Sunday, July 31, 2011

Tobacco quitlines suffer from budget cuts

An editorial in the July 15th issue of AFP by Drs. Stephen Rothemich and Scott Strayer extols the value of telephone quitlines in helping family physicians convince patients to stop smoking. Noting that many practices "lack the time and resources to provide effective counseling," the authors recommend that busy clinicians refer patients to the national toll-free quitline number (800-QUIT-NOW) to fill in these gaps. In addition, they review high-quality evidence that quitlines improve smoking cessation rates over counseling or medications alone:

The effectiveness of quitline counseling is well established. A Cochrane review reported successful cessation in patients who received counseling from quitlines (number needed to treat = 32). Quitline counseling combined with smoking cessation medications is particularly effective, with a cessation rate of 28.1 percent (more than three times the rates with minimal or no counseling or with self-help).

Unfortunately, funding for quitlines has recently fallen victim to budget cuts in at least two states. In Ohio and Washington State, quitlines that were once free to all smokers now only serve patients with certain types of insurance. State officials attributed their inability to continue to fully fund the quitlines to ending of federal grants and the need to divert funds from the 1998 Master Settlement Agreement with tobacco companies to other non-tobacco-related programs.

These cuts could not have come at a worse time, as the U.S. Food and Drug Administration's new requirement that cigarette packs display graphic health warning labels by September 2012 seems to have increased smokers' interest in using quitlines. For information about any eligibility limitations on your state's quitline, you can consult the website of the North American Quitline Consortium at