New quitline project helps patients stop smoking

A new study from the University of California shows that electronic referrals (e-referrals) made by healthcare providers for their patients to California's tobacco quitline can help patients quit smoking in the long term. The study, which was published in the journal Nicotine & Tobacco Research, shows that e-referrals lead to similar quit rates as those who called the quitline seeking help. The study is the first collaboration of its kind to be conducted by all five University of California health systems.

Importance of Quitlines in Tobacco Cessation

Tobacco is the leading cause of preventable disease, disability, and death in the United States. Quitlines offer free help to stop tobacco use and typically double the chances that a person can quit for good. However, until this study was conducted, there had been little research about the real-world implementation, maintenance, and outcomes of e-referrals to quitlines.

Implementation of E-Referrals

In 2013, UC Davis Health was the first health system to implement an e-referral to the California quitline, now known as Kick it California. Beginning in 2014, the UC-wide project UC Quits worked with inpatient, outpatient, and nursing champions to scale up quitline e-referrals from one to five UC health systems. This also included UC San Francisco, UC Irvine, UC Los Angeles, and UC San Diego.

Data Collection and Analysis

Data on e-referred patients and quitline callers were collected from April 2014 to March 2021, and analysis of referral trends and cessation outcomes was conducted in 2021-2022. Of the more than 20,000 patients referred, the quitline contacted 47.1%; 20.6% of those completed the intake process. Data collected showed that 15.2% requested counseling and 10.9% received the cessation help. In a sample randomly selected for follow-up, patients e-referred by their UC providers were as likely as general quitline callers to attempt quitting (68.5% vs. 71.4%), quit for 30 days (28.3% vs. 26.9%) and quit for six months (13.6% vs. 13.9%).

Benefits of E-Referrals

The study supports the broad implementation of tobacco quitline e-referrals across healthcare settings and finds that modifying electronic health records systems and clinical workflows will enable and encourage e-referrals. If implemented and maintained appropriately, the study showed that e-referrals will improve patient care, make it easier for clinicians to support patients in quitting, and increase the number of patients using evidence-based treatment.

Journal Information: Elisa K Tong et al, Implementation, Maintenance, and Outcomes of an Electronic Referral to a Tobacco Quitline Across Five Health Systems, Nicotine & Tobacco Research (2023). DOI: 10.1093/ntr/ntad008