230044 Barriers to use of the tobacco quitline in the Arkansas Mississippi delta region

Wednesday, November 10, 2010 : 1:30 PM - 1:45 PM

Laney Brackman, MPH , College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Christine E. Sheffer, PhD , College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Mary Olson, DDiv , Board of Directors, Tri County Rural Health Network, Helena, AR
Naomi Cottoms , Tri-Country Rural Health Network, Helena, AR
Understanding the utilization of evidence-based telephone counseling (quitlines) for tobacco use for lower socioeconomic (SES) groups is important given higher prevalence of tobacco use in lower SES groups and the recent CDC recommendations promoting quitlines. All 50 states provide a quitline with the assumption that the quitline is particularly acceptable and accessible to lower SES groups. Method: Community-based participatory methods were used to collect qualitative and quantitative data in the Arkansas Mississippi delta that addressed access and use of the Arkansas quitline. Qualitative outcomes were used to develop a survey instrument which was administered to 799 delta residents. Results: Most residents were unaware of the quitline and expressed distrust of the quitline provider. Beliefs related to use of the quitline included concerns about providing personal information over the telephone; getting sick when they quit tobacco; the stressful socio-economic context; and strong beliefs in the role of God and faith in the process of quitting. Few differences in the intensity of these beliefs between African-American and White tobacco users were found, but there were numerous differences between lower and higher SES groups. Importantly, 35% of tobacco users did not have access to adequate telephone services to use the quitline. Conclusions: Communications about the quitline should be tailored to the concerns of lower SES groups by using trusted local sources and acknowledging the challenging socio-economic context as well as the significant role of faith. The assumption that quitlines are acceptable and accessible to lower SES groups may need to be reconsidered.

Learning Areas:
Communication and informatics
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Program planning
Public health or related research

Learning Objectives:
1. Identify attitudes, beliefs, and other factors associated with the non-use of proactive telephone counseling (quitline) for treating tobacco dependence. 2. Describe how communication about the quitline might be tailored to address particular concerns about quitting tobacco and using the quitline.

Keywords: Tobacco Control, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have extensive experience training health care providers in Arkansas and across the country with colleagues at the University of Mississippi Medical Center ACT Center. I also have extensive experience implementing and managing statewide programs that deliver brief and intensive interventions for tobacco dependence to large numbers of participants, with a particular emphasis on primary care environments and other health care settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.