States may improve tobacco cessation results by offering both telephone- and Web-based cessation services rather than one or the other, according to an article published in the January 2 issue of the Centers for Disease Control and Prevention (CDC) publication Morbidity and Mortality Weekly Report.

Mary Puckett, PhD, from the CDC’s Epidemic Intelligence Service, and colleagues describe the results of a survey CDC researchers conducted involving four states’ quitline service participants between July 2011 and February 2012.

Quitline participants in Alabama, Arizona, Florida, and Vermont responded to standard demographic and smoking-related questions via Web, mail, or telephone when they enrolled in a telephone- or Web-based program. Researchers administered a follow-up questionnaire 7 months later, asking whether the participants had smoked in the past 30 days and whether they used a single or both services.

Of the 5393 participants included in the final analysis, 2238 were telephone users, 1848 were Web users, and 1307 were dual-service users.

Dual-service users were almost 20% more likely to have abstained from smoking during the past 30 days than telephone users and about 50% more likely to have abstained than Web users. At 7 months’ follow-up, 38% of dual-service users reported abstinence from smoking, compared with 34% of telephone users and 29% of Web users.

Dual-service users were younger than telephone users but older than Web users (mean ages, 44, 47, and 40 years, respectively), had higher levels of education than telephone users but lower than Web users, and were slightly more likely to be white than black or Hispanic compared with telephone users but about 10% less likely to be white than Web users.

Sex and age made no significant difference.

However, participants living with a spouse were more likely to abstain from smoking if no other person living in the house was a smoker.

“[T]he availability and combined use of telephone-only and Web-based services might enhance quit success, but it might also reflect a greater commitment to quit among persons who use both services,” the researchers write.

Physicians who provide initial counseling to patients seeking to quit smoking can use these findings based on their patient population. Public health practitioners can use the information to determine the best smoking cessation programs to offer based on their patient populations, and to identify more effective programs for patients who have already tried unsuccessfully to quit smoking.

Limitations include possible lack of generalizability because only four states were involved whereas all states provide one or the other type of program, as well as the self-reported data. The study also did not include any tobacco products other than cigarettes.
The researchers conclude, “These findings suggest that access to and use of both cessation services might improve tobacco cessation success. Use of Web-based and telephone cessation services in combination provides a new tool for public health programs, such as CDC’s National Comprehensive Cancer Control Program, to prevent lung cancer. As such, tobacco and cancer control programs might choose to focus on implementation and improvement of both types of cessation services in their populations.”