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Predictors of client retention in a state-based tobacco quitline

Published online by Cambridge University Press:  09 March 2020

Uma S. Nair*
Affiliation:
Department of Family and Community Medicine, College of Medicine, University of Arizona, 655 N. Alvernon Way, Suite 228, TucsonAZ-85711, USA
Brooke Rabe
Affiliation:
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, Tucson, AZ-85724, USA
Benjamin R. Brady
Affiliation:
Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, Tucson, AZ-85724, USA
Melanie L. Bell
Affiliation:
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Drachman Hall, Tucson, AZ-85724, USA
*
Author for correspondence: Uma S. Nair, E-mail: [email protected]

Abstract

Introduction

Quitlines are standard care for smoking cessation; however, retaining clients in services is a problem. Little is known about factors that may predict dropout.

Aims

To examine predictors of retention while in-program and at follow-up for clients enrolling in a state quitline.

Methods

This was a retrospective analysis of quitline enrolled clients from 2011 to 2017 (N = 49,347). Client retention in-program was categorized as (a) low adherence to treatment (receiving zero coaching calls), moderate (1–2 calls), and high adherence (3+ calls). Dropout at follow-up included participants who were not reached for the 7-month follow-up.

Results

More than half the sample dropped out during treatment; 61% were not reached for follow-up. Women (odds ratio (OR) = 1.21; 95% confidence interval (CI) = [1.16, 127]) and those with high levels of nicotine dependence (OR = 1.03; 95% CI = [1.02, 1.04]) were more likely to have moderate adherence to treatment (1–2 coaching calls). Dropout at follow-up was more likely among clients who used nicotine replacement therapy (OR = 1.14; 95% CI = [1.09, 1.19]) and less likely among those who had high treatment adherence (OR = 0.41; 95% CI = [0.39, 0.42]).

Conclusion

Given the relapsing nature of tobacco use and the harms related to tobacco use, quitlines can improve their impact by offering tailored services to enhance client engagement and retention in-treatment and at follow-up.

Type
Original Articles
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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