title: Association Between Utilization of Quitline Services and Probability of Tobacco Abstinence in Low-Income Smokers.
abstract: Quitlines (QL) are an effective means for smoking cessation, but a paucity of data exist examining the dose-response relationship between use of QL services and quit rates, especially among low-income smokers. The purpose of this study was to study the relationship between tobacco abstinence and use of QL services among low-income smokers.
  
  
  
  Secondary analysis of a randomized trial of every- or some-day smokers aged 18 years or older visiting an urban emergency department. Inclusion criteria included self-pay or Medicaid insurance, as a proxy for low-income and low socioeconomic status. Intervention participants received a motivational interview, 6 weeks of nicotine patches and gum, a referral faxed to the state-sponsored QL, a booster call, and a quitline brochure. Control participants received the brochure. Smoking status was assessed by phone at 1 and 3 months, with confirmation via exhaled carbon monoxide testing at 3 months for those reporting abstinence. QL usage was obtained by utilization data from the QL database.
  
  
  
  Of 778 subjects, 197 (25.3%) reported any use of QL services at 3 months. Participants were trichotomized: no QL usage, 1 call only, and >1 call (583, 99, and 98 participants, respectively). Quit rates at 3 months in these no, low-, and high-use groups were, respectively, 7.2%, 9.1%, and 15.3% (P=0.03). Participants who used the QL had a median of 28 total minutes of telephone contact.
  
  
  
  Among low-income smokers, greater use of QL services is associated with higher abstinence. Whether this resulted from a direct effect of the QL, or greater motivation among smokers using QL services cannot be determined from these data.
authors: Department of Emergency Medicine, New Haven, CT, United States; Yale Comprehensive Cancer Center, New Haven, CT, United States; Yale School of Medicine, New Haven, CT, United States. Electronic address: Steven.bernstein@yale.edu.
authors: Steven L
authors: SL
authors: Bernstein
authors: Department of Emergency Medicine, New Haven, CT, United States; Yale School of Medicine, New Haven, CT, United States.
authors: June-Marie
authors: JM
authors: Weiss
authors: Department of Psychiatry, New Haven, CT, United States; Yale Comprehensive Cancer Center, New Haven, CT, United States; Yale School of Medicine, New Haven, CT, United States; Medical University of South Carolina, Seattle, WA, United States; Hollings Cancer Center, Seattle, WA, United States.
authors: Benjamin
authors: B
authors: Toll
authors: Alere Wellbeing, Inc., Seattle, WA, United States.
authors: Susan M
authors: SM
authors: Zbikowski
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D015277:Hotlines / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011203:Poverty; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*
keywords: Quitlines; Smoking cessation; Tobacco abstinence