Nicotine & Tobacco Research, Volume 16, Number 5 (May 2014) 544–553
Original Investigation
Prevalence and Correlates of Quitline Awareness and Utilization in the United States: An Update From the 2009–2010 National Adult Tobacco Survey Gillian L. Schauer MPH1,2, Ann M. Malarcher PhD1, Lei Zhang PhD1, Martha C. Engstrom MS1, Shu-Hong Zhu PhD3 1Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA; 2Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA; 3Moores Cancer Center, University of California, San Diego, CA
Corresponding Author: Gillian L. Schauer, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Prevention and Control, 4770 Buford Highway, NE, MS F-79, Atlanta, GA 30341. Telephone: 770-488-5491; Fax: 770-488-5767; E-mail: [email protected]
Abstract Introduction: Tobacco quitlines are evidence-based cessation resources that have been underutilized. The purpose of this study is to provide population-level data about quitline awareness and utilization in the United States and to assess correlates of awareness and utilization. Methods: Data were from the 2009–2010 National Adult Tobacco Survey. Descriptive statistics were produced for nationaland state-level quitline awareness and for national quitline utilization. Bivariate and multivariable logistic regressions were used to identify correlates of quitline awareness and utilization. Results: Quitline awareness among the total sample was 33.9% (current smokers 53.9%, former smokers 34.0%, never-smokers 27.0%). Awareness varied by state (range: 35.8%–84.6% for current smokers). Among current smokers who tried to quit in the past year, correlates of lower awareness included being Black, non-Hispanic, and making 30% of the value. Alpha levels for all analyses were set at 0.05. Missing data ranged between 0% and 7% (for income), with the majority of variables having < 1% missing data; missing values were not imputed.
Results Quitline Awareness Quitline awareness among the total sample (regardless of smoking status) was 33.9% (95% confidence interval [CI] = 33.4, 34.5), with 53.9% of current smokers (95% CI = 52.4, 55.4), 34.0% of former smokers (95% CI = 32.8, 35.2), and 27.0% of never-smokers (95% CI = 26.3, 27.7) reporting awareness of quitlines (p < .0001). Unadjusted awareness data are presented by smoking status and demographic characteristic in Table 1. Among current smokers, females had greater awareness than males (p < .01); individuals identifying as Black had significantly lower awareness than other racial/ethnic groups (p < .0001); awareness increased as education and income level increased; those with insurance had higher awareness than those without (p < .0001); those who had seen or been advised to quit by a health professional in the past 12 months had higher awareness than those who had not seen a health professional (p < .0001); and those who reported having seen cessationrelated media in the past 12 months had higher awareness than those who did not see cessation media (p < .0001; Table 1). An analysis of awareness data by sociodemographic characteristics among those who tried to quit in the past year revealed similar patterns to the current smoker group (data not shown).
Downloaded from http://ntr.oxfordjournals.org/ at University of North Dakota on May 22, 2015
current smokers and recent quitters (e.g., those quit within the past year), “The last time you tried to quit smoking did you call a telephone quitline?” For the purposes of these analyses, data about quitline utilization were restricted to participants who reported making at least one quit attempt in the past year to capture recent utilization. Smoking status was defined using the questions, “Have you smoked at least 100 cigarettes in your entire life?” and “Do you now smoke cigarettes every day, some days, or not at all?” Current smokers are defined as those who had smoked at least 100 cigarettes and currently smoked every day or some days; former smokers are defined as those who had smoked 100 cigarettes in their entire life but did not currently smoke; neversmokers are defined as those who had never smoked cigarettes or had not smoked at least 100 cigarettes in their entire life. Sociodemographic characteristics, including sex, age, race/ ethnicity, education, income, insurance status, and chronic disease status were assessed for all respondents. Age was categorized into four groups (18–24, 25–44, 45–64, and ≥65 years), and race and ethnicity variables were combined into a four-category variable (White, non-Hispanic; Black, non-Hispanic; Hispanic; and other, non-Hispanic). Education was collected in 17 categories and recategorized to < high school, equal to high school or a General Equivalency Diploma (GED), and > high school. Eight income categories were recategorized to
Original Investigation
Prevalence and Correlates of Quitline Awareness and Utilization in the United States: An Update From the 2009–2010 National Adult Tobacco Survey Gillian L. Schauer MPH1,2, Ann M. Malarcher PhD1, Lei Zhang PhD1, Martha C. Engstrom MS1, Shu-Hong Zhu PhD3 1Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA; 2Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA; 3Moores Cancer Center, University of California, San Diego, CA
Corresponding Author: Gillian L. Schauer, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Prevention and Control, 4770 Buford Highway, NE, MS F-79, Atlanta, GA 30341. Telephone: 770-488-5491; Fax: 770-488-5767; E-mail: [email protected]
Abstract Introduction: Tobacco quitlines are evidence-based cessation resources that have been underutilized. The purpose of this study is to provide population-level data about quitline awareness and utilization in the United States and to assess correlates of awareness and utilization. Methods: Data were from the 2009–2010 National Adult Tobacco Survey. Descriptive statistics were produced for nationaland state-level quitline awareness and for national quitline utilization. Bivariate and multivariable logistic regressions were used to identify correlates of quitline awareness and utilization. Results: Quitline awareness among the total sample was 33.9% (current smokers 53.9%, former smokers 34.0%, never-smokers 27.0%). Awareness varied by state (range: 35.8%–84.6% for current smokers). Among current smokers who tried to quit in the past year, correlates of lower awareness included being Black, non-Hispanic, and making 30% of the value. Alpha levels for all analyses were set at 0.05. Missing data ranged between 0% and 7% (for income), with the majority of variables having < 1% missing data; missing values were not imputed.
Results Quitline Awareness Quitline awareness among the total sample (regardless of smoking status) was 33.9% (95% confidence interval [CI] = 33.4, 34.5), with 53.9% of current smokers (95% CI = 52.4, 55.4), 34.0% of former smokers (95% CI = 32.8, 35.2), and 27.0% of never-smokers (95% CI = 26.3, 27.7) reporting awareness of quitlines (p < .0001). Unadjusted awareness data are presented by smoking status and demographic characteristic in Table 1. Among current smokers, females had greater awareness than males (p < .01); individuals identifying as Black had significantly lower awareness than other racial/ethnic groups (p < .0001); awareness increased as education and income level increased; those with insurance had higher awareness than those without (p < .0001); those who had seen or been advised to quit by a health professional in the past 12 months had higher awareness than those who had not seen a health professional (p < .0001); and those who reported having seen cessationrelated media in the past 12 months had higher awareness than those who did not see cessation media (p < .0001; Table 1). An analysis of awareness data by sociodemographic characteristics among those who tried to quit in the past year revealed similar patterns to the current smoker group (data not shown).
Downloaded from http://ntr.oxfordjournals.org/ at University of North Dakota on May 22, 2015
current smokers and recent quitters (e.g., those quit within the past year), “The last time you tried to quit smoking did you call a telephone quitline?” For the purposes of these analyses, data about quitline utilization were restricted to participants who reported making at least one quit attempt in the past year to capture recent utilization. Smoking status was defined using the questions, “Have you smoked at least 100 cigarettes in your entire life?” and “Do you now smoke cigarettes every day, some days, or not at all?” Current smokers are defined as those who had smoked at least 100 cigarettes and currently smoked every day or some days; former smokers are defined as those who had smoked 100 cigarettes in their entire life but did not currently smoke; neversmokers are defined as those who had never smoked cigarettes or had not smoked at least 100 cigarettes in their entire life. Sociodemographic characteristics, including sex, age, race/ ethnicity, education, income, insurance status, and chronic disease status were assessed for all respondents. Age was categorized into four groups (18–24, 25–44, 45–64, and ≥65 years), and race and ethnicity variables were combined into a four-category variable (White, non-Hispanic; Black, non-Hispanic; Hispanic; and other, non-Hispanic). Education was collected in 17 categories and recategorized to < high school, equal to high school or a General Equivalency Diploma (GED), and > high school. Eight income categories were recategorized to
