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Non-responders in a quitline evaluation are more likely to be smokers: a drop-out and long-term follow-up study of the Swedish National Tobacco Quitline
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland. Karolinska Inst, Dept Med, Stockholm, Sweden..
Karolinska Inst, Dept Publ Hlth Sci, Social Med, Stockholm, Sweden.;Stockholm Cty Council, Ctr Epidemiol & Community Med, Stockholm, Sweden.;Reykjavik Univ, Reykjavik, Iceland..
2016 (English)In: Tobacco Induced Diseases, ISSN 1617-9625, E-ISSN 1617-9625, Vol. 14, 5Article in journal (Refereed) Published
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Abstract [en]

Background: A previous randomized controlled trial (RCT) of the Swedish National Tobacco Quitline detected no significant differences in smoking cessation outcomes between proactive and reactive services at 12-month follow-up. However, the response rate was only 59 % and non-responders were over-represented in the proactive service. We performed a drop-out analysis to assess the smoking status of initial responders and non-responders. Methods: At 29-48 months after the first call, a postal questionnaire with six questions was sent to 150 random clients from the RCT database, with equal numbers from the proactive and reactive services as well as responders and non-responders at 12-month follow-up. Clients who did not return the questionnaire were contacted by telephone. The outcome measures were point prevalence (PP) and 6-month continuous abstinence (CA), and their associations with response status at 12 months were assessed by logistic regression. Results: The response rate was 74 % (111/150). Abstinence was significantly higher among initial responders than non-responders (PP 54 % vs. 32 %, p=.023 and CA 49 % vs. 21 %, p=.003). The odds ratios for initial responders vs. initial non-responders were, for PP = 2.5 (95 % CI 1.1-5.6, p=.024), and for CA = 3.7 (95 % CI 1.5-8.9, p=.004), after adjusting for proactive/reactive service. Conclusions: Non-responders to a 12-month follow-up smoking cessation questionnaire in a quitline setting were more likely to be smokers 1.5-3 years later. We propose a conservative correction factor of 0.8 for self-reported abstinence in telephone-based cessation studies if the response rate is approximately 55-65 %.

Place, publisher, year, edition, pages
2016. Vol. 14, 5
Keyword [en]
Effectiveness, Intention-to-treat, Non-response, Per protocol, Proactive, Reactive, Responder-only analysis, Smoking, Telephone, Questionnaire
National Category
Substance Abuse Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-277978DOI: 10.1186/s12971-016-0070-2ISI: 000369136400001PubMedID: 26843854OAI: oai:DiVA.org:uu-277978DiVA: diva2:908262
Funder
Swedish Heart Lung FoundationSwedish Heart Lung FoundationSwedish Cancer SocietySwedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareStockholm County Council
Available from: 2016-03-02 Created: 2016-02-23 Last updated: 2017-11-30Bibliographically approved

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Nohlert, Eva

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