Quit Rates of New York State Smokers Sara M. Abrams, MPH Data Manager NYS Smokers Quitline Sara.Abrams@roswellpark.org September 6, 20
Presentation Outline Basic Quitline Service How Quit Rates are defined Evaluation Survey Methodology 3-Month and 12-Month Quit Rates Overall and Intent-to-Treat Medicaid/uninsured vs. Privately insured NRT vs. Counseling only Fax-to-Quit vs. Called Quitline - underway Application of Quit Rates to NYS Smokers
NYS Smokers Quitline: Basic Services Telephonic support & written materials Smoking seeking quitting assistance complete intake interview Provider referral services (Fax-to-Quit) Free NRT to eligible clients (patch, gum or lozenge) NRT Follow-up call approximately 2 weeks from initial call Enhanced services for Uninsured/Medicaid clients Up to 4 counseling calls At first Proactive call, eligibility for additional NRT is assessed (eligible for up to 6 weeks total)
Quit Rates: How is Quitting Measured? Percent of smokers who have stopped smoking during a given time period Seven-day non-smoker prevalence Assessed by asking Have you smoked a cigarette, even a puff, in the last seven days? Quitters defined as those who have not smoked even a puff in the seven days. 6-month continuous abstinence Quitters are defined as those who have been off cigarettes continuously for at least 6 months.
Quitline Evaluation: 3-Month and 12-Month Surveys Randomly select 24 clients for 3-month Evaluation Survey per week: 16 Privately Insured clients 8 Medicaid or uninsured clients Survey questions used to assess quitting at 3 months: Do you now smoke everyday, some days or not at all? Have you smoked a cigarette, even a puff, in the past 7 days? Clients who complete 3-Month survey are re-contacted in 9 months to participate in 12-month survey As of August 31, 20: 1,233 3-month surveys completed (70% response rate) 75% response rate among Privately insured clients 54% response rate among Medicaid/uninsured clients 382 12-month surveys completed (69% response rate)
3-Month Quit Rates: Seven-Day Non-Smoker Prevalence Overall Quit Rate: 34.0% Of the 1,233 clients who completed the survey, 419 reported successful quitting. Intent to Treat Analysis: 23.1% Assumes that clients who did not complete the survey did not quit. More conservative estimate of quit rates. Of the 1,816 clients who were randomly selected to complete the 3-month evaluation, 419 quit.
3-Month Quit Rates: Seven-Day Non-Smoker Prevalence Privately Insured Clients (non-proactive): N = 9 (73.5% of completed surveys) Smokers who received counseling, but did NOT get NRT : 17.9% Smokers who were sent NRT : 33.2% Smokers who received starter kit of NRT and completed the NRT Follow-up Interview: 37.2% Proactive Clients (Medicaid/uninsured): N = 327 (26.5% of completed surveys) Smokers who completed at least 2 callbacks: 44.4% Smokers who were sent additional NRT and completed at least 2 callbacks: 50.0%
12-Month Quit Rates Preliminary Data Seven-day Non-smoker Prevalence Same measure used for 3-Month quit rates Overall Quit Rate: 33.5% Intent to Treat Analysis: 21.8% 6-Month Continuous Abstinence Standard measure used for 12-month quit rates Overall Quit Rate: 22.0% Intent to Treat Analysis: 14.3%
12-Month Quit Rates: 6-month Continuous Abstinence Privately insured clients (non-proactive): N = 295 (77.2% of completed surveys) Smokers who received counseling, but did NOT get NRT : 23.7% Smokers who were sent NRT : 23.7% Smokers who received started kit of NRT and completed the NRT Follow-up Interview: 25.3% Proactive Clients (Medicaid/uninsured): N = 87 (22.8% of completed surveys) Smokers who completed at least 2 callbacks: 8.9% Smokers who were sent additional NRT and completed at least 2 callbacks: 20.5%
Fax-to-Quit # of Referrals: Dec. 2004 August 20 800 755 700 644 668 627 702 600 500 460 5 450 426 414 421 461 530 591 400 300 200 173 231 196 286 339 302 367 100 0 Dec- 04 Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug-
Application of Quit Rates to NYS Smokers Randomized design of ongoing 3-month and 12-month evaluations allows for application of quit rates to all Quitline clients. Use quit rates specific to population served Strategies for the future: Improve reach to Medicaid/uninsured population Continue to work with health plans to promote Quitline services to members and providers