Telephone Counseling for Smoking Cessation

Overview

This study aimed to determine the relation between the number of counseling calls a smoker receives with a cessation specialist and whether or not the individual quits smoking. In their design, the researchers compared three smoking cessation programs - self-help booklets, one counseling call (before quitting), and six counseling calls (1 before and 5 after quitting). Specialists from the University of California, San Diego (UCSD) performed the counseling calls; the American Lung Association and the Stanford Center for Research in Disease Prevention created the self-help booklets used in the study.

Design

Participants in this study were recruited from San Diego County through advertisements of the county's ongoing antismoking campaign. The researchers recruited and randomized 3,030 smokers into one of three study groups that varied on type and intensity of behavioral intervention, as shown in Figure 1.0.

Figure 1.0

According to the above design, some participants received self-help booklets, others received 1 counseling call, and still others received up to 6 counseling calls. Since it offered a series of calls, the multiple call program focused on three counseling strategies: 1.) Identifying smokers' motivation and reasons to quit; 2.) Developing strategies for coping with urges to smoke; and 3.) Focusing on steps to prevent relapse after the quit occurred.

While the single call program addressed motivation and coping with short-term urges, it did not address relapse prevention strategies that may make the difference in helping a person stay quit in the long run. The multiple call format offered up to five calls after the person quit smoking and was tailored to help each individual stay quit and prevent relapse. Furthermore, the five calls following the quit attempt were timed to when a person is most prone to relapse after quitting. Therefore, a person [in the multiple call group] received 1 call before the quit attempt and then calls arrived 1, 3, 7, 14, and 30 days after the quit attempt.

Findings

The researchers studied how many people in the three treatment groups attempted to quit (defined as staying quit for at least 24 hours) and found the numbers in the counseling groups to be comparable. Specifically, 58.8% of subjects in the self-help group made a serious quit attempt; 66.7% of those in the one call program made a serious quit attempt; and, finally, 66.5% of those in the multiple call program made a serious quit attempt, as shown in Figure 2.0.

Figure 2.0

Then, the researchers tabulated the number of people who had quit for various lengths of time. The number of people who had quit smoking for 3 months varied by treatment group, as shown in Figure 3.0.

Figure 3.0

Finally, of those who made an attempt to quit within the first three months of enrolling in the study, the researchers estimated that 14.7% of smokers in the self-help group would be quit for at least 12 months, 19.8% of those with one counseling call would be quit for at least 12 months, and 26.7% of those with multiple counseling calls would be quit for at least 12 months. A dose-response relation was found so that the more counseling calls a smoker received, the more likely the smoker was to quit smoking. The 12-month quit projection is shown in Figure 4.0.

Figure 4.0

In comparison between groups, the researchers found the single counseling call achieved higher cessation rates than the self-help materials; moreover, the multiple counseling sessions produced more nonsmokers than single call counseling sessions.

Conclusion

The results of this study show that even one counseling call between a specialist and a smoker is more effective than self-help materials for smoking cessation. Additionally, the more calls a person receives, the more likely he or she is to successfully quit smoking. A multiple counseling call program best supports people trying to quit because it enables specialists to provide ongoing training so that people can stay quit and avoid a relapse down the road.

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