Phone Counseling Helps Smokers Quit
A free state-sponsored program in Maine that offers telephone counseling and access to nicotine patches or gum resulted in 15 percent of participants remaining smoke-free six months after enrolling, according to a new study.
"Services must be consistent with smokers' preferences," says Susan H. Swartz, M.D., of the Maine Medical Center and lead study author. "We know from experience that a number of smokers would like to use medications to help them quit, so access plays a big role.".
The scientists studied 12,479 adult smokers who used the service from 2003 to 2004. Of these smokers 1,864 had quit at six months after enrolling, according to the study reported in the November issue of the American Journal of Preventive Medicine. The smokers who called to avail themselves of the service represent 3 percent of Maine smokers.
The treatment has been available in Maine since 2001. Health professionals counsel callers to increase confidence with quitting, teach problem-solving and coping skills and educate callers on the side effects of nicotine-replacement therapy. Nicotine patches or gum are prescribed based on the smoker's health status, tobacco use history and patient preferences. Participants receive three follow-up calls and are provided with a new quit plan if they relapse.
Older smokers, those on Medicaid and people without insurance used the program at a higher rate than other smokers. Participants who used both nicotine-replacement therapy and phone counseling had the highest quit rates; however, only uninsured patients and those on Medicaid - which encompassed 73.8 percent of the participants - received NRT at no cost. The cost of the program was estimated at $1,344 per smoker.
"State programs should not be the default for paying for medication to help smokers quit," Swartz says. "Insurers and purchasers must step up to the plate and pay for effective treatments. I believe there is marked synergy generated by having real funding for real program components - media, direct services such as the quit line and medications, training and education of providers and community-based efforts.".
C. Tracy Orleans, Ph.D., senior program officer with the Robert Wood Johnson Foundation says, "All but four states have their own state-managed quit lines. One year ago there were 12 states without such programs, so we've come quite a way in just a year." Orleans said funding and support from Department of Health and Human Services, along with the work of state health officials, has expedited the expansion of state smoking cessation programs.
"Quit line use appears to depend on a number of factors, including counseling capacity, medication availability, and promotional efforts," the authors conclude. "At this time, there is little evidence that quit lines have yet maximized their overall impact.".