When Free Is Not for Me: Confronting the Barriers to Use of Free Quitline Telephone Counseling for Tobacco Dependence

• Published in: International journal of environmental research and public health 2015-12, Vol.13 (1), p.ijerph13010015-ijerph13010015
• Main Authors: Sheffer, Christine, Brackman, Sharon, Lercara, Charnette, Cottoms, Naomi, Olson, Mary, Panissidi, Luana, Pittman, Jami, Stayna, Helen
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arkansas - epidemiology; Communication Barriers; Community-Based Participatory Research; Counseling; Counseling - statistics & numerical data; Female; Hotlines - statistics & numerical data; Humans; Low income groups; Male; Middle Aged; Minority & ethnic groups; Rural areas; Rural Population - statistics & numerical data; Smoking Cessation - methods; Smoking Cessation - statistics & numerical data; Socioeconomic Factors; Surveys and Questionnaires; Telephone; Tobacco; Tobacco Use Disorder - epidemiology; Tobacco Use Disorder - prevention & control; United States - epidemiology
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph13010015

Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%-2% of smokers. We used community-based participatory methods to develop a survey instrument to assess barriers to use of the quitline in the Arkansas Mississippi delta. Barriers were quitline specific and barriers to cessation more broadly. Over one-third (34.9%) of respondents (n = 799) did not have access to a telephone that they could use for the quitline. Respondents reported low levels of knowledge about the quitline, quitting, and trust in tobacco treatment programs as well as considerable ambivalence about quitting including significant concerns about getting sick if they quit and strong faith-based beliefs about quitting. These findings suggest quitlines are not accessible to all lower socioeconomic groups and that significant barriers to use include barriers to cessation. These findings suggest targets for providing accessible tobacco use treatment services and addressing concerns about cessation among lower income, ethnic minority, and rural groups.