Comparison of quitline vs. web-based tobacco cessation interventions in four states, implications for publicly-funded tobacco cessation services

Tobacco use is increasing in spite of sufficient evidence that it causes ten types of cancer, and suggestive evidence of a causal relationship to others. Tobacco quitlines are a common approach for cessation while Web-based modalities are increasingly prevalent. The reach, user population, and effectiveness of each approach vary considerably. Large studies comparing these modalities focus on healthcare plan based cessation programs or are limited to one state. It is difficult to apply the results from these studies to state-based cessation programs. The Centers for Disease Control and Prevention collected intake and 7-month follow-up information from tobacco cessation program users in 4 states. Participants were enrolled through either a state-hosted quitline or website throughout 2011 and 2012. The primary outcome measure was prevalence of 30-day abstinence (30-day AP) at follow-up. Investigators recruited 2,724 quitline and 2,561 Web-based users. A majority of study participants were female (61%) and white, non-Hispanic (79%). The 30-day AP was 32% for quitline and 27% for Web-based users. Web-based users were significantly more likely to be younger ( 40 yrs vs. 47 yrs), employed (62% vs. 37%), and partnered (52% vs. 40%) than quitline users. Among participants with two or more interactions in either modality, quitline participants had 1.37 the odds (95% Cl 1.09–1.72) of 30-day abstinence at 7-month follow-up versus Web-based users. Further analyses of the cost-effectiveness of each approach are underway. These results will help public health agencies focus their tobacco and cancer control interventions.