Promoting smoking cessation resources among uninsured and Medi-Cal populations in Los Angeles County

Adult smoking prevalence in Los Angeles County (LAC) is 14.3% and higher among those without health insurance (18.8%) and those covered by Medi-Cal (19.8%). Most smokers want to quit and using resources such as cessation counseling and medication can significantly increase a smoker's chance of quitting successfully. To increase access and utilization of these resources among vulnerable populations, the Los Angeles County Tobacco Control and Prevention Program launched a tobacco cessation initiative in collaboration with Ralphs and the L.A. Care Health Plan. The initiative included a county-wide effort to distribute free two-week Nicotine Replacement Therapy (NRT) starter kits to LAC residents through local Ralphs pharmacies, LAC public health centers, and community health events. Between June 2008 and January 2011, over 28,700 kits were distributed. Preliminary data (n=7,863) indicates that 50.2% of the NRT recipients reported either having no insurance, Medicare, or Medi-Cal. Many recipients (38.5%) had never attempted to quit, and among those who tried to quit before, 45.9% reported quitting “cold turkey.” These findings suggest that efforts to promote cessation resources such as NRT were successful, particularly among the initiative's target populations. Further, preliminary findings from a follow-up survey of NRT recipients (n=2403) conducted approximately one year after the NRT distribution indicate that 26.8% of the recipients reported not smoking within the past 30 days. Although a more rigorous research design is needed to validate findings, the results suggest that this initiative was effective in encouraging smokers to utilize counseling and medication to achieve a successful quit attempt.