Connecting Spanish-Speaking Patients with Quitline Improves Quit Rates

TAMPA, Fla. - Cigarette smoking causes an estimated one of every five deaths in the United States each year and 30% of cancer-related deaths. While the prevalence of smoking has decreased over the past several decades, 30.8 million American adults still report smoking.

Several national health care-based smoking cessation initiatives have been developed to facilitate smoking cessation in primary care settings. However, Spanish-speaking patients have few treatment options and are less likely to receive evidence-based treatments than English-speaking patients. This suggests that efforts are needed to connect Spanish-speaking smokers with smoking cessation programs.

Moffitt Cancer Center researchers are working to develop smoking cessation tools and improve access for Spanish-speaking smokers. In a new article published in Annals of Family Medicine, Moffitt researchers report that proactively connecting Spanish-speaking patients with tobacco treatment delivered by state Quitlines leads to dramatic improvements in treatment enrollment and smoking cessation outcomes.

Ask-Advise-Connect is an approach designed to connect smokers in health care settings with state Quitlines through an automated connection system within the electronic health record. All U.S. state Quitlines offer treatment in Spanish, yet less than 1% of Hispanic/Latino smokers call Quitlines on their own for assistance each year. Ask-Advise-Connect improves Quitline treatment enrollment and engagement, as well as cessation outcomes, by seamlessly sending patients' contact information directly to Quitlines rather than requiring patients to call on their own.

The Moffitt team examined differences in Quitline treatment enrollment, engagement and smoking cessation outcomes among Spanish- and English-speaking patients connected with treatment via Ask-Advise-Connect. The researchers partnered with a large safety-net health care system to implement Ask-Advise-Connect. Of the 218,915 patients accessed, 8.4% of Spanish-speaking patients and 27% of English-speaking patients reported current smoking. They discovered that Spanish-speaking patients were slightly less likely to enroll in smoking cessation treatment than English-speaking patients when offered. However, patients who received treatment in Spanish completed twice as many counseling calls as patients who received treatment in English. Additionally, patients who received treatment in Spanish were more than twice as likely to report abstinence from smoking six months following treatment enrollment.

"We were particularly excited to see the high level of engagement among Spanish-speaking patients after they enrolled in treatment with the Quitline, as Spanish-speaking patients are less likely to be advised to quit smoking in primary care settings and have limited options for smoking cessation treatment," said the study's first author Bethany Shorey Fennell, Ph.D., a postdoctoral fellow in the Department of Health Outcomes and Behavior at Moffitt.

These data suggest that the Ask-Advise-Connect approach, which prior studies have demonstrated leads to better patient engagement and improves smoking cessation outcomes, may be especially effective among Spanish-speaking patients.

"Connecting smokers in primary care settings with Quitline treatment through streamlined, point of care approaches such as Ask-Advise-Connect has great potential to reduce tobacco-related health disparities, as Spanish-speaking smokers appear to be particularly likely to benefit from such approaches," explained senior study author Jennifer I. Vidrine, Ph.D., senior member in the Department of Health Outcomes and Behavior and assistant center director for research strategic partnerships at Moffitt.

This study was supported by the National Cancer Institute (P30CA076292, T32CA090314, P30CA225520), the Cancer Prevention Research Institute of Texas (PP120191) and the Oklahoma Tobacco Settlement Endowment Trust (092-016-0002).

About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. The Tampa-based facility is one of only 53 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt's scientific excellence, multidisciplinary research, and robust training and education. Moffitt's expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet® status, its highest distinction. With more than 7,800 team members, Moffitt has an economic impact in the state of $2.4 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit MOFFITT.org, and follow the momentum on Facebook, Twitter, Instagram and YouTube.

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