1. Introduction
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REGRESSION
People who smoke often make several quit attempts before successfully maintaining abstinence. Therefore, incorporating re-engagement for people who fail to initially quit could increase quit attempts and ultimately increase cessation rates. Within the context of quit line-based interventions, it remains unknown what characteristics are associated with re-engagement. The purpose of this study was to assess associations between demographic and motivational characteristics, tobacco use, and initial intervention engagement with re-engagement in a tobacco quit line intervention. Among 372 adults who reported smoking three months after initiating a quit line-facilitated quit attempt as part of a larger randomized clinical trial, associations between personal characteristics (e.g., age, gender, nicotine dependence, and confidence in their ability to quit smoking) and initial intervention engagement (number of completed counseling sessions and use of nicotine replacement therapy (NRT)) with re-engagement (accepting an offer to re-initiate the quit line intervention) were determined using multivariable logistic regression modeling. Compared to non-White participants, White participants had lower odds of re-engaging (OR: 0.42, 95% CI: 0.23, 0.75). Number of initial counseling sessions completed was associated with re-engaging. NRT use during the initial intervention was not associated with re-engaging. Initial intervention engagement is important in the process of re-engagement, specifically attending counseling sessions. Exploration of associations between initial intervention engagement and potentially modifiable motivational factors is needed to be potentially leveraged in future interventions to maintain continued engagement in cessation among adults who smoke.Cigarette smoking remains the leading cause of preventable death in the US [To inform tailoring strategies, the characteristics of people who smoke who are interested in re-engaging following a failed quit attempt need to be identified. Insight concerning who is likely to re-engage may enable resource-limited quit lines to target outreach strategies for maximum re-engagement. To our knowledge, two previous studies have examined predictors of re-engagement in a tobacco quit line. Using data from the Arizona Quit line, Nair et al. found that individuals who chose to re-engage had higher odds of both mental health and chronic health diagnoses [Thus, the previous literature has assessed associations between demographic characteristics, tobacco use characteristics, and the initial mode of intervention with re-engagement. However, the paucity of research in this area warrants continued evaluation. Further, there remain additional areas for investigation that have not been previously considered. Specifically, it is unclear if engagement in the initial intervention, or interactions between use of initial intervention components (e.g., attending counseling sessions and using NRT) influence re-engagement. It is also unknown if confidence in quitting or reasons for quitting influence re-engagement. Consequently, this study sought to assess the association between demographic and motivational characteristics, tobacco use, and initial intervention engagement with re-engagement in a tobacco quit line intervention.