title: Barriers to Telephone Quitline Use Among Methadone-Maintained Smokers.
abstract: BACKGROUND
  Drug users have high rates of tobacco use and tobacco-related disease. Telephone quitlines promote smoking cessation, but their reach among drug users is unknown. We thus aimed to assess utilization of and barriers to telephone quitlines among methadone-maintained smokers.
  
  
  METHODS
  Subjects were opioid-dependent smokers in Bronx, New York, methadone treatment programs who were enrolled in a clinical trial of varenicline. All subjects were offered referral to a free, proactive quitline. We examined quitline records, surveyed barriers to quitline use, and queried reasons for declining referral.
  
  
  RESULTS
  Of the 112 subjects enrolled, 47% were male, 54% were Hispanic, and 28% were Black. All subjects were offered referral, and 25 (22% of study participants) utilized the quitline. Quitline utilizers (vs. nonutilizers) were significantly more likely to have landline phone service (72 vs. 42%, p = .01), interest in quitline participation (92 vs. 62%, p < .01), and willingness to receive calls (96 vs. 76%, p = .02). Nonutilizers were significantly more likely to report cell phone service lapse (38 vs. 14%, p = .04), and difficulty charging cell phones (19 vs. 0%, p = .02). Reasons for quitline refusal included: (a) skepticism of quitline efficacy; (b) aversion to telephone communication; (c) competing life demands (e.g., drug treatment, shelter); and (d) problems with cell phone service or minutes.
  
  
  CONCLUSIONS
  Despite several limitations to quitline access among methadone-maintained smokers, routine quitline referral was associated with 22% utilization. To expand provision of smoking cessation treatment to opioid-dependent smokers, interventions to promote routine quitline referral in substance abuse treatment programs warrant investigation.
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY;
authors.forename: Judith L
authors.initials: JL
authors.lastname: Griffin
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY;
authors.forename: Kate S
authors.initials: KS
authors.lastname: Segal
authors.affiliation: Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY snahvi@montefiore.org.
authors.forename: Shadi
authors.initials: S
authors.lastname: Nahvi
mesh_terms: D000328:Adult; D040421:Cell Phone / Q000191:economics; D005260:Female; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000191:economics / Q000379:methods*; D012907:Smoking / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000191:economics / Q000453:epidemiology / Q000628:therapy
chemical_list: D008691:Methadone