Alcohol use, risky sexual behavior, and condom possession among bar patrons

HIGHLIGHTS

• Bar patrons' intentions to engage in unsafe sex varied by sex and BrAC.
• Significant predictors of condom possession were gender, race, age and BrAC level.

PURPOSE:

The current study seeks to: 1) assess the relationship between alcohol consumption and intentions to engage in unprotected sex in an uncontrolled environment, and 2) to identify if covariates (race, age, sex, breath alcohol content (BrAC), intentions to engage in sex, hazardous drinking rates) are significant predictors of condom possession during time of uncontrolled alcohol consumption.

METHODS:

Data were collected from 917 bar patrons to assess alcohol use using the Alcohol Use Disorders Identification Test (AUDIT-C), BrAC levels, intentions to engage in risky sex, and condom possession. Correlational analysis and hierarchical binary logistic regression was conducted using SPSS.

RESULTS:

Correlational analyses indicated a negative relationship between AUDIT-C scores (r=-0.115, p=0.001), BrAC (r=-0.08, p=0.015), and intentions to use a condom. Over 70% of participants intended to use a condom if they engaged in sex; however, only 28.4% had a condom to use. The regression analysis indicated the predictive model (χ²=114.5, df=8, p<0.001) was statistically significant, and correctly classified 72.9% of those in possession of a condom.

CONCLUSIONS:

Alcohol consumption was associated with intentions to have unprotected sex; however, intentions to engage in protected sex and condom possession were higher for males and those with higher BrAC levels.

Purchase full article at:   http://goo.gl/gF1QL8

By:  Chaney BH1, Vail-Smith K2, Martin RJ3, Cremeens-Matthews J4.

• 1East Carolina University, Department of Health Education & Promotion, 3105 Carol G. Belk Building, Greenville, NC 27858, United States. Electronic address: chaneye@ecu.edu.
• 2East Carolina University, Department of Health Education & Promotion, 3208 Carol G. Belk Building, Greenville, NC 27858, United States. Electronic address: vailsmithk@ecu.edu.
• 3East Carolina University, Department of Health Education & Promotion, 2206 Carol G. Belk Building, Greenville, NC 27858, United States. Electronic address: martinry@ecu.edu.
• 4East Carolina University, Department of Health Education & Promotion, 2302 Carol G. Belk Building, Greenville, NC 27858, United States. Electronic address: cremeensj@ecu.edu. 
• Addict Behav. 2016 Apr 6;60:32-36. doi: 10.1016/j.addbeh.2016.03.035.

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Retrospective Analysis of Reproductive Health Indicators in the United Nations High Commissioner for Refugees Post-Emergency Camps 2007–2013

Background

The United Nations Refugee Agency’s Health Information System issues analytical reports on the current camp conditions and trends for priority reproductive health issues. The goal was to assess the status of reproductive health by analyzing seven indicators and comparing them to standards and host country estimates.

Methods

Data on seven indicators were extracted from the database during a seven-year period (2007 through 2013). A standardized country inclusion criterion was created based on the year of country implementation and the percentage of missing reports per camp and year. The unit of analysis was monthly camp reports by year within a country. To account for the lack of independence of monthly camp reports, the variance was computed using Taylor Series Linearization methods in SAS.

Results

Ten of the 23 eligible countries met the inclusion criterion. The mean camp maternal and neonatal mortality rates, except for two country years, were lower than the host country estimates for all countries and years. There was a significant increase in the percent of births attended by a skilled birth attendant (p < 0.0001), and 8 of 10 countries did not meet the standard of 100 % for all reporting years. The percent of births performed by Caesarian section (p < 0.001), were below the recommended minimum standard for nearly half of the countries every year. There was a significant increase in the percent of women screened for syphilis across years (p < 0.0001) and the percent of women who received post HIV exposure prophylaxis (p < 0.0001) and 10 % reached the standard for all reporting years, respectively.

Conclusion

Comprehensive, consistent and comparable statistics on reproductive health provides an opportunity to assess progress towards indicator standards. Despite some improvements over time, this analysis confirms that most countries did not meet standards and that there were differences in reproductive health indicators between countries and across years. Consequently, the HIS periodic monitoring of key reproductive health indicators at the camp level should continue. Data should be used to improve intervention strategies.

Below:  Proportion of women screened for syphilis annually by country. UNCHR target is 100 percent

Below:  Rate of condom distribution* in the population by year. *Figure depicts percentage (monthly rate*100)

Below:  Proportion of rape survivors who received post-exposure prophylaxis (PEP) within 72 h of an incident occurring. UNHCR target is 100 percent

Full article at:  http://goo.gl/iwPEIk

By:  Jennifer Whitmill, Curtis Blanton, Sathyanarayanan Doraiswamy, Nadine Cornier, Marian Schilperood, Paul Spiegel, andBarbara Tomczyk

Rollins School of Public Health Grace Crum Rollins Building, 1518 Clifton Road, Atlanta, GA 30322 USA

Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 USA

Emergency Response and Recovery Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333 USA

United Nations High Commissioner for Refugees, Case Postale 2500 CH-1211, Genève 2, Dépôt Switzerland

Rollins School of Public Health Grace Crum Rollins Building, 1518 Clifton Road, Atlanta, GA 30322 USA

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The S'Khokho 'bushcan' initiative: Kick a bush and condoms fall out

BACKGROUND:

People living in rural areas have limited access to condoms owing to distance, cost and time involved in travelling to public health facilities, around which most condom distribution efforts are centralised.

OBJECTIVE:

In an effort to increase access to condoms in these areas, we explored the feasibility and efficacy of condom distribution by placing 'condocans' on trees along informal footpaths used by residents.

METHODS:

From October 2012, steel condocans, typically seen in clinic settings, were erected on trees along pathways in bushy areas with high levels of foot traffic at several rural locations in the Umgungundlovu district of KwaZulu-Natal Province, South Africa (SA). Because of their location, the condocans were referred to as 'bushcans'. Condom uptake was closely monitored, and the bushcans were restocked when necessary.

RESULTS:

Following the introduction of the bushcans, male condom distribution increased by 237% from October 2012 to December 2012. Condom distribution in these areas increased on average by 187% from October 2012 to October 2015, with more than 408 000 condoms distributed over the 3-year period using the bushcans alone. Discussions with residents revealed that they were pleased about the increased access to condoms via the bushcans, and they recommended other areas for potential implementation of this initiative.

CONCLUSIONS:

The bushcan initiative highlighted the fact that condoms are not as easily accessible to all South Africans as is often thought. By providing access to condoms in a discreet and convenient manner, the bushcans have the potential to increase access to condoms in other rural and periurban areas in SA where communities face similar barriers to access.

Full PDF article at:  http://goo.gl/VoyzKx

By:  Pienaar J1.

• 1S'Khokho Community Health, KwaZulu-Natal, South Africa. jpienaar@skhokho.org. 
• S Afr Med J. 2016 Mar 9;106(4):372-3. doi: 10.7196/SAMJ.2016.v106i4.10146.

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Beyond Condoms: Risk Reduction Strategies among Gay, Bisexual & Other Men Who Have Sex with Men Receiving Rapid HIV Testing in Montreal, Canada

Gay, bisexual, and other men who have sex with men (MSM) have adapted their sexual practices over the course of the HIV/AIDS epidemic based on available data and knowledge about HIV. This study sought to identify and compare patterns in condom use among gay, bisexual, and other MSM who were tested for HIV at a community-based testing site in Montreal, Canada. 

Results showed that while study participants use condoms to a certain extent with HIV-positive partners and partners of unknown HIV status, they also make use of various other strategies such as adjusting to a partner's presumed or known HIV status and viral load, avoiding certain types of partners, taking PEP, and getting tested for HIV. 

These findings suggest that MSM who use condoms less systematically are not necessarily taking fewer precautions but may instead be combining or replacing condom use with other approaches to risk reduction.

Full PDF article at:   http://goo.gl/HuCkMf

By:  Otis J1,2, McFadyen A3, Haig T3,4,5, Blais M3, Cox J6, Brenner B7, Rousseau R8, Émond G9, Roger M10, Wainberg M7; Spot Study Group.

• 1Department of Sexology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville, Montreal, QC, H3C 3P8, Canada. otis.joanne@uqam.ca.
• 2CIHR Canadian HIV Trials Network, Vancouver, Canada. otis.joanne@uqam.ca.
• 3Department of Sexology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
• 4CIHR Canadian HIV Trials Network, Vancouver, Canada.
• 5COCQ-SIDA, Montreal, QC, Canada.
• 6Direction de santé publique du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.
• 7Faculty of Medicine, McGill University, Montreal, QC, Canada.
• 8RÉZO, Montreal, QC, Canada.
• 9Applied Human Sciences, Concordia University, Montreal, QC, Canada.
• 10Laboratoire de Biologie Moléculaire, Centre hospitalier de l'université de Montréal, Montreal, QC, Canada. 
• AIDS Behav. 2016 Mar 9

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HIV Knowledge and Risky Sexual Behavior among Men in Rwanda

Introduction: 

New infections of Human Immunodeficiency Virus (HIV) remain a big problem in many countries. Different interventions have been implemented to improve the general knowledge of HIV, with the hypothesis that increasing HIV knowledge will reduce risky sexual behavior (RSB). However, HIV knowledge may not necessarily reduce RSB. This study explores HIV knowledge and its effect on RSB.

Methods: 

The study used data from the 2005 and 2010 Rwanda Demographic and Health Surveys to analyze the association between HIV risk factors and two types of RSB (having two or more partners in the past 12 months; and among those with two or more partners, not using a condom at last sex) and the association between HIV knowledge and those RSB. Multivariate logistic regression was used to determine predictors of RSB.

Results: 

Among 2,773 men in 2005 and 3,772 men in 2010, 5% and 7% respectively reported having two or more sexual partners. Among them, 93% in 2005 and 74% in 2010 did not use a condom at the last sex. Between 2005 and 2010, knowledge of the protective effect of having just one uninfected faithful partner, and basic knowledge of HIV decreased. Knowledge of the protective effect of using condoms increased from 90% to 94%. However, HIV knowledge was not associated with either type of RSB.

Conclusion: 

In setting up policies and strategies related to HIV prevention, policymakers should consider that focusing on HIV knowledge is not sufficient in itself.

Below: Factors model for predicting risky sexual behavior among men

Below:  Percentage of men who had two types of risky sexual behavior

Full article at:   http://goo.gl/jw0E4X

By:   Etienne Rugigana¹, Francine Birungi¹, Manassé Nzayirambaho^1,&

¹School of Public Health, College of Medicine and Health Sciences, University of Rwanda

Manassé Nzayirambaho, School of Public Health, College of Medicine and Health Sciences, University of Rwanda

 

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Conflict & Expectancies Interact to Predict Sexual Behavior Under the Influence among Gay & Bisexual Men

As the mechanisms of the associations between substance use and risky sex remain unclear, this study investigates the interactive roles of conflicts about casual sex and condom use and expectancies of the sexual effects of substances in those associations among gay men. 

Conflict interacted with expectancies to predict sexual behavior under the influence; low casual sex conflict coupled with high expectancies predicted the highest number of casual partners, and high condom use conflict and high expectancies predicted the highest number of unprotected sex acts. 

Results have implications for intervention efforts that aim to improve sexual decision-making and reduce sexual expectancies.

...Each kind of conflict interacted uniquely with expectancies to predict sexual behavior under the influence. Contrary to our hypothesis, men who were low in casual sex conflict and high in expectancies reported the highest number of casual partners under the influence. For conflict about condom use, however, men who were both high on condom use conflict and high in expectancies tended to be in the highest risk group, which was consistent with our hypothesis. Practically, it seems that conflict about casual sex may lead men to avoid casual sex when they are under the influence of drugs or alcohol. However, men who were conflicted about unprotected sex may still engage in casual sex but be more likely to succumb to the influence of substances (and/or their expectations of substances’ effects) to ultimately engage in risk behavior. In short, men who were high in conflict about condom use seemed to be especially sensitive to the effect of expectancies. Though a causal mechanism cannot be determined from cross-sectional data, these results suggest that there may be a causal mechanism in the association between substance use and sexual risk behavior, though other psychosexual and contextual factors may moderate this association. These findings are consistent with research indicating that self-regulation is important in balancing the effects of sexual sensation seeking on unprotected sex but not in the association between sensation seeking and the number of casual sex partners (Adam et al., 2008)...

Below:  (a) Casual sex conflict × expectancies and (b) unsafe sex conflict × expectancies

Full article at:  http://goo.gl/6ubw4X

By:   Brooke E Wells,1 Tyrel J Starks,1 Jeffrey T Parsons,1,2 and Sarit Golub2

¹Center for HIV/AIDS Educational Studies and Training (CHEST), New York, NY, USA

²Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, USA

Corresponding author: Sarit Golub, Department of Psychology, Hunter College, The City University of New York (CUNY), 695 Park Avenue, New York, NY 10065, USA. Email: ude.ynuc.retnuh@bulog.tiras

  

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The Role of Relationship Types on Condom Use among Urban Men with Concurrent Partners in Ghana & Tanzania

Multiple concurrent partnerships are hypothesized to be important drivers of HIV transmission. Despite the demonstrated importance of relationship type (i.e., wife, girlfriend, casual partner, sex worker) on condom use, research on concurrency has not examined how different combinations of relationship types might affect condom use. 

We address this gap, using survey data from a sample of men from Ghana (GH: n = 807) and Tanzania (TZ: n = 800) who have at least three sexual partners in the past three months. We found that approximately two-thirds of men's reported relationships were classified as a girlfriend. 

Men were more likely to use a condom with a girlfriend if their other partner was a wife compared to if their other partner was a sex worker (GH: OR 3.10, 95% CI, 1.40, 6.86; TZ: OR 2.34, 95% CI 1.35, 4.06). 

These findings underscore the importance of considering relationship type when designing HIV prevention strategies in these settings.

Purchase full article at:   http://goo.gl/B3Qenq

By:   Fleming PJ1, Mulawa M, Burke H, Shattuck D, Mndeme E, Attafuah J, Mbwambo J, Guest G.

• 1 FHI 360 , Durham , NC , USA. 

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Economics of Mass Media Health Campaigns with Health-Related Product Distribution: A Community Guide Systematic Review

Context

The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge.

Evidence Acquisition

Economic evaluation studies from a literature search from January 1980–December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011.

Evidence Synthesis

The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy (NRT).

Conclusion

Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with NRT products may translate to a cost per quality-adjusted life year (QALY) less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health.

Table 2

Details of included studies

Study and Year Location Population Design Type of economic analysis	Intervention components Length of intervention Volunteers and in-kind contributions	Effectiveness	Intervention cost and components	Economic benefits considered	Summary economic outcome
Child safety seat use
St Louis 200819 Oakland County, MI Area Pop: 197,846 Low-income community pop: Not reported Hispanic community pop: 11,355 Pre-Post with Comparison Funded amount	TV, radio, print, small media, community mobilization, child seats, small group education 15 months Used volunteers	No difference for low- income community Hispanic community: Before - 9.7% After - 14.9% (Control: Before- 18.2%, After-14.8%) 358 free seats distributed	$53,209 grant to each of two communities No details about number of vouchers redeemed	None	None
Pedometer distribution
Brown 20069 Eakin 200711 Rockhampton, Australia Pop: 60,000 (40,000 adults) Pre-Post with Comparison Funded amount and partial intervention cost	TV, radio, print, small media, pedometers, phone support, website, small group education, improved municipal signage and footpaths, formative research 2 years Volunteers and in-kind contributions	No significant effect	Grant plus in-kind contributions: $530,700 Includes paid advertising and event marketing: $17,400, with additional $43,500 in-kind	None	None
Condom distribution
Alstead 19996 Seattle, WA Pop size not reported 15-17-year-olds in three communities within Seattle Pre-Post Partial intervention cost	Radio, small media, community mobilization, condoms, small group education, formative research 7 months Volunteers used	No significant difference in condom use at last intercourse between those exposed and unexposed to campaign	$276,617 for formative research, media and placement, professional advertising and vending services plus $15,000 for condoms	None	None
Kahn 200113 Intervention: Eugene, OR Control: Santa Barbara, CA Target gay men aged 18-27 years (approx 1,100 in area) Pre-Post with Comparison Modeled cost- effectiveness	(Print, small media, community mobilization, small group education, formative research, condoms) 8 months Modeled 1, 5, 20 years Volunteers used	27% reduction in risk sex behavior (measured as reduction in unprotected anal sex) Assumed reduction in risk translates directly to same percent reduction in HIV incidence. Authors provide rationale for assumption based in literature.	$113,641 or $676 per person (For personnel, computers and supplies, publicity and communications, condoms, travel, workspace)	Health care averted based on lifetime medical care cost for treating HIV infections using estimates from literature	Societal net savings= intervention cost minus averted medical costs: 1 year: $265K 5 years: $875K 20 years: $1,714K
Kennedy 200014 Sacramento, CA About 6,000–10,000 sexually active adolescents Pre-Post with series of surveys Funded amount	Radio, small media, community mobilization, phone support, small peer-led group education, condoms 1 year	OR of condom use with main partner at last intercourse: 1.26 OR of condom carrying: 1.27	Funding: $335,358 (~$42 per target person) No component details provided	None	None
Rebchook 200616 Multiple sites, U.S. Young gay men Cross-section of 26 community-based organizations (CBOs) Program budgets	Print, small media, community mobilization, small group education, formative research NA – data collected during 2002–2005	NA	26 CBOs provided data Annual operating budget: >$171K: 19%; $79,800-$171K: 19%; $22,800- $79,800: 5%; ≤$22,800: 23%; Don’t know: 23% Avg: $112,570; Median: $80,370; Range: $7,980– $394,349	NA	NA
Recreational helmets distribution
Bergman 19908 Seattle, WA Elementary school children and parents (N=56,179) Pre-Post with Comparison Product discount information	TV, radio, print, small media, community mobilization, helmets, phone support 3 years Volunteers used	At 16 months: Intervention (Seattle): – 5% to 16%; Control (Portland): 1% to 3%; Difference: 9%	Only intervention cost was $5K contribution to small media. Usual price of helmets $40–$60. Round 1: $19.95 helmets with coupons (5,155 of 109,450 coupons redeemed) Round 2: $25 helmet sales increasing from 1986-1.5K; 1987- 5K; 1988-22K; Partial 1989-30K	None	None
Levy 200715 Denver, CO Pop. size not reported Skiers and snowboarders in area Pre-Post with Comparison Product discount information	TV (newscast), print, small media, community mobilization, helmets, formative research 4 ski seasons starting 1998-1999 Volunteers used	Helmet acceptance among renters: 1998-99:13.8% 2001-2002: 33.5% For control stores, corresponding percentages were 1.38% and 4.48% Observations of helmet days/rental days: 98-99: 2,150/15,567 99-00:55,581/179,705 00-01: 44,351/132,219 01-02: 75,037/224,008 Observed helmet use on slopes by skiers: 98-99: 7.7% to 01-02: 20.3%	Usual helmet rental cost: $3.74 to $12.46 provided free to renters of package. Based on helmet days from effect size and lower estimate for rental cost, 4-year outlay was $662,425 with annual average of $165,606	None	None
Rouzier 199517 Grand Junction, CO 8,600 elementary school children and parents Pre-Post Product discount information	Radio (news), print, small media, community mobilization, helmets, small group education 2 years Volunteers used	Observed helmet use over 3 years: 1992: 5.6% 1993: 12.5% 1994: 30%	Phase 1: Helmets purchased for 18.36-$26.01. 1,080 sold for $7.65; 1,080 for $22.95; and 240 for $26.01 Phase 2: 4,000 sold for $19.87	None	None
Smith 199118 Oakland County, MI 3,100 middle and junior high students and parents from six schools Pre-Post Funded amount and partial intervention cost	TV, small media, community mobilization, phone support, small group education, formative research 5 months	Self-reported helmet ownership increased from 5% to 18.5%. From pre to post, parent-reported helmet use 50% of time increased ~2% to ~4% for low-intensity group and ~2% to ~11% for high- intensity group	Grant $358,355 fully financed intervention. 200 helmets given away in low-intensity group at cost of $14681.28 63 helmets given away in high- intensity group for cost of $4624.80	None	None
Wood 198821 Victoria, Australia Statewide population Pre-Post Partial intervention cost	TV, radio, print, small media, reduced price, formative research 1 year Volunteers used	Metro Melbourne: Observed helmeted: Primary school students: 4.6% in 1983 to 38.6% in 1985 Secondary school students: 1.6% in 1983 to 14.0% in 1985 Adults: 26.1% in 1983 to 42% in 1985 20% reduction in bicycle-related motor vehicle crash head injury in Victoria in 1982-1983 combined, compared to 1984	Partial cost provided as cost of TV/radio campaign was $294,286; total cost of rebates for helmets of $745,200 (calculated by reviewers)	None	None
Nicotine replacement therapy (NRT) distribution
Bauer 20067 Western NY All callers to quitline Pre-Post with Comparison Cost per additional quitline caller	Print, small media, community mobilization, phone support, NRT, supplies 3-4 weeks 3 Treated Arms: Arm 1: Newspaper and magazine ad with NRT Arm 2: Newspaper ad Arm 3: Newspaper ad with cigarette look-alike	Arm 1: Incremental calls – 4724 Quit (7-day abstinence): 22% for those redeeming NRT versus 12% pre-NRT, implying OR=1.77 Arm 2: Incremental calls – 14 Arm 3: Not reported Treated quits: 20% Controls: 24%	Arm1: $58,487 (For newspaper and magazine ad and NRT) Arm 2: $3,810 for newspaper ad Arm 3: Not reported (For newspaper ad and plastic cigarette at $1.71 each)	None	Cost per incremental call Arm 1: $12.54. Arm 2: $272.46 Arm 3: $93.48
Cummings 2006a10 (linked to Miller 200522 and Cummings 2006b23) 4 regions of New York Region I: Buffalo area, n=1,099 Region II: 8 counties, n=1,334 Region III: 15 counties, n=2,323 Region IV: NYC, n=35,334 All callers to quitline Pre-Post with Treated Comparison Cost per additional quit	Radio, print, small media, NRT, phone support 4 regions with varying durations of free NRT and type of media Region I: 2 weeks with earned media Region II: 2 months with earned media and paid radio Region III: 4 weeks with earned media and print ads Region IV: 6 weeks with earned media	Daily call volume by region Region: Before/After I: 312/63=5.0 II: 393/79=4.97 III: 931/60=15.5 IV: 7,213/552=13.1 Region: Percent quits (risk ratio) Pre-NRT: 12% (1.0) I: 27% (2.9) II: 21% (2.0) III: 24% (2.4) IV: 33% (3.8)	Intervention cost (per enrollee) by region: I: $52,856 ($48) II: $43,823 ($33) III: $110,382 ($48) IV: $3.08 Mil ($87)	None	Cost per quit due to NRT by region: I: $312(n=169) II: $349(n=125) III: $396(n=279) IV: $396(n=7770)
Fellows 200712 State of Oregon Pop. size not reported All callers to quitline Pre-Post Cost per LYS	TV, radio, NRT, phone support, counseling 3 months	Calls to quitline Jan- June (monthly avg): Pre-Patch: 3,214 (136) Patch Period: 6,823 (1,137); Difference: 3,609 (602) Quits defined as 30- day abstinence at 6 months: Pre-Patch: 8.2% Patch:15.7%	Note: 2 months of paid ads assumed for post- patch period for cost-effectiveness analysis. Pre vs patch period Total cost: $224,5897 vs $256,5552 Media cost: $1,579,056 vs $483,789 NRT+counseling cost: $666,841 vs $2,081,763	Quits converted to LYS based on age- specific estimates from literature	Pre vs. patch period Callers: 6,428 vs 13646 Quits (%): 527 (8.2) vs 2,142 (15.7) LYS: 1,246 vs 4,502 Cost/quit: $4,261 vs $1,197 Incremental cost/quit: NA vs $198 Incremental cost/LYS: NA vs $98 (Bounds of $25 to $402 per LYS based on sensitivity analysis on quit rate, intervention cost, and discount rate)
Tinkelman 200720 State of Ohio All callers to quitline Pre-Post with Comparison Partial intervention cost	NRT, phone support, formative research Multimillion $ media campaign but no details about channels. NRT became available in July 2005; 4-week supply plus another 4 weeks if continuing in program. NRT promoted through media Sept 2005–April 2006 (7 months).	Call volume per day: increase from 78 per day pre-NRT to 188 post-NRT Quit (7-day abstinence) 10.3% pre NRT and 14.9% post NRT, measured at 6- month follow-up. Post NRT quit rate 11.2% for Counseling Only and 20.2% for Counseling + NRT.	Pre-NRT (Jul 2004-Apri 2005) media costs $4,620,000; Post-NRT (Sept 2005–Apr 2006) $3,180,000. No cost of NRTs provided. Reviewers assumed difference went to finance free NRT.	None	None

Avg, average; K, thousand (000); LYS, life-years saved; NRT, nicotine replacement therapy

Full article at:   http://goo.gl/KEZeVX

By:   Verughese Jacob, PhD, MPH, Sajal K. Chattopadhyay, PhD, Randy W. Elder, PhD, MEd, Maren N. Robinson, MPH,Kristin A. Tansil, MSW, Robin E. Soler, PhD, Magdala P. Labre, PhD, Shawna L. Mercer, MSc, PhD, and Community Preventive Services Task Force

Community Guide Branch, Division of Epidemiology, Analysis, and Library Services (Jacob, Chattopadhyay, Elder, Robinson, Tansil, Soler, Labre, Mercer), CDC, Atlanta, Georgia.

Address correspondence and reprint requests to: Verughese Jacob, Community Guide Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E69, Atlanta, GA 30333. vog.cdc@0rih Phone: 404-498-6884 FAX: 404-498-0989

  

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