Improving Quitline Support Study

This study seeks to evaluate ways to improve outcomes for low‐education, uninsured or Medicaid‐eligible smokers who do not successfully quit with standard telephone quit line treatment. The study will use an efficient factorial study design to evaluate four evidence‐based strategies to improve follow‐up care offered by the Wisconsin Tobacco Quit Line (WTQL) to socioeconomically disadvantaged callers who report smoking four months following initial WTQL treatment comprising a single counseling call and 2‐week supply of a single nicotine replacement therapy. The four factors (strategies) to be studied include: (1) Quit line counseling intensity (1 vs 4 proactive calls); (2) Nicotine replacement therapy (NRT) intensity (Patch for 2 weeks vs Patch+Lozenge for 4 weeks); (3) SmokefreeTXT text messages (proactive enrollment vs none); and (4) financial incentives for treatment engagement (vs none). The study design is a fully‐crossed 4‐factor factorial design. The primary aim is: Assessment of the main and interactive effects of the four treatment factors on biochemically‐confirmed 7‐day point‐prevalence abstinence at the 6‐month followup. Secondary aims include testing: (1) self‐reported abstinence at 12 weeks post‐quit; (2) continuous abstinence between 1 and 6 months; (3) cost‐effectiveness; and (4) moderators of treatment engagement and mediators of treatment effectiveness on 6‐month abstinence.