Clinical Research News for Arizona Physicians

Arizona Smokers Helpline

Despite the compelling and extensively documented reasons for quitting cigarettes, smokers rarely utilize smoking cessation services. Several studies have found that the majority of smokers who want to quit seldomly participate in tobacco treatment programs. This finding is particularly discouraging since other investigators report that tobacco users who participate in such programs consistently show higher rates of cessation than those who do not.

Quite recently, however, The University of Arizona Program for Nicotine and Tobacco Research (APNTR) has implemented a free telephone helpline designed to increase the number of people participating in smoking cessation programs. The program is called Arizona Smokers' Helpline, or ASH.

Arizona physicians are encouraged to provide this number (1-800-556-6222) to their patients who use tobacco.

Making Cessation Services Accessible

One reason for the low participation rates within cessation programs is that traditional programs are inaccessible to many people. Often tobacco users either cannot afford or choose to avoid smoking cessation classes--especially youth, certain ethnic groups, and less educated users. In addition, several Arizona communities do not offer cessation services. Even when they are offered, many people are either unable or unwilling to transport themselves to where the services take place.

With this in mind, APNTR has implemented a program designed to increase the convenience and accessibility of tobacco cessation programs. This newly developed program, called the Arizona Smokers' Helpline (ASH), uses an 800 telephone line to eliminate the barriers that keep tobacco users from utilizing cessation services. Its goal is to make cessation services available to a variety of smokers and to improve the participation rates among special Arizona populations such as ethnic minorities, adolescents, and pregnant women.

ASH maximizes accessibility to tobacco treatment in three ways.

First, the ASH program is free. Callers are able to receive one-on-one counseling, tobacco quit-kits, and information tailored to their specific needs without incurring a fee.
Second--because the services are provided via telephone and postal services---the client has a clear channel to cessation information, without having to worry about transportation problems or the insecurities sometimes aroused by face-to-face counseling sessions.
Third, both counseling and quit-kits are available in Spanish; thus, large segments of the Arizona population are able to easily access ASH.

The California Smokers Helpline

Since ASH has been in operation only a few months, it is too early to assess the cessation efficacy of the program.

However, research on the California Smokers' Helpline, which ASH has been modeled after, has been promising. Since its beginning in 1992, the California Smokers' Helpline has proved to be an effective cessation tool. This program has not only attracted large numbers of callers wanting to begin cessation treatment, but it has also been successful at reaching Hispanic and African American communities which are typically underrepresented in cessation treatment programs.

The quit rates of California callers is also impressive. In a pilot study, callers who used the toll-free helpline number (as opposed to just written self-help materials) doubled their success rate. Moreover, "success" was defined as abstinence after one year--a relatively strict parameter.

ASH is also showing promising signs. In its first three months of service, the helpline has received more than 800 calls. Callers' ages have ranged from 13 to 82 years. In addition, callers have been comprised of many ethnic groups, including Hispanics (3 percent), African Americans (1 percent), and American Indians (.5 percent).

Such groups should be providing more calls in the future, as advertising strategies will specifically target these populations.

Procedures

Most callers receive one of three general services (although the procedures used to effectively deliver each of those services are tailored to the needs of the client).

To determine the overall type of program that the caller will receive, a helpline counselor asks the client questions designed to determine which of the following services will best fit his or her needs:

Many callers who contact the helpline are not ready to make a commitment to actually quit and are just beginning to ponder the idea of living tobacco-free. These callers are sent motivational materials, a list of cessation programs available in their area, and are encouraged to call back at a future time for further information or to begin counseling services.
Other callers are serious about quitting but prefer to do it without the aid of helpline counselors. Such callers are sent self-help quit kits to aid them in their efforts to quit and a list of cessation programs available in their area. These callers are also encouraged to call back with further questions or to receive counseling services.
The bulk of callers contacting ASH are ready to quit and are seeking assistance from counselors. For these callers, a quit date is set for the following week and they are mailed a quit kit to help them prepare for their target quit day. In addition, callers are encouraged to identify their own idiosyncratic smoking habits and to develop plans to cope with smoking urges before they are contacted by a helpline counselor for their first counseling session. Subsequently, callers are contacted the day before they quit, the day after they quit, and one week after they quit.

Future Plans

ASH is planning to expand and add new features to existing services. Plans include additional service hours, continued tailoring of counseling techniques to cultural and situational needs of callers, and providing cessation consultation for interested organizations.

Scott Moldenhauer, MA
Coordinator
Arizona Smokers' Helpline
The University of Arizona Program for Nicotine and Tobacco Research