Quitline utilization rates of African-American and white smokers: the California experience

To compare the utilization rate of a statewide tobacco quitline by African-American smokers to that of white smokers.

Observational study of 18 years of state quitline operation in California. Subjects were 61,096 African-American and 279,042 white smokers who called the quitline from August 1992 to December 2009. Data from six California Tobacco Surveys, 1993, 1996, 1999, 2002, 2005, and 2008 were also used.

Callers' answers to the question how they heard about the quitline were grouped into four categories: media, health care providers, friends/family, and others.

The averaged annual quitline call volume for each ethnic group was divided by the total number of smokers in that group, based on California Tobacco Surveys, to produce the annual quitline utilization rate.

In five out of six periods of comparison, African-American smokers had a higher annual utilization rate than white smokers. The odds ratios [ORs] ranged from 1.44 to 2.40 (all p < .05). In the 1996 comparison, the OR was .90 (p <.05). The difference in utilization rates that is attributed to media, accounts for most of the difference in total utilization rates between the two ethnic groups.

Within the context of California's comprehensive tobacco control program, which includes a strong media campaign, African-American smokers were significantly more likely to call the state quitline than white smokers were. Promoting the quitline as part of antismoking media campaigns can help reduce disparity in cessation service utilization.