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