Expanding the reach of the Quitline by engaging volunteers to market it in hospitals and shopping venues – a pilot study
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Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada
Submission date: 2015-01-15
Acceptance date: 2015-06-03
Publication date: 2015-06-10
Corresponding author
Barry A. Finegan   

Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada
Tobacco Induced Diseases 2015;13(June):13
In Canada, although there are periodic media campaigns to raise awareness of Quitlines, these services are underused. We sought to determine if a dedicated kiosk, similar to that used in the retail industry but staffed by volunteers trained in smoking cessation techniques, would be effective method to enhance Quitline reach.

We located a kiosk in the foyer of two hospitals and in two shopping malls in Edmonton, Canada between Feb/2012 and July/2014. The cessation intervention was based on the 5 A's approach. Outcome was assessed by number of visits to the kiosk and referral rates to the Quitline. A cross sectional survey among small sample of visitors was used for evaluation. Descriptive statistics were used to summarize visitors’ data.

Of 1091 kiosk visitors, 53.3 % were current smokers, of whom 93.3 % indicated a willingness to quit. Of these, 32.1 % requested a Quitline referral at the time of the kiosk visit. Referral requests to the Quitline were greater when the kiosk was located in the non-hospital setting 39.1 % compared to 31.1 % in hospitals (P = 0.2). Referrals from the kiosk represented 6 % of total referrals received by the provincial Quitline during the study period. Following referral the Quitline was able to reach 50 % of those referred, of those, 17 % refused to proceed. At seven month follow up 30 day abstinence rate was 3.8 % of smokers who wished quit. Visitors agreed that the kiosk design was interesting (89.3 %) and increased their knowledge about tobacco and cessation options (88.8 %) and encouraged them to take action to quit (85.7 %).

A “volunteer manned kiosk” can increase awareness of smoking cessation resources in the community and increase referral rates to Quitline services.

Health Canada. Canadian Tobacco Use Monitoring Survey (CTUMS) 2012. 2012.
Reid J, Hammond D, Rynard V, et al. Tobacco Use in Canada : Patterns and Trends. Waterloo, ON: 2015.
Centers for Disease Control and Prevention (CDC. Current Cigarette Smoking Among Adults - United States, 2005–2013. MMWR Morbid Mortal Wkly Rep. 2014;63:1108–12.
King BA, Dube SR, Tynan MA. Current tobacco use among adults in the United States: findings from the National Adult Tobacco Survey. Am J Public Health. 2012;102:e93–100. doi:10.2105/AJPH.2012.301002; 10.2105/AJPH.2012.301002.
Reid JL, Hammond D, Driezen P. Socio-economic status and smoking in Canada, 1999–2006: has there been any progress on disparities in tobacco use? Can J Publ Heal Can sante publique. 2010;101:73–8.
Health Canada. Canadian Tobacco Use Monitoring Survey (CTUMS) 2011 Supplementary Tables. 2011; 2012.
Harkins C, Shaw R, Gillies M, et al. Overcoming barriers to engaging socio-economically disadvantaged populations in CHD primary prevention: a qualitative study. BMC Public Health. 2010;10:391. doi:10.1186/1471-2458-10-391.
Baliunas D, Patra J, Rehm J, et al. Smoking-attributable morbidity: acute care hospital diagnoses and days of treatment in Canada, 2002. BMC Public Health. 2007;7:247. doi:10.1186/1471-2458-7-247.
Wilkins K, Shields M, Rotermann M. Smokers’ use of acute care hospitals–a prospective study. Health Rep. 2009;20:75–83.
Sachs R, Wild TC, Thomas L, et al. Smoking cessation interventions in the pre-admission clinic: assessing two approaches. Can J Anaesth. 2012;59:662–9. doi:10.1007/s12630-012-9716-6.
Lawn S. Habit or addiction: the critical tension in deciding who should enforce hospital smoke-free policies. CMAJ. 2011;183:2085–6. doi:10.1503/cmaj.111579.
Schultz AS, Finegan B, Nykiforuk CI, et al. A qualitative investigation of smoke-free policies on hospital property. CMAJ. 2011;183:E1334–44. doi:10.1503/cmaj.110235.
Krishen AS, Bui M, Peter PC. Retail kiosks: how regret and variety influence consumption. Int J Retail Distrib Manag. 2010;38:173–89. doi:10.1108/09590551011027113.
Runyan R, Kim J, Baker J. The mall as bazaar : How kiosks influence consumer shopping behaviour. J Mark Manag. 2012;28:85–102.
Ellins J, Coulter A. How engaged are people in their health care ? Findings of a national telephone survey. Oxford: 2005. engaged are people in their healthcare full report.pdf?realName=vqk1xh.pdf.
Ellins J. MS. Supporting patients to make informed choices in primary care: what works? Birmingham: 2009.
Johnson A, Sandford J, Tyndall J. Written and verbal information versus verbal information only for patients being discharged from acute hospital settings to home (Review). Health Educ Res. 2005;20:423–9. doi:10.1093/her/cyg141.
Alberta Health Services. Tobacco Free Futures Guidelines. 2014.
Fiore MC, Bailey WC, Cohen SJ, et al. Treating Tobacco Use and Dependence. Clinical Practice Guideline. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2000.
Alberta Health Services. Alberta Quits Helpline. 2014.
Krishen A, Bui M, Peter P. Kiosk retailing environments: Exploring the role of regret and variety on consumer behavior. Int J Retail Distrib Manag. 2010;38:173–89.
Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence 2008 update. Rockville: U.S. Department of Health and Human Services. Public Health Service; 2008.
Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev. 2008;2, CD000165. doi:10.1002/14651858.CD000165.pub3.
Raupach T, Merker J, Hasenfuss G, et al. Knowledge gaps about smoking cessation in hospitalized patients and their doctors. Eur J Cardiovasc Prev Rehabil. 2011;18:334–41. doi:10.1177/1741826710389370.
Schultz AS, Bottorff JL, Johnson JL. An ethnographic study of tobacco control in hospital settings. Tob Control. 2006;15:317–22. doi:10.1136/tc.2005.015388.
Smith PM, Sellick SM, Brink P, et al. Brief smoking cessation interventions by family physicians in northwestern Ontario rural hospitals. Can J Rural Med. 2009;14:47–53.
Vogt F, Hall S, Marteau TM. General practitioners’ and family physicians’ negative beliefs and attitudes towards discussing smoking cessation with patients: a systematic review. Addiction. 2005;100:1423–31. doi:10.1111/j.1360-0443.2005.01221.x.
Vidrine DJ, Vidrine JI. Active vs passive recruitment to quitline studies: public health implications. J Natl Cancer Inst. 2011;103:909–10. doi:10.1093/jnci/djr193.
Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2006;3, CD002850. doi:10.1002/14651858.CD002850.pub2.
Stead LF, Perera R, Lancaster T. A systematic review of interventions for smokers who contact quitlines. Tob Control. 2007;16 Suppl 1:i3–8. doi:10.1136/tc.2006.019737.
Kirst M, Schwartz R. Promoting a smokers’ quitline in Ontario, Canada: an evaluation of an academic detailing approach. Health Promot Int Published Online First: 2013. doi:10.1093/heapro/dat040.
Mathew M, Goldstein AO, Kramer KD, et al. Evaluation of a direct mailing campaign to increase physician awareness and utilization of a quitline fax referral service. J Health Commun. 2010;15:840–5. doi:10.1080/10810730.2010.522223.
Hurd AL, Augustson EM, Backinger CL, et al. Impact of national ABC promotion on 1-800-QUIT-NOW. Am J Health Promot. 2007;21:481–3.
Tzelepis F, Paul CL, Wiggers J, et al. A randomised controlled trial of proactive telephone counselling on cold-called smokers’ cessation rates. Tob Control. 2011;20:40–6. doi:10.1136/tc.2010.035956; 10.1136/tc.2010.035956.
Nohlert E, Ohrvik J, Helgason AR. Effectiveness of proactive and reactive services at the Swedish National Tobacco Quitline in a randomized trial. Tob Induc Dis. 2014;12:9. doi:10.1186/1617-9625-12-9.
North American Quitline Consortium. Tobacco Cessation Quitlines A Good Investment to Save Lives, Decrease Direct Medical Costs and Increase Productivity. 2009.
Duffy SA, Ewing LA, Louzon SA, et al. Evaluation and costs of volunteer telephone cessation follow-up counseling for Veteran smokers discharged from inpatient units: a quasi-experimental, mixed methods study. Tob Induc Dis. 2015;13:4. doi:10.1186/s12971-015-0028-9.
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