Measuring the Impact of Group Class Counseling on Long-Term Quit Status among Louisiana's Public Hospital Patients

Introduction: Cessation counseling and medication increase quit rates. However, more than half of smokers who try to quit do not use these evidence-based treatments. Providing adequate coverage and universal access to treatments are important steps to promoting cessation, especially among low-income, under- and un-insured populations. This study characterizes smokers who used group behavioral counseling to quit and compares long-term quit rates of class attendees versus non-attendees.

Methods: This cross-sectional study analyzed patient tobacco use data collected by the Louisiana State University public hospitals’ Tobacco Control Initiative from 2005 and 2009. Control (scheduled-only smokers, n=3,245) and intervention (smokers scheduled and attended at least one group class, n=1,413) group comparisons were made. Demographic, tobacco use, and 90-day abstinence rates were presented.

Results: Most participants were female (71%), white (65%), between 45 and 59 years old (58%), and un-insured (57%). Adjusting for demographics and insurance status, smokers who attended class had significantly higher long-term quit rates (16.1%) compared to scheduled-only smokers (10.5%). Multivariate regression analysis indicated class attendees had greater odds (OR=1.53 95%CI=1.31-1.81) of 90-day sustained abstinence than non-attendees. And, attendees 60 years and older were more likely to have quit when compared to attendees 30 years and younger (OR=1.55 95%CI=1.00-2.38).

Conclusion: These findings suggest that when universal access to counseling is made available to low SES patient populations, participants have higher abstinence rates than non-participants. Additional research is needed to identify barriers to behavioral counseling participation and determine access to and preference for alternative mediums for delivery of cessation services.