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New Zealand has a national (free) telephone Quitline service that is promoted through regular mass media campaigns. Data are routinely collected on the over 100 callers per day. We used this data source to investigate the impact of the 11 September 2001 terrorist attacks in the USA on calls to this service.
On Wednesday 12 September (11 September in New York was 12 September in New Zealand) there was a sudden decline in the number of new callers to the Quitline (only 137 callers relative to 237 on the previous day—a 42% reduction). Similarly, relative to the preceding Wednesday, the number of new callers was down by 41%.
The effect was felt for at least several weeks. There was an overall 35% drop in the total number of new callers per week, when comparing the five weeks before 11 September with the five weeks afterwards. Using a generalised linear model we found an interaction between a “September 11” effect and time (week) (p = 0.002). Details of the model and the graphed results are available on a website.1
It appears that quitting “dropped off the personal agenda” for some New Zealand smokers in September 2001. It seems likely that at this time of increased media publicity of global security threats, the quitting plans of smokers were eclipsed by other concerns (for example, the psychological impact of these events appears to have been significant—at least for Americans2). This was despite the fact that New Zealand is an island nation that is very far removed from international trouble spots. It was also despite the fact that international terrorism has historically posed only a tiny risk of death to the general public relative to that from smoking (which kills half of long term smokers).
This reduction in calls is of concern considering that the Quitline (especially in the context of providing subsidised nicotine replacement therapy (NRT)) appears to be very successful in supporting quitting. Preliminary data from one survey suggests a point prevalence quit rate at three months of 44%.3
Other explanations for this sudden and sustained reduction in calls to the Quitline from 12 September seem unlikely. Nevertheless, this decline in new callers did occur in the context of a longer term decline in calls to the Quitline which had been occurring since a peak in November 2000. That peak was a result of callers becoming eligible to obtain vouchers for heavily subsidised NRT through the Quitline service.
One implication of this relation between global security issues and Quitline calls is that publicity for Quitline services may be less cost effective at times of perceived international crisis. However, the continuance of at least 120 calls per day to the Quitline, during September and October 2001, indicates the strength of the desire to quit in the population of smokers that the Quitline has tapped into.