User Satisfaction as a Tool for Assessment and Improvement of Quitline in the Republic of Korea

Telephone-Based Smoking Cessation Counseling Service: Satisfaction and Outcomes in Vietnamese Smokers

BACKGROUND

As a method to acknowledge the devastating health and economic impacts of tobacco usage worldwide, telephone-based tobacco cessation counseling services have emerged as a potential tool to aid people in their quitting process. This study explores the satisfaction of smokers who use the QUITLINE service and factors associated with their quit attempts and cessation.

METHODS

A cross-sectional survey of 110 participants was conducted from June to July 2016 at the Respiratory Center at Bach Mai Hospital, Hanoi, Vietnam. Multivariate logistic regression was used, and it was found that the percentage of people quitting smoking increased after using the service.

RESULTS

In total, 65.5% of participants were completely satisfied with the counseling service. The mean score of staff/s capacity/responsiveness, motivation, and service convenience were 4.37 ± 0.78, 4.30 ± 0.81, and 4.27 ± 0.66, respectively. The smoking relapse rate was relatively high at 58.3%, which mainly resulted from cravings and busy work (26.2% and 14.3%, respectively). A higher satisfaction score in "Staffs' capacity and responsiveness" was negatively associated with "ever tried to quit smoking in consecutive 24 h" and actually quit smoking after receiving counseling. Meanwhile, a higher score in the "Motivation" domain was positively associated with both quit attempt indicators as well as actually quitting smoking after receiving counseling (OR = 9.48; 95%CI = 2.27; 39.57).

CONCLUSIONS

These results suggest that it is crucial for decision makers to place more focus on countermeasures for smoking relapse and to strengthen the capacity of staff, especially in motivating clients. Interventions should also be maintained throughout a long period of time to prevent relapse.

Implementing a smoking cessation intervention for people experiencing homelessness: Participants' preferences, feedback, and satisfaction with the 'power to quit' program

BACKGROUND

Smoking rates among populations experiencing homelessness are three times higher than in the general population. Developing smoking cessation interventions for people experiencing homelessness is often challenging. Understanding participant perceptions of such interventions may provide valuable insights for intervention development and implementation. We assessed participants' satisfaction and preferences for the Power to Quit (PTQ) program.

METHODS

PTQ was a 26-week community-based smoking-cessation RCT among people experiencing homelessness. A total of 315 of the 430 enrolled participants completed the 26 week-study feedback survey. Overall program satisfaction was measured on a 5-point Likert scale by asking the question "Overall, how satisfied were you with the Power to Quit Program?" Analyses were conducted to identify factors associated with overall program satisfaction.

RESULTS

Participants were mostly male (74.9%), African American (59.0%), 40 years and older (78.2%), and not married or living with a partner (94.9%). Visa gift cards were the most preferred incentive followed by bus tokens and Subway restaurant coupons. The patch and counseling were the top-ranked intervention component, 55.3% rated the patch as very helpful; 59.4% felt counseling sessions was very helpful; 48.6% found reminder phone calls or messages most helpful for appointment reminders. Majority (78.7%) said they were very satisfied overall, 80.0% were very satisfied with the program schedule, and 85.4% were very satisfied with program staff. Race and age at smoking initiation were predictors of overall program satisfaction. African American/Black participants were 1.9 times more likely to be satisfied with the program compared to White participants.

CONCLUSION

Majority of the participants of PTQ were satisfied with the program. This study supports the acceptability of a smoking cessation program implemented in a population experiencing homelessness. The high rate of satisfaction among African American participants may be in part because of race concordance between participants, study staff, and community advisory board. Including staff that have a shared lived experience with participants in a smoking cessation study may improve the participant satisfaction within such studies.

Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

Comparison of smoking cessation rates of Quitline users in Korea between smokers of ultra-low nicotine yield cigarettes and other types of cigarette: a prospective study

AIMS

It is not known whether the machine-smoked nicotine yield of usual brand of cigarette smoked is associated with the chances of success of quit attempts. This study aimed to assess this association.

DESIGN

Prospective study.

SETTING

Republic of Korea.

PARTICIPANTS

A total of 16 808 male smokers registered for the Quitline between 7 April 2006 and 31 December 2013. Of these, 13 176 participants who were > 19 years of age and provided data on their demographic characteristics, smoking-related behaviors, nicotine dependence, tobacco brands used and self-efficacy were included in this study.

MEASUREMENTS

Machine-smoked nicotine yield was based on information provided by tobacco companies on cigarette packages that smokers reported as their usual brand. Ultra-low nicotine yield was defined as ≤ 0.1 mg machine-smoked nicotine yield per cigarette, whereas higher nicotine yield was defined as > 0.1 mg machine-smoked nicotine yield. Participant personal information and self-reported continuous abstinence at 1-month, 6-month and 1-year follow-up were recorded in electronic databases.

FINDINGS

Continuous abstinence rates in the ultra-low nicotine yield versus higher nicotine yield groups were, respectively, 40.7 versus 34.6% at 1 month [odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.12-1.33], 22.7 versus 18.8% at 6 months (OR = 1.20, 95% CI = 1.08-1.32) and 19.5 versus 16.6% (OR = 1.19, 95% CI = 1.10-1.29) at 1 year. The association between ultra-low nicotine yield cigarette smoking and successful quitting was stronger among the smokers with higher cigarette dependence.

CONCLUSIONS

Male smokers who use the Korean Quitline are more likely to quit successfully if they smoke ultra-low nicotine yield cigarettes than if they smoke higher nicotine yield cigarettes.

User characteristics of national smoking cessation services in Korea: who chooses each type of tobacco cessation program?

BACKGROUND

Relatively little is known about which characteristics of smokers are related to choosing a specific type of smoking cessation service. The user characteristics of different smoking cessation services were compared to determine the service preferred by user characteristics.

METHODS

The characteristics of adult smokers from Korea National Health and Nutrition Examination Survey (3762) and registered users of national smoking cessation services operated through the web (14,762), at Public Health Center-based Smoking Cessation Clinics (PHC-based SCCs) (335,532), and by telephone (Quitline) (2983) were compared.

RESULTS

Females and younger aged were more in web and telephone-based cessation service users, while aged 50 years or older were more in PHC-based SCCs users. Although manufacturing and production workers were the most prevalent among smokers in the general population, office workers and others including housewives and unemployed were most prevalent among the users of Quitline and PHC-based SCCs, respectively. The number of cigarettes smoked per day was twice as high among cessation service users as in general population. Smokers with greater nicotine dependency were most prevalent in the web-based service. Overseas users were in the web-based cessation service.

CONCLUSION

Identifying user-specific characteristics by the type of cessation services looks necessary to develop and offer appropriate cessation services.

The Development and Evaluation of Online Smoking Cessation Services: A Narrative Literature Review

Introduction:The use of quitlines for smoking cessation has contracted, with service providers adapting through the development of comprehensive interactive online smoking cessation services. The primary aim of this review is to investigate the continuum of online cessation services, innovations in design and service components, measures used in formative, process and outcome evaluations, as well as evidence of effectiveness.

Methods:This review includes the peer-reviewed literature, scholarly articles and the grey literature material. Databases searched included: PubMed, Google Scholar, SCOPUS and the Cochrane Collaboration.

Results/findings:56 academic journal articles and the 5 grey literature reports met the inclusion criteria for this review. Developmental stages of online/combination services included: static websites, tailored feedback, email and text services, interactive components, social media, pharmacological offers; as well as social and professional support mechanisms. Innovations in online smoking cessation include: chat rooms, new recruitment strategies, mobile apps, service tailoring and messaging support groups. Online cessation services were significantly cheaper and more popular than quitlines; however, abstinence rates appear higher amongst quitline users.

Conclusions:Three likely catalysts for the shift from quitlines to online services are the rapid development of technology, increased internet access and the general movement of the goods and services sector to digital channels. The challenge for online cessation service providers is to leverage their comparative cost advantage and develop strategies that keep pace, engage users and increase service effectiveness.

Implications:Our paper synthesises a wide-range of the literature that evaluates the effectiveness and scope of online smoking cessation programs. Through applying this literature to the stages of evaluation framework, we also provide one of the first detailed roadmaps towards developing comprehensive evaluation methodology for online smoking cessation services.

Polite, professional, practical: What drives caller 'satisfaction' with the New South Wales Quitline, Australia

INTRODUCTION AND AIMS

Previous studies on smoking quitlines have focused on service effectiveness and usage, describing client characteristics, referral sources and service utilisation. There is a lack of qualitative research examining callers' perspectives on service quality. The analysis aimed to describe the factors which underpin quitline callers' descriptions of their satisfaction with the service.

DESIGN AND METHODS

We conducted qualitative interviews with 46 callers to the NSW Quitline's English and multilingual lines. We used an iterative, inductive, thematic approach to identify common patterns within interviewees' descriptions of what informed their level of satisfaction with the service.

RESULTS

Interviewees evaluated the Quitline service format (frequency, duration and convenience of call-backs), call content and advisor competence in terms of whether these components conveyed care, developed rapport and demonstrated a general professionalism (polite, reliable and convenient service). Satisfaction rested on callers finding advice and resources personally relevant and matching prior expectations, although many did not have an accurate idea of Quitline's services prior to calling. These themes were evident across age, gender, language background and quitting status.

DISCUSSION AND CONCLUSIONS

'Satisfaction' with Quitline is complex and not wholly dependent on achieving cessation. Evaluations emerged out of dynamic interactions between callers' preconceived notions and needs of smoking cessation services and the particular service experience of the caller. While callers' descriptions of the Quitline were predominantly positive, developing specialised modules for long-term smokers and those with a strong sense of personal responsibility for quitting may broaden the utility of the service.

Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea: A Cross-Sectional Study

We identified factors associated with relapse after 6 months of smoking cessation (late relapse) among males of the Republic of Korea. Of the 222,707 smokers who visited public health center-based smoking cessation clinics (SCCs) between January 1, 2009 and mid-December 2009, we included 1720 individuals who successfully completed a 6-month smoking cessation program at an SCC. These participants were selected via a random stratified sampling design and completed an SCC user satisfaction survey between December 31, 2009 and January 6, 2010. Multiple logistic regression was used to identify factors associated with late relapse, and path analysis was employed to explore relationships among these factors. The frequency of late relapse was 21.6% (n = 372). Residence in a metropolitan area, low socioeconomic status, and the use of nicotine replacement therapy (NRT) were associated with statistically significant increases in late relapse, whereas greater access to counseling and more satisfaction with the SCC were associated with reduced late relapse. The path analysis showed that a greater number of cigarettes smoked daily and a younger age at smoking initiation exerted significant indirect effects on late relapse when NRT was employed. Residence in a metropolitan area indirectly prevented late relapse as counseling frequency increased. NRT use, counseling frequency, and SCC user satisfaction were affected by both smoking behavior and socioeconomic status. Relapse prevention efforts should concentrate on increasing both counseling frequency and SCC user satisfaction. Future studies should focus on the effect of NRT on the maintenance of long-term cessation at the population level in real-world settings.