Jim McCord, Project DirectorTobacco Control Program

SD DOH615 E. 4th St.

Pierre, SD 57501

Phone: (605) 773-3737Fax: (605) 773-5942

Email: jim.mccord@state.sd.us

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)

Eligibility Requirements

Must be a resident of the state of South Dakota

Must be a current tobacco user ready to quit

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

QuitLine Medications

Up to 8 weeks of: Nicotine Replacement Patch Nicotine Replacement Gum

Up to 12 weeks of: Zyban Chantix

Medication DescriptionsZyban (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

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

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 participant’s home address

Must Enroll & Participate in Coaching

In 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

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

Coaching Sessions 1 & 2Preparation (Prior to Quit Date)

Develop a Personalized Quit Plan

Plan a Quit Date

Medication Information

Discuss: TriggersCoping MechanismsWithdrawal Symptoms

Coaching Session 3On Quit Date

Coach Provides Support and EncouragementAddition Information on Medication

Coaching Session 4After Quit Date

Follow-UpReview Quit StrategiesAddress Relapses

Coaching Session 5Graduation Session

Contact Information

Graduation Letter Issued

Leave with any Last Suggestions

Answer Questions

QuitLine Hours of Operation

Monday-Friday: 7:00 am – 11:00 pmSaturday: 8:00 am – 5:00 pmSunday: 10:00 am – 4:00 pm

Voicemail available 24 hours/day with a return call within 24 hours

Challenges with Chantix Reasons Chantix users stopped using the medication (n=

1,614)

Reasons Chantix users were not able to stay quit (n=838)

Reason Percent

n

Experienced unpleasant side effects 26% 413

Ran out of medication 12% 193

Medication didn’t work 2% 36

Reasons unrelated to medication 60%

Reason Percent

n

Medication didn’t help 10% 84

Ran out / Couldn’t afford / Couldn’t get medication

5% 43

Didn’t like / Couldn’t use medication 5% 40

Reasons unrelated to medication 80%

Challenges with ChantixThe 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).

Successes with ChantixRx mailed directly to participant’s 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.

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

74% (n=1,614) of coaching participants used Chantix- 2% of these participants also used NRT (n=29)

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.

 

Medication RequestsIn 2008, 69% of callers who requested

coaching wanted to use the prescription medication, Chantix.

EnrollmentSD QuitLine use increased nearly three-fold

in 2008.

SD QuitLine Timeline

13mo quit rate (7dpp): 29% 26% 38% N/A

2005 2006 2007 2008