Evaluation of Smoking Trajectories during Telephone Counseling, K. Witkiewitz (PI).

Tobacco use is the leading preventable cause of death in the United States, with cigarette smoking accounting for approximately 1 in 5 deaths every year. To combat smoking rates a network of telephone-based smoking cessation counseling services or "quitlines" provide all smokers in the United States with smoking cessation resources; currently there are quitlines in all 50 states, as well as 10 provinces of Canada (McAfee, 2007). Free & Clear (F&C), a quitline vendor located in Seattle Washington, has a client-base of 50 million people across the United States. F&C is contracted to provide services by 16 state governments and over 230 commercial clients (health plans and employers). The proposed study will be an analysis of smoking data from a subsample of 60,000 quitline clients (n = 2,500) who received services from F&C between October 2007 and May 2008. The goal of the proposed study is to evaluate trajectories of smoking, as well as predictors of smoking trajectories, during the course of five quitline counseling calls and 6- and 12-months following the initial quitline contact. Specifically, we are interested in studying whether the pattern of smoking observed during the course of the five calls is predictive of longer term smoking cessation outcomes. It is hypothesized that individuals will display heterogeneous and discontinuous patterns of smoking, as reported at each quitline call and follow-up assessment points. The ultimate objective of this research is to identify predictors of smoking cessation outcomes following contact with telephone tobacco counseling services. To meet this objective we intend to evaluate both distal and proximal predictors of smoking status during the course of receiving F&C services and 6- and 12-months following the initial quitline contact. This research has the potential to identify additional points of intervention for telephone-based smoking cessation services.