1. The Missouri Tobacco Quitline at a Glance, 2010
(July 1, 2005 – June 30, 2009)
Noaman Kayani, PhD
Office of Epidemiology
Chronic Disease and Nutritional Epidemiology Response Team
Missouri Department of Health and Senior Services

2. The Missouri Tobacco Quitline
The Missouri Tobacco Quitline (MOQL) is funded through a cooperative agreement with the Centers for Disease Control and Prevention and a three-year grant from the Missouri Foundation for Health
The Missouri Department of Health and Senior Services (DHSS) has contracted with Free & Clear, Inc. to operate the MOQL
Free & Clear, Inc. currently provides tobacco cessation treatment services to more than 19 states across the nation

3. Missouri Tobacco Quitline
This report provides a quick glance at the MOQL utilization through graphs and GIS maps
Data for the period July 1, 2005 through June 30, are presented in the report
Number of Calls during this period: 15,872
The weekly call volume indicated that the average number of calls rose from 47 in 2005 to 32 in 2006 to 85 in 2007 to 88 in 2008 to 211 in 2009 (Only in this instance using calendar year)

4. The Missouri Tobacco Quitline Over Time
Weekly Calls to Missouri Quitline by Year
Year
Min.
Max.
Average
S.D.
C.O.V.
2005 4
241 47 99
2006 16
107 32 49
2007 5
1526 85
228
268
2008 26
161 88 36 41
2009
109
400
211 62 30
SD: Standard Deviation
COV: Coefficient of Variation

5. Caution
The content of this presentation is graphic in nature It may not be suitable for some audience We do not accept any responsibility how it would change your views

6. Who are the Callers to the Missouri Tobacco Quitline?
The following two graphs depict the demographic and other characteristics of the callers to the MOQL

7. Demographics of Callers to the Missouri Tobacco Quitline At A Glance July 1, 2005 - June 30, 2009

8. Demographics of Caller to the MOQL
Gender: Two-thirds (66.4%) were female Ethnicity: Only 2.0% Hispanics Race: Predominantly White (78.5%) Blacks 14.0% American Indians/Alaskan Natives 2.7% Other races 4.8% Education: Two-thirds (65.9%) with high school or less education Age: Majority years of age (30.6%) followed by years of age (21.8%) years of age (18.4%)

9. Callers to the Missouri Tobacco Quitline At A Glance July 1, 2005 - June 30, 2009

10. Other Information about Callers at a Glance
95% of callers were cigarette smokers
More than one-half of the callers to the MOQL (56%) had a chronic condition like asthma, chronic obstructive pulmonary disease (COPD), diabetes mellitus or coronary artery disease (CAD)
The majority of these callers (81%) requested an intervention

11. Other Information about Callers at a Glance
About one-third of the callers heard about the MOQL from one of the media sources (33%)
However, the role of the media as a referral source has been declining in recent years from 63% in FY05 to 15% in FY09 and referral from friends/family has become the most effective source, rising from 9% in FY05 to 37% in FY09
Among the media, the most effective media source was ‘TV/TV commercials/news’ (66%)

12. Types of Services Requested
81.2% requested an intervention
15.4% had general questions
3.1% requested material only

13. Services Requested Over Time
More and more Missourians are becoming familiar with the MOQL since the proportion that requested/received an intervention went up by 26.1%; from 70.4% in FY06 to 88.8% in FY09

14. Callers to MOQL in Context of Composition of Missouri Smokers

15. The Gender Composition
Disproportionately more callers to the MOQL were female (66.4%), female smokers in Missouri were 52% during the same period
The proportion of female smokers calling the MOQL has increased slightly from 63% in FY06 to 67% in FY09

16. How the Callers Heard About the Missouri Tobacco Quitline?
A majority of the callers to the MOQL heard about it through one of the media sources (32.7%)
Other prominent sources were ‘Family and Friends’ (25.7%) and ‘Health Professionals’ (19.3%)

17. Over Time: How the Callers Heard About the Missouri Tobacco Quitline?
Traditionally, media had been the major source where people heard about the MOQL
However, 'Family/Friend' and ‘Health Professional’ are increasingly popular sources.
Last year (FY09)'Family/Friend' had become the most effective source

18. Media Source Effectiveness in Promoting Calls to the Missouri Tobacco Quitline
The most effective media sources that the callers mentioned were ‘TV/Commercials/News’ (65.9%), followed by ‘Brochures/Newsletters/Flyers’ (12.1%), Website (8.2%), ‘Newspapers/Magazines’ (6.5%), ‘Radio/Commercials/News’ (4.4%), and ‘Outdoor Ads’ (3.0%)

19. Over Time: Media Source Effectiveness in Promoting Calls to the Missouri Tobacco Quitline
Traditionally, ‘TV/Commercials/News’ had been the major media source where people heard about the MOQL
However, ‘Brochures/Newsletters/Flyers’ had became the major media source followed by , ‘TV/Commercials/News’, ‘Website’ and ‘Radio/Commercials/News’

20. The Proportion of Priority Population Among Callers to the Missouri Tobacco Quitline
The Missouri Tobacco Quitline defines Uninsured, Medicaid Enrollees and Pregnant Women as the priority populations
They were 69.3% of all callers
More than one-third of them were on Medicaid and almost one-third had no insurance

21. Callers to the Missouri Tobacco Quitline by Health Insurance Status
An examination of callers to the MOQL by health care plan revealed that the largest group did not have health insurance (29.9%)
Disproportionately more calls were made by Missourians with Medicaid and the Uninsured
More than 50% of Missouri smokers had private insurance but only 15.6% of this group called the MOQL over this time period

22. Callers to the Missouri Tobacco Quitline by the Type of Tobacco Used
The callers to the MOQL were predominantly cigarette smokers (95.3%) even though cigarette smokers were 70.1% of tobacco users
Cigar, pipe and other tobacco use prevalence was 18.1% but the callers were 2.9%
Smokeless tobacco users were 11.8 % but their proportion among callers was only 1.8 %

23. Callers to the Missouri Tobacco Quitline by Ethnicity

24. Callers to the Missouri Tobacco Quitline by Racial Status
Compared to the percent of smokers in Missouri, disproportionately, fewer White smokers and more African American smokers called the MOQL
White smokers comprise about 84% and Black smokers were about 13% of the total smokers in Missouri

25. Callers to the Missouri Tobacco Quitline by Education Level
A majority of the callers to the MOQL had a high school diploma or GED (37.5%), followed by callers with less than a high school education (28.4%), some college education (25.1%), and college graduates (9.1%)
Missouri smokers with less than a high school education made disproportionately more calls to the MOQL
In contrast, the numbers of calls by all three other categories were less than their proportion of smokers in Missouri

26. Callers to the Missouri Tobacco Quitline by Age Groups
The highest proportion of calls to the MOQL was by adult smokers in the age group years (30.6%), followed by the year olds (21.8%)
Below the age of 40 except (18-24 year olds) and over 60, disproportionately fewer smokers called the MOQL

27. Did the Callers to the Missouri Tobacco Quitline Have Any Chronic Condition?
More than one-half of the callers to the MOQL (56.2%) had a chronic condition like asthma, chronic obstructive pulmonary disease (COPD), diabetes mellitus or coronary artery disease (CAD)
About 18.1% of the callers reported asthma, 17.9% reported COPD, 11.3% reported diabetes and 8.7% reported CAD

28. County Level Information about the Callers to the Missouri Tobacco Quitline
The county-level information from the weekly/monthly report on ‘How the Callers Heard about the Missouri Tobacco Quitline’ was used to produced several Geographical Information System (GIS) maps
The information analyzed through GIS maps not only provides information about the reach of the MOQL in Missouri counties but they also show the mode that is most effective in informing Missourians about the Quitline
With the help of these maps, we attempted to depict the difference in the reach over the lifetime of the MOQL

29. County Level Information …(Cont.)
Separate maps for total calls, major sources of referrals and for other referral categories are presented
All maps show the rate of calls per 10,000 of the smokers from a county (July 2005 through June 30, 2009)
First map shows that the highest rates of calls were made from St. Louis City followed by St. Louis, St. Charles, Webster, Stone, Ozark, Taney and Carter counties of Missouri.

31. County Level Information …(Cont.)
Next set of four maps shows the cumulative calls during the four fiscal years during July 1, June 30, 2009

32. Rate of Calls to the Missouri Tobacco Quitline from Missouri Counties Cumulative Over Time FY 2005 – FY 2009 (Rate per 10,000 Smokers) Source: Number of Callers: Missouri Tobacco Quitline (July 1, June 30, 2009) Number of Smokers: Missouri County Level Study, 2007

33. County Level Information …(Cont.)
Next three maps show the rate of calls from the top three referral sources:
Media
Friends and family
Health professionals

37. County Level Information …(Cont.)
Following set of four maps show the rate of calls from the other four referral sources:
Health department
Newspaper/magazines
Employer/work
Brochure/newsletters

38. Rate of Calls to the Missouri Tobacco Quitline by Missouri Counties and Referral Sources, FY06 – Fy09 Referral: Health Department, Newspaper/Magazines, Employer/Work and Brochure/Newsletters (Rate per 10,000 Smokers) Source: Number of Callers: Missouri Tobacco Quitline (July 1, June 30, 2009) Number of Smokers: Missouri County Level Study, 2007

39. County Level Information …(Cont.)
Following set of four maps show the rate of calls from the other four referral sources:
Non-profit organizations
Outdoor ads
Radio
Schools

40. Rate of Calls to the Missouri Tobacco Quitline from Missouri Counties and Referral Sources, FY06 – FY09 Referral: Non-Profit Organizations, Outdoor Ads, Radio and Schools (Rate per 10,000 Smokers) Source: Number of Callers: Missouri Tobacco Quitline (July 1, June 30, 2009) Number of Smokers: Missouri County Level Study, 2007

41. Weekly Call Volume to the Missouri Tobacco Quitline, June 5, 2005 - Nov 8, 2009

42. Take Away Message
The Missouri data shows that the evidence-based cessation strategies do make a difference
Tobacco tax increase – Federal tax increase of 62 cents
Media campaign – Missouri Cancer Consortium media campaign
Funding for Quitline –Free NRT created record high calls
Health professionals – Should be top referral source?
Friends and families – Their role is increasing as a referral source
Encourage people to call the Missouri Tobacco Quitline at
1-800-QUIT-NOW ( )
For more information:
Use DHSS website for more information and links

43. References
Centers for Disease Control and Prevention, Behavioral Risk Factor Surveillance System;
Missouri Department of Health and Senior Services, Missouri Tobacco Quitline data received from Free and Clear, Inc. Seattle, Washington, July 1, 2005 – June 30, 2009
Missouri County-level Study, 2007, Missouri Department of Health and Senior Services

44. Noaman Kayani, PhD Thank you Email: noaman.kayani@dhss.mo.gov
Office of Epidemiology
Chronic Disease and Nutritional Epidemiology Response Team
Missouri Department of Health and Senior Services