Role of the National Network of Quitlines in the Cessation Services Delivery System Linda A. Bailey Innovations in Building Consumer Demand for Tobacco Cessation Products and Services Roundtable Meeting 1 December 7-8, 2005 Washington, DC

Bottom Line Optimal quitlines (barrier-free, well- promoted, counseling & meds) can reach 16% of all smokers every year and can achieve 20% quit rates Quitlines are PART of a comprehensive tobacco cessation delivery system and have been proven effective Critical Factors are funding AND quality of/access to services

Product & Services Services vary from state to state, but may include: Proactive and reactive cessation counseling Mailed information or self-help resources Recorded messages and messages Web-based information and web-based interactive counseling Group cessation programs Provision of quit smoking medication at low or no cost Fax referral and/or outreach to health care providers Referral to other services (quit smoking group programs, professional services) Training for health professionals and others

Product & Services Capacity: 46 state-managed quitlines and 5 states covered by feds/nat’l organizations Strengths: Integrated system using minimal data set for evaluation and national number Referral & medical outreach programs Customer-friendly Weaknesses: “Best-practices” still being determined Low funded, no reimbursement mechanisms

Populations Current reach: Under 2% of population Strengths: Racial/ethnic pops served in same proportion as state proportions; languages Gender: Males under-represented Age: Mid-adults over-represented; great results in Medicare population NCI award to UCSD to study disparities using minimal data set

Place & Provider Access/venue: National toll-free line & state toll-free lines; translation services Vendors: F&C and ACS = 25 states NCI, Mayo, NJMC, IQH = 16 states 10 other vendors = 10 states Issues: convenience (ph & extended hrs), limited $$ = limited services or reach (eligibility)

Price Cost to Consumer: FREE (eligibility criteria) Quitline Budgets (FY 03): $500K median, with a range from $150K to $3.8M National Action Plan: Proposed $3.2B, with $1.1B for meds and $2.1B for quitline counseling and operations

Promotion * Promotion DRIVES call volume * Est. $1:$1 for operations and promotion * Consider: media, referral networks, free meds (and other incentives) * Lessons learned from ABC * Related projects: NAQC task force, Canadian knowledge synthesis, Global Dialogue

Policy Quitline budget limitations impact reach, intensity of services, and promotion of services (need policy action for sustainable budgets) Opportunity to link cessation tx (including quitlines) with policy interventions (smoke-free, tax)

Key Opportunities for Innovation Set goal of 16% reach and 20% quit rates for the nation Involve quitlines as full partners in promotion activities Assure supply = demand (ie, do not create unfunded mandates) Promote to smokers, policymakers & professionals Consider “incentives”