Evaluation of the Illinois Tobacco Quitline Thomas W. ORourke, PhD, MPH 1, Diane O'Rourke, MA 1, Harold Wimmer, MS 2 and Lynda Preckwinkle, RRT 2 (1)University of Illinois, Champaign, IL, (2)American Lung Association of Upper Midwest, Springfield, IL

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 1 PURPOSE To evaluate the Illinois Tobacco Quitline by a telephone survey of Quitline callers. To query the callers about their assessment of the Quitline. To determine how the callers learned about the Quitline, what quit smoking aids they used, and their current smoking status. To evaluate the Illinois Tobacco Quitline by a telephone survey of Quitline callers. To query the callers about their assessment of the Quitline. To determine how the callers learned about the Quitline, what quit smoking aids they used, and their current smoking status.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 2 METHODOLOGY Professional telephone interviewers interviewed 459 respondents who had called the Quitline at least once and whose Quitline record included a name and telephone number. Interviewing was conducted using a CATI (computer assisted telephone interviewing) system. Made up to 8 telephone calls in an effort to reach potential respondents. Professional telephone interviewers interviewed 459 respondents who had called the Quitline at least once and whose Quitline record included a name and telephone number. Interviewing was conducted using a CATI (computer assisted telephone interviewing) system. Made up to 8 telephone calls in an effort to reach potential respondents.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 3 METHODOLOGY 295 were ineligible because they were non-working numbers or not the residential phone number for the person (e.g., business, hospital, another person). 34 were excluded because, when reached, the person said they did not call the Quitline for themselves or did not remember calling. Of the 680 remaining eligible cases, interviews were completed with 459, for a response rate of 67.5%. 26 people refused (3.8%) and 195 (28.7%) could not be reached after 8 calls (e.g., answering machine, ring-no-answer). 295 were ineligible because they were non-working numbers or not the residential phone number for the person (e.g., business, hospital, another person). 34 were excluded because, when reached, the person said they did not call the Quitline for themselves or did not remember calling. Of the 680 remaining eligible cases, interviews were completed with 459, for a response rate of 67.5%. 26 people refused (3.8%) and 195 (28.7%) could not be reached after 8 calls (e.g., answering machine, ring-no-answer). Of the 1,009 telephone numbers called,

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 4 DEMOGRAPHICS RACE (most White) 89% White 9% African-American Other Age (most Middle-aged) Mean 48 Median 48 Wide range Education (fairly well-educated) 51% at least some college Only 11% less than a high school diploma Health Insurance Approximately three-fourths (76%) of respondents have health insurance. Having health insurance may facilitate quitting efforts, since many plans provide varying degrees of coverage for smoking cessation efforts such as the nicotine patch, medications, and education programs.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 5 SMOKING STATUS Not surprisingly, most respondents (59%) reported smoking everyday. Another 17% reported smoking on some days. An encouraging finding was that nearly a quarter (24%) of the respondents reported not smoking at all currently. Some of them had stopped smoking before calling the Quitline and others quit after calling. No significant association were noted by smoking behavior and gender, race or education.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 6 SATISFACTION WITH QUITLINE There was high satisfaction with the Quitline. Eighty-five percent of all respondents were very or mostly satisfied. Only 4% were not satisfied. However, there was a strong significant association (p<.001) between satisfaction and smoking behavior. While all groups reported high satisfaction, those not smoking at all exhibited the greatest satisfaction (93%), followed closely by those smoking only some days (90%), and to a lesser extent (79%) those smoking every day.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 7 LAST TIME SMOKED DAILY Of the respondents who said they were not currently smoking at all, approximately one quarter (26%) indicated they were not smoking daily before they called the Quitline. Quite possibly many of them had already initiated quitting and were calling the Quitline to seek assistance with maintaining quitting, while others called about initiating quitting. Nearly half (43%) of these callers reported not smoking daily for at least one or more months at the time of the telephone interview. A similar pattern was noted for the last time respondents reported smoking even a puff.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 8 AVERAGE DAILY NUMBER OF CIGARETTES SMOKED For those currently still smoking, the mean was (16.1) and median number (15) of cigarettes smoked on days that they smoked indicating that the typical amount smoked was about three-fourths of a pack a day. A wide range of cigarettes smoked daily was noted (1-80). The median is the usually a more useful statistic because it is not influenced by extreme scores. In this study both the mean and median were similar indicating a relatively normal distribution of cigarette consumption.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 9 INTEND TO QUIT WITHIN NEXT 30 DAYS Most current tobacco users (62%) intend to quit within the next 30 days. Only about a quarter (26%) said they did not intend to quit. Few indicated being ambivalent (dont know about quitting). These results are not surprising given that respondents have initiated a call to the Quitline. Results indicate that most callers are receptive to cessation efforts. It appears that the focus should not be on efforts to convince smokers to quit, but rather on providing them with the knowledge and skills to quit.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 10 QUIT FOR 24 HOURS OR LONGER The vast majority (75%) said they had quit using tobacco for 24 hours or longer since calling the Quitline.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 11 METHODS USED TO TRY TO QUIT SMOKING By far, the nicotine patch was the most common method used to try to quit smoking 63%, followed by medication (29%) nicotine gum (14%), and another nicotine product (8%).

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 12 USE OF NICOTINE PATCH Nearly two-thirds (63%) of respondents reported using a nicotine patch. A significant association was found by smoking status, with quitters reporting a greater use of the nicotine patch. Similar patterns were found for those smoking every day and on some days. Possibly those more motivated to quit were more receptive to using the patch.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 13 HELPFULNESS OF NICOTINE PATCH Nearly half (45%) of nicotine patch users found it somewhat helpful and another third (35%) found it very helpful. Only a fifth (20%) said it was not at all helpful. A significant association was found by smoking status. Not surprisingly those who were no longer smoking were much more likely to rate the patch as very helpful (61%) than either those smoking every day or some days (23% and 29% respectively).

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 14 USE OF MEDICATIONS Most respondents (72%) did not use medications. However, there was a significant association between medication use and smoking status, with nonsmokers reporting a higher use of medications. This is not surprising because they may have been more motivated to quit and to use medications to do so.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 15 HELPFULNESS OF MEDICATIONS Most respondents who used medications found them very or somewhat helpful. Only about a quarter (24%) found them not helpful. No association was found between perceived helpfulness and smoking status.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 16 USE OF NICOTINE GUM The vast majority of respondents (86%) did not use nicotine gum. No significant association was found between nicotine gum use and smoking status.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 17 HELPFULNESS OF NICOTINE GUM Of the few respondents (14%) who used nicotine gum, only a few (15%) found it very helpful. Most (55%) found it not at all helpful. No significant association was found use of nicotine gum and helpfulness or smoking stauts. Although not quite statistically significant, a possible trend was that while most who were not currently smoking rated nicotine gum as not at all helpful (63%), more than a third of the nonsmokers found it very helpful, as well as 25% of those who smoked on some days. In contrast, only 9% of every day smokers rated the gum as very helpful.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 18 HEARD ABOUT QUITLINE Referral (69%)was clearly the most frequent way of hearing about the Quitline, followed by media (26%) and other advertising (10%) No significant differences were noted by group. For each group, referral was clearly reported method of hearing about the Quitline.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 19 READINESS TO QUIT SMOKING Most respondents (62%) were very ready to quit smoking. Another 35% were somewhat ready. Few respondents (3%) said they were not at all ready. No significant association between readiness to quit and smoking status was found. A majority of each group expressed being very ready to quit, with few saying they were not at all ready to quit. This is not surprising. However, it is also apparent that indicating a willingness to quit does not translate into quitting.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 20 HELPFULNESS OF QUITLINE INFORMATION PACKET The majority of respondents found the information packet very helpful. Few respondents found it not at all helpful. There was a significant association between smoking status and helpfulness of the packet. Those currently not smoking at all or only on some days were more likely to find the information packet to be very helpful than those smoking every day.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 21 HELPFULNESS OF QUITLINE TELEPHONE COUNSELING Across all groups on a 1-10 point scale, respondents found the Quitline telephone counseling helpful. Median (middle) scores (8.0) are better indicators than mean (average) scores (7.3) since they are not influenced by scores at either extreme. Overall, the median rating was a favorable 8 or higher on a 10-point scale. The range of respondent scores was from Not surprisingly, smoking status was significantly associated with helpfulness rating (p <.05), with those smoking every day having the least favorable score.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 22 RECOMMEND QUITLINE Consistent with past studies, results of this question were very positive. Nearly all respondents (94%) would recommend the Quitline to a family member or friend. Very encouraging was the finding of no association between recommending the Quitline and smoking status. Those smoking every day or on some days were equally and as highly positive as those not smoking. It would appear that Quitline callers, regardless of smoking status, might serve the ALA of the Upper Midwest as a referral group to increase Quitline participation.

SIRS 2007 Quitline Evaluation American Lung Association of the Upper Midwest 23 Slides of this presentation are available on the AAHPERD Convention website. For more info contact Prof. Tom ORourke at illinois.edu