Session 7—Presentation and Panel Discussion International Quitline Institute 2011 Conference October 11, 2011 Seattle, Washington National Center for Chronic Disease Prevention and Health Promotion Office on Smoking and Health The findings and conclusions in this presentation are those of the author and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Setting Up a National Quitline Service: A 10-Step Framework

A 10-Step Framework  Create and launch a Quitline service.  Reexamine an existing Quitline service. 2

Identify a Quitline expert. A 10-Step Framework 3

Assess the need for a Quitline service in your country. A 10-Step Framework 4

Case Study: California Smokers Helpline  Provided Asian-language Quitlines with separate phone numbers.  Identified themes important to Asian callers:  Establishing credibility of counselor  Educating on cessation  Debunking health myths  Stressing the importance of the family  Managing social norms  Having a sensitivity to shame 5

Determine the place and role of the Quitline services in your national tobacco control strategy. A 10-Step Framework 6

Determine the goals of the Quitline. A 10-Step Framework 1. High reach with minimal counseling. 2. High effectiveness with lower reach. 3. High reach and high effectiveness. 7

Case Study: New Zealand Quitline  Offers free telephone support, low-cost nicotine replacement therapy, and other resources to all residents.  Used television, radio, and print campaigns, along with an interactive website and text messaging service.  Registered 44,000—or 5% of all smokers to make a quit attempt either by telephone or via the website in one year. 8

Determine the range of services and desired utilization rates.  Do this based on your assessment of needs and the goals you set. A 10-Step Framework 9

Determine strategies for creating demand for your Quitline. A 10-Step Framework 10

Case Study: Brazil  Brazil was the first country in Latin America to launch a nationwide Quitline in  Brazil was also the first large country to act on the WHO FCTC recommendation to put their Quitline number on the back of all cigarette packs, with graphic pictorial health warnings.  When Brazil put the telephone number on cigarette packs, the Quitline experienced unprecedented call volumes. 11

Determine which sponsors could fund and oversee the Quitline. A 10-Step Framework 12

Determine a project management plan for implementation. A 10-Step Framework 13

Determine which organization will deliver services. A 10-Step Framework 14

Determine who is accountable for ensuring the success of the Quitline. A 10-Step Framework 15

Case Study: Large Country  Limited budget for cessation, yet a high prevalence of tobacco use.  The majority of its health care workers, including doctors, smoked.  It targeted that group with aggressive promotion and proactive counseling to decrease tobacco use among its health care workers. 16

RE-AIM Model (Reach x Efficacy) x (Adoption x Implementation x Maintenance) = Impact Glasgow, RE, Vogt, TM, Boles, SM. Evaluating the public health impact of health promotion interventions: The RE-AIM framework. Am J Public Health 1999;89(9):1322–

Closing Contact others who have been involved in Quitline issues and operations for further consultation and assistance. 18

Questions for our Panelists  What is the place and the role of quit line services in the national tobacco control and treatment strategy?  Are there technological cultural or language issues that are barriers to acceptance of the quitline?  How have the features and services of your quitline changed as it has grown in experience and call volume?