Philippe Boucher's Rendez Vous: Helen Glasgow

Rendez-vous with . . . Helen Glasgow

Executive Director of the Quit Group

By Philippe Boucher

Tuesday, December 26, 2000

PB: Thank you Helen for accepting our rendez-vous.
May I ask you to introduce yourself?

Helen Glasgow : I am the recently appointed Executive Director of The Quit Group, which is an incorporated charitable trust set up to carry out programs aimed at reducing smoking in New Zealand. We are funded by the Government to run several different programs:

1. The free phoneline (the Quitline) which people can call to obtain support and advice on quitting smoking. This program has been recently enhanced so that people calling the Quitline can also receive Government funded and heavily subsidized nicotine patches or gum.
2. Media campaigns aimed at motivating people to quit smoking and advertising the free phoneline
3. Smoking cessation programs run in nine hospitals throughout the country - this is just getting under way
I've been working in tobacco control in New Zealand for the past 11 years, having been until recently with the national office of the Cancer Society of New Zealand. In recent years I have worked with other agencies in coalitions to work in advocacy for strengthening of tobacco control legislation; to develop teaching resources for use in schools; to organise two-yearly national tobacco control conferences and to organize programs to mark World Smokefree Day. while with the Cancer Society I organized the publication of three important publications: Tobacco Statistics 1996, Tobacco Statistics, 2000 and The Big Kill Continues. I am currently the chairperson of the Smokefree Coalition, an advocacy group working for stronger tobacco control legislation and increased government funding for tobacco control.

Q1. Can you give us some background about the creation of the quitline in NZ: how is it organized, with what budget, what staff, what are your priorities and objectives?

HG: The Quitline was first set up as a part of a pilot campaign, by the Quit Group . The pilot campaign consisted of (1) the free phoneline (the Quitline) and (2) media advertising and public relations to promote smoking cessation and invite people to phone for free support and advice. We received a great deal of help from the staff of the Victorian Smoking and Health Program, particularly from Judith Watt and Pat Kee, in developing the Quitline two years ago, and we modeled the Quitline on the Victorian Quitline.

We use a call center to deal with the callers 24 hours a day. They offer callers our Quit pack which consists of a self help book and other items. They also offer callers an opportunity to speak to our Quit Advisors and if the caller wants this, they are then transferred to our Quit Advisors. Our Quit Advisors are available from 8.30am to 10pm on weekdays and during afternoons on Saturday and Sunday.

Pat Kee, the Victorian Quitline manager helped us with the training of our first Quit Advisors in 1998. We trained 16 people and set them up to deal with callers, using a database to enter each caller who registers to quit smoking and go on our call back system - this provides for the smoker to have up to 6-7 call backs for support and advice. We now have 40 Quit Advisors in our team. Currently we have 12-15 Quit Advisors on most shifts. We expect they will deal with 30,000 people on the call back service this year. Our objective is to provide support and advice to callers and to assist them to quit smoking. We have a budget of around $2 million to operate the Quitline in the current year.

Q2. Recently the NZ government adopted a proposal from the Green party so that part of the cost of nrt products is subsidized by the State. Could you explain to us the reasoning behind this proposal, how it works and the role played by the quitline?

HG: For several years, the major health agencies such as the Cancer Society and the National Heart Foundation have been lobbying health officials and Ministers of Health to provide some subsidization of NRT for smokers, on the basis that this is a cost effective health intervention. In May this year the Minister of Health announced that smokers would be provided with subsidized nicotine patches or gum later in the year through the Quitline and other smoking cessation services.

The Minister launched the new program on November 1, 2000 and we began providing NRT through the Quitline. That week we had 30,000 callers trying to get through to obtain this help, indicating how smokers view this help. Since then demand has dropped, but we are still receiving 1000 calls in a day. We have an assessment process for dealing with these callers. If the caller is assessed as likely to benefit from NRT, the Quit Advisor mails out an exchange card to the caller. These can be presented at any pharmacy and the smoker will receive 4 weeks supply of patches or gum. They pay $10 (about $US4.50) for the 4 weeks supply which is less than one tenth the usual price. Our Quit Advisors call the person back three weeks later, and if they are seriously proceeding with quitting smoking, they provide the person with an exchange card for a further four weeks supply. We are currently running an abridged service, due to the heavy load of callers. Normally we would provide each person on our call back service with about six call backs.

Other smoking cessation programs can now also provide these exchange cards for subsidized NRT as part of their program of support. The program has $6 million worth of NRT to provide each year for the next three years.

Q3. In the US and in many countries the price of drugs is very controversial. What is now the situation in NZ concerning the NRT products? Do you think this experience of subsidized drugs is sustainable on the longer term? Could it lead to cheaper nrts for everybody, without public subsidies?

HG: In New Zealand the health care system provides many subsidized drugs, with the public normally paying a small portion of cost of common drugs. However, normally these drugs are obtainable after a medical practitioner has provided a prescription. The subsidized NRT operates differently, because it is not primarily provided by medical practitioners, though those medical practitioners who run smoking cessation programs can access the NRT exchange cards.

I would imagine that if the evaluation of the NRT program shows that it is effective in achieving lower smoking rates in the population of New Zealand, that there would be continuing funding for this program. I don't have any information about the likely effect on the market price of NRT products.

Q4. We have seen that the number of calls to the quitline is directly related to the importance of the media campaign about the quitline. Are there best practices to follow for the media campaign? Should there be a campaign all year around, is/should the quitline number be printed on the packs? what do you recommend for maximal efficiency? are some themes more effective than others?

HG: We have definitely seen a strong relationship between the volume of calls to the Quitline and the promotion of the Quitline. We are using the Australian National Tobacco Campaign advertising campaign which uses health effects advertising, and we have found that to be effective. We run the Quitline number on the end of the advertising and peaks of calls always follow the playing of these advertisements on TV. We also have a straight Quitline advertisement which also prompts lots of calls. However, the Minister's announcement of the NRT programme has massively increased the response.

We are not currently running any advertising, but plan to resume advertising in February, 2001. Normally we aim to run advertising two weeks on and two weeks off and would ideally run it for as much of the year as we could fund. In New Zealand the Quitline number is on cigarette packs, though it does not identify it as the Quitline - simply says for further information phone 0800 778 778 (our number)

Q5. How do physicians fit (or not) into a quitline strategy? and can a quitline also address other tobacco control issues, like ETS for instance (if non-smokers call to complain because they are smoked out)?

HG: There is no particular involvement of physicians, though we certainly work with any who approach us for any kind of advice or involvement. The Quitline provides general information about wider issues as they arise from our callers. We have material on a variety of topics, including second hand smoke.

Q6. Is there anything else you would like to add ?

HG : Only that it is safe to say that everyone here in New Zealand has been very surprised at the response from smokers to the provision of the subsidized NRT. We had expected a strong demand, but nothing like this. The general impression is that many people are doing well with the NRT. There are several follow ups of samples of our callers under way, one follow up, before the NRT program, and one from a group recruited in the first week of the NRT program, and another group is due to be recruited in March, when things have settled down a little, so in due course we will have results.

PB: Thank you Helen for taking the time to be with us today.

Rendez-vous is supported by a contract from the Robert Wood Johnson Foundation
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