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NYS Smokers’ QuitlineNYS Smokers’ Quitline Maximizing Quitline ReachMaximizing Quitline Reach
Ann Wendland, MSLAnn Wendland, MSLNYSDOH Tobacco Control Program NYSDOH Tobacco Control Program
NYSSQL & NRT Programs ManagerNYSSQL & NRT Programs [email protected]@health.state.ny.us
Paula CelestinoPaula CelestinoRoswell Park Cancer InstituteRoswell Park Cancer Institute
NYSSQL Project DirectorNYSSQL Project [email protected]@roswellpark.org
New York State New York State Tobacco ControlTobacco Control ProgramProgram
Goal: Reduce adult smoking prevalence to 12% Goal: Reduce adult smoking prevalence to 12% Current 2008: Adult smoking prevalence: 16.7% Current 2008: Adult smoking prevalence: 16.7%
Currently 2.5 million smokers in NYS
= 1 million fewer = 1 million fewer smokers in New Yorkerssmokers in New Yorkers
NY TCP 3 Key Programmatic StrategiesNYS Quitline functions one component of the broader NYS TCPNYS Quitline functions one component of the broader NYS TCP
Statewide and Community
action
Public Health communication
Cessation
interventions
Statewide and Community Action…to change the community environment to support a tobacco-free norm, change community attitudes about tobacco, and de-normalize tobacco use
Taxes Clean Indoor & Outdoor polices/laws Smoke-Free Dwellings Reduce Tobacco Access Reduce or Remove Retail Tobacco Advertising
Public Health Communication –to motivate tobacco users to stop, promote smoke-free homes, expose tobacco industry propaganda, deglamorize tobacco use, and educate community members and decision makers about tobacco control
NYTCP Strategies Using Media
Paid advertising on television, radio, print, Internet, and other venues to
educate New Yorkers about the health risks of tobacco use and the dangers of secondhand smoke (SHS)
motivate smokers to quit; and promote adoption of smoke-free homes and environments
Public relations and media advocacy (e.g., press releases, communications with decision makers) to
increase coverage and discussion of tobacco control issues and events in the news media; and
supplement paid advertising
Percentage of Adult Smokers Who Made at Least One Quit Attempt During the Past 12 Months by
Recall of NY TCP Ads, ATS 2003–2008
62.2%58.5%
51.0%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Did not recall any NYTCPads
Confirmed recall of anyNYTCP ad
Confirmed recall of Cessationads
Health Systems Change Referral Networks Quitline NRT Distribution Program FQHC initiative
Cessation Interventionsto establish and maintain systems changes that promote cessation, increase access to and delivery of evidence based cessation services, and motivate individual tobacco users to quit successfully
Health Care Organization and Provider Awareness of Cessation Resources in New York State
Health Care Organization and Provider Study (HCOPS) 2004–2005 and 2007
46.9%
61.0%
79.7%
53.4%
72.9% 71.7%
95.5%
87.1%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Cessation Centers Medicaid benefit Quitline NRT starter kit
Organizational awareness Provider awareness2005 2007
Influences on Quit Attempts in the Past 12 Months (Odds Ratios), ATS
……NYSSQL Service Goal…NYSSQL Service Goal…
Extend NYS’ Extend NYS’ population health model to the population health model to the Quitline and function within its comprehensive Quitline and function within its comprehensive
TCP approach to advance the goal of TCP approach to advance the goal of reducing adult smoking prevalence.reducing adult smoking prevalence.
2 Key Ingredients to reduce prevalence 2 Key Ingredients to reduce prevalence
Reach X Efficacy = ImpactReach X Efficacy = Impact
PopulationPopulation + evidence-based service + evidence-based service
= = ImpactImpact
2010 Goal: 2010 Goal: Reduce adult smoking prevalence to 12% Reduce adult smoking prevalence to 12%
Ready to Quit within 30 days:
Quit coaching in English or Spanish (other languages available through translators) plus free quit materials
Two week starter kit of Nicotine Replacement Therapy (NRT), choice of patch gum or lozenge
NRT check callback- verify delivery One scheduled coaching callback
Already Quit:
Relapse prevention coaching and support materials
Not Ready to Quit within 30 days:
Brief ‘5 R's’ coaching and support materials
Web-based services: NRT application Web-based community support Tailored programming (winter 2009)
Services
NYS Strategies to Increase Quitline Reach
Link policy change media (earned & paid) with Quitline
Run Hard Hitting Paid Media tagged with Quitline/Quitsite• TV • Radio• Print• Internet• Collateral Media Outlets
Free 2 week NRT starter kit
Build Referral Networks
Quitline Infrastructure & efficiency
Media
NYS Annual media campaigns since 2004 NYC Annual media campaigns since
2003 Concurrently run ads in multi-media
venues (TV, Print, radio, internet) Strategically placed (type of ads and
timing of ads)
Media Campaigns & Tax Increases& Call Volume
Annual Call Volume: June 2007- M ay 2008
01,0002,0003,0004,0005,0006,0007,0008,0009,00010,00011,00012,00013,00014,00015,000
NYSDO H Re ady to Q uit Sm oking
J uly 16 - Sept 17, 2007
Gangre ne /Didn 't Liste nNYSDO H
Nov 12 - Dec 16, 2007
Se condhand Sm oke C am paign
Sept 17 - Nov 1, 2007
Q uitting Isn 't EasyNYSDO H
J an 21 - M ar 8, 2008
NYC Patch & Gum Give away
A pril 16 - M ay 9, 2008
NRT Offer
Offer of free NRT drives calls/web applications
Promote offer through Ads Earned media Direct mail Email notices NYS TC Partners Network
NYC NRT offer announcement April 2003
NYC Patch Program, April 2nd - May 14th, 2003Total Number of people from NYC who dialed the Quitline Number
41,1
8223
6,84
099
,558
5,87
796
93,
010
1,52
61,
258
1,32
699
138
925
174
984
487
580
15,
374
1,26
967
42,
034
1,02
599
385
679
939
130
187
481
070
566
159
51,
984
287
894
862
636
611
2,34
21,
238
428
1,36
891
061
3
0
50,000
100,000
150,000
200,000
250,000
Ap
r-2
Ap
r-4
Ap
r-6
Ap
r-8
Ap
r-1
0
Ap
r-1
2
Ap
r-1
4
Ap
r-1
6
Ap
r-1
8
Ap
r-2
0
Ap
r-2
2
Ap
r-2
4
Ap
r-2
6
Ap
r-2
8
Ap
r-3
0
Ma
y-2
Ma
y-4
Ma
y-6
Ma
y-8
Ma
y-1
0
Ma
y-1
2
Ma
y-1
4
Online NRT Since July 2006Online NRT Since July 2006
0
2000
4000
6000
8000
10000
12000
14000
16000
18000Ju
l-06
Au
g-0
6
Sep
-06
Oct
-06
No
v-06
Dec
-06
Jan
-07
Feb
-07
Mar
-07
Ap
r-07
May
-07
Jun
-07
Jul-
07
Au
g-0
7
Sep
-07
Oct
-07
No
v-07
Dec
-07
Jan
-08
Feb
-08
Mar
-08
Ap
r-08
May
-08
Jun
-08
Jul-
08
Au
g-0
8
Sep
-08
Oct
-08
No
v-08
Dec
-08
Jan
-09
Feb
-09
Web Phone
Added Enhancement to NYSSQL NRT Services Added Enhancement to NYSSQL NRT Services via Online Registration: Jan. 1, 2008 - Currentvia Online Registration: Jan. 1, 2008 - Current
12
:00
AM
1:0
0 A
M
2:0
0 A
M
3:0
0 A
M
4:0
0 A
M
5:0
0 A
M
6:0
0 A
M
7:0
0 A
M
8:0
0 A
M
9:0
0 A
M
10
:00
AM
11
:00
AM
12
:00
PM
1:0
0 P
M
2:0
0 P
M
3:0
0 P
M
4:0
0 P
M
5:0
0 P
M
6:0
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M
7:0
0 P
M
8:0
0 P
M
9:0
0 P
M
10
:00
PM
11
:00
PM
NRT via Online Registration
NRT via Phone Interviews
100% increase in Enhancement of Services
38%47%
46%
43%
54%
73%
69%
82%
39%
Average Daily NRTRegistrations per Hour
Referral Networks
19 Regional Cessation Centers 28 Community Partnerships Statewide umbrella groups Health Plans Health Care Providers Local Health Departments
0
100
200
300
400
500
600
700
800
Jan-08 Mar-08 May-08 Jul-08 Sep-08 Nov-08 Jan-09 Mar-09 May-09 Jul-09 Sep-09
NYSSQL Fax-to-Quit ReferralsJan 2008 –Sept 2009
No. of Referrals
How & Why these strategies helped maximize reach
Comprehensive approach addresses social norms,attitudes and beliefs, promotes education and awarenessand offers assistance.
Consequently smoking-related behaviors in NYhave changed over time:
Increase in smoke-free homes and cars Increase in use of Quitline Increase in number of individuals trying to quit
Significantly higher than national average Average number cigarettes smoked per day decreased
Percentage of Adult Smokers WhoHave Heard of the New York State Smokers’
Quitline, Adult Tobacco Survey (ATS) 2003–2008
0
10,000
20,000
30,000
40,000
50,000
Jan-00 Jan-01 Jan-02 Jan-03 Jan-04 Jan-05 Jan-06 Jan-07 Jan-08
NYC Free NRT
Growth since 2004 Call volume up 94%
NRT shipments up 277% Hits to website up 550% (since 2006)
NYS starts free NRT
Mass media campaigns
Lessons Learned
Focus–group tested ads Loss framed ads result in larger call spikes Secondhand smoke ads can sustainably drive
calls when content triggers loss emotions Loading ads on Mon, Tues & Wed Awareness of phone & web-based offer of NRT Sustainability & reliability drives returning clients
and word of mouth referrals
Notable Challenges to date
Approval Process for Campaigns Controversial ads Balancing push & pull ads and ad
saturation Balancing call volume with Quitline
capacity NRT supply
Moving forward
Continuing evaluations of reach, ads/program impact (RTI)
Implementation of media messages and online cessation study
Continue to build cost-efficient Quitline/Quitsite services to expand capacity
If a state wants to increase their reach, what is your best advice?
Comprehensive tobacco programming High sensation value ads Build referral networks Offer NRT Quitline as a population health model Balance degree of service in order to
maximize reach and build capacity Sustainability
Contact Information
Paula CelestinoPaula [email protected] [email protected]
(716) 845-8817 (716) 845-8817
Ann Wendland, MSLAnn Wendland, [email protected]@health.state.ny.us
(585) 423-8151 (585) 423-8151
New York State Smokers' Quitline New York State Smokers' Quitline Roswell Park Cancer Institute Roswell Park Cancer Institute Elm & Carlton Sts.Elm & Carlton Sts.Buffalo, NY 14263Buffalo, NY 14263Fax: 716-845-4135Fax: 716-845-4135
