Tracey Strader, MSW, Executive Director

Oklahoma Tobacco Settlement Endowment Trust

traceys@tset.ok.gov 405-525-8738

The The Oklahoma Oklahoma Tobacco Tobacco HelplineHelpline

Oklahoma Tobacco Helpline

• Funded by the Oklahoma Tobacco Settlement Endowment Trust

• Operated by Free & Clear, Inc. in Seattle, WA

• Administered by the Oklahoma State Department of Health Tobacco Use Prevention Service

• Independently evaluated by the University of Oklahoma College of Public Health

Overview of NRT Provision

• Aug 03 to Sep 04 offered counseling only – All service levels, including the 5-call program,

available to all callers

• Sep 04, began offering 8 weeks (4 x 4) of NRT as an adjunct to the 5-call program – “Totally” uninsured and Medicare participants only – OK Medicaid covers Rx and OTC pharmacotherapy– All other callers eligible for all counseling levels

Rationale for NRT Provision

• It’s what they want

• PHS Guidelines indicate that:– Counseling is effective– Pharmacotherapy is effective

• Other published literature indicates that the combination of counseling and NRT is effective

• No way to justify large media promotion budget when demand and need for NRT were so high

• Based on South Dakota’s experience, we knew that NRT would create a large demand for Helpline services

NRT as Incentive to Counseling

• We hoped the NRT would be an incentive to get people engaged in effective counseling

• Enrollments into the 5-call program:– Prior to NRT, 50% of callers enrolled– After offering NRT, 80% of callers enrolled

Dates of Service

F&C Only

F&C + NRT

08-03 through 06-04 92% --

09-04 through 12-04 89% 96%

Satisfaction: 3-month follow-up

Primary complaint:

• Aug 03 through Jun 04 – no NRT offered for anyone

• Sep 04 through Dec 04 – no NRT offered for underinsured

Nearly 94% of Helpline registrants receiving NRT reported making a serious quit attempt since calling the Helpline compared to 85.3% who did not receive NRT.

Quit Attempts: 3-month follow-up

Serious quit attempt since calling the Helpline

93.5

5.4 1.1

85.3

14.7

00

20

40

60

80

100

Yes No DK/Refused

Perc

en

t

NRT+FC

FC only

Quit Rates: 3-month follow-up

*Adjusted rates include refusals and unable to contact in denominator**ITT rates include all those initially pulled for the follow-up sample (refusals, unable, wrong info, ill/incapable)

7-day and 30-day abstinence rates at 3-month follow-up by treatment group: comparison of quit measures

7-day abstinence 30-day abstinence NRT+FC FC Only NRT + FC FC Only

Follow-up completers 52.7% 31.4% 42.2% 25.5%

Adjusted* rates 41.3% 20.0% 32.9% 16.2%

ITT** rates 33.7% 15.0% 26.8% 12.2%

•12-month follow-up data available from 08-03 thru 03-04 indicate 30-day quit rates for F&C only participants at 26%

Media and Tobacco Control Links

• FY 04– Helpline budget was $500,000 for services and about

$325,000 for promotion.

• Aug 03 – Press conference to launch Helpline resulted in over

2,000 “hits to the line” in two days.

• Sep 03– Clean Indoor Air law took effect– Helpline information mailed to all employers to

emphasize the support available during transition.

Media and Tobacco Control Links

• FY 05– Helpline budget increased to $1.5 million plus

$325,000 for promotion

• Nov 04– Tobacco tax passed by voters– Press release for Great American Smokeout– Two weeks “Quitting Takes Practice” ad

• Dec 04– Press release for New Year’s resolutions– Emphasized support available for smokers wanting to

quit as a result of the tax

Call Volume FY 2005 to Date

Month Registered Calls 1-Call Program 5-Call Program

Jul-04 210 113 97

Aug-04 383 168 215

Sep-04 445 194 251

Oct-04 531 278 253

Nov-04 1,696 816 880

Dec-04 1,376 569 807

Jan-05 2,404 877 1,527

Feb-05 1,514 568 946

Mar-05 1,268 526 742

672,928 Oklahoma Adult Smokers = 1.5% reached in 9 months513,075 Oklahoma Adult Daily Smokers = 1.9% reached in 9 months

Enrollment Rates in Programs

1-Call Program

5-Call Program

0500

10001500

20002500

3000

July

August

Septe

mber

Oct

ober

Novem

ber

Decem

ber

Januar

y

Febru

ary

Mar

ch

PressRelease

PressRelease

Media and Tobacco Control Links

• Due to the high call volumes we are unable to run any paid media.

• Currently promoting through community grantees and health systems, and most referrals are word of mouth.

• We have a need to do press releases related to the increase in cessation as a result of the tax increase but we are reluctant, as it will generate more calls.

• We hope to conduct targeted print and other paid media to increase calls from disparate populations in FY 06

Impact Formula

Example:

2,000 Participants from Sep 04 thru Dec 04

Potential Impact (Reach x Efficacy = Impact): • Free & Clear only

2,000 participants x 26% quit = 520 quit smokers

• Free & Clear + NRT

2,000 participants x 42% quit = 840 quit smokers