Maryland Tobacco Quitline 10 th Anniversary: Past, Present, and Future MD Quit 10 th Annual Best Practices Conference January 21, 2016 Dawn Berkowitz, MPH, CHES Director Center for Tobacco Prevention and Control
History of Quitlines First QLs 1992: CA launches first QL after research demonstrates effectiveness Mid-1990s: MA, AZ, OR launch QLs MSA 1998: Exponential increase in QLs was driven by influx of funds from the states Master Settlement Agreement with the tobacco industry National Launch In 2004, former HHS Secretary, Tommy Thompson, launched the national 1 800 QUIT NOW 1 800 QUIT NOW is a national portal and this number is active and promoted across the U.S. 2
Maryland Tobacco Quitline Launch 2006: Launch of the FREE Maryland Tobacco Quitline (phone counseling), multiple languages, and logo 2006: Launched Fax-to-Assist 2007: Passage of Clear Indoor Air Act (CIAA); Baltimore City NRT provision, expanded to State; web program launched 2007: SmokingStopsHere.com website dedicated to the Quitline Expansion 2012: Text messaging launched 2012: Expanded live hours to 24/7 2012: Added customizations behavioral health, youth, diabetes, pregnancy Sustained Growth 2013: ENDS questions added to intake questionnaire 2014: Pregnancy Incentive Program launched 2015: NRT expanded to 12 week combination therapy (patches and/or gum) 2015: Enabled e-referrals 3
Quitline by the Numbers 2006 2015 Over 80,000 registered callers Over 33,000 web participants Over 8,800 text message participants Over 750 pregnant callers Over 120,000 materials sent (pamphlets, etc) Over 53,000 shipments of NRT (patches/gum) Over 1,200 provider calls 4
20000 18000 Quitline Registered Callers 2006-2015 18523 16000 14000 12000 10000 10046 12173 12678 9818 10319 11636 15812 14490 8000 6000 4000 2000 1704 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Total Registered Callers 5
Quitline Demographics (2013-2014) 45% of all participants struggled with a mental health condition and about 70% of them felt that this made it harder for them to quit tobacco. 52% of participants reported having one or more chronic health condition. Female tobacco users were almost twice as likely to use the Quitline. African Americans made up over half of all Quitline callers. 6
Effective Interventions to Increase Utilization Promotion of resources in conjunction with natural cessation opportunities: New Year s resolutions Smoke-free policy implementation Establish partnerships and Quitline referral interventions for LHDs, health care systems, and providers Provide free evidence-based tobacco cessation medications for Quitline clients interested in quitting Outreach to targeted populations Implement mass-reach health communication interventions that combine cessation messages with QL promotion 7
Cessation Opportunity: New Year s Resolutions 8
Took effect 2/1/08 Prohibits smoking in virtually all indoor workplaces, including bars and restaurants Toolkits sent to all licensed retailers Ads promoted Quitline as FREE resource Cessation Opportunity: Clean Indoor Air Act of 2007 9
Cessation Opportunity: Clean Indoor Air Act Call Volume: July 2007 June 2008 Total Calls Per Month - Maryland Tobacco Quitline 1,097 inbound calls in January 2007 compared to 3,831 calls in January 2008 4500 4000 3500 3000 2500 2000 1500 1000 500 0 1158 958 743 2320 1877 945 3831 1607 1533 1226 964 1236 Total Calls July August September October November December January February March April May June 10
Partnerships: Provider Training Help Your Patients Quit and E-referrals 11
2008 2009 2010 2011 2012 2013 2014 2015 Partnerships: Local Health Departments Bi-directional Referrals 1600 1400 1200 1000 800 600 400 200 0 Referrals to Quitline (including LHDs & non-lhds) Additionally, there have been over 15,000 referrals from the Quitline to LHDs. 12
Partnerships: LHDs and OBs Targeting Pregnant Women PATCH initiative to reduce smoking rates among pregnant women, women of child bearing age, and members of their households. Utilized LHDs, Community Partners and Toolkits to OBs. Pregnancy Rewards Program provides up to $90 in gift cards to women pregnant/post-partum who call the QL (four installments). 13
Partnership Results Pregnancy Program Participants/Incentives 210 65 133 Pregnancy Incentives earned 2 2012 2013 2014 2015 10-Call Participants 120 100 80 60 40 20 0 21 111 2014 2015 14
Partnerships: Health Systems Pilot Projects Implementing strategies to institute systems level tobacco dependence treatment policies. Support systematic screening, incorporate electronic health records/referrals, train staff/provide academic detailing, provide ongoing cessation support after discharge. Baltimore City Health Department Johns Hopkins University Mosaic Community Services Prince George's Health Department Sheppard Pratt Health System University of Maryland Baltimore 15
Partnerships: Medicaid Medicaid Match for QL Services Nearly 40% of callers receive Medicaid benefits 50% match (> $700,000 since June 2011) Identified MCO formulary coverage/benefits to provide NRT and prescription medications (ACA requirement) 16
Health Communication Interventions 2007 17
Health Communication Interventions 2008 18
Targeted Campaigns Secondhand Smoke and Kids 2011/12 Secondhand Smoke and Pets 2013 19
Targeted Campaign Youth Cessation Ads 2013 20
Targeted Campaign Outreach to Health Professionals 2013/14 Maryland Nurse Maryland Academy of Family Physicians 21
Targeted Campaign Sports Fans 2014 22
Targeted Populations Behavioral Health Campaign 2014 23
Targeted Populations Smokeless Tobacco and LGBT 2015 (Print / Online / Radio) 24
Testimonial Ads 2015 (Print / Online / TV / Radio) Real Quitline Participants Ads promoted free NRT 25
Health Communication Interventions Digital Marketing 2015 26
Quitline Evaluation Results (2013-2014) 97% of participants would recommend the program to a friend trying to quit. 93% of callers were satisfied with the program. Participants who used patches, gum, or medication were most satisfied. Quit rates (7-month follow-up) 27% of MDQL callers had quit for 30 days or longer; 33% had quit for 7 days or longer. 30% of Web Only users had quit for 30 days or longer; 40% had quit for 7 days or longer. 3 out of every 5 callers smoked less cigarettes at the end of the program than when they enrolled the program works! 27
Testimonials I am really grateful for this program and that you all do. You all are amazing. You help me so much. I ve recommended this service to all my friends. It s been the most success I ve ever had at quitting Thank you for sending me the medicine; it really helped me to quit. 28
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