Using Diverse Communication Strategies to Re-Engage Relapsed Tobacco Quitline Users in Treatment, New York State, 2014.

INTRODUCTION: Most smoking cessation programs lack strategies to reach relapsed participants and encourage a new quit attempt. We used a multimodal intervention to encourage past quitline registry participants to recycle into services. METHODS: We invited 3,510 past quitline participants back to quitline services, using messages consecutively delivered through Interactive Voice Response (IVR), followed by postcard and email reminders, 2 Short Messaging Services (SMS) texts, and a final cycle of IVR. The primary study outcome was recycling into a new quitline-assisted quit attempt. We used statistical analyses to assess rates and predictors of recycling (socioeconomic, health- and tobacco-related variables) with study participants and compared the study sample with registry participants not selected for the study (comparison group). RESULTS: Quitline services were re-initiated by 12.2% of the intervention sample and 1.9% of the comparison group (z = 6.03, P < .001, effect size of 0.44). Most re-enrollments were done via direct IVR-transfer to the quitline. Predictors of re-enrollment were age (odds ratio [OR] = 1.45 for every 10 years of age; 95% confidence interval [CI], 1.34-1.57), number of years smoking (OR = 1.27; 95% CI, 1.18-1.36), and reporting cancer (OR = 2.32; 95% CI, 1.47-3.68) or chronic obstructive pulmonary disease (OR = 1.55; 95% CI, 1.16-2.10). Living with other smokers was correlated with a lower chance of recycling into treatment (OR = 0.72; 95% CI, 0.57-0.91). CONCLUSION: Recycling previous quitline participants using a proactive, IVR-based intervention is effective in reinitiating quitline-assisted quit attempts. Older, long-term smokers reporting chronic conditions are more likely than younger smokers to re-engage in quitline support when these methods are used.

A randomized trial for hazardous drinking and smoking cessation for callers to a quitline.

OBJECTIVE: This study evaluated whether tobacco quitline telephone coaches can be trained to counsel hazardous-drinking smokers to improve smoking cessation success and to limit or abstain from alcohol use. METHOD: Smokers (N = 1,948) who called the New York State Smokers' Quitline and reported hazardous drinking (exceeding sex-specific weekly limits [14 drinks for men, 7 drinks for women] or meeting/exceeding daily drinking limits [5 drinks for men, 4 drinks for women] at least once in the past year) were randomized to receive either brief motivational counseling to limit or abstain from alcohol plus an alcohol reduction booklet added to standard care (Alcohol + Tobacco Counseling; ATC), or only smoking cessation counseling plus a smoking cessation booklet added to standard care (Tobacco-Only Counseling; TOC). RESULTS: Acceptable coach adherence was achieved. The intention-to-treat (ITT) analysis showed that ATC was associated with a significantly higher rate of smoking abstinence at 7-month follow-up (13.5%) compared with TOC (10.3%; p = .03). The respondent analysis (ATC= 26.2%; TOC = 20.4%) paralleled the ITT findings. When controlling for treatment condition, participants who did not report any heavy drinking were significantly more likely to quit smoking than those who reported any heavy drinking (OR = 1.87, 95% CI [1.29, 2.71]; p = .001). CONCLUSIONS: A brief alcohol intervention plus standard care via a telephone quitline resulted in significantly higher smoking cessation rates for hazardous-drinking callers. Given that quitline coaches were trained to provide the intervention with acceptable adherence, the potential to extend this intervention for wide-scale implementation and impact is promising.

A self-administered Timeline Followback to measure variations in underage drinkers' alcohol intake and binge drinking.

Underage drinkers typically have not developed regular patterns of drinking and so are likely to exhibit situational variation in alcohol intake, including binge drinking. Information about such variation is not well captured by quantity/frequency (QF) measures, which require that drinkers blend information over time to derive a representative estimate of "typical" drinking. The Timeline Followback (TLFB) method is designed to retrospectively capture situational variations in drinking during a specific period of time. We compared our newly-developed Self-administered TLFB (STLFB) measure to a QF measure for reporting alcohol intake. Our sample of 429 (men=204; women=225) underage (i.e., age 18-20 years) drinkers completed the two drinking measures and reported on alcohol problems. The STLFB and QF measures converged in assessing typical daily intake, but the STLFB provided more information about situational variations in alcohol use and better identification of regular versus intermittent binge drinkers. Regular binge drinkers reported more alcohol problems. The STLFB is an easy-to-administer measure of variations in alcohol intake, which can be useful for understanding drinking behavior.