The Potential Impact of the New York State Smokers' Quitline on Population-Level Smoking Rates in New York.

Nathan Mann,Kevin Davis,James Nonnemaker,Jesse Thompson,Letonya Chapman,Harlan R Juster

doi:10.3390/ijerph16224477

Abstract

Receiving smoking cessation services from telephone quitlines significantly increases quit success compared with no intervention or other quitting methods. To affect population-level smoking, quitlines must provide a sufficient proportion of smokers with effective interventions. Nationally, quitlines reach around 1% of adult smokers annually. From 2011 through 2016, the average annual reach of the New York State Smokers’ Quitline (NYSSQL) was 2.9%. We used data on the reach and cessation outcomes of NYSSQL to estimate its current impact on population-level smoking prevalence and to estimate how much reach would have to increase to achieve population-level smoking prevalence reductions. We estimate NYSSQL is associated with a 0.02 to 0.04 percentage point reduction in smoking prevalence in New York annually. If NYSSQL achieved the recommended annual reach of 8% (CDC Best Practices) and 16% (NAQC), state-level prevalence would decrease by an estimated 0.07–0.12 and 0.13–0.24 percentage points per year, respectively. To achieve those recommended levels of reach, NYSSQL would need to provide services to approximately 3.5 to 6.9 times more smokers annually. Given their reach, quitlines are limited in their ability to affect population-level smoking. Increasing quitline reach may not be feasible and would likely be cost-prohibitive. It may be necessary to re-think the role of quitlines in tobacco control efforts. In New York, the quitline is being integrated into larger efforts to promote cessation through health systems change.

Highlights

All U.S states maintain and operate state telephone tobacco cessation quitlines that offer free tobacco use cessation counseling and mailed self-help materials to tobacco users
We use data from New York to address three unanswered research questions related to the potential population impact of quitlines: (1) what is the current impact of quitlines on population-level smoking prevalence?; (2) what is the potential impact of quitlines on population-level smoking prevalence if the quitline reach increased to recommended levels?; and (3) how much would it cost to increase annual quitline reach to recommended levels? We examine each of these research questions from the perspective of comprehensive state tobacco control programs (TCPs) that implement and largely fund telephone quitlines as one component of a larger system of interventions designed to reduce population-level tobacco use
Because states have limited funding and resources for tobacco control efforts, they must invest their limited resources in programs and interventions that will reach the largest number of tobacco users and have the greatest effectiveness at reducing population-level tobacco use

Summary

Introduction

All U.S states maintain and operate state telephone tobacco cessation quitlines that offer free tobacco use cessation counseling and mailed self-help materials to tobacco users. Some state quitlines offer free nicotine replacement therapy (NRT) and web-based cessation services. Tobacco quitlines have been shown to effectively increase tobacco use cessation and are a recommended component of comprehensive state tobacco control programs (TCPs) [1,2,3,4,5]. Quitline counseling significantly increases quit success compared with minimal intervention, self-help, or no counseling [5]. For tobacco quitlines to have a meaningful impact on tobacco use at the population level, they must be able to provide effective interventions to a sufficient proportion of tobacco users [6].

Objectives

Methods

Results

Discussion

Conclusion