Quit Outcomes and Program Utilization by Mode of Entry Among Clients Enrolling in a Quitline

Uma S. Nair, Ryan C. Reikowsky, Betsy C. Wertheim, Cynthia A. Thomson, Judith S. Gordon

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: To investigate how mode of entry into a quitline influences program utilization and quit outcomes among clients seeking cessation services. Design: This is a retrospective analysis of clients receiving quitline services from January 2011 to June 2016. Setting: The study was conducted at the Arizona Smokers’ Helpline. Participants: Enrolled clients completed a 7-month follow-up (N = 18 650). Measures: The independent variable was referral mode of entry (ie, proactive, passive, and self-referral). Outcome variables included tobacco cessation medication use, number of coaching sessions completed, and 30-day tobacco abstinence at 7 months. Analysis: Logistic regression was used to analyze tobacco abstinence after controlling for potential confounders. Results: Compared to self-referred clients, proactively referred clients were least likely (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81-0.97), whereas passively referred clients were most likely (OR: 1.14; 95% CI: 1.00-1.30) to report tobacco abstinence. Proactively referred (OR: 0.79; 95% CI: 0.70-0.88), but not passively referred, clients were 21% less likely to report tobacco cessation medication use than self-referred clients. Conclusion: Proactive referrals are associated with lower utilization of tobacco cessation medication and less successful quit outcomes; however, provider referrals are critical to reaching tobacco users who may have more significant health risks and barriers to quitting. Examining potential barriers among both providers and provider-referred clients is needed to inform improvements in training providers on brief interventions for tobacco cessation.

Original languageEnglish (US)
Pages (from-to)1510-1517
Number of pages8
JournalAmerican Journal of Health Promotion
Issue number7
StatePublished - Sep 1 2018


  • cessation
  • mode of entry
  • provider referrals
  • quitline services
  • tobacco

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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