Turning Community Feedback into a Culturally Responsive Program for American Indian/Alaska Native Commercial Tobacco Users.

Background: American Indian/Alaska Native (AI/AN) cigarette smoking prevalence is disproportionately high, especially in the northern United States. Tailored quitlines are needed to support AI/AN commercial tobacco users with quitting.

Objectives: Obtain community feedback by working with trusted AI/AN partners; genuinely incorporate feedback into program design; collaboratively develop and implement culturally relevant quitline services for Minnesota's AI/AN community.

Online Versus Telephone Registration: Differences in Quitline Participant Characteristics.

Introduction: Although 72% of Internet users have searched for health information, online quitline registration is not universally available. In 2014, QUITPLAN Services (Minnesota's quitline) added options (Individual Services: 2-week nicotine-replacement therapy starter kit, text messaging, e-mail messaging, quit guide) to the existing Helpline (telephone counseling, nicotine-replacement therapy, integrated e-mails and texts, quit guide) and online registration for all programs. Demographic and quit outcome differences by registration mode (online versus telephone) and program type (Individual Services versus Helpline) were examined.

Utilizing Reach Ratios to Assess Menthol Cigarette Smoker Enrollment in Quitline Services.

Introduction: Increasing the reach of evidence-based cessation services is a longstanding public health priority, especially for subgroups who may be most at risk. Little research has examined whether quitlines are reaching menthol cigarette smokers who may have increased difficulty quitting compared with nonmenthol cigarette smokers. This study aims to understand whether quitline services are reaching menthol cigarette smokers.

Perceived harm of menthol cigarettes and quitting behaviors among menthol smokers in Minnesota.

Although overall smoking prevalence in Minnesota has declined, the proportion of current smokers who smoke menthol cigarettes has increased. While studies have examined associations between smokers' perceived risks of smoking and quitting, similar studies on menthol smoking are lacking. This study examined whether perceived harm of menthol cigarettes was associated with menthol smokers' quitting behaviors.

Projecting the future impact of past accomplishments in tobacco control.

Background: The benefits to adults who quit smoking increase over time as former smokers live longer, healthier lives. Youth who never smoke will benefit for decades. Thus, the long-term population effects of tobacco prevention and control policies may be substantial.

The 20-year impact of tobacco price and tobacco control expenditure increases in Minnesota, 1998-2017.

Introduction: Tobacco control programs and policies reduce tobacco use and prevent health and economic harms. The majority of tobacco control programs and policies in the United States are implemented at local and state levels. Yet the literature on state-level initiatives reports a limited set of outcomes.

Replicating state Quitline innovations to increase reach: findings from three states.

Background: Reaching tobacco users is a persistent challenge for quitlines. In 2014, ClearWay Minnesota changed its quitline services and media campaign, and observed substantial increases in reach and strong quit outcomes. Oklahoma and Florida implemented the same changes in 2015 and 2016.

Changing patterns in E-cigarette use among Minnesota adults between 2014 and 2018.

Minnesota has observed declining combustible tobacco use and a large increase in e-cigarette use among youth and young adults. Less is known about adult e-cigarette users' frequency of use, smoking status, use of flavors, and demographic differences. The Minnesota Adult Tobacco Survey (MATS) is a cross-sectional, random digit-dial telephone survey representative of Minnesotans aged 18 and over.

Financial incentives and proactive calling for reducing barriers to tobacco treatment among socioeconomically disadvantaged women: A factorial randomized trial.

Improved strategies and scalable interventions to engage low-socioeconomic status (SES) smokers in tobacco treatment are needed. We tested an intervention designed to connect low-SES smokers to treatment services, implemented through Minnesota's National Breast and Cervical Cancer Early Detection Program (Sage) in 2017; the trial was designed to last 3 months (July through October). Participants were female smokers who were 250% below the federal poverty level (randomized N = 3723; analyzed N = 3365).

Creating Culturally-Specific and Community-Specific Approaches to Linking Low Socioeconomic Smokers to Cessation Services.

While smoking has declined, rates remain alarmingly high for people of low socioeconomic status. Funding community-based organizations to link low socioeconomic status smokers to cessation services holds promise for reaching this population. This approach also shows potential for elevating addressing tobacco use as a priority within these organizations.

Support person interventions to increase use of quitline services among racially diverse low-income smokers: A pilot study.

Introduction: Social support from nonsmokers may have a role in prompting smokers to use evidence-based cessation treatment. Prior studies found that an intervention for nonsmoking support persons (SPs) was effective for promoting smokers' use of free, state quitline services. This pilot study adapted and assessed feasibility of this intervention for a racially diverse, low-income population.

Engaging Smokeless Tobacco Users in Population-Based Cessation Services: Findings From an Observational Study.

Although telephone quitlines are effective for helping smokeless tobacco (ST) users quit, ST users are underrepresented among quitline participants. After ClearWay MinnesotaSM implemented multiple changes to its quitline service (QUITPLAN® Services), utilization increased dramatically, including by ST users. We examined data from Minnesota and Wisconsin to determine whether these changes were unique to Minnesota.

Impact and Effectiveness of a Stand-Alone NRT Starter Kit in a Statewide Tobacco Cessation Program.

Purpose: To examine 2-week nicotine replacement therapy (NRT) starter kit quit outcomes and predictors and the impact of adding this new service on treatment reach.

Design: Observational study of a 1-year cohort of QUITPLAN Services enrollees using registration and utilization data and follow-up outcome survey data of a subset of enrollees who received NRT starter kits.

Setting: ClearWay Minnesota's QUITPLAN Services provides a quit line that is available to uninsured and underinsured Minnesotans and NRT starter kits (a free 2-week supply of patches, gum, or lozenges) that are available to all Minnesota tobacco users.

Never Quit Trying: Reengaging Tobacco Users in Statewide Cessation Services.

Context: Tobacco dependence is well established as a chronic condition typically requiring numerous quit attempts. Tobacco users are unlikely to return to the same cessation program on their own.

Objective: This program evaluation examined the effectiveness of using multiple outreach methods to reengage tobacco users in a statewide cessation program at varying time points after their initial program enrollment.

Increasing reach by offering choices: Results from an innovative model for statewide services for smoking cessation.

Although state quitlines provide free telephone counseling and often include nicotine replacement therapy (NRT), reach remains limited (1-2% in most states). More needs to be done to engage all smokers in the quitting process. A possible strategy is to offer choices of cessation services through quitlines and to reduce registration barriers.

Tobacco User Characteristics and Outcomes Related to Intensity of Quitline Program Use: Results From Minnesota and Pennsylvania.

Context: Tobacco users in all 50 states have access to quitline telephone counseling and cessation medications. While studies show multiple calls relate to quit success, most participants do not complete a full call series. To date, quitline program use studies have analyzed single factors-such as number of calls or counseling minutes.

Seizing an opportunity: increasing use of cessation services following a tobacco tax increase.

Background: Tobacco tax increases are associated with increases in quitline calls and reductions in smoking prevalence. In 2013, ClearWay Minnesota(SM) conducted a six-week media campaign promoting QUITPLAN® Services (QUITPLAN Helpline and quitplan.com) to leverage the state's tax increase.

Facilitators of health systems change for tobacco dependence treatment: a qualitative study of stakeholders' perceptions.

Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. Health systems change - changes to health care processes, policies and financing - has potential to build capacity within these systems to address tobacco use. In 2010, ClearWay MinnesotaSM piloted a health systems change funding initiative, providing resources and technical assistance to four health care systems.

Minnesota's smokefree policies: impact on cessation program participants.

Background: Smokefree policies are enacted to protect individuals from secondhand smoke; however, these laws may have broader cessation effects.

Purpose: This study investigated the relationship between Minnesota's local and statewide smokefree policies and quitting outcomes among cessation program enrollees.

Methods: Data were collected from 2006 to 2008 from two groups of participants (n=1644 pre-statewide law; n=1273 post-statewide law) and analyzed in 2009.

Experience of smokers and recent quitters with smokefree regulations and quitting.

Background: Bans on smoking in public areas have increased as knowledge of secondhand smoke dangers has grown. Restrictions on smoking in public areas may lead to less smoking and increased quitting.

Purpose: This study examines the experiences of smokers and recent quitters with local smokefree regulations to better understand the possible mechanisms by which smokefree regulations affect individual tobacco users' patterns of tobacco consumption and quitting.

Enhancing tobacco quitline effectiveness: identifying a superior pharmacotherapy adjuvant.

Introduction: Telephone tobacco quitlines are effective and are widely used, with more than 500,000 U.S. callers in 2010.

Increasing consumer demand among Medicaid enrollees for tobacco dependence treatment: the Wisconsin "Medicaid covers it" campaign.

Purpose: Smoking prevalence among Medicaid enrollees is higher than among the general population, but use of evidence-based cessation treatment is low. We evaluated whether a communications campaign improved cessation treatment utilization.

Design: Quasi-experimental.

State-level factors influencing tobacco cessation quitline spending in 2008.

Tobacco cessation quitlines are an effective population-based smoking cessation treatment. However, quitline funding varies widely. Analyzing state-level factors may help explain these differences.

Closing tobacco-related disparities: Using community organizations to increase consumer demand.

Background: Individuals living in poverty are more likely to smoke, and they suffer disproportionately from tobacco use. Strategies used to deliver tobacco-cessation interventions often fail to reach smokers living in poverty. Providing tobacco interventions to smokers when they present to community organizations is a potential strategy, but the acceptability and effectiveness of such interventions is unknown.