title: Real-world impact of quitline interventions for provider-referred smokers.
abstract: BACKGROUND
  The healthcare provider-referral quitline model has potential to help identify and connect more smokers to effective cessation services as compared to the self-referral model alone. However, research is limited as to whether provider-referred smokers, who may have more barriers to quitting, can have similar rates of quit success using traditional quitline interventions as self-referred smokers.
  
  
  OBJECTIVE
  To (1) determine how provider-referred smokers may differ from self-referred smokers in their demographics, service utilization, and quit rates and (2) quantify the impact of traditional quitline services on provider-referred smokers' ability to quit.
  
  
  METHODS
  Data were collected for 2,737 provider-referred and 530 self-referred Massachusetts quitline clients between November 2007 and February 2012. Analysis was performed in 2012. Wald chi-square tests and two-sample t-tests were used to identify differences between the two referral populations. A multivariable logistic regression model was used for each referral population, and smoker quit status at follow-up was the primary outcome. Tests and models were weighted using inverse probability of treatment weights propensity score weighting method.
  
  
  RESULTS
  Compared with self-referred smokers, provider-referred smokers were more likely to be non-white, less educated, and have public insurance. They were less ready to quit and had lower service utilization and quit rates. In both referral populations, clients who used services had greater odds of quitting than those who did not.
  
  
  CONCLUSIONS
  Expanding the provider-referral model may require quitlines to address the various risk factors associated with this population. Providers serve critical roles in preparing patients for quitline participation prior to referral.
authors.affiliation: Tobacco Cessation and Prevention Program, Boston, Massachusetts. Electronic address: glory.song@state.ma.us.
authors.forename: Glory
authors.initials: G
authors.lastname: Song
authors.affiliation: Tobacco Cessation and Prevention Program, Boston, Massachusetts.
authors.forename: Anna S
authors.initials: AS
authors.lastname: Landau
authors.affiliation: Tobacco Cessation and Prevention Program, Boston, Massachusetts.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Gorin
authors.affiliation: Massachusetts Department of Public Health, Boston, Massachusetts.
authors.forename: Lois
authors.initials: L
authors.lastname: Keithly
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015277:Hotlines; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D055815:Young Adult