Abstract

IntroductionMost smoking cessation programs lack strategies to reach relapsed participants and encourage a new quit attempt. We used a multimodal intervention to encourage past quitline registry participants to recycle into services.MethodsWe invited 3,510 past quitline participants back to quitline services, using messages consecutively delivered through Interactive Voice Response (IVR), followed by postcard and email reminders, 2 Short Messaging Services (SMS) texts, and a final cycle of IVR. The primary study outcome was recycling into a new quitline-assisted quit attempt. We used statistical analyses to assess rates and predictors of recycling (socioeconomic, health- and tobacco-related variables) with study participants and compared the study sample with registry participants not selected for the study (comparison group).ResultsQuitline services were re-initiated by 12.2% of the intervention sample and 1.9% of the comparison group (z = 6.03, P < .001, effect size of 0.44). Most re-enrollments were done via direct IVR-transfer to the quitline. Predictors of re-enrollment were age (odds ratio [OR] = 1.45 for every 10 years of age; 95% confidence interval [CI], 1.34–1.57), number of years smoking (OR = 1.27; 95% CI, 1.18–1.36), and reporting cancer (OR = 2.32; 95% CI, 1.47–3.68) or chronic obstructive pulmonary disease (OR = 1.55; 95% CI, 1.16–2.10). Living with other smokers was correlated with a lower chance of recycling into treatment (OR = 0.72; 95% CI, 0.57–0.91).ConclusionRecycling previous quitline participants using a proactive, IVR-based intervention is effective in reinitiating quitline-assisted quit attempts. Older, long-term smokers reporting chronic conditions are more likely than younger smokers to re-engage in quitline support when these methods are used.

Highlights

  • Most smoking cessation programs lack strategies to reach relapsed participants and encourage a new quit attempt

  • Quitline services were re-initiated by 12.2% of the intervention sample and 1.9% of the comparison group (z = 6.03, P < .001, effect size of 0.44)

  • Most re-enrollments were done via direct IVRtransfer to the quitline

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Summary

Introduction

Most smoking cessation programs lack strategies to reach relapsed participants and encourage a new quit attempt. Relapsed smokers are interested in treatment but generally do not seek it proactively [2,3,4,5,6]. Most smoking cessation programs lack strategies to encourage relapsed smokers to make another quit attempt (“recycle”). Research suggests that relapsed smokers experience decreased self-efficacy and feelings of disappointment and guilt that may hinder them from proactively seeking treatment [2]. They may have limited knowledge about treatment and health coverage for repeated quit attempts [4]. Effective interventions are needed to reconnect relapsed smokers with cessation support

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