• Free & Clear Difference
  • Quit For Life Program
  • About Us

Evidence

Free & Clear provides the only commercial tobacco cessation program in the U.S. with proof of effectiveness published in multiple peer-reviewed scientific journals over the course of over 20 years.


Free & Clear's Quit For Life® Program is grounded in cognitive behavioral theory, is scientifically based and proven, and incorporates the effective strategies for tobacco dependence treatment documented in scientific literature and outlined in the newly revised 2008 U.S. Public Health Service Clinical Practice Guideline. New research findings are continually incorporated into the Quit For Life Program, creating a uniquely dynamic product that leads the industry in innovative delivery, service quality and most importantly, reach and effectiveness.1

The Quit For Life Program evolved out of ground-breaking research funded by the National Cancer Institute in 1987 to test the effectiveness of telephonic smoking cessation treatment. The results of the study showed that combining self-management materials with cessation calls boosted quit rates over 50% compared to controls. Since then, the program has been tested in multiple clinical trials. These studies have demonstrated that proactive phone counseling is more effective than less intensive approaches such as self-help materials and tailored mail.2 Other studies demonstrate the effectiveness of the Quit For Life Program across a broad range of populations, including youth, seniors,3 low-income/uninsured individuals,4 and blue-collar workers.5

Innovative Delivery

Free & Clear introduced Web Coach™ in 2006 as a robust complement to our phone-based counseling services. Web Coach is a fully featured online community designed to help participants in the Quit For Life Program track their progress, learn new skills and gain support from others in the program. The first study to explore the effectiveness of integrated phone- and web-based programs has been accepted for publication in the Journal of Medical Internet Research and is scheduled to be in print later this year. The study examined utilization and outcomes of over 11,000 participants who had access to Free & Clear's integrated phone and web program. This study found that while individuals tend to use phone services more than web services for tobacco cessation, for those using the integrated service, web utilization was significantly associated with increased call completion and improved tobacco abstinence rates at the six-month follow-up evaluation.

Recognition

  • We are invited to present at many leading scientific conferences such as the National Conference on Tobacco or Health and the World Conference on Tobacco or Health, as well as the annual meetings of the Society of Behavioral Medicine and the Society for Research on Nicotine and Tobacco.
  • We are invited to provide testimony to public policy members for tobacco treatment.
  • We are recognized by the CDC and the Robert Wood Johnson Foundation as a model tobacco cessation program.
  • We have been the recipient of 5 consecutive awards from the American Association of Health Plans’ Managed Care Achievements in Tobacco Control Awards Program.

Selected Publications

Free & Clear has contributed to more than 80 research publications in the field of tobacco use prevention and cessation. A selection of research topics includes:

  • Proven effectiveness of telephone-based counseling for tobacco cessation. (The first published paper on the topic, this study tested the first generation of the Quit For Life Program.) 6
  • Potential savings from investment in tobacco cessation for workers and health plan members.7
  • Effectiveness with three populations: Medicaid, uninsured and the commercially insured.8
  • Effectiveness of the Quit For Life Program when combined with Bupropion SR.9
  • Effectiveness of the Quit For Life Program in a blue-collar population.10
  • The removal of financial barriers to increase program utilization while not diminishing outcomes.11
  • Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization.12

Footnotes

1 Orleans TC, Schoenbach VJ, Wagner EH, Quade D, Salmon MA, Pearson DC, Fiedler J, Porter CQ, Kaplan BH. “Self-help quit smoking interventions: effects of self-help materials, social support instructions, and telephone counseling.” J Consult Clin Psychol 1991; 59(3):439-448.
2 Swan GE, McAfee T, Curry SJ, Jack LM, Javitz H, Dacey S, Bergman K. "Effectiveness of bupropion sustained release for smoking cessation in a health care setting: a randomized trial." Arch Intern Med 2003;163(19): 2337-2344.
3 Zbikowski SM, Bush T, Baker A, McClure JB, Redmond L, Paloma M, Fiore M (2004, February). "Tobacco treatment for seniors: lessons from the Wisconsin tobacco quit line." Poster presented at the 10th Annual Meeting of the Society for Research on Nicotine and Tobacco, Scottsdale, AZ.
4 El-Bastawissi A, McAfee T, Zbikowski SM, Hollis J, Stark M, Wassum K, Clark N, Barwinski R, Broughton E. "The uninsured and Medicaid Oregon tobacco user experience in a real world, phone based cessation program." Tob Control 2003;12: 45-51.
5 Ringen K, Anderson N, McAfee T, Zbikowski SM, Fales D. "Smoking cessation in a blue-collar population: results from an evidence-based pilot program." Am J Industrial Med 2002;42:367-37.
6 Orleans CT, Schoenbach VJ, Wagner EH, Quade D, Salmon MA, Pearson DC, Feidler J, Porter CQ, Kaplan BH. “Self-help quit smoking interventions: effects of self-help materials, social support instructions, and telephone counseling.” J Consult Clin Psychol. 1991;59:439-448.
7 McAfee T, Montanari D, Tifft S, Zbikowski SM. “Preventing premature death: tobacco treatment services for employees.” Empl Benefits J.2004; 29:18-23
8 El-Bastawissi A, McAfee T, Zbikowski SM, Hollis J, Stark M, Wassum K, Clark N, Barwinski R, Broughton E. “The uninsured and Medicaid Oregon tobacco user experience in a real world, phone based cessation programme.”
9 Swan GE, McAfee T, Curry SJ, Jack LM, Javitz H, Dacey S, Bergman K. “Effectiveness of bupropion sustained release for smoking cessation in a health care setting: a randomized trial.” Arch Intern Med. 2003; 163:2337-2344.
10 Ringen K, Anderson N, McAfee T, Zbikowski SM, Fales D. “Smoking cessation in a blue-collar population: results from an evidence-based pilot program.” Am J Ing Med. 2002; 42:367-377.
11 Curry SJ, Grothaus LC, McAfee T, Pabinak C. “Use and cost effectiveness of smoking-cessation services under four insurance plans in a health maintenance organization.” N Engl J Med. 1998; 339:673-679.
12 Ibid.

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