Tracey Strader, MSW, Executive Director Oklahoma Tobacco Settlement Endowment Trust The Oklahoma Tobacco Helpline

Oklahoma Tobacco Helpline Funded by the Oklahoma Tobacco Settlement Endowment Trust Operated by Free & Clear, Inc. in Seattle, WA Administered by the Oklahoma State Department of Health Tobacco Use Prevention Service Independently evaluated by the University of Oklahoma College of Public Health

Overview of NRT Provision Aug 03 to Sep 04 offered counseling only –All service levels, including the 5-call program, available to all callers Sep 04, began offering 8 weeks (4 x 4) of NRT as an adjunct to the 5-call program –“Totally” uninsured and Medicare participants only –OK Medicaid covers Rx and OTC pharmacotherapy –All other callers eligible for all counseling levels

Rationale for NRT Provision It’s what they want PHS Guidelines indicate that: –Counseling is effective –Pharmacotherapy is effective Other published literature indicates that the combination of counseling and NRT is effective No way to justify large media promotion budget when demand and need for NRT were so high Based on South Dakota’s experience, we knew that NRT would create a large demand for Helpline services

NRT as Incentive to Counseling We hoped the NRT would be an incentive to get people engaged in effective counseling Enrollments into the 5-call program: –Prior to NRT, 50% of callers enrolled –After offering NRT, 80% of callers enrolled

Dates of Service F&C Only F&C + NRT through % through %96% Satisfaction: 3-month follow-up Primary complaint: Aug 03 through Jun 04 – no NRT offered for anyone Sep 04 through Dec 04 – no NRT offered for underinsured

Nearly 94% of Helpline registrants receiving NRT reported making a serious quit attempt since calling the Helpline compared to 85.3% who did not receive NRT. Quit Attempts: 3-month follow-up

Quit Rates: 3-month follow-up * Adjusted rates include refusals and unable to contact in denominator **ITT rates include all those initially pulled for the follow-up sample (refusals, unable, wrong info, ill/incapable) 7-day and 30-day abstinence rates at 3-month follow-up by treatment group: comparison of quit measures 7-day abstinence30-day abstinence NRT+FCFC OnlyNRT + FCFC Only Follow-up completers52.7%31.4%42.2%25.5% Adjusted* rates 41.3%20.0%32.9%16.2% ITT** rates33.7%15.0%26.8%12.2% 12-month follow-up data available from thru indicate 30-day quit rates for F&C only participants at 26%

Media and Tobacco Control Links FY 04 –Helpline budget was $500,000 for services and about $325,000 for promotion. Aug 03 –Press conference to launch Helpline resulted in over 2,000 “hits to the line” in two days. Sep 03 –Clean Indoor Air law took effect –Helpline information mailed to all employers to emphasize the support available during transition.

Media and Tobacco Control Links FY 05 –Helpline budget increased to $1.5 million plus $325,000 for promotion Nov 04 –Tobacco tax passed by voters –Press release for Great American Smokeout –Two weeks “Quitting Takes Practice” ad Dec 04 –Press release for New Year’s resolutions –Emphasized support available for smokers wanting to quit as a result of the tax

Call Volume FY 2005 to Date MonthRegistered Calls1-Call Program5-Call Program Jul Aug Sep Oct Nov-041, Dec-041, Jan-052, ,527 Feb-051, Mar-051, ,928 Oklahoma Adult Smokers = 1.5% reached in 9 months 513,075 Oklahoma Adult Daily Smokers = 1.9% reached in 9 months

Enrollment Rates in Programs Press Release Press Release

Media and Tobacco Control Links Due to the high call volumes we are unable to run any paid media. Currently promoting through community grantees and health systems, and most referrals are word of mouth. We have a need to do press releases related to the increase in cessation as a result of the tax increase but we are reluctant, as it will generate more calls. We hope to conduct targeted print and other paid media to increase calls from disparate populations in FY 06

Impact Formula Example: 2,000 Participants from Sep 04 thru Dec 04 Potential Impact ( Reach x Efficacy = Impact) : Free & Clear only 2,000 participants x 26% quit = 520 quit smokers Free & Clear + NRT 2,000 participants x 42% quit = 840 quit smokers