Creating a Perfect Storm to Increase Consumer Demand for Wisconsin's Tobacco Quitline

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Background

Telephone quitlines are a clinically proven and cost-effective population-wide tobacco-dependence treatment, and this option is now available in all 50 states. Yet, only 1% of the smoking population accesses these services annually. This report describes a series of policy, programmatic, and communication initiatives recently implemented in Wisconsin that resulted in a dramatic increase in consumer demand for the Wisconsin Tobacco Quitline (WTQL).

Intervention

In 2007, the Wisconsin legislature voted to increase the state cigarette excise tax rate by $1.00, from $0.77/pack to $1.77/pack effective January 1, 2008. In preparation for the tax increase, the Wisconsin Tobacco Prevention and Control Program, the University of Wisconsin Center for Tobacco Research and Intervention, which manages the WTQL, and the state's quitline service provider, Free & Clear, Inc., collaborated to enhance quitline knowledge, availability, and services with the goal of increasing consumer demand for services. The enhancements included for the first time, a free 2-week supply of over-the-counter nicotine replacement medication for tobacco users who agreed to receive multi-session quitline counseling. A successful statewide earned media campaign intensified the impact of these activities, which were timed to coincide with temporal smoking-cessation behavioral patterns (i.e., New Year's resolutions).

Results

As a result, the WTQL fielded a record 27,000 calls during the first 3 months of 2008, reaching nearly 3% of adult Wisconsin smokers.

Conclusions

This experience demonstrates that consumer demand for quitline services can be markedly enhanced through policy and communication initiatives to increase the population reach of this evidence-based treatment.

Section snippets

Background

Telephone tobacco-cessation quitlines have consistently been identified as an effective, population-wide treatment option for tobacco dependence.1, 2 Yet, the population penetration of this option remains modest, reaching only about 1% of smokers annually.3, 4 A variety of strategies, including media campaigns to raise awareness and free nicotine-replacement medication to eliminate financial barriers, have been shown to increase consumer demand for quitline services; however, these strategies

Intervention

The Wisconsin Tobacco Quitline (WTQL), a service provided to Wisconsin smokers by Free & Clear, Inc., was initiated in 2001. From 2002 to 2007, it provided cessation services to approximately 10,000 tobacco users annually, reaching nearly 1% of adult smokers in the state each year. On October 4, 2007, the Wisconsin legislature voted to increase the state cigarette excise tax rate by $1.00 per pack, effective January 1, 2008. The tax increase from $0.77 to $1.77 per pack moved Wisconsin to the

Results

The four integrated components to enhance WTQL utilization were associated with a flurry of earned media coverage. Wisconsin media coverage of the expanded quitline services during the first quarter of 2008 included 15 TV stations, 15 radio stations, and 93 newspapers. In terms of the key outcome measure—quitline calls—the response was quite substantial. In contrast to the approximately 10,000 calls received annually from 2002 to 2007, during the first 3 months of 2008, the WTQL fielded a

Discussion

The 3% population-reach of the WTQL during the first 3 months of 2008 demonstrates the potential of coordinated strategies designed to increase consumer utilization of a population-based tobacco counseling and treatment program. The UW-CTRI, WTCP, and WTQL worked collaboratively to implement a number of strategies recommended by the U.S. Public Health Service (USPHS) and the Task Force on Community Preventive Services to increase use of this population-wide treatment option.1, 13, 14 In

Conclusion

This simultaneous implementation of a statewide policy initiative ($1.00 per pack cigarette excise tax increase); temporal smoking behavioral patterns (tobacco users resolving to quit with the beginning of a new year); an aggressive, successful statewide earned media campaign; and enhanced quitline services (barrier-free access to NRT) produced optimal conditions for a “perfect storm” for treating tobacco dependence in Wisconsin. Following these initiatives, the WTQL fielded 27,000 calls during

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