Wyoming Quit Tobacco Program Follow-Up Survey

February 22, 2016 Wyoming Quit Tobacco Program Follow-Up Survey January – June 2015 Interviews Muneyuki Kato, MA, Assistant Research Scientist Timoth...
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February 22, 2016

Wyoming Quit Tobacco Program Follow-Up Survey January – June 2015 Interviews Muneyuki Kato, MA, Assistant Research Scientist Timothy M. Pearson, PhD, Assistant Research Scientist Tiffany Comer Cook, MS, Senior Research Scientist Laran H. Despain, PhD, Associate Research Scientist

Wyoming Survey & Analysis Center University of Wyoming 1000 E. University Avenue, Department 3925 Laramie, Wyoming 82071 307.766.2189 | [email protected] www.uwyo.edu/wysac

WYOMING QUIT TOBACCO PROGRAM FOLLOW-UP SURVEY: JANUARY – JUNE 2015 INTERVIEWS

ABOUT THIS REPORT Under contract to Wyoming Department of Health, Public Health Division 6101 Yellowstone Road, Suite 420 Cheyenne, WY 82002 (307) 777-6340 This publication was supported by tobacco settlement funds. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Wyoming Department of Health. CITATION WYSAC. (2016). Wyoming quit tobacco program follow-up survey: January – June 2015 interviews by M. Kato, T. M. Pearson, T. C. Cook, & L. H. Despain. (WYSAC Technical Report No. CHES-1535). Laramie, WY: Wyoming Survey & Analysis Center, University of Wyoming.

© 2016 WYOMING SURVEY & ANALYSIS CENTER 2 | UNIVERSITY OF WYOMING

WYOMING QUIT TOBACCO PROGRAM FOLLOW-UP SURVEY: JANUARY – JUNE 2015 INTERVIEWS

Contents Contents....................................................................................................................................................... 3 List of Figures and Tables ............................................................................................................ 3 Introduction ................................................................................................................................................ 4 Enrollee Information.................................................................................................................................. 5 WQTP Outcomes........................................................................................................................................ 7 Alternative Nicotine Products.................................................................................................................. 8 Mental Health and Cessation ................................................................................................................... 9 Pregnancy and Cessation ........................................................................................................................ 10 Enrollee Reports on Strengths and Weaknesses of the WQTP .......................................................... 11 In your opinion, what is good about the Wyoming Quit Tobacco Program? .................... 12 In your opinion, how can the Wyoming Quit Tobacco Program be improved? ............... 14 Conclusions ............................................................................................................................................... 17 References ................................................................................................................................................. 18

LIST OF FIGURES AND TABLES Figure 1: Logic Model for CDC’s Tobacco Cessation Goals................................................................. 4 Figure 2: Enrollment by Month ................................................................................................................ 5 Table 1: Follow-Up Survey Response Rates............................................................................................ 5 Figure 3: Type of Tobacco Trying to Quit............................................................................................... 6 Figure 4: WQTP Component Use ............................................................................................................ 6 Figure 5: Overall Quit Rates ..................................................................................................................... 7 Figure 6: Quit Rates by WQTP Coaching and Medication Services ................................................... 7 Figure 7: Progress toward Cessation ....................................................................................................... 7 Figure 8: Overall Satisfaction.................................................................................................................... 8 Figure 9: Current and Former ENDS Use among WQTP Enrollees ................................................... 8 Figure 10: Mental Health and Use of Program Components............................................................... 9 Figure 11: Mental Health and WQTP Outcomes ................................................................................. 10 Figure 12: Problems Enrollees Experienced ......................................................................................... 11

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Introduction The Wyoming Quit Tobacco Program (WQTP) assists enrollees in their efforts to quit using tobacco products by offering free telephone, online, and texting coaching services. The program also provides enrollees with free nicotine replacement therapies (NRTs) or vouchers for reduced-price prescription (Rx) medications. Under contract to the Wyoming Department of Health, Public Health Division, the Wyoming Survey & Analysis Center (WYSAC) at the University of Wyoming conducts monthly surveys of WQTP enrollees to assess WQTP quit rates and enrollee satisfaction. The survey also assesses enrollees’ use of coaching, NRTs, or prescription medications and enrollees’ opinions of different program elements. This report includes data on WQTP participants surveyed between January and June 2015, seven months after they enrolled in WQTP. These participants enrolled in WQTP between June and November 2014. During this period, National Jewish Health (NJH) provided WQTP services in Wyoming. Providing cessation services, including the WQTP, to Wyoming residents is an important part of the state’s Tobacco Prevention and Control Program (TPCP). The WY TPCP follows the guidelines established by the Centers for Disease Control and Prevention (CDC) for state tobacco prevention programs (Starr et al., 2005). Figure 1 shows how the WQTP and the data presented in this report fit into the goals of Wyoming’s TPCP.

Figure 1: Logic Model for Wyoming’s Tobacco Cessation Goals

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Source: Starr et al. (p. 193, 2005). Highlighting added. WYOMING SURVEY & ANALYSIS CENTER

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Enrollee Information This report includes data on adult WQTP

Figure 2: Enrollment by Month

participants surveyed between January and June

Total enrollees by enrollment month, 2013-2014

2015, seven months after they enrolled in WQTP. The follow-up participants enrolled in WQTP

256

between June and November 2014. How many

268 214

2014

people did WQTP serve during this time? Figure 2

2013

provides the monthly enrollment for June–

264 197

118

182

November 2014. For comparison, this figure also

128

135

Aug

Sep

158 105

shows the same months, except June, from the previous year. Enrollees may sign up online or by

Jun

completing an intake survey by phone.

Jul

Oct

Nov

Note: Total enrollees include those who completed only the intake process, those who had their first coaching call, and those who enrolled only for WQTP online services. The total for June 2013 is not included because NJH became the new WQTP service provider in July 2013.

How many enrollees completed the follow-up survey? The January-June 2015 follow-up survey data include responses from 375 completed follow-

Source: NJH Monthly Report.

up interviews (Table 1). Overall, WYSAC achieved

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a 40% response rate.

Table 1: Follow-Up Survey Response Rates Response rate by follow-up month Intake survey month

Jun 14

Jul

Aug

Sep

Oct

Nov

Follow-up survey month Jan 15

Feb

Mar

Apr

May

Jun

Total eligible respondents* Total complete interviews Response rate

Total

168

186

162

193

145

77

931

78

78

72

71

52

24

375

46%

42%

44%

37%

36%

31%

40%

* Total eligible respondents includes all persons who were 18+ years old, provided a phone number on the WQTP intake questionnaire seven months previously, enrolled in WQTP, and had an in-service phone number at the time of the survey. It excludes those who did not wish to be contacted for the follow-up survey. For those who enrolled more than once within a six-month timeframe, WYSAC used the date of the first enrollment to determine eligibility for a follow-up interview. WYOMING SURVEY & ANALYSIS CENTER

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get help with quitting? Enrollees could

Figure 3: Type of Tobacco Trying to Quit

choose more than one option, but most

Percentage of enrollees who enrolled to quit …

Which type of tobacco products did enrollees

enrolled in WQTP to get help with quitting Cigarettes

cigarettes (Figure 3). Which program components were enrollees most likely to use? NRTs, which are mailed to enrollees’ homes, were the most popular program component (Figure 4). Prescription

89%

Smokeless tobacco Other tobacco

14% 3%

enrollees used the quitline, while fewer than

Note: n=375. Smokeless tobacco includes chewing tobacco, snuff, and dip. Other tobacco includes cigars, cigarillos, little cigars, e-cigarettes, vapors, and pipes. Percentages do not add to 100% because enrollees could choose more than one option.

one in five used the online program.

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medications, which require a visit to a physician, were the least popular. Most

Relatively few enrollees, 25, reported not using any program component (i.e., none of the above). These enrollees may have completed only the intake questionnaire without participating in any other program component. Additionally, because these responses are self-reported, respondents’ perspective or memory about using the program may differ from NJH’s administrative records. Still, these enrollees form a useful comparison group for gauging

Figure 4: WQTP Component Use

the effectiveness of different program

Percentage of enrollees who had used …

components.

Quitline

55%

Online program

17%

NRTs

63%

Rx medications

16%

Texting program

25%

Written materials

Other None of the above

31% 3% 7%

Note: n=375. Percentages do not add to 100% because enrollees could choose more than one option except None of the above. WYOMING SURVEY & ANALYSIS CENTER

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WQTP Outcomes Figure 5: Overall Quit Rates

Were enrollees successful in their cessation effort? The follow-up survey asked enrollees

Percentage of enrollees who had not used any tobacco in the past 7 or 30 days

if they had used any tobacco products in the previous seven days. If they had not, the survey asked if they had used any tobacco

Quit for 7 days

34%

Quit for 30 days

31%

products in the previous 30 days. The data show that 34% of enrollees were quit for seven days; 31% were quit for 30 days (Figure 5)

Note: n=375.

Which program component was most

Figure 6: Quit Rates by WQTP Coaching and Medication Services

effective? The best outcome was associated with those who used medications only. Enrollees who used medication (NRTs,

Enrollees who used medication, but not coaching, had the highest 30-day quit rate

prescription, or both) had the highest 30-day quit rate (38%) seven months after enrollment (Figure 6). Those who used coaching and medication had the next highest quit rate at 33%. Did those who were not quit make progress toward cessation? For those who had not quit, the survey asked about changes in tobacco consumption and quit attempts

Neither coaching nor medication (n=38)

13%

Coaching only (n=60)

27%

Medication only (n=84)

38%

Coaching and medication (n=193)

33%

(stopping the use of tobacco for 24 hours or longer since enrolling in the WQTP). Half of enrollees reported using less tobacco

Figure 7: Progress toward Cessation

compared to three months prior and 79%

Of enrollees who were not quit, percentage who …

reported making at least one quit attempt since enrolling (Figure 7).

Used less tobacco than 3 months prior (n=256)

50%

Made at least 1 quit attempt (n=247)

79%

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Figure 8: Overall Satisfaction

How satisfied were enrollees with the service

Percentage of enrollees who…

they received from the WQTP? Three-fourths of enrollees (75%) were mostly or very

Were very or mostly satisfied (n=366) Had recommeded WQTP (n=373)

Very

Mostly

satisfied with the WQTP, and 62% reported

54%

21%

that they had recommended the program to someone else (Figure 8).

62%

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Alternative Nicotine Products Electronic nicotine delivery systems (ENDS) such as e-cigarettes, e-hookahs, or vape pens are battery-operated devices that simulate smoking, but do not involve the burning of tobacco. The heated vapor produced by ENDS often contains nicotine and can come in different flavors. Have enrollees ever used ENDS or

Figure 9: Current and Former ENDS Use among WQTP Enrollees 5%

Using now to cut down on other tobacco

5%

lifetime (Figure 9). Moreover, 82%

not approved as cessation aids by

Not using now, but had used to cut down on other tobacco

15%

Note: n=375. WYOMING SURVEY & ANALYSIS CENTER

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used them to quit or cut-down on other tobacco, although they are

15%

Never used

of enrollees who had used ENDS

2%

Not using now, but had used to quit other tobacco

Not using now, but had used for some other reason

did they use them? Nearly half of enrollees had used ENDS in their

Using now to quit other tobacco

Using now for some other reason

other nicotine products? If so, why

the U.S. Food and Drug Administration (FDA). Only 2% of the enrollees had used another smoke-free form of

7%

nicotine (such as Nicogel, Camel 51%

strips, and orbs) that was not approved as a smoking cessation product.

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Mental Health and Cessation People with mental health conditions are more likely to smoke and to smoke more than people without mental health conditions (Centers for Disease Control and Prevention [CDC], 2013). Based on combined data from the 2009-2011 National Survey on Drug Use and Health (NSDUH), 21.8% of Wyoming adults had a mental health condition1; 36.7% of them had smoked part or all of a cigarette within the 30 days prior to being surveyed (CDC, 2013). Do people with mental health conditions benefit from WQTP in a way that is comparable to enrollees who do not have mental health conditions? Enrollees who completed the intake survey over the phone answered questions about their mental health. The WQTP online intake form did not include these questions.2 For this reason, the results below do not apply to enrollees who used the online program only. The intake questionnaire asks, “Do you have any mental health conditions, such as anxiety disorder, depression disorder, bipolar disorder, alcohol/drug abuse, or schizophrenia?” WYSAC merged responses to this mental health question at intake with the follow-up survey data, which resulted in 278 follow-

Figure 10: Mental Health and Use of Program Components Quitline

up survey respondents with mental health information. Of these respondents, 40% said they had a mental health condition at the time of the intake survey. How did program usage rates differ for enrollees who reported mental health conditions? Enrollees who reported mental

Any MH condition No MH condition

mental health conditions (Figure 10). Enrollees who reported mental health

74% NRTs

Any MH condition

69%

No MH condition

68%

health conditions were less likely to use the quitline than people who did not report

66%

Rx medications Any MH condition No MH condition

15% 21%

conditions were also less likely to use

Note: n for Any MH condition=110; n for No MH condition=168.

prescription medications. Chantix

Source: WQTP Intake and Follow-Up Surveys.

(varenicline), one of the medications

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In this study, a mental health condition was defined as “having a mental, behavioral, or emotional disorder, excluding developmental and substance use disorders, in the past 12 months.” 1

The WQTP online intake form was updated and now includes mental health questions. NJH has been using the new online intake form since August 28, 2015. 2

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included in the WQTP, is contraindicated for some people with mental health

Figure 11: Mental Health and WQTP Outcomes

conditions because of increased risk of suicidal behavior (FDA, 2015). For the other program components, usage rates for people who reported mental health conditions were comparable to usage rates

Quit for 30 days Any MH condition (n=110)

25%

No MH condition (n=168)

35%

for other enrollees. How successful were enrollees in their cessation effort, depending on their mental health condition? All outcomes were worse for people who reported mental health

Used less tobacco than 3 months prior

Any MH condition (n=81)

49%

No MH condition (n=109)

55% Made at least 1 quit attempt

conditions compared to those who did not report such conditions (Figure 11). The differences in these outcomes could be related to the lower usage rates for two effective WQTP components: quitline

Any MH condition (n=78)

83%

No MH condition (n=105)

85% Very or Mostly Satisfied

coaching and prescription medication. Any MH condition (n=108)

Pregnancy and Cessation Smoking is linked to complications during pregnancy, including miscarriage and birth defects (CDC, 2015). These excess risks make pregnant women a priority population for the WQTP. How did pregnant women perform in their cessation efforts?

52%

No MH condition (n=167)

20%

57%

22%

Had Recommended WQTP

Any MH condition (n=109)

63%

No MH condition (n=167)

69%

Source: WQTP Intake and Follow-Up Surveys. WYOMING SURVEY & ANALYSIS CENTER

Three of the 17 enrollees who identified as pregnant at the time of enrollment responded to the follow-up survey. All three had enrolled in the specialty program for pregnant and postpartum women. One respondent reported being quit for 7 days, but not for 30 days. Two respondents reported using fewer tobacco products than three months prior. All three had made at least one quit attempt since enrolling. The small sample size means that it is not possible to generalize the results to all pregnant WQTP enrollees or pregnant women trying to quit. 10 | UNIVERSITY OF WYOMING

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Enrollee Reports on Strengths and Weaknesses of the WQTP What did enrollees report about the strengths and weaknesses of the WQTP? Most enrollees (79%) reported not having any issues with the core program components (Figure 12). Among those who reported difficulty,

Have you had any of the following problems with the Wyoming Quit Tobacco Program? Difficulty contacting the program by telephone

contacting the program by telephone and acquiring NRT products tended to be more problematic than accessing the program on the Internet or getting medication vouchers. The remainder of this section provides the analysis of two open-ended questions asked

10%

Difficulty accessing the program on the Internet

5%

Difficulty getting medication vouchers

4%

Difficulty acquiring NRT products

11%

None of the above

on the WQTP follow-up survey: (1) In your opinion, what is good about the Wyoming Quit Tobacco Program? (2) In your opinion, how can the Wyoming Quit Tobacco Program be improved?

Figure 12: Problems Enrollees Experienced

79%

Note: n=374. Percentages do not add to 100% because enrollees could choose more than one option except None of the above. WYOMING SURVEY & ANALYSIS CENTER

Excluding blank responses and responses such as don’t know, not applicable, and no answer, 359 of the 375 respondents answered the first question about what is good about the program, and 166 respondents answered the second question about what could be improved. Although the responses to the open-ended questions may not generalize to all WQTP enrollees, they can be useful in identifying strengths and weaknesses of the WQTP. WYSAC analyzed the two questions separately, using content and text analyses. For the content analysis, we read all the comments for each question and noted preliminary themes. During a second reading, we identified new themes and then confirmed, discarded, or combined previous themes. We then sorted the comments into appropriate thematic categories. For the text analysis, WYSAC used Text Analyzer, an online tool to analyze word and phrase frequency. The themes resulted from a systematic grouping of responses. Themes emerged when multiple respondents commented on a particular topic. The themes may be contradictory. For example, some respondents suggested increased follow-up and coaching while others suggested reduced coaching with more focus on medications. WYOMING SURVEY & ANALYSIS CENTER • UWYO.EDU/WYSAC | 11

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Below, WYSAC presents the themes we identified through the content analysis. Representative quotations from the interview transcripts illustrate the themes. Some responses, as recorded by telephone interviewers, required minor modifications. For the answers below, we standardized and corrected capitalization, grammar, misspellings, and added words in brackets to clarify meaning when necessary.

In your opinion, what is good about the Wyoming Quit Tobacco Program? The content and text analyses identified five positive themes: (a) quit product access, (b) supportive coaches, (c) successful cessation, (d) community health resource, and (e) availability of the WQTP.

QUIT PRODUCT ACCESS Respondents were pleased that free or reduced-price tobacco

Positive Themes Quit Product Access Supportive Coaches Successful Cessation

cessation products were available to them through the WQTP.

Community Health Resource

 “[I] probably wouldn't have gotten patches if they were

Availability of the WQTP

not free.”  “A lot of people who smoke are low-income, so they don’t have the means to buy the expensive patches.”

SUPPORTIVE COACHES Respondents commented that the WQTP coaches were supportive and non-judgmental.  “I think they really care about you as an individual.”  “They never judged me if I lapsed. They were proactive, and we brainstormed ideas about reducing my stress.”  “They are there to help people who have the willpower to quit.” According to some respondents, coaches demonstrated their support through follow-up communication. Respondents mentioned that phone calls and texts helped keep them on track to quit.  “It was nice to have someone check on me and congratulate me when I made progress.”  “They are persistent, very helpful, and offer alternatives.”

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SUCCESSFUL CESSATION Respondents stated that the WQTP helped them quit.  “It’s another tool to use when you can’t do it by yourself.”  “It worked.” Several respondents mentioned that the WQTP provided them with the added motivation they needed to quit using tobacco products.  “They didn’t give up on me. They kept reminding me that I was going to quit.”  “[It provided] the extra motivation [I needed] to quit.”

COMMUNITY HEALTH RESOURCE Respondents commented that they were glad there was a program available to help people quit.  “I like that there is a service like this to help people.”  “They are doing God’s work, and I am grateful for it.”

AVAILABILITY OF THE WQTP Some respondents cited ease of access to the WQTP as a benefit.  “They’re there 24/7. You can call them if you need them.”  “It's right there. You don't have to travel. You just call, and it's right there on the phone. Convenience.”

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In your opinion, how can the Wyoming Quit Tobacco Program be improved? Half as many people suggested ways WQTP could be improved, compared to those who commented on the benefits of the program. However, eight critical themes did emerge, based on the 166 respondents who offered ideas on how to improve the program: (a) improve quit product access, (b)

Critical Themes Improve Quit Product Access

increase follow-up, (c) improve communication, (d) extend

Increase Follow-Up

coaching and quit product timelines, (e) improve WQTP

Improve Communication

access, (f) improve advertising and messaging, (g) provide local support, and (h) reduce coaching.

Extend Coaching and Quit Product Timelines

IMPROVE QUIT PRODUCT ACCESS

Improve WQTP Access

Although many respondents commented they were pleased

Improve Advertising and Messaging

about the access to free quit products, others expressed frustration regarding their access to these products.

Provide Local Support

Respondents said they would like more affordable or free

Reduce Coaching

access to tobacco quit products.  “When they put out a pamphlet and say their product is free. When I called, the counselor told me it would be $50. That turned me off right there.”  “I can’t afford the prescription medication. I make less than $24,000 per year.” Some respondents described slow access to cessation products or the lack of local availability of products.  “They could go through a regular pharmacy instead of a mail-in pharmacy.” Other respondents had trouble with quit products and found substitutions were not possible. One respondent said no alternative was offered when working outdoors caused the patches to fall off. Some said they were allergic to a quit product.

 “I was allergic to the patches and wasn't offered alternatives. I felt I was struggling with quitting, and the counselor gave up on me.”

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INCREASE FOLLOW-UP Some respondents perceived poor follow-up communication from coaches. They commented that they had not been contacted after their initial contacts or requests.  “Follow through more with calling.”  “Follow up after registration would be good.”

IMPROVE COMMUNICATION Respondents had critical feedback regarding communication with the WQTP coaches, commenting that they had difficulty understanding the coaches. There were also complaints about the quality or detail of the information they received during their calls.  “There should be more specialized counseling on the telephone calls. The coaches could be more helpful.” Some respondents were disappointed with the repetition of questions asked by the coaches.  “They asked the same questions over and over. This was a little daunting. They would repeat answers back to you. They could do better kind of questioning.”  “Not having to be asked the same questions over and over again with every call.” Two respondents commented that they had difficulty contacting coaches and asked for greater accessibility.  “Make counselor hours easier to get a hold of.”

EXTEND COACHING AND QUIT PRODUCT TIMELINE Some respondents wished they were allotted more time to use WQTP services.  “They only counseled five times over the telephone, and they told me it was my seventh time, and they wouldn't call me anymore. They sent me a piece of paper saying I completed the program, but I hadn’t.”  “Make sure that if someone needs to stay on that first step a bit longer, they can do so.”

IMPROVE WQTP ACCESS Some respondents reported technical problems or suggested improvements to the system. One participant said that having an out-of-state phone number made it hard to contact the WQTP. A few others said they had difficulty navigating the online system.  “The website was not user-friendly.”

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 “I had problems with getting onto the online program. I had a password and couldn’t use it.” Others had difficulty navigating the online program or thought they had enrolled online but were not contacted by coaches.  “[They need] better support services for the Internet and to call if you had any problems getting on the website.”  “More information on the website, [and make] it easier to use and navigate.” Two WQTP users said that National Jewish Health had not contacted them after using the online service. They suggested better follow-up for those who provide contact information on the website.

IMPROVE ADVERTISING AND MESSAGING Respondents thought the program could be more effectively advertised in Wyoming communities. They suggested advertising methods including distributing more fliers or posters, hospital visits by the program staffers to promote the WQTP, and more advertising on television. One respondent explained the need for better messaging by relating his/her experience with seeking help.  “I couldn't find a number to call. It took me three weeks to find a number. I even looked at my doctor's office. I looked on the Internet and had a hard time finding it. I finally found it at my dentist's office.”

PROVIDE LOCAL SUPPORT A few respondents wanted more localized support or suggested face-to-face contact.  “They need to have meeting groups locally. They need to have an actual person to meet, over a cup of coffee, or something. More human interaction, not just a machine or a computer.”

REDUCE COACHING A few respondents suggested that the WQTP provided more coaching support than they wanted.  “Back off on the phone calls and text messages.”  “[The WQTP should] not be so focused on counseling.”

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Conclusions The data for WQTP enrollees who completed the follow-up survey between January and June 2015 show that most program participants enrolled to get help with quitting cigarettes. Most enrollees had used NRTs and/or the quitline. Consistent with previous WQTP follow-up reports (WYSAC, 2014; WYSAC, 2015), the 30-day quit rate for enrollees was about one-third (31%). The highest 30-day quit rate was experienced by those who used medication only (38%), followed by those who used a combination of coaching and medication (33%). Satisfaction with WQTP was high: 75% of enrollees reported being very or mostly satisfied with the program and the majority (62%) had recommended WQTP to someone else. WYSAC analyzed the follow-up data to report on three priority populations: those who used electronic nicotine delivery systems (ENDS), those who reported mental health conditions, and those who participated in the pregnancy/postpartum program. Nearly half of enrollees had used ENDS in their lifetime. Of these, 83% had used them to quit or cut-down on other tobacco even though they are not approved as cessation aids by the FDA. Use of the quitline and prescription medications was less common among enrollees reporting a mental health condition than among enrollees who did not report a mental health condition. Enrollees who reported a mental condition also reported lower 30-day quit rates and lower satisfaction with the WQTP. These differences could be related to the lower usage rates for two effective WQTP components: quitline coaching and prescription medication. WYSAC only had three enrollees, who were pregnant at intake, respond to the follow-up survey between January and June 2015. This low number of data points impedes our ability to draw conclusions about the effectiveness of the WQTP pregnancy program. The majority (79%) of respondents reported no problems with the WQTP. When asked about specific feedback, those who commented on the benefits praised the supportive coaches, the access to quit products, the effectiveness of the program (i.e., it helped them quit), and the existence of WQTP as a community health resource. Those who provided ideas on how the program could be improved suggested additional communication/follow-up and improved access to quit products. The follow-up data show that WQTP program components successfully help enrollees quit. The increased use of these components would likely increase the overall success of the program.

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WYOMING QUIT TOBACCO PROGRAM FOLLOW-UP SURVEY: JANUARY – JUNE 2015 INTERVIEWS

References Centers for Disease Control and Prevention. (2013). Vital signs: Current cigarette smoking among adults aged ≥18 years with mental illness — United States, 2009–2011. MMWR, 62(05), 81-87. Centers for Disease Control and Prevention. (2015). Reproductive health: Tobacco use and pregnancy. Retrieved November 6, 2015, from http://www.cdc.gov/reproductivehealth/maternalinfanthealth/tobaccousepregnancy/ind ex.htm Starr, G., Rogers, T., Schooley, M., Porter, S., Wiesen, E., & Jamison, N. (2005). Key outcome indicators for evaluating comprehensive tobacco control programs. Atlanta, GA: Centers for Disease Control and Prevention. U.S. Food and Drug Administration. (2015). FDA 101: Smoking cessation products. Retrieved December 1, 2015, from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm WYSAC. (2014). Wyoming quit tobacco program follow-up survey: February–June 2014 interviews by M. Kato, & T. C. Cook. (WYSAC Technical Report No. CHES-1428). Laramie, WY: Wyoming Survey & Analysis Center, University of Wyoming. WYSAC. (2015). Wyoming quit tobacco program follow-up survey: July–December 2014 interviews by M. Kato, & T. C. Cook. (WYSAC Technical Report No. CHES-1508). Laramie, WY: Wyoming Survey & Analysis Center, University of Wyoming.

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