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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
