Jim McCord, Project Director

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• Jim McCord, Project Director
• Tobacco Control Program
• SD DOH
• 615 E. 4th St.
• Pierre, SD 57501
• Phone [phone]
• Fax [phone]
• Email jim.mccord_at_state.sd.us

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SD QuitLine Offers

• Free written materials to assist tobacco users
  who are ready to quit
• Free telephonic cessation counseling delivered by
  trained health coaches
• Access to free cessation medication
• Referrals to other cessation services (if
  interested)

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Eligibility Requirements

• Must be a resident of the state of South Dakota
• Must be a current tobacco user ready to quit

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3 Opportunities

• Those participants who have previously used the
  QuitLine but have relapsed may call up to a total
  of 3 times in their lifetime
• Eligible 3 months after their last date of
  service with the QuitLine

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QuitLine Medications

• Up to 8 weeks of
• Nicotine Replacement Patch
• Nicotine Replacement Gum
• Up to 12 weeks of
• Zyban
• Chantix

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Medication Descriptions

• Zyban (Generic Name Bupropion)
• Non-nicotine containing prescription drug that
  reduces the symptoms of nicotine withdrawal by
  acting on the chemicals in the brain related to
  nicotine craving
• Chantix (Generic Name Varenicline)
• Non-nicotine containing prescription drug that
  reduces the urge to smoke by preventing nicotine
  from reaching the key nicotine pleasure receptors
  in the brain

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Over-the-Counter Medication Patch, Gum

• Individual must call the QuitLine to enroll in
  the program
• Participant receives letter member ID with
  explanation of how to pick up at a local
  participating pharmacy
• Pick up 2 weeks patch or gum at a time coach
  approves in 2 week increments after 1st, 3rd,
  4th, and 5th coaching sessions

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Prescription Medication Zyban, Chantix

• Individual must call the QuitLine to enroll in
  program
• Healthcare provider determines the medication is
  safe and appropriate for individual
• Healthcare provider faxes a QuitLine prescription
  form to Central Pharmacy
• QuitLine coach sends Central Pharmacy
  notification of completion of 1st, 3rd, and 5th
  coaching sessions
• Medication is sent to participants home address

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Must Enroll Participate in CoachingIn Order To
Receive Free Cessation Medication

• Typically 5 coaching sessions centered around a
  Quit Date
• Sessions scheduled by the participant at their
  convenience
• QuitLine Coach calls the participant at scheduled
  time

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Approximate Length of Coaching Sessions

• Initial Call (1st call to QuitLine by a
  participant to enroll in program) 10-15 minutes
• 1st coaching session 25-45 minutes
• 2nd-4th coaching sessions 15-20 minutes
• 5th coaching session 10-15 minutes

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Coaching Sessions 1 2Preparation (Prior to
Quit Date)

• Develop a Personalized Quit Plan
• Plan a Quit Date
• Medication Information
• Discuss
• Triggers
• Coping Mechanisms
• Withdrawal Symptoms

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Coaching Session 3On Quit Date

• Coach Provides Support and Encouragement
• Addition Information on Medication
• Coaching Session 4
• After Quit Date
• Follow-Up
• Review Quit Strategies
• Address Relapses

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Coaching Session 5Graduation Session

• Contact Information
• Graduation Letter Issued
• Leave with any Last Suggestions
• Answer Questions

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QuitLine Hours of Operation

• Monday-Friday 700 am 1100 pm
• Saturday 800 am 500 pm
• Sunday 1000 am 400 pm
• Voicemail available 24 hours/day with a return
  call within 24 hours

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Challenges with Chantix

• Reasons Chantix users stopped using the
  medication (n 1,614)
• Reasons Chantix users were not able to stay quit
  (n838)

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Challenges with Chantix

• The provider sends the Rx to the pharmacy, but
  client never calls the QL to initiate cessation
  coaching.
• When the Rx does not reach the pharmacy, it
  results in a delay in med distribution.
• Rx scripts are signed but incomplete, illegible
  or wrong medication amount prescribed.
• Rx scripts are faxed to local pharmacy rather
  than central pharmacy.
• Lack of follow through from provider (no fax
  sent).

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Successes with Chantix

• Rx mailed directly to participants home SD
  address, no need to go to pharmacy which is
  critical in rural areas.
• Central pharmacy tracks amount of Rx received by
  participant so as not to exceed 3-month supply.
• Ease of QL client in receiving Rx through the
  mail and coaching over the phone (no travel).
• Physician referrals increased to 44 of all QL
  callers.
• Quit Rates have significantly improved.

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Data from 7 month follow-up evaluations
January-August 2008

• 74 (n1,614) of coaching participants used
  Chantix
• - 2 of these participants also used NRT (n29)
• 89 of Chantix users reported that it was very
  easy to get the medication
• Quit rates are significantly higher for 2008 than
  for previous years.
•  

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Medication Requests

• In 2008, 69 of callers who requested coaching
  wanted to use the prescription medication,
  Chantix.

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Enrollment

• SD QuitLine use increased nearly three-fold in
  2008.

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SD QuitLine Timeline
2005 2006 2007 2008
13mo quit rate (7dpp) 29
26 38
N/A
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