Representativeness of reach and effectiveness of proactive tobacco quitline follow-up treatment for adults who smoke tobacco products: Secondary analyses of a factorial experiment.
6 affiliations
- 1Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public HealthMadisonUnited States.
- 2Department of MedicineDivision of General Internal Medicine, University of Wisconsin School of Medicine and Public HealthMadisonUnited States.
- 3Institute on Aging, University of WisconsinMadisonUnited States.
- 4Department of Family Medicine and Community HealthUniversity of Wisconsin School of Medicine and Public HealthMadisonUnited States.
- 5Center for Wellbeing Research, RVO HealthFort MillUnited States.
- 6Department of Health ScienceCollege of Human Environmental Sciences, University of AlabamaTuscaloosaUnited States.
Abstract
Introduction
Tobacco quitlines deliver no-cost evidence-based tobacco use treatment, but many quitline callers continue smoking after a single round of treatment. The aim of this study was to evaluate the representativeness of follow-up quitline treatment reach and effectiveness to inform efforts to enhance quitline re-treatment among adults experiencing socioeconomic disadvantage.Methods
Secondary analyses used recruitment, self-report, and salivary cotinine data collected from participants in a randomized controlled trial evaluating smoking cessation interventions among previously treated quitline participants with socioeconomic disadvantages recruited in Wisconsin from 7 June 2018 to 25 January 2023. Logistic regression analyses examined differential population representation occurring in re-treatment outreach, screening, enrollment, and biochemically confirmed abstinence.Results
Proactive outreach was more likely to reach previously treated quitline callers who were aged >45 years (adjusted odds ratio, AOR=1.69-2.33; 95% CI: 1.55-2.63), male (AOR=1.16; 95% CI: 1.08-1.25), Black (AOR=1.18; 95% CI: 1.08-1.30), health-insured (AOR=1.26; 95% CI: 1.11-1.67), less nicotine-dependent (AOR=1.11; 95% CI: 1.02-1.20), co-using alternative tobacco products (AOR=1.46; 95% CI: 1.25-1.70), or living with chronic disease (AOR=1.12; 95% CI: 1.05-1.21). Interest in trial screening was higher among quitline participants who were aged <65 years (AOR=1.45; 95% CI: 1.25-1.89), Black (AOR=2.32; 95% CI: 1.95-2.76), living with chronic disease (AOR=1.34; 95% CI: 1.18-1.53), and had more than a high school education (AOR=1.59; 95% CI: 1.36-1.85). Exclusion criteria differentially excluded Black participants (AOR=1.59; 95% CI: 1.27-2.00) and those with lower nicotine dependence (AOR=1.88; 95% CI: 1.49-2.36). Among trial enrollees, abstinence rates were higher among women (AOR=2.04; 95% CI: 1.37-3.03) and Hispanic (AOR=5.73; 95% CI: 2.68-12.21) participants. Individual differences did not significantly predict treatment engagement or interaction with treatment interventions in predicting abstinence.Conclusions
Quitline re-treatment outreach to previous users of the quitline may help to close gaps in tobacco treatment among socioeconomically disadvantaged older adults and Black people. Relaxing smoking heaviness and frequency criteria may improve representation of Black people in quitline re-treatment trials. Additional research is needed to guide efforts to improve the representation of groups experiencing disadvantage in quitline trials.
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BibTeX
@article{mccarthy2026representativeness,
title = {{Representativeness of reach and effectiveness of proactive tobacco quitline follow-up treatment for adults who smoke tobacco products: Secondary analyses of a factorial experiment.}},
author = {Danielle E McCarthy and Julie A Kirsch and Jesse T Kaye and Kate Kobinsky and David L Fraser and Katrina Vickerman and Kristina Mullis and Nayoung Kim and Timothy B Baker and Michael C Fiore},
journal = {Tobacco prevention \& cessation},
year = {2026},
month = oct,
doi = {10.18332/tpc/225321},
url = {https://europepmc.org/article/MED/42923458},
note = {CC BY},
}
RIS
TY - JOUR
TI - Representativeness of reach and effectiveness of proactive tobacco quitline follow-up treatment for adults who smoke tobacco products: Secondary analyses of a factorial experiment.
AU - Danielle E McCarthy
AU - Julie A Kirsch
AU - Jesse T Kaye
AU - Kate Kobinsky
AU - David L Fraser
AU - Katrina Vickerman
AU - Kristina Mullis
AU - Nayoung Kim
AU - Timothy B Baker
AU - Michael C Fiore
PY - 2026
DA - 2026/10/15
JO - Tobacco prevention & cessation
DO - 10.18332/tpc/225321
UR - https://europepmc.org/article/MED/42923458
AB - Introduction Tobacco quitlines deliver no-cost evidence-based tobacco use treatment, but many quitline callers continue smoking after a single round of treatment. The aim of this study was to evaluate the representativeness of follow-up quitline treatment reach and effectiveness to inform efforts to enhance quitline re-treatment among adults experiencing socioeconomic disadvantage.Methods Secondary analyses used recruitment, self-report, and salivary cotinine data collected from participants in a randomized controlled trial evaluating smoking cessation interventions among previously treated quitline participants with socioeconomic disadvantages recruited in Wisconsin from 7 June 2018 to 25 January 2023. Logistic regression analyses examined differential population representation occurring in re-treatment outreach, screening, enrollment, and biochemically confirmed abstinence.Results Proactive outreach was more likely to reach previously treated quitline callers who were aged >45 years (adjusted odds ratio, AOR=1.69-2.33; 95% CI: 1.55-2.63), male (AOR=1.16; 95% CI: 1.08-1.25), Black (AOR=1.18; 95% CI: 1.08-1.30), health-insured (AOR=1.26; 95% CI: 1.11-1.67), less nicotine-dependent (AOR=1.11; 95% CI: 1.02-1.20), co-using alternative tobacco products (AOR=1.46; 95% CI: 1.25-1.70), or living with chronic disease (AOR=1.12; 95% CI: 1.05-1.21). Interest in trial screening was higher among quitline participants who were aged <65 years (AOR=1.45; 95% CI: 1.25-1.89), Black (AOR=2.32; 95% CI: 1.95-2.76), living with chronic disease (AOR=1.34; 95% CI: 1.18-1.53), and had more than a high school education (AOR=1.59; 95% CI: 1.36-1.85). Exclusion criteria differentially excluded Black participants (AOR=1.59; 95% CI: 1.27-2.00) and those with lower nicotine dependence (AOR=1.88; 95% CI: 1.49-2.36). Among trial enrollees, abstinence rates were higher among women (AOR=2.04; 95% CI: 1.37-3.03) and Hispanic (AOR=5.73; 95% CI: 2.68-12.21) participants. Individual differences did not significantly predict treatment engagement or interaction with treatment interventions in predicting abstinence.Conclusions Quitline re-treatment outreach to previous users of the quitline may help to close gaps in tobacco treatment among socioeconomically disadvantaged older adults and Black people. Relaxing smoking heaviness and frequency criteria may improve representation of Black people in quitline re-treatment trials. Additional research is needed to guide efforts to improve the representation of groups experiencing disadvantage in quitline trials.
SN - 2459-3087
ER -