Telephone-based tobacco-cessation treatment: re-enrollment among diverse groups

Abstract

Background: Telephone quitlines are utilized by diverse individuals and represent an effective tobacco-cessation modality. Quitlines allow tobacco users to seek support for multiple quit attempts. Little is known about how frequently tobacco users take advantage of this opportunity. No studies have been conducted to determine how communication strategies affect quitline re-enrollments. This study aimed to determine the rates of quitline re-enrollment and to compare the responses of people of varying racial/ethnic identities to invitations utilizing different communication strategies.

Design: Four-cell RCT.

Setting/ participants: Random sample of 2400 tobacco users who enrolled into services during 2006, with oversampling of ethnic populations.

Intervention: Between November 2006 and January 2007, participants received either no invitation to re-enroll or were invited to re-enroll into services via a letter, a letter with ethnic-specific content, or a letter and a telephone call.

Main outcome measures: Re-enrollment into quitline services.

Results: Analysis of the 252 days prior to the intervention resulted in a spontaneous re-enrollment rate of 0.54% per 30 days. Recruitment using mailers did not significantly change this rate; the addition of telephone calls increased re-enrollment to 6.93% per 30 days. No significant differences were found among the subpopulations studied. Invalid addresses (16%); invalid telephone numbers (29.1%); and the inability to reach subjects after five call attempts (37.9%) were barriers to recruitment.

Conclusions: For those who have previously called quitlines for help, proactive re-enrollment can be one way to initiate a new quit attempt after relapse. This study has shown that it is feasible to re-enroll former quitline participants, making the test of effectiveness the next logical step.

Figure 1

Flow diagram of subject progress through the study