title: Efficacy of a Tobacco Quitline in Active Duty Military and TRICARE Beneficiaries: A Randomized Trial.
abstract: A higher proportion of military personnel than civilians smoke cigarettes. Few randomized trials of tobacco use interventions have been conducted in the U.S. military. We evaluated the efficacy of a tobacco quitline (QL) in 1298 active duty military personnel, their dependents, reservists, and retirees who smoke cigarettes. Participants were randomized to either a proactive (counselor-initiated) or reactive (participant-initiated) QL intervention for 8 weeks. The proactive condition included up to an 8-week supply of free nicotine replacement therapy, and the reactive condition included a 2-week supply. The primary outcome was 12-month smoking abstinence. The enrolled population was predominantly affiliated with the Air Force and Army. At the end of treatment, proactive treatment was associated with a greater odds of both prolonged (44.22% vs. 24.96%; odds ratio [OR] = 2.4, P < 0.0001) and 7-day point prevalence (49.92% vs. 28.20%; OR = 2.5, P < 0.0001) smoking abstinence, a difference that was maintained for prolonged smoking abstinence at 12 months (22.03% vs. 13.41%; OR = 1.8, P < 0.0001). Our findings provide evidence that a proactive QL with nicotine replacement therapy is highly efficacious among Air Force and Army active duty and TRICARE beneficiaries and would provide an effective telephonic treatment option for this population of smokers.
authors.affiliation: Department of Preventive Medicine & Center For Population Sciences, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Klesges
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
authors.forename: Jon O
authors.initials: JO
authors.lastname: Ebbert
authors.affiliation: Department of Preventive Medicine & Center For Population Sciences, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163.
authors.forename: G Wayne
authors.initials: GW
authors.lastname: Talcott
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163.
authors.forename: Fridtjof
authors.initials: F
authors.lastname: Thomas
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163.
authors.forename: Phyllis A
authors.initials: PA
authors.lastname: Richey
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163.
authors.forename: Catherine
authors.initials: C
authors.lastname: Womack
authors.affiliation: Joint Base San Antonio-Lackland, 2200 Bergquist Drive Suite 1, San Antonio, TX 78236.
authors.forename: Ann
authors.initials: A
authors.lastname: Hryshko-Mullen
authors.affiliation: Air Force Medical Support Agency, 7700 Arlington Boulevard Suite 5158, Falls Church, VA 22042.
authors.forename: John
authors.initials: J
authors.lastname: Oh
mesh_terms: D003376:Counseling / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D008889:Military Personnel; D012189:Retrospective Studies; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology