Telephone support for smoking cessation : The Swedish example
Author: Tomson, Tanja
Date: 2005-12-02
Location: Aulan, plan 2, Norrbackabyggnaden, Karolinska Universitetssjukhuset, Solna
Time: 9.00
Department: Institutionen för folkhälsovetenskap / Department of Public Health Sciences
View/ Open:
thesis.pdf (4.312Mb)
Abstract
Background : Tobacco is a major public health problem that needs to be
addressed. The Swedish quitline is a telephone-based free-of-charge
tobacco cessation service.
Objective : To study the effectiveness and the cost-effectiveness of the
Swedish quitline.
Methods : The study population comprised clients calling the quitline and
returning a registration questionnaire mailed home to the caller directly
after first call from April 1999 to November 2002. Each individual was
followed up 12 months after first contact (follow-up questionnaire). All
those returning the registration questionnaire were included in the study
base. The questionnaires assessed point prevalence abstinence as well as
several factors potentially related to abstinence. Study I comprised 496
and 629 smokers receiving a reactive and a proactive treatment
respectively. Studies II, III and IV comprised all 1131 smokers who had
signed up for smoking cessation treatment from February 2000 to November
2001. Of those, 741 individuals (66%) reporting to have been abstinent
for at least 24 hours were examined in study II. In study III, a sample
of 84 out of 475 non-responders were included in a drop-out analysis.
Study IV, was based on 354 abstinent smokers. Outcome measures were cost
per quitter and cost per life year saved ( LYS).
Main findings : Factors significantly related to abstinence (I) included
no nicotine use at baseline, the adjusted OR and 95% CI, being 6.4
(2.1-19.4), additional support from health care professionals 3.5
(1.0-12.3), additional social support 3.1 (1.6-6.1), absence of stress or
depressive mood 2.7 (1.6-4.7), nicotine replacement therapy (NRT) for
five weeks or more 2.1 (1.1-4.1), and no exposure to second-hand smoke
1.9 (1.1-3.3). High intensity of craving, irritability,
apprehension/anxiety, difficulties concentrating, restlessness, depressed
mood, and insomnia were related to unsuccessful quitting attempts (II).
With the exception of insomnia all these symptoms comprised a factor
labelled psychological which was related to unsuccessful quitting
attempts. Using NRT for five weeks or longer was correlated with lower
intensity of the psychological symptoms. Of the non-responders in study
III, 39% claimed to have been smoke-free at the time they received the
12-month follow-up questionnaire compared with 31% of the responders in
the original study population (III). The cost per quitter in the
investigated cohort (IV) was 1062 USD and cost per life year saved was
estimated to be 311 USD.
Conclusions : The Swedish quitline proved to be a cost-effective
intervention that significantly increased 12 month abstinence. Treatment
efficacy may be further enhanced by focusing on factors identified in the
different studies as being related to 12 month abstinence. Non-responders
to the 12 month follow-up questionnaire were not more likely to be
unsuccessful quitters.
List of papers:
I. Helgason AR, Tomson T, Lund KE, Galanti R, Ahnve S, Gilljam H (2004). "Factors related to abstinence in a telephone helpline for smoking cessation. " Eur J Public Health 14(3): 306-10
Pubmed
II. Tomson T, Toftgard M, Gilljam H, Helgason AR (2005). "Symptoms in smokers trying to quit." (Submitted)
III. Tomson T, Bjornstrom C, Gilljam H, Helgason A (2005). "Are non-responders in a quitline evaluation more likely to be smokers? " BMC Public Health 5(1): 52
Pubmed
IV. Tomson T, Helgason AR, Gilljam H (2004). "Quitline in smoking cessation: a cost-effectiveness analysis. " Int J Technol Assess Health Care 20(4): 469-74
Pubmed
I. Helgason AR, Tomson T, Lund KE, Galanti R, Ahnve S, Gilljam H (2004). "Factors related to abstinence in a telephone helpline for smoking cessation. " Eur J Public Health 14(3): 306-10
Pubmed
II. Tomson T, Toftgard M, Gilljam H, Helgason AR (2005). "Symptoms in smokers trying to quit." (Submitted)
III. Tomson T, Bjornstrom C, Gilljam H, Helgason A (2005). "Are non-responders in a quitline evaluation more likely to be smokers? " BMC Public Health 5(1): 52
Pubmed
IV. Tomson T, Helgason AR, Gilljam H (2004). "Quitline in smoking cessation: a cost-effectiveness analysis. " Int J Technol Assess Health Care 20(4): 469-74
Pubmed
Issue date: 2005-11-11
Rights:
Publication year: 2005
ISBN: 91-7140-430-9
Statistics
Total Visits
Views | |
---|---|
Telephone ...(legacy) | 785 |
Telephone ... | 75 |
Total Visits Per Month
August 2020 | September 2020 | October 2020 | November 2020 | December 2020 | January 2021 | February 2021 | |
---|---|---|---|---|---|---|---|
Telephone ... | 6 | 2 | 6 | 3 | 9 | 2 | 6 |
File Visits
Views | |
---|---|
thesis.pdf(legacy) | 487 |
thesis.pdf | 108 |
thesis.pdf.txt(legacy) | 2 |
Top country views
Views | |
---|---|
United States | 372 |
Sweden | 135 |
Germany | 64 |
China | 43 |
South Korea | 22 |
United Kingdom | 17 |
Denmark | 10 |
Finland | 10 |
Russia | 10 |
France | 6 |
Top cities views
Views | |
---|---|
Stockholm | 37 |
Romeo | 31 |
Sunnyvale | 28 |
Kiez | 19 |
Seoul | 17 |
Beijing | 11 |
Berlin | 10 |
London | 7 |
Mountain View | 7 |
University Park | 7 |