The Swedish Quitline Proactive treatment Hans Gilljam & Asgeir Helgason Center for Tobacco...
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The Swedish QuitlineProactive treatment
Hans Gilljam & Asgeir Helgason
Center for Tobacco Prevention
Hans Gilljam CTP 2001
Cancerfonden, Folkhälsoinstitutet, Hjärt - Lungfonden, Apoteket AB och Centrum för Tobaksprevention
Smoking prevalence in SwedenSmoking prevalence in Sweden
19
0
10
20
30
40
50
60
63 77 80 81 82 83 84 85 86 87 88 91 92 93 94 95 96 97 98 99
Men
Women
Men and women 16-84 years oldPercent
SCB Year
Snus/Men
SNUS - oral moist snuffa peculiar habit of swedish men
• Health effects of snus– locally - oral cavity
• cancer - no evidence• gingiva • neck of tooth
– systemic - little harm described as yet• cancer - no evidence • cardio-vascular - still debated• type 2 diabetes (x2.6 risk increase)
– strong dependence
SNUFF
Snus - harm reduction in real life
• Snus was a habit of elderly, rural men
• Snus was intensively marketed from 1970´s
• 2001: prevalence snus users = smokers (males)
• About 5% of quitline callers are snus users
• No established cessation programs
Centre for Tobacco Prevention
• Smoking cessation
• Education & training
• Research and development
• Health information
• Epidemiology
• Primary prevention
Budget 1 mill EuroStaff 16 full-time15 part-timeProfessions2 physicians2 dentists2 psychologists6 nurses1 information off3 assistants+15 part time counsellors
*
Hälso L I N J E N
020
-331
122#
Smokefreeat work
The smorgasbordof support systemsrun by CTP
Computer-tailoredsmoking cessationon internet withautomatic follow-up and evaluation
Tone-dial 24h service
52h/week
Nationwidecontinouscampaign
Characteristics
• Medium-sized, free-of-charge Quitline – 2-3 lines open 52h/week – 4000-5000 serious quit attempts/year
• Emphasis on data collection/evaluation– data recorded at point of origin aided by techn. – no data overload or interference w. Counseling– research
• Proactive service
Time line
02/98 05/98 09/98 04/99 11/99 09/01
PlanningPhase Start
TVAdverts
Reactiveservice
Proactiveservice Present
Evaluation 1 Evaluation 2
Hans Gilljam CTP 2001
Continous Evaluation
No ofcalls
Opinions about reactive service
85
13
2 00
10
20
30
40
50
60
70
80
90
Very satisf. Satisfied Dissatisf. Very dissat.
Percent
340 responders
Proactive service
• Ask client if he/she desires call back and/or evaluation
• Negotiate dates for calls
• Register dates/time of day
• Proactive calls automatically registered
• Send questionnaire & material
Attracts spectrum of quitters
Attracts spectrum of quitters
I II III IV V
Precont Contempl Preparation Action Maintenance
Characteristics of callers (first call)
• 2 % Precontemplators
• 40 % Contemplation
• 38 % Preparation
• 20 % Action
• < 1% Maintenance
• > 80% chose proactive treatment
Preliminary results
Abstinence at 12 months (% self report)
Reactive Proactive
Women 26 42
Men 29 32
Total 27 39