engagement Mobile internet site Fundraising SMS call to action SMS information alerts Mobile apps Engagement Mobile internet site Fundraising SMS call to action SMS information alerts Mobile apps Interaction Mobile donations Personal support Helping and supporting others Interaction Mobile donations Personal support Helping and supporting others Some of the ways we can use mobile technology Mobile Technology

19. Text2Stop Study, 2007 Method Mobile phone text messaging automated smoking cessation support doubles the rate of self-reported quitting in the short term. We assessed the long term effects of the txt2stop mobile phone text messaging smoking cessation support programme on biochemically verified continuous abstinence at 6 months. Results Jan 2011 A randomised controlled trial of mobile phone text messaging smoking cessation support: txt2stop

20. I-Phone Applications In September 2010 Total Active Apps (currently available for download): 282,979 Total Submissions September (Non-Games): 14,844 ( 571 / day ) (Total): 17,005 ( 654 / day ) Current Average App Price: $2.86 Current Average Game Price: $1.18 Current Average Overall Price: $2.62 In the UK – 8% of the population own an I-phone. Potential revenue generation for Quitlines?

21. Skype Advantages / PositiveDisadvantages / Negative Calls are free of chargePotential line delays / connection issues Increases geographical reachUser needs to be sitting at a computer Option of video is availableLimited to those who are online Offers a home based f2f serviceF2F interaction may dissuade people Counselor can display materials ‘live’ Potential to run groups or work with a ‘buddy’ In the UK, QUIT is piloting a pro-active Skype video cessation service from Jan 2011. We shall be specifically looking at how feasible this new service could be. Out colleagues from Poland are using a limited service now, with their counsellor working from the UK and taking calls from Poland. Initial feedback is very positive. There are several advantages and disadvantages that we can immediately recognise

22. Who uses Skype in the UK? Skype Source: www.comscore.comwww.comscore.com

23. Viral Media In the early 00’s, internet usage became dictated by the twin-pillars of video-sharing and social networking, allowing people to establish more contacts and reach an audience wider than previously imaginable. These portals are growing more intertwined as the technology behind them increases in complexity. This is facilitating multimedia communication between people all over the world, with youth making the absolute most it. In order to engage with this important group of internet users, their imaginations should be stimulated and brought into a discussion.

24. Don’t be scared of new technology It may make your life easier and more effective

25. Where can new technology lead us?

26. Pan-European Quitline?

27. Be mindful of new technology. Use it with caution and employ the evidence Please remember!!!

28. Andrew Stripp a.stripp@quit.org.uk a.stripp@quit.org.uk