Background
Minnesota | Oklahoma | Florida | |
---|---|---|---|
Population (2017)a | 5,568,155 | 3,932,640 | 20,976,812 |
Smoking prevalence (2017)b | 14.5% | 20.1% | 16.1% |
Smokeless tobacco use prevalence (2017)b | 4.8% | 7.4% | 2.7% |
State tobacco cessation program summary description | QUITPLAN® Helpline – up to five telephone counseling calls, four weeks of nicotine replacement therapy (NRT) (combination NRT option), integrated text and email messaging, print materials. Individual QUITPLAN® Services – choice of two week “starter kit” of NRT (monotherapy only), standalone text messaging program, standalone email program, and/or printed quit guide. quitplan.com – unlimited access to self-directed website offered during the pre period only. (No NRT provided) (Program ended February 2014) | Oklahoma Tobacco Helpline- All Access: All callers receive one coaching call, at least 2 weeks of NRT (patches, gum or lozenges), print materials, integrated text, web coach. Uninsured, Medicare, IHS participants are eligible for 8 weeks of combination NRT (patches, gum or lozenges) and 5 calls with a quit coach. Web Coach – unlimited access to self-directed website, receive 2 weeks of NRT, emails, text, printed materials. Individual Services – choice of two week “starter kit” of NRT (monotherapy only), standalone text messaging program, standalone email program, and/or printed quit guide. | Quit Your Way – Phone Quit: up to three telephone counseling calls, two weeks of NRT (combination NRT option), integrated text and email messaging, integrated web coach messaging, printed quit guide. Web Quit: unlimited access to self-directed website, two weeks of NRT (combination NRT option), optional text and email messaging. Individual Quit Your Way services - choice of two week “starter kit” of NRT (monotherapy only), standalone text messaging program, standalone email program and/or printed quit guide. |
Program eligibility criteria | QUITPLAN Helpline:– uninsured and underinsuredc Minnesotans age 13 years and older. -must be 18 years or older to receive NRT and text messaging. -can enroll twice in a 12-month period. Individual QUITPLAN Services: – all Minnesotans age 13 years and older. -must be 18 years or older to receive NRT and text messaging. -can receive two NRT “starter kits”, and all other services once, in a 12-month period. | All Oklahomans age 13 years and older are eligible for some level of services. NRT is provided only to those 18 years and older. Cost sharing partnerships with Medicaid and other private partners increase the number of calls and/or other services available to members. Oklahomans can enroll twice in all services in a 12-month period. | Services are open to all Floridians. NRT is provided only to those 18 years and older; other services available to those 13 years or older. Floridians can enroll twice in all services in a 12-month period. |
Methods
Design
State | Pre | Soft launcha | Post |
---|---|---|---|
Minnesota | Mar 2013 - Feb 2014 | Mar 2014 | Apr 2014 - Mar 2015 |
Oklahoma | Jul 2014 - Jun 2015 | Jul 2015 - Sep 2015 | Oct 2015 - Sep 2016 |
Florida | Jan 2015 - Dec 2015 | Jan 2016 - Jul 2016 | Aug 2016 - Jul 2017 |
Minnesota Pre Period | Minnesota Post Period | |
Oct 2011-Dec 2011 | May 2014-Jul 2014 | |
Helpline Enrollments (N = 895) | Helpline and Individual Services Enrollments (N = 5031) | |
Excluded (n = 311) • Sampled for an unrelated evaluation study (n = 267) • Did not consent (n = 38) • Less than 18 years old (n = 2) • Duplicate enrollments (n = 4) | Excluded (n = 1429) • Non-tobacco user (n = 177) • Did not enroll (e.g., called for information only) (n = 441) • Prior enrollment in study period (n = 147) • Did not consent (n = 658) • Less than 18 years old (n = 1) • No contact information (n = 5) | |
Eligible for Follow-up (N = 584) | Eligible for Follow-up (N = 3602) | |
Exhaustively sampled (N = 584) | Randomly sampled within program strata: Helpline, Individual Services (IS) with NRT only, IS with NRT and text/email, IS with text/email only (N = 2006) | |
Responded to survey (N = 372) | Responded to survey (N = 1170) | |
Study participants N = 372 | Study participants N = 1170 | |
Excluded for quit rates (n = 54) • Did not receive phone counseling or NRT (n = 48) • Quit for 30 days or more at intake (N = 6) | Excluded for quit rates (n = 78) • Did not receive phone counseling or NRT (n = 73) • Quit for 30 days or more at intake (n = 5) | |
Study participants included in quit rate N = 318 | Study participants included in quit rate N = 1092 | |
Oklahoma Pre Period | Oklahoma Post Period | |
Jul 2014-Jun 2015 | May 2013-Sep 2013 | Oct 2015-Sep 2016 |
Helpline Enrollments (N = 24,882) | Web Coach Enrollments (N = 1903) | Helpline, Web Coach, and Individual Services Enrollments (N = 37,175) |
Excluded (n = 9690) • Did not consent (n = 2520) • Less than 18 years old (n = 84) • Non-OK resident (n = 1) • Non-English speaker (n = 157) • Invalid contact information (n = 677) • Did not receive phone counseling or NRT (n = 3123) • Prior enrollment in past 12 months (n = 2336) • Sampled for survey in past 12 months (n = 792) | Excluded (n = 1100) • Did not consent (n = 324) • Less than 18 years old (n = 8) • Non-English speaker (n = 7) • Did not log into web program (n = 705) • Prior enrollment in past 12 months (n = 30) • Sampled for survey in past 12 months (n = 26) | Excluded (n = 13,851) • Did not consent (n = 3124) • Less than 18 years old (n = 109) • Non-OK resident (n = 2) • Non-English speaker (n = 207) • Invalid contact information (n = 195) • Did not receive phone counseling or NRT (n = 6318) • Prior enrollment in past 12 months (n = 2319) • Sampled for survey in past 12 months (n = 1577) |
Eligible for Follow-up (N = 15,192) | Eligible for Follow-up (N = 803) | Eligible for Follow-up (N = 23,324) |
Randomly sampled (N = 2475) | Randomly sampled (N = 709) | Randomly sampled (N = 3320) |
Responded to survey (N = 1273) | Responded to survey (N = 356) | Responded to survey (N = 1748) |
Study participants N = 1273 | Study participants N = 356 | Study participants N = 1748 |
Excluded for quit rates (n = 7) • Quit for 30 days or more at intake (n = 7) | Excluded for quit rates (n = 75) • Did not receive phone counseling or NRT (n = 74) • Quit for 30 days or more at intake (n = 1) | Excluded for quit rates (n = 5) • Quit for 30 days or more at intake (n = 5) |
Study participants included in quit rate N = 1266 | Study participants included in quit rate N = 281 | Study participants included in quit rate N = 1743 |
Florida Pre Period | Florida Post Period | |
Jan 2015-Dec 2015 | Aug 2016-Jul 2017 | |
Helpline and Web Coach Enrollments (N = 58,213) | Helpline, Web Coach and Individual Services Enrollments (N = 103,709) | |
Excluded (n = 5787) • Did not consent (n = 5564) • Less than 18 years old (n = 73) • Non-FL resident (n = 3) • Sampled for same survey within past 4 months (n = 147) | Excluded (n = 41,320) • Prior enrollment in past 12 months (n = 23,226) • Did not consent (n = 16,407) • Quit for past 30 days at intake (n = 392) • No contact information (n = 109) • Less than 18 years old (n = 44) • Non-FL resident (n = 70) • Sampled for same survey within past 4 months (n = 602) • Individual Services enrollment with no service received (n = 470) | |
Eligible for Follow-up (N = 52,426) | Eligible for Follow-up (N = 62,389) | |
Randomly sampled within program strata: Helpline and Web Coach (N = 3151) | Randomly sampled (N = 3519) | |
Responded to survey (N = 1676) | Responded to survey (N = 1768) | |
Study participants N = 1676 | Study participants N = 1768 | |
Excluded for quit rates (n = 459) • Did not receive phone counseling or NRT (n = 383) • Quit for 30 days or more at intake (n = 76) | Excluded for quit rates (n = 196) • Did not receive phone counseling or NRT (n = 196) | |
Study participants included in quit rate N = 1217 | Study participants included in quit rate N = 1572 |
Sample
Measures
Analysis
Results
Pre | Post | ||
---|---|---|---|
Number enrolled | N | N | |
Minnesota | 5599 | 16,319 | |
Oklahoma | 28,950 | 35,634 | |
Florida | 55,242 | 85,967 | |
Number of unique tobacco users receiving evidence-based treatmenta | N | N | |
Minnesota | 2784 | 14,880 | |
Oklahoma | 22,241 | 29,763 | |
Florida | 41,982 | 74,039 | |
Treatment reach | % (95% CI) | % (95% CI) | % change |
Minnesota | 0.36 (0.34–0.38) | 2.09 (2.00–2.18) | 480.56 |
Oklahoma | 3.22 (3.00–3.47) | 4.85 (4.52–5.23) | 50.62 |
Florida | 1.57 (1.47–1.69) | 2.62 (2.45–2.83) | 66.88 |
Significance Test | |||
24-h quit attempt rate | % (95% CI) | % (95% CI) | Χ2 (p-value) |
Minnesota | 89.94 (85.92–92.95) | 84.13 (81.83–86.19) | 6.26 (0.01*) |
Oklahoma | 87.04 (85.26–88.64) | 86.98 (85.28–88.50) | 2.37 (0.12) |
Florida | 84.96 (82.89–86.90) | 85.08 (83.18–86.80) | 0.00 (1.00) |
30-day point prevalence abstinence rate | % (95% CI) | % (95% CI) | Χ2 (p-value) |
Minnesota | 26.10 (21.43–31.37) | 26.18 (23.65–28.87) | 0.00 (1.00) |
Oklahoma | 29.69 (27.46–32.02) | 31.67 (29.50–33.92) | 1.44 (0.23) |
Florida | 35.50 (32.86–38.23) | 30.28 (28.02–32.65) | 8.21 (0.004**) |
Estimated number quitb | % change | ||
Minnesota | 727 | 3896 | 435.90% |
Oklahoma | 6603 | 9426 | 42.75% |
Florida | 14,904 | 22,419 | 50.42% |
Pre | Post | Χ2 | p-value | |||
---|---|---|---|---|---|---|
N | % | N | % | |||
Gender | ||||||
Minnesota | 76.32 | <.0001** | ||||
Female | 3458 | 61.76% | 8979 | 55.05% | ||
Male | 2141 | 38.24% | 7333 | 44.95% | ||
Oklahoma | 5.90 | .02* | ||||
Female | 16,417 | 56.74% | 20,548 | 57.69% | ||
Male | 12,519 | 43.26% | 15,070 | 42.31% | ||
Florida | 15.48 | <.0001** | ||||
Female | 31,892 | 57.75% | 48,718 | 56.69% | ||
Male | 23,331 | 42.25% | 37,223 | 43.31% | ||
Race | ||||||
Minnesota | a | a | ||||
Oklahoma | 4.64 | .2003 | ||||
White | 21,294 | 75.32% | 25,605 | 75.42% | ||
Black or African American | 2633 | 9.31% | 3020 | 8.89% | ||
American Indian | 3186 | 11.27% | 3944 | 11.62% | ||
Other | 1159 | 4.10% | 1383 | 4.07% | ||
Florida | 347.24 | <.0001** | ||||
White | 40,514 | 77.87% | 67,187 | 81.97% | ||
Black or African American | 6357 | 12.22% | 7892 | 9.63% | ||
American Indian | 673 | 1.29% | 905 | 1.10% | ||
Other | 4482 | 8.61% | 5985 | 7.30% | ||
Age (mean) | Years | Years | t | p-value | ||
Minnesota | 43.14 | 41.85 | 5.94 | <.0001** | ||
Oklahoma | 43.83 | 44.60 | −6.59 | <.0001** | ||
Florida | 46.30 | 45.88 | 5.44 | <.0001** |