Telephone care and counseling for smoking cessation may help smokers quit

Smokers who receive telephone care and counseling for smoking cessation have higher rates of stopping smoking than those who receive routine care by health care providers, according to a study in the March 13 issue of Archives of Internal Medicine.

Previous studies have shown that telephone counseling is an effective aid for helping smokers quit, according to background information in the article. One component of the U.S. national action plan for tobacco cessation is the recommendation for creation of a telephone quitline network, offering smokers access to counseling and medications. However, it is not clear that access to telephone care would provide additional benefits when added to the physician-patient dialogue that occurs in the course of routine health care. "For clinicians and administrators, this information identifies the potential value of adding telephone care to existing clinical programs," the authors write. "For public health and policy experts, this information helps define the role of telephone care as part of a comprehensive cessation program, such as the national action plan."

Lawrence C. An, M.D., University of Minnesota and Minneapolis Veterans Affairs Medical Center, and colleagues studied 837 daily smokers (751 men and 86 women) who received care at five Veterans Affairs medical centers in the upper Midwest in the year prior to the study. All the participants committed to setting a quit date within the next 30 days. The 420 smokers (average age 57.1) in the standard care group were mailed self-help materials and had continued access to smoking cessation services through their medical center. The 417 individuals in the telephone care group (average age 57.2) received counseling sessions using a telephone care protocol, which consisted of seven calls over a two-month period, with additional calls as needed at the discretion of the counselor. There were an average of 7.7 behavioral counseling sessions by telephone over the following year.

After three months in the study, 39.6 percent of the telephone care group had not smoked in the previous seven days, compared with 10.1 percent of the standard care group. At the one-year mark, 13 percent of the telephone care group and 4.1 percent of the control group had abstained from smoking for the previous six months. Compared with those in the standard care group, individuals receiving telephone care were more likely to use other techniques to help them stop smoking, including smoking cessation counseling programs (97.1 vs. 24 percent after one year) and medications (89.6 vs. 52.3 percent after one year). They also made more attempts to quit than those in the control group.

"At a minimum, telephone care for smoking cessation should be made available to veterans who are interested in stopping smoking," the authors conclude. "The findings of this study lend additional support to the recommendation for a national network of quitlines that would make these services available to all tobacco users in this country."