The Impact of a Regional Smoking Cessation Program on Referrals and Use of Quitline Services in Queensland, Australia: A Controlled Interrupted Time Series Analysis

Abstract

Background: Prevalence of smoking in Central Queensland (CQ), Australia was higher than state and national averages. A regional smoking cessation initiative (“10,000 Lives”) was launched to promote available interventions (e.g. Quitline). We investigated the impact of “10,000 Lives” on referral to and use of Quitline services. Methods: We conducted interrupted time series analysis using a segmented Poisson regression model to measure the impact of “10,000 Lives” on monthly referrals to and use of Quitline services (program participation, Quitline calls and nicotine replacement therapies dispatched by Quitline), in CQ compared to other areas in the state (control population). The control population was regional areas in Queensland with a comparable smoking prevalence and similar access to Quitline’s Intensive Quit Support Program. We calculated the level and trend changes of outcomes in CQ relative to control after “10,000 Lives” commenced. The models were checked for autocorrelation and seasonality and adjusted accordingly. Findings: Mean monthly numbers of referral to, participation in, and interaction with Quitline, and NRT gum, lozenge and patch dispatches from Quitline in CQ increased by 277·2%, 154·9% and 242·7% and, 573·9%, 1170·6% and 740·9% respectively after “10,000 Lives” introduction. The result was validated by the controlled interrupted time series analysis which showed 238·5%, 248·6% and 251·6% and, 93·6%, 141·4% and 121.6% relative increase in CQ compared to control for the monthly rates of these outcomes. Interpretation: Our study demonstrates a low-cost health promotion initiative can promote and boost the referral to and use of Quitline smoking cessation services. Funding Statement: The research is funded by the collaborative research grant between School of Public Health at University of Queensland and Central Queensland Public Health Unit which is awarded by the Central Queensland Hospital and Health Service (CQHHS93907). Declaration of Interests: Lead author (AK) is supported by a University of Queensland Research Training Scholarship and a Research Higher Degree Top-up Scholarship; Dr. Gartner reports grants from Central Queensland Hospital and Health Service, during the conduct of the study; Dr. Green reports grants from Central Queensland Hospital and Health Service, during the conduct of the study; Dr. Lawler reports a collaborative research grant between School of Public Health at University of Queensland and Central Queensland Public Health Unit which is awarded by the Central Queensland Hospital and Health Service (CQHHS93907), Australia, for the conduct of the study; r. Khandaker reports grants from Central Queensland Hospital and Health Service, during the conduct of the study. Ethics Approval Statement: The study was approved by the CQHHS Human Research Ethics Committee (HREC) approved (HREC/2019/QCQ/50602) which was subsequently ratified by the HREC of the University of Queensland (Clearance Number: 2019001760).