Promoting abstinence among relapsed chronic smokers: the effect of telephone support.

Abstract

OBJECTIVES: The present study used telephone support both to sustain abstinence and to encourage renewed quit attempts in smokers who had completed an intensive smoking cessation clinic. METHODS: Subjects were hard-core smokers (n = 1083) who had attended a multisession cessation clinic. They were then assigned randomly to receive telephone support (intervention calls 3, 9, and 21 months after the targeted cessation clinic quit date) or no further intervention. RESULTS: In the intervention condition, subjects who relapsed were significantly more likely to resume abstinence (that is, to recycle) than those in the comparison condition at follow-up (6 months: 17.8% vs 11.3%; 24 months: 25.7% vs 18.2%). Telephone support was not effective in preventing relapse, and overall differences in abstinence outcome were not significant. CONCLUSIONS: The major hypothesis of the current study--that telephone support would enhance the resumption of abstinence--received partial support. However, there was no evidence either of an overall treatment effect or of an effect in preventing relapse. Telephone outreach may be more effective in the context of self-help or other less intensive interventions.

Relapse prevention in UK Stop Smoking Services: current practice, systematic reviews of effectiveness and cost-effectiveness analysis.

“…Of the 18 studies [42][43][44][45][46][48][49][50][51][52][53][54][55][56][57][58][59][60] that randomised smokers, nine investigated the effectiveness of interventions matched for programme length, [42][43][44][45][46][48][49][50][51] six compared interventions of varying programme lengths [52][53][54][55][56][57] and two trials examined the effectiveness of RPI adjuncts to cessation programmes. 58,59 Thirteen of these trials verified self-reported smoking abstinence with carbon monoxide measurements, 42,45,46,[48][49][50][52][53][54][55]57,58,60 one used saliva thiocyanate, …”

“…58,59 Thirteen of these trials verified self-reported smoking abstinence with carbon monoxide measurements, 42,45,46,[48][49][50][52][53][54][55]57,58,60 one used saliva thiocyanate, 44 another saliva cotinine, 59 two verified abstinence with urine cotinine 43,56 and one used self-reported abstinence only. 51 …”

Quitlines in North America: Evidence Base and Applications

“…28,29 There seems to be a dose response effect, with multiple calls producing higher abstinence relative to a single call. 22 Promising results have been found for a small number of studies using telephone counseling to extend effects of a school-based prevention program, 30 to promote requitting among smokers with recent unsuccessful quit attempts, 31 to support short-term abstinence among low-income women provided with free nicotine patches and proactive calls, 32 to promote short-term abstinence among smokeless tobacco users, 33 and as part of a tailored intervention for African American smokers. 34 Mixed results have been found for proactive calls to augment personalized written feedback, with a 12-month effect found for calls when combined with stage-tailored materials and expert system personalized feedback in the second of 2 trials by Prochaska et al 35,36 and higher short-term abstinence reported in a trial by Curry et al 37 Mixed results have also been found for proactive calls to support nicotine replacement use.…”

“…There is some evidence that the availability of proactive telecounseling may be viewed positively by physicians and health systems, who may be more likely to intervene with patients in the context of this referral source. 41,42 No effect has yet been demonstrated for proactive calls as a follow-up for smokers in alcohol treatment 43 or smoking clinics, 31 although the latter case may indicate a difference in populations served. For example, a recent report found that when given the choice between clinics or proactive calls, two thirds chose the calls as an alternative to clinics.…”

Applying genetic approaches to the treatment of nicotine dependence

“…Standard minimal contact smoking cessation interventions have produced 12-month quit rates of 14% (Cohen et al, 1989). Brief telephone counseling has been shown to significantly increase long-term quit rates to 20 -25% (Lando et al, 1996;Orleans et al, 1991) to approximate the quit rates of more intensive treatments.…”