1. The Relationship Between Reach and Spending for U.S. Quitlines Mignonne Guy, Ph.D. Jessie E. Saul, Ph.D. Michele Walsh, Ph.D. Pamela Luckett, M.C.C., L.P.C., C.T.T.S. Linda Bailey, J.D., M.P.H. SRNT, Toronto, February 18, 2011

2. North American Quitline Consortium (NAQC) Established in 2004 Mission: Maximize the access, use, and effectiveness of quitlines; Provide leadership and a unified voice to promote quitlines; and Offer a forum to link those interested in quitline operations. Over 400 individual and organizational members in the U.S. and Canada

3. NAQC Annual Survey Conducted Annually 2004-2006, 2008, 2009 Research Partner 2008 & 2009 Surveys: Evaluation, Research and Development Unit, University of Arizona Data collected based on each quitline’s own fiscal year Methods 2008 –Web-based survey –53 US quitlines completed the survey (100%) –10 Canadian quitlines completed the survey (100%) Methods 2009 –Two waves of data collection –53 US quitlines completed wave 1 (100%); 52 completed wave 2 (98%) –10 Canadian quitlines completed wave 1 (100%); 9 completed wave 2 (90%)

4. NAQC and CDC Goals for Quitline Spending and Reach by 2014 $10.53 to be spent on quitline services (counseling) and medications per adult smoker in the state Reach 8% of smokers annually (# of callers) Serve 6% of smokers with quitline services (counseling and medications) (treatment reach) Source: Methodology presented in CDC, Best Practices for Comprehensive Tobacco Control Programs – 2007; calculations done by NAQC

5. Promotional Reach for Quitlines CanadaNMinMaxMeanMedian 200890.28%0.94%0.52%0.54% 200990.14%1.37%0.38%0.27% USNMinMaxMeanMedian 2008460.13%5.92%1.66%0.89% 2009490.16%9.84%1.89%1.18% Source: 2008 and 2009 NAQC Annual Surveys; reach calculated by dividing the number of callers indicating an interest in treatment by the number of estimated smokers in each state or province.

6. Spending Per Smoker on Services and Medications CanadaNMinMaxMeanMedian 20088$0.15$1.73$0.63$0.58 20099$0.16$2.83$0.85$0.68 USNMinMaxMeanMedian 200845$0.08$24.05$3.33$1.33 200950$0.14$20.81$3.15$1.96 Source: 2008 and 2009 NAQC Annual Surveys

7. Spending Per Smoker on Promotions and Outreach CanadaNMinMaxMeanMedian 200810$0.00$4.52$0.83$0.45 20099$0.30$4.66$1.51$0.67 USNMinMaxMeanMedian 200836$0.00$17.79$2.13$0.83 200944$0.00$25.42$2.49$1.20 Source: 2008 and 2009 NAQC Annual Surveys

8. Reach vs. Spending (services + meds) Per Smoker 2008 (U.S.) CDC recommendation: 8% reach, $10.53 per smoker r 2 =.81; p<.01

9. Reach vs. Spending Per Smoker (services + meds) 2009 (U.S.) r 2 =.89; p<.01 CDC recommendation: 8% reach, $10.53 per smoker

10. Reach vs. Spending Per Smoker (promotions + outreach) 2008 (US) r 2 =.37; p<.05

11. Reach vs. Spending Per Smoker (promotions + outreach) 2009 (US) r 2 =.42; p<.01

12. Conclusions Reach of US quitlines is very highly correlated with spending on services and medications, and moderately correlated with spending on promotions and outreach To reach and serve 6% of smokers, additional funding needs to be allocated to quitlines If sufficient funding is allocated, quitlines can serve larger numbers of smokers CDC estimated amounts seem to be in line with what quitlines are achieving in practice

13. Funding for the 2008 NAQC Annual Survey provided by: Centers for Disease Control and Prevention American Cancer Society American Legacy Foundation Robert Wood Johnson Foundation Novartis Consumer Health, Inc. Funding for the 2009 NAQC Annual Survey provided by: Centers for Disease Control and Prevention Pfizer, Inc. Robert Wood Johnson Foundation NAQC membership dues

14. For more information on the survey or on NAQC’s data request and review process, please contact; Jessie Saul, Ph.D. Director of Research North American Quitline Consortium Ph: 602.279-2719 x6 Email: jsaul@naquitline.orgjsaul@naquitline.org