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Enrolling Smokers from Health Systems into Quitline Services: ‘Results of two enrollment strategies’

  • Barrett Sewali (a1) (a2), Janet L. Thomas (a2) (a3) (a4) (a5), Hongfei Guo (a6), Kevin Peterson (a1), Jasjit S. Ahluwalia (a3) (a4) (a5), Matthew J. Carpenter (a7), Christi Patten (a8), Edward F. Ellerbeck (a9) and Kolawole S. Okuyemi (a1) (a2) (a3) (a4)...


Objective: To determine the effects of motivational interviewing (MI) counselling versus a minimal intervention control on the enrollment of smokers in the Minnesota QUITPLAN Helpline.

Study design: Two-group randomized controlled trial of 235 community-dwelling adult smokers. Participants were randomly assigned to receive either a three-session phone based motivational interviewing intervention (n = 118) or the control (n = 117) consisting of mailed printed materials about the Minnesota QUITPLAN helpline services.

Data collection: Participants completed demographic and smoking-related survey questionnaire at baseline (by mail) and at weeks 4 and 26 (by phone) follow-up. Quitline enrollment status data was provided by the Minnesota QUITPLAN Helpline.

Principal findings: At week 4 follow-up, a higher proportion of participants in the MI group (22.3%) had enroled in the Minnesota QUITPLAN Helpline compared to those in the control arm (13.6%; p = 0.098). At week 26 follow-up, enrollment rates were similar for MI (28.0%) and control (26.5%) arms. Of those who enroled in the Helpline, participants in the MI group reported completing more Helpline sessions than those in control group (4.9 vs. 3.2; p = 0.087).

There was no significant interaction between readiness to quit and intervention for the outcome of enrollment in the Helpline.

Conclusions: A minimal intensity control such as mailing printed materials resulted in quitline enrollment rates similar to a more resource intensive intervention like motivational interviewing and several folds higher than the current state or national averages. We recommend that health plans should consider mailing smoking cessation promotional messages to encourage smokers to enrol in quitlines.


Corresponding author

Address for correspondence: Barrett Sewali, MBChB., M.P.H., Department of Family Medicine and Community Health 717 Delaware St. SE. Ste. 166 Minneapolis, MN 55414. Email:


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Ahluwalia, J. S., Dang, K. S., Choi, W. S., & Harris, K. J. (2002). Smoking behaviors and regular source of health care among African Americans. Preventive Medicine, 34 (3), 393396. Doi: 10.1006/pmed.2001.1004
Ahluwalia, J. S., Okuyemi, K., Nollen, N., Choi, W. S., Kaur, H., Pulvers, K., et al. (2006). The effects of nicotine gum and counseling among African American light smokers: A 2 × 2 factorial design. Addiction, 101 (6), 883891. Doi: 10.1111/j.1360-0443.2006.01461.x
American Medical Association (2012). Summary Table of Measures, Product Lines and Changes. NCQA 2013.
Amodei, N., & Lamb, R. J. (2004). Convergent and concurrent validity of the contemplation ladder and URICA scales. Drug and Alcohol Depend, 73 (3), 301306. Doi: 10.1016/j.drugalcdep.2003.11.005.
Barton, M. K. (2011). Smoking cessation telephone quitlines effective regardless of recruitment method. CA: A Cancer Journal for Clinicians, 61 (6), 361362. Doi: 10.3322/caac.20130.
Bentz, C. J., Bayley, K. B., Bonin, K. E., Fleming, L., Hollis, J. F., & McAfee, T. (2006). The feasibility of connecting physician offices to a state-level tobacco quit line. American Journal of Preventive Medicine, 30 (1), 3137. Doi: 10.1016/j.amepre.2005.08.043.
Biener, L., & Abrams, D. B. (1991). The contemplation ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychology, 10 (5), 360365.
Borland, R., & Segan, C. J. (2006). The potential of quitlines to increase smoking cessation. Drug and Alcohol Review, 25 (1), 7378. Doi: 10.1080/09595230500459537.
Bronar, C., & Saul, J. (2009). Increasing reach of tobacco cessation quitlines: A review of the literature and promising practices. Phoenix, Ariz NAQC.
Curry, S. J., Wagner, E. H., & Grothaus, L. C. (1991). Evaluation of intrinsic and extrinsic motivation interventions with a self-help smoking cessation program. Journal of Consulting and Clinical Psychology, 59 (2), 318324.
Davis, M. F., Shapiro, D., Windsor, R., Whalen, P., Rhode, R., Miller, H. S., et al. (2011). Motivational interviewing versus prescriptive advice for smokers who are not ready to quit. Patient Education and Counseling, 83 (1), 129133. Doi: 10.1016/j.pec.2010.04.024.
Fiore, M. C., & Baker, T. B. (2011). Clinical practice. Treating smokers in the health care setting. New England Journal of Medicine, 365 (13), 12221231. Doi: 10.1056/NEJMcp1101512.
Gordon, J. S., Lichtenstein, E., Severson, H. H., & Andrews, J. A. (2006). Tobacco cessation in dental settings: Research findings and future directions. Drug and Alcohol Review, 25 (1), 2737. Doi: 10.1080/09595230500459495.
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. Journal Biomedical Information, 42 (2), 377381. Doi: 10.1016/j.jbi.2008.08.010.
Hettema, J. E., & Hendricks, P. S. (2010). Motivational interviewing for smoking cessation: A meta-analytic review. Journal of Consulting and Clinical Psychology, 78 (6), 868884. Doi: 10.1037/a0021498.
Holtrop, J. S., Wadland, W. C., Vansen, S., Weismantel, D., & Fadel, H. (2005). Recruiting health plan members receiving pharmacotherapy into smoking cessation counseling. American Journal of Managed Care, 11 (8), 501507.
Hymowitz, N., Cummings, K. M., Hyland, A., Lynn, W. R., Pechacek, T. F., & Hartwell, T. D. (1997). Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tobacco Control, 6 (Suppl. 2), S57–62.
Katz, D. A., Muehlenbruch, D. R., Brown, R. B., Fiore, M. C., & Baker, T. B. (2002). Effectiveness of a clinic-based strategy for implementing the AHRQ smoking cessation guideline in primary care. Preventive Medicine, 35 (3), 293301.
Miller, W. R. (1996). Motivational interviewing: Research, practice, and puzzles. Addict Behav, 21 (6), 835842.
Nollen, N. L., Mayo, M. S., Sanderson Cox, L., Okuyemi, K. S., Choi, W. S., Kaur, H., et al. (2006). Predictors of quitting among African American light smokers enrolled in a randomized, placebo-controlled trial. Journal of General Internal Medicine, 21 (6), 590595. Doi: 10.1111/j.1525-1497.2006.00404.x.
O’Connor, R. J., Carlin-Menter, S. M., Celestino, P. B., Bax, P., Brown, A., Cummings, K. M., et al. (2008). Using direct mail to prompt smokers to call a quitline. Health Promotion Practical, 9 (3), 262270. Doi: 10.1177/1524839906298497.
Okuyemi, K. S., Ahluwalia, J. S., Ebersole-Robinson, M., Catley, D., Mayo, M. S., & Resnicow, K. (2003). Does menthol attenuate the effect of bupropion among African American smokers? Addiction, 98 (10), 13871393.
Okuyemi, K. S., Thomas, J. L., Hall, S., Nollen, N. L., Richter, K. P., Jeffries, S. K., et al. (2006). Smoking cessation in homeless populations: A pilot clinical trial. Nicotine and Tobacco Research, 8 (5), 689699. Doi: 10.1080/14622200600789841.
Okuyemi, K. S., et al. (2007). Pathways to health: A cluster randomized trial of nicotine gum and motivational interviewing for smoking cessation in low-income housing. Health Education and Behavior, 34 (1), 4354. Doi: 10.1177/1090198106288046.
Okuyemi, K. S., Goldade, K., Whembolua, G. L., Thomas, J. L., Eischen, S., Sewali, B., et al. (2013). Motivational interviewing to enhance nicotine patch treatment for smoking cessation among homeless smokers: A randomized controlled trial. Addiction, 108 (6), 11361144. Doi: 10.1111/add.12140.
Ossip-Klein, D. J., & McIntosh, S. (2003). Quitlines in North America: Evidence base and applications. American Journal of the Medical Sciences, 326 (4), 201205.
Rabius, V., McAlister, A. L., Geiger, A., Huang, P., & Todd, R. (2004). Telephone counseling increases cessation rates among young adult smokers. Health Psychology, 23 (5), 539541. Doi: 10.1037/0278-6133.23.5.539.
Shelley, D., Cantrell, J., Wong, S., & Warn, D. (2010). Smoking cessation among sheltered homeless: A pilot. American Journal of Health Behaviour, 34 (5), 544552.
Solberg, L. I., Maciosek, M. V., Edwards, N. M., Khanchandani, H. S., & Goodman, M. J. (2006). Repeated tobacco-use screening and intervention in clinical practice: Health impact and cost effectiveness. American Journal of Preventive Medicine, 31 (1), 6271. Doi: 10.1016/j.amepre.2006.03.013.
Stead, L. F., Hartmann-Boyce, J., Perera, R., & Lancaster, T. (2013). Telephone counselling for smoking cessation. The Cochrane Database of Systematic Reviews, 8, Cd002850. Doi: 10.1002/14651858.CD002850.pub3.
Vidrine, J. I., Shete, S., Cao, Y., Greisinger, A., Harmonson, P., Sharp, B., et al. (2013). Ask-Advise-Connect: A new approach to smoking treatment delivery in health care settings. JAMA Internal Medicine, 173 (6), 458464. Doi: 10.1001/jamainternmed.2013.3751.
Zhu, S. H., Anderson, C. M., Tedeschi, G. J., Rosbrook, B., Johnson, C. E., Byrd, M., et al. (2002). Evidence of real-world effectiveness of a telephone quitline for smokers. New England Journal of Medicine, 347 (14), 10871093. Doi: 10.1056/NEJMsa020660.


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Enrolling Smokers from Health Systems into Quitline Services: ‘Results of two enrollment strategies’

  • Barrett Sewali (a1) (a2), Janet L. Thomas (a2) (a3) (a4) (a5), Hongfei Guo (a6), Kevin Peterson (a1), Jasjit S. Ahluwalia (a3) (a4) (a5), Matthew J. Carpenter (a7), Christi Patten (a8), Edward F. Ellerbeck (a9) and Kolawole S. Okuyemi (a1) (a2) (a3) (a4)...


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