Treating tobacco users with mental health challenges in a quit line setting: a pilot

Authors:
Ken Wassum, Steve Tutty and Tim McAfee

Presenter:
Ken Wassum
Senior Clinical Product Manager, Free and Clear, Seattle, USA

Abstract
In order to assess how mental or emotional challenges may affect quit outcomes, tobacco dependent adults calling a Quitline were asked to complete a brief mental health survey. 94% (N = 543) consented. The survey asked ‘Do you have a mental or emotional challenge that you feel will make it hard for you to quit and stay quit?’ (self-prognosis question). The survey also assessed recent depressive symptoms, using the Patient Health Questionnaire 2 (PHQ-2). One-third of callers answered ‘yes’ to the self-prognosis question, and 15% answered the PHQ-2 indicating moderate to severe depression. Callers received usual treatment, consisting of 5 scheduled proactive behavioural support calls, access to cessation medication, web-based support, and a printed quit guide. The program (‘Quit for Life’) has been validated for the general population in multiple randomised trials.

Quit status was assessed at six months post treatment. Participants answering ‘yes’ to the self prognosis question were less likely to be quit for at least 30 days at six months (14.7 vs. 25.3%, p = 0.01), but answers to the PHQ-2 were not predictive of quit status.
These brief screening questions appear to be acceptable, and a self-prognosis question may help identify tobacco dependent adults with a greater risk for relapse.

Source of funding: Free and Clear is a for-profit Quit Line vendor in the US and currently serves 25 States and District of Columbia.

Declaration of interest: The ACS Quit for Life Program is a for-profit company that has been delivering treatment via phone and web in the USA for over 20 years. We receive no funding from the tobacco industry or pharmaceutical companies.

About the presenter
Ken was sum has been treating tobacco users in a Quit Line setting for over 17 years. He is Past President of the Association for the Treatment of Tobacco Use and Dependence and a current Board member. He is internationally active in tobacco dependence treatment and in 2009 organised a pre-conference session on treatment at WCTOH in Mumbai that attracted over 140 individuals from over 40 countries. He is a graduate of the University of Washington with a BA in Education.