An exploration of attitudes regarding the use of a state tobacco Quitline for smoking cessation among low-income adults with a history of smoking.

Introduction: Smoking rates among low-income smokers are significantly elevated. State tobacco quitlines offer free and evidence-based treatments for smokers living in that state. This study investigated knowledge, attitudes, and beliefs associated with engagement with the Illinois Tobacco Quitline among confirmed smoking patients at a Federally Qualified Health Center (FQHC). Further goals were to obtain recommendations for strategies to improve patient awareness and engagement.

Methods: Data for this study were collected from August to October 2021 from patients receiving care in an FQHC in a large midwestern city in the USA. Clinic-based recruitment was used to enroll a sample of adult current smokers. In-depth interviews and brief surveys were completed with a volunteer sample of patients recruited from an FQHC. The interviews took approximately 60 minutes. Data analysis used descriptive statistics to summarize the responses to the study and deductive thematic analysis to analyze the qualitative interviews.

Results: Study participants (n=25) were primarily male, African American, and middle-aged (mean age: 52.5 years). The majority were daily smokers. Over half had heard about the Quitline from sources such as radio advertisements, but usage was low. Barriers to use included low motivation to quit, questions about effectiveness, and poor success with prior Quitline attempts. Participants described factors that would increase the appeal of the Quitline, including testimonials, personalization, and an empathetic approach. Participants were asked about the acceptability of receiving information about the Quitline via patient portals, and most were in support.

Conclusions: Interventions are needed to raise awareness and utilization of Quitlines among patients receiving care in FQHC settings. Distribution of Quitline information via patient portals is an acceptable strategy for increasing awareness of services.