Range of Quitline Practice in North America and Europe Sharon Cummins, Ph.D., Shu-Hong Zhu, Ph.D.,...

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Range of Quitline Practice in North America and Europe

Sharon Cummins, Ph.D., Shu-Hong Zhu, Ph.D., Linda Bailey, JD, MHS,

Regina Van der Meer, Ph.D., Sharon Campbell, Ph.D.

World Conference on Tobacco Or HealthWashington, DCJuly 12-15, 2006

Quitlines

• Common goal• Diversity of practice

– Rich source of ideas– Challenge of definition of terms

Quitlines

• Telephone-based programs • Evidence-based counseling,

recommended in Clinical Practice Guidelines

• Efficient—centralized• Convenient• Accessible

Quitline Networks

• North American Quitline Consortium (NAQC) and European Network of Quitlines (ENQ)

• Share better practices• Establish common language• Collaborate on research• Raise the bar on service to lower

smoking and other tobacco use

NAQC 2005 Quitline Survey

• One in a series • Fielded—sent to funders

– U.S. and Canada in October 2005– modified survey to European Network

of Quitlines in April 2006• Good participation

– US—100%– Canada—90%– EU—almost 90%

Median Hours of Operation

96

77

40

8777

40

0

20

40

60

80

100

US Canada EU

ho

urs

per

wee

k

incoming counseling

Types of Telephone-based Services

29

8075

10090

50

0

20

40

60

80

100

US Canada EU

per

cen

t

brief single multiple-reactive multiple-proactive

Eligibility for Counseling

• Restrictions to counseling services– U.S. 61.5% – Canada no restrictions– EU 19.7%

Restrictions to Counselingfor QLs with restrictions

83

64

19 1728

0

20

40

60

80

100

perc

en

t

Counseling

• Multiple session• Longer first session• Follow up calls after quit date• Topics• Timing of follow up calls

Specialized Protocol

US N=52

CanadaN=9

EUN=24

Pregnantwomen

88.5% 88.9% 12.5%

Smokeless tobacco

69.2% - -

Racial/ethnic

50% 11.1% 4.2%

Teens 44.2 11.1% 12.5%

Types of Internet-based Service

0

20

40

60

80

100

US Canada EU

per

cen

t

quit info self-directed quit plan chat room interactive counseling

Free Quit Aids

• In the U.S. 18 quitlines (32.7%) provide free quit aids

– Patch—94.4%– Gum—61.1%– Other—11.1%

Eligibility for Free Quit Aids

• Eligibility criteria– Low income/lack of insurance 61%– Enrollment in counseling program

22.2%– Readiness to quit 16.7%– Addiction level 2%

Multiple Language Service

89 88

37

92 90

53

0

20

40

60

80

100

US Canada EU

pe

rce

nt

materials counseling

Sources of Funding

1522

62

0

20

40

60

80

100

US Canada EU

per

cen

t

State/province Federal local non-government

Quitline Budget for Service

Fiscal year 2004-2005

US N=44

CanadaN=6

EUN=16

currency USdollars

Canadiandollars

euros

range 40,000 to4,169,210

59,920 to512,134

6,580 to3,641,200

median $621,696 $204,893 €59,792

Phone Calls to QL Answered Live

4 54

10

5

8

0

5

10

US Canada EU

tho

usa

nd

s

median mean

Total Tobacco Users Served

0

100

200

tho

usa

nd

s

US Canada EU

Clinical Training

0

20

40

60

80

100

US Canada EU

per

cen

t

classroom role play call shadowing online

Types of Supervision

0

20

40

60

80

100

US Canada EU

per

cen

t

group individual peer taped calls live monitor

Evaluation

US

N=51

%

Canada

N=8

%

EU

N=24

%

Conduct evaluation 68.6 100.0 41.7

Conducted by

QL staff

Outside agency

57.1

51.4

25.0

87.5

80.0

30.0

Evaluation Pool

• Criteria– phone number– Consent– Age– Language

• Timing

Evaluation Pool

• Service– All– Only counseling– Only X number of sessions

• Selection– all callers– convenience sample– random sample –50% of QL who answered

Evaluation

67

100

33

0

20

40

60

80

100

US Canada EU

per

cen

t

outcomes satisfaction staff performance

Acknowledgements

• NAQC Research and Evaluation work group and survey review team

• Quitline administrators and service providers

• NAQC staff and funders• Carrie Koon, M.A. and Victor Wong, Ph.D.

from the UCSD Research Team• NCI grant #5 P30-CA023100-22

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