NRT & NRT+ Pilot Preliminary Results Gowri Shetty MS, MPH Gita Bewtra MPH

Background Some sort of NRT benefit has been available to clients since In 2006, we offered a 50% discount on NRT and medications like Zyban An NRT workgroup was formed to address issues related to NRT and NRT+ coverage. Based on recommendations of the NRT workgroup, a pilot program was started in March 2008 where all clients received 12 week free NRT or NRT+ (including medications like Zyban, Welbutrin and Chantix) This pilot program was implemented for all clients enrolling in cessation services for the months of March and April 2008.

Background Funding –Pilot funded through Arizona tobacco tax, received by ADHS-BTEP –Estimated billing between March 1, 2008 thru April 30, 2008: ~$200K – 250K

Purpose of the Pilot Program To assess the impact of offering 12 week free NRT and NRT+ on Quitline service utilization and cessation outcomes Specifically we looked at: –How effective is offering free medication in motivating people to call the quit line? –Do free medications impact someone’s ability to quit for at least 7 days, 30 days or more? Does this vary by type of NRT/medication? –Do people value the behavioral support offered through the Quitline, and is there a difference if they do?

Pilot Program Description All clients enrolled in cessation services were offered 12 week free NRT/NRT+ NRT/NRT+ was mail ordered through BeBetter Networks Inc.

Methods Compared Quitline utilization for months before, during and after the pilot program All clients enrolled during the months of March and April 2008 were followed up at 4 months to assess their smoking status Criteria for follow-up –Complete the Client Intake Form (CIF) –Consent for follow up Up to 10 attempts were made to contact eligible callers

Demographics Age Gender Race/Ethnicity Insurance

Age Age RangeAll Callers N (%) Callers reached for follow up N (%) Mean <2444 (2.2%)18 (1.8%) 24 - <34268 (13.%)118 (11.5%) 34 - <44399 (19.8%)184 (17.9%) 44 - <54569 (28.2%)308 (30.0%) 54 - <64472 (23.4%)252 (24.5%) (12.8%)146 (14.2%) Missing5 (0.2%)1 (0.1%)

Gender All Callers N (%) Callers reached for follow up N (%) Male752 (37.3%)393 (38.3%) Female1224 (60.7%)619 ( 60.%) Missing39 (1.9%)15 (1.5%)

Race/Ethnicity All Callers N (%) Callers reached for follow up N (%) White1715 (85.1%)896 (87.2%) Latino194 (9.6%)74 (7.2%) African American57 (2.8%)30 (2.9%) American Indian/Alaskan Native 36 (1.8%)17 (1.7%) Asian10 (0.5%)6 (0.6%) Other129 (6.4%)51 (5.0%)

Insurance Insurance Coverage All Callers N (%) Callers reached for follow up N (%) Yes1173 (88.0%)900 (87.6%) AHCCCS443 (22.0%)210 (20.4%)

Results Call volume –2015 calls Clients reached at follow up –1027

Follow – up Clients Participants who enrolled in the free NRT program –854 (83.2%) How important was the offer of the free quit medication in your decision to quit tobacco? –Almost 80% said it was important

Follow – up Clients NRT/NRT+Number of Clients Chantix543 (52.9%) Bupropion6 (0.6%) Patch65 (6.3%) Gum16 (1.6%) Lozenge19 (1.9%) Did not use NRT378 (36.8%)

Quit Rate Calculation REACHED ONLY – Continuous quit Number of participants who have not used tobacco since last call Total number reached at call (1027) REACHED ONLY – 24 hour quit Number of participants who have not used tobacco in the past 24 hours Total number reached at call (1027)

Follow – up Clients NRT/NRT+ type Continuous Quit percentage Continuous Quit Rate 24 hour Quit percentage 24 Quit Rate Chantix (543) 44.6%23.6%10.3%5.5% Bupropion* (6) 66.7% Sample size too small 16.7% Sample size too small Patch (65) 38.5%2.4%16.9%1.1% Gum (16) 37.5% Sample size too small 18.8% Sample size too small Lozenge (19) 31.6% Sample size too small 15.8% Sample size too small Did Not Use NRT (378) 21.7%8.0%8.7%3.2%

Follow – up Clients NRT/NRT+ type Continuous Quit percentage Continuous Quit Rate 24 hour Quit Percentage 24 Hour Quit Rate Chantix (543) 44.6%23.6%10.3%5.5% All Other (106) 38.7%4.0%17.0%1.8% Did Not Use NRT (378) 21.7%8.0%8.7%3.2%

Follow – up Clients How important was the offer of quit coaching in your decision to quit tobacco? –Over 75% said it was important How helpful did you find the coaching in your efforts to quit tobacco? –Over 55% said it was helpful Overall, how satisfied were you with the service you received from the cessation quitline? –Over 67% said they were mostly or very satisfied

Next Steps Calculation of quit rates, based on new NAQC recommendations Recommendations for provision of NRT/NRT+ Compare pilot data to before and after data

Questions?