Background:
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.
Aim:
To identify the uptake of the Quitstair model and cessation rates among proactively recruited community smokers
Methods:
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.
Results:
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.
Conclusions:
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.