To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services.
Design:
This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016.
Setting:
The study was conducted at the Arizona Smokers’ Helpline.
Participants:
Enrolled clients completed a 7-month follow-up (N = 18 650).
Measures:
The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months.
Analysis:
Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders.
Results:
Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients.
Conclusion:
Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.
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