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 Part II - Quitline Information

According to the United States Department of Health and Human Services (US DHHS), telephonic cessation counseling services have the potential to reach a diverse population of smokers. Using Quitlines to assist smokers through the quitting process is a common component of many comprehensive tobacco control programs. State Quitlines can be resources that provide social and financial support (in the form of pharmacological therapy). Quitlines are staffed by counselors trained to deliver information, advice, support and referrals to tobacco users[1]. Providers can use state tobacco Quitlines as part of an array of cessation services (self-help materials, face-to-face counseling, medication) for women who want to quit smoking.

By dialing the national quitline network (1-800-QUIT NOW) a caller is immediately routed to their state smoker’s quitline. Some states also have proactive direct fax referral capability for providers to connect pregnant smokers directly to their state quitline.

Fax-to-quit programs are a type of proactive counseling which allows providers to fax contact information for an identified smoker, who gives consent, directly to the Quitline. After receiving the fax, the Quitline counselor will make a proactive, outbound call to the smoker within 48 hours to encourage participation in the telephone-based cessation program. A fax-referral system with proactive recruitment to increase the continuity of care removes the clinician’s burden to ‘assist’ smokers to quit and has been shown to significantly increase the number of smokers who receive cessation services[2]. In addition, smokers can call the quitlines on their own to enroll in services.

Quitlines develop specialized protocols that counselors can use with specific populations such as pregnant and postpartum women. A recommended protocol for use with pregnant and postpartum women is available and some states have implemented this protocol. Click here to see an example of one such pregnancy and post-partum Quitline protocol.

Quitlines are appealing for pregnant and postpartum smokers because: 1) they offer women a convenient, flexible, and confidential way to receive repeated smoking cessation counseling; 2) they can be helpful in reaching pregnant women with limited mobility or who live in rural areas[3] , [4].

Provider Referral to Quitlines

According to ACOG, the provider’s role is to encourage and support a patient through the cessation process. This can be done by referring the patient to a smoker’s quitline. Though the role of the provider may be clear, it is not always clear to providers how Quitlines work and what their patient’s experience will be when they call. Below are some FAQs regarding what happens when a patient is referred to the state Quitline. You can also visit the 1-800 QUIT-NOW website where they have videos of what to expect when you call the quitline: http://1800quitnow.cancer.gov/whathappens.aspx

FAQS

What happens when my patient calls the Quitline?
Each state Quitlines may operate differently, but the most typical ways calls are handled by the state Quitline are: 1) callers speak directly to a counselor; 2) callers are directed to a recording while the call is fielded to a counselor; or 3) callers are able to select the service they need from a menu of options.

What services will be available to my patient who calls the Quitline?
Services commonly include: telephone counseling, nicotine-replacement therapy, referrals (i.e. to other cessation services), materials, often available in a variety of languages and directed to a variety of populations, internet counseling, and chat rooms (about tobacco cessation)[5].

Are there specific instructions on referring my patient to the Quitline?
State Quitlines that use a fax referral system have their own fax referral forms that are generally available at the Quitline website. Also, Quitline websites have a contact number that providers can call to get additional information. An example of a state Quitline with a dedicated Healthcare Provider section is available at http://www.indianatobaccoquitline.net/Default.aspx. In this example, once on the homepage, providers will see a section with specific information for them.

Some state quitlines will provide feedback regarding patients that are referred to quitlines. Ask your quitline provider if this is possible in your area.


[1] 1-800-QuitNow.U.S Department of Health and Human Serivces. National Institutes of Health, National Cancer Institute: http://1800quitnow.cancer.gov/faq.aspx

[2] Rohweder C, DiBiase L, Schell D. Pregnancy and Postpartum Quitline Toolkit. Chapel Hill, NC: The National Partnership to Help Pregnant Smokers Quit. January 2007.

[3] Solomon LJ, Secker-Walker RH, Flynn BS, Skelly JM, Capeless EL. Proactive telephone peer support to help pregnant women stop smoking. Tob Control. 2000;9 Suppl 3:III72-4. PubMed PMID: 10982914; PubMed Central PMCID: PMC1766314.

[4] Rigotti NA, Park ER, Regan S, Chang Y, Perry K, Loudin B, Quinn V. Efficacy of telephone counseling for pregnant smokers: a randomized controlled trial. Obstet Gynecol. 2006 Jul;108(1):83-92. PubMed PMID: 16816060.