Tobacco cessation outcomes: The case for milestone-based services

INTRODUCTION: This study focuses on a Midwest State’s tobacco quitline. The purpose was to understand possible relationships between services provided and cessation rates. METHODS: The data examined in this study came from aggregated intake/treatment data and follow-up interview data. The overall response rate was 22.9%. Measures included quit rate, quit duration, length of services, number of services, stage of change, confidence to quit, and source of referral. RESULTS: The dataset included 1452 cases; 77% enrolled in services only once, 17% enrolled twice and 6% enrolled three or more times. Use of medication was higher among those who quit [χ(2)(1)=7.1, p=0.009, Cramer’s V=0.07] than among those who did not. Use of e-cigarettes was lower among those who quit at the time of follow-up [χ(2)(1)=31.5, p<0.001, Cramer’s V=0.15]. Respondents who had quit at the time of the follow-up were significantly more likely to have reported a higher confidence to quit at intake [χ(2)(1)=24.1, p<0.001, Cramer’s V=0.13]. Among those who improved their stage of change during treatment, 35% had quit at follow-up, compared with 18% among those who did not improve. CONCLUSIONS: Study findings related to stage of change and associations between confidence and cessation may have meaningful implications. Cessation success may depend on what is accomplished during treatment and the intersection of clients’ motivation, satisfaction, confidence, and cessation status at the end of treatment.