RESEARCH PAPER
Non-responders in a quitline evaluation are more likely to be smokers – a drop-out and long-term follow-up study of the Swedish National Tobacco Quitline
Eva Nohlert 1  
,  
John Öhrvik 1, 2
,  
 
 
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1
Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
2
Department of Medicine, Karolinska Institutet, Stockholm, Sweden
3
Department of Public Health Sciences, Social Medicine, Karolinska Institutet and Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
4
Reykjavik University, Reykjavik, Iceland
CORRESPONDING AUTHOR
Eva Nohlert   

Centre for Clinical Research, Uppsala University, Västmanland County Hospital, 721 89 Västerås, Sweden
Publish date: 2016-02-03
 
Tobacco Induced Diseases 2016;14(February):5
KEYWORDS
ABSTRACT
Background:
A previous randomized controlled trial (RCT) of the Swedish National Tobacco Quitline detected no significant differences in smoking cessation outcomes between proactive and reactive services at 12-month follow-up. However, the response rate was only 59 % and non-responders were over-represented in the proactive service. We performed a drop-out analysis to assess the smoking status of initial responders and non-responders.

Methods:
At 29–48 months after the first call, a postal questionnaire with six questions was sent to 150 random clients from the RCT database, with equal numbers from the proactive and reactive services as well as responders and non-responders at 12-month follow-up. Clients who did not return the questionnaire were contacted by telephone. The outcome measures were point prevalence (PP) and 6-month continuous abstinence (CA), and their associations with response status at 12 months were assessed by logistic regression.

Results:
The response rate was 74 % (111/150). Abstinence was significantly higher among initial responders than non-responders (PP 54 % vs. 32 %, p = .023 and CA 49 % vs. 21 %, p = .003). The odds ratios for initial responders vs. initial non-responders were, for PP = 2.5 (95 % CI 1.1–5.6, p = .024), and for CA = 3.7 (95 % CI 1.5–8.9, p = .004), after adjusting for proactive/reactive service.

Conclusions:
Non-responders to a 12-month follow-up smoking cessation questionnaire in a quitline setting were more likely to be smokers 1.5–3 years later. We propose a conservative correction factor of 0.8 for self-reported abstinence in telephone-based cessation studies if the response rate is approximately 55–65 %.

 
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