A number of countries need to significantly accelerate reductions in smoking rates to reach policy targets. Uptake of a number of effective cessation strategies remains poor. The ‘Quitstair’ is a comprehensive stepped care model that uses evidence-based smoking cessation strategies. It encourages those who can quit with minimal intervention to do so, and offers more intensive support to those who need additional support to quit.
To identify the uptake of the Quitstair model and cessation rates among proactively recruited community smokers
A cohort pilot-test involving 250 current smokers from the general community in New South Wales, Australia. Random-digit dialling was used to identify households with a smoker and randomly select a smoker from each eligible household. Participants completed a telephone interview at recruitment and 4 months later. The stepped care intervention involved sequential steps through different types of support (e.g. written/online materials, Quitline telephone counselling, pharmacotherapy, referral) over a 4 month period. Intervention delivery was guided by a stepped care coordinator who contacted participants by telephone at 3, 7, 9 and 13 weeks.
Approximately 55% of pro-actively-recruited smokers opted to enter the program. Drop-out rates at each step of the Quitstair ranged from 2% to 8% of remaining participants. The majority of participants: made at least one quit attempt; elected to follow the model and agreed to use more than one evidence-based strategy to assist in a quit attempt.
The Quitstair approach represents a shift towards a coordinated, systematic, and long-term model of care that includes repeated effort to assist individuals to use evidence-based strategies. This chronic-disease model of care capitalises on existing services and can be implemented in a range of settings. A randomised controlled trial of the approach is planned.