Telephone quitlines help people stop smoking

  Article date: 2002/11/05,elephone counseling services called quitlines help people stop smoking and

Telephone counseling services called quitlines help people stop smoking and are a good use of public funds, according to a recent report in the New England Journal of Medicine (Vol. 347, No. 14: 1087-1093).

Shu-Hong Hu, PhD, and associates from the department of family and preventive medicine at the University of California, San Diego tried to find out if the quitlines, which had proven themselves useful in closely watched clinical trials, still worked when taken out into the community.

Thirty-three states and many countries other than the US have established quitlines based on reports that they are successful.
Success In The Community

But what works in a research setting may not always do as well when used by larger numbers of people, according to the authors.

"The staff may differ in skills and enthusiasm," the authors said, "and quality control, a critical element in behavioral interventions, may suffer under the pressure to meet clients’ expressed needs. "Given the increasing public investment in quitlines, it is therefore important to determine whether such services can maintain the effectiveness found in clinical trials," they said.

The researchers conducted a trial where they divided smokers who called the California Smokers’ Helpline into several groups, some of whom received treatment by telephone and others who only received information in the mail. In all, 3282 smokers participated in the program.

The people who received counseling were "treated" by telephone for up to six sessions. Treatment sessions were all initiated by the counselor who called the smoker, rather than having the smoker call the counselor. The researchers considered this an important part of their program.

The quitline counseling was helpful in getting people to stop smoking. Almost one-fourth of the smokers who received counseling stopped smoking for at least one month. People who received only educational brochures were less successful. Only one in six stopped smoking for at least one month.

Over time, many of the smokers relapsed. Even so, when the researchers looked at the data, they concluded that twice as many smokers stopped when treated by the quitline, compared to the self-help group.
Bottom Line: Keep Trying

How did the quitline help smokers quit? According to the authors, "The intervention achieved its effect through two mechanisms: by increasing the percentage of smokers making attempts to quit and by reducing the probability of relapse."

The authors noted that quitlines are an important part of states’ anti-tobacco efforts. As a result, they say, "Many states allocate a large share of their smoking-cessation funds to support widely promoted, centrally operated quitlines rather than traditional cessation clinics."

This is probably a wise use of state funds, the authors conclude, since smokers are four times more likely to use quitlines instead of smoking-cessation clinics. So, for the same amount of money promoting a service, the quitlines are probably going to get a larger response from smokers.

Some of the early quitlines have done a good job reaching a large number of smokers, in particular underserved populations," said Zhu, who is also the director of the California Smokers’ Helpline.

"Quitting smoking is a difficult thing to do," Zhu said. "Still, we’ve shown there’s a significantly higher probability of long-term success for people who go through a quitline program than for those who don’t."

The California Smokers’ Helpline is an ongoing statewide quitline operated by the University of California, San Diego. It provides free smoking cessation services to state residents, including teens and adults, in six languages. It receives calls from 55,000 tobacco users each year, including many from ethnic minority backgrounds.

The American Cancer Society can also help if a person is ready to quit smoking.

Self-help material, such as the ACS series ’Break Away from the Pack’ has been shown to double a smoker’s chances of quitting successfully. These materials are made available to people when they join the ACS Quitline.

In all, 33 states have quitlines. The ACS has information about all quitlines, and it directly manages 10 of these programs. Individuals can get help finding one in their area by calling 1-800-ACS-2345. If a state doesn’t provide a quitline program, a person can inquire about enrolling in the ACS Quitline Clinical Trial.

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