The Spanish Quitline Network. The case study of the Catalonia Quitline Dolors Marin Tuyà

1. The Spanish Quitline Network. The case study of the Catalonia Quitline Dolors Marin Tuyà Psychologist specialist in Clinical Psychology Public Health Directorate. Health Department of Catalonia European Network of Quitlines Roma, 10-11 December 2007

2. The spanish Quitline Network • Every Autonomous Community develops a specific Plan, the common main focus, the implementation of the law 28/2005. • Different levels of development and different priorities. • Annual Conference on Tobacco treatment and Prevention, October 2007 • Quitlines were not a specific subject (only a poster by the Catalan Quitline was presented and accepted).

3. The existing Spanish Quitlines, 2007 • Madrid • “Vida sin tabaco” (“Tobacco free life”). Based in Carlos III Hospital. Novartis. It gives reactive and proactive advice and covers all Spain. • Web developed by the Municipality • Planning a Quitline by the Autonomous community • Castilla-Leon • An small Quitline that gives reactive advice and information about the law 28/2005. • Andalusia: • Operating a public Quitline, directed by psychologists. • Catalonia Quitlines Working Group.

4. Evaluation of the 1st year of the Catalan working group. • launched by the Catalan Health Department • Includes the two lines functioning in Catalonia: • “Sanitat Respon”(“Health answers”) a general health information line with a specific group focussed on Mental health risk that provided advice in Catalonia in a reactive approach between 2004-6 and information about the law 28/2005 . • “Respira sin humo” (“Smoke free breath”). Based in Bellvitge Hospital (BCN). Sponsored by Pfizer and some Public Institutions. It was launched at the end of 2005. • And the Health services to help smokers quit (coordination meeting • Aiming to develop a two level structure with “Sanitat respon” acting as gatekeeper and “Respira sin humo” providing more specialised advice and support.

5. Some Catalonia data on tobacco use • 7,000,000 inhabitants • 29.4% of adults smoke • 48.4% (approx. 835,000) want to quit • 73.3% are young (15-44 years old) ESCA, 2006

6. Health services to help smokers quit Network of Smoke-free Primary Care Centres (225) Helping smokers Services Smoke-free pregnancy Program Network of Smoke-free Hospitals (46, 15 with patient program) Pharmacies 22 Specialized units Workplace Health Services / HMO Private health services CommunityPrograms (as Quit&Win)

7. Network of Smoke free PrimaryCare Centres 1 3 1 1 1 1 9 4 2 225 Centres 4 3 12 1 2 4 7 18 5 3 1 71 3 35 5 1 3 13 9 1 37.757 smokers quit during 2006 (data based on 80% of centres; ICS) 1

9. 22 Specialized Units 3 4 1 2 3 6 2 More than 2.000 smokers visited in 2006 1

10. Free Pharmacological treatment • During 2006  2350 freepharmacological treatments for: • hospitalized people, • role model professionals and • people living in deprived areas • (300,000 €)

11. Health services to help smokers quit Network of Smoke-free Primary Care Centres (225) Helping smokers Services Smoke-free pregnancy Program Workplace Health Services Network of Smoke-free Hospitals (46, 15 with patient program) Pharmacies Private health services 22 Specialized units Community Programs (as Quit&Win)

12. Quitline Characteristics Catalonia Health Department launched on the second of June 2007 a proactive public quitline based on the service “Sanitat Respon” • 24 hours /365 days /year. • People do and pay the first contact call (approx 0,5€) • Trained nurses are responsible for the service provided, they establish a therapeutic plan tailored to people characteristics and needs and based on a series of free calls. • Can be used as an unique method and as a complementary resource. • Phone number (SR): 902 111 444

13. The service has an specific software to collect, to organize the information and to guide the intervention: • users characteristics, • motivation to quit, • tobacco use and dependence • Environment/support • skills

14. Characteristics of people calling to the quitline in the first 3 months(june-July and Augost 2007) • Total calls 837 (received /made) • from / to 341 different users. • 50,6% male. • Median of Age 43 years P25: 35 P75: 53 Range 19 to 81.

15. At the first call

16. 30,2 > 3 32,7 > 3 27,6% > 3 30,8 > 25 37,8% > 25 P=0,038 23,3% > 25 Tobacco use, dependence and motivation to quit

17. Environment

18. The main concerns of quitline users were • anxiety • weight increase (more frequent in women). • and not being capable to quit • 15,9% set a quit date at the first call .

19. Concluding remarks The users profile of our quitline is: • Young adults • Moderate-high dependence • Environment against quiting smoking • High Motivation to quit • Medium Confidence to quit

20. Further steps In the context of the Health services to help smokers quit • To develop a second level of treatment • More specialised • conducted by psychologist • working together with a private quitline that can be contracted by our Department • To develop a specific website • To give publicity of the quitline (media campaign)