Chest
Volume 136, Issue 5, November 2009, Pages 1229-1236
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Original Research
Smoking Cessation
“Real-World” Effectiveness of Reactive Telephone Counseling for Smoking Cessation: A Randomized Controlled Trial

https://doi.org/10.1378/chest.08-2425Get rights and content

Background

Reactive telephone helplines for smoking cessation (where all calls to counselors are smoker initiated) are increasingly used in the United States. However, limited data from randomized controlled trials are available on their effectiveness. The study objective was to evaluate the real-world effectiveness of reactive telephone counseling for smoking cessation using a randomized controlled trial study design.

Methods

The study was implemented during a period from 2003 to 2006 to evaluate a reactive telephone helpline run by the American Lung Association chapter of Illinois-Iowa. The 990 new callers, all adult current smokers who called the helpline, were randomized on their first call into one of the two following groups: a control group that received only mailed self-help literature (n = 496); and a study group that received supplemental live reactive telephone counseling (n = 494). Telephone follow-up was completed at 1, 3, 6, and 12 months after study enrollment by interviewers blinded to group assignment. Seven-day point prevalence rates of self-reported abstinence at follow-up evaluations were compared between the two groups using an intent-to-treat design.

Results

The two groups did not differ significantly in baseline demographics and smoking-related behavior. The abstinence rates (ranging between 0.09 and 0.15) were not significantly different between the two groups at 1-, 3-, 6-, and 12-month follow-up evaluations. Post hoc subgroup analysis showed that black callers had lower abstinence rates at the 3- and 12-month follow-up evaluations as compared with white callers.

Conclusion

Supplemental live, reactive telephone counseling does not provide greater success in smoking cessation than self-help educational materials alone.

Section snippets

Design Overview

A randomized controlled trial was implemented comprising 990 new callers, all adult current smokers, who called a reactive telephone helpline run by the American Lung Association chapter of Illinois-Iowa during the period January 2003 to December 2005. Eligible subjects were randomized on their first call (prior to offering counseling) into one of the following two groups: a control group that received only self-help literature by mail; and a study group that received supplemental live reactive

Subject Characteristics

Of the 999 eligible subjects who were screened, 990 subjects were randomized into one of the following two groups: a control group that received only self-help literature by mail (n = 496); and a study group that received supplemental live reactive telephone counseling (n = 494). Seven hundred twenty-two subjects (72.9%), 707 subjects (71.4%), 611 subjects (61.7%), and 521 subjects (52.6%), respectively, completed follow-up at 1, 3, 6, and 12 months (Fig 1).

The study and control groups did not

Discussion

This randomized controlled trial demonstrates that the combination of live reactive telephone counseling and self-help educational material does not provide greater success in smoking cessation than self-help educational materials alone. The abstinence rates in this study (range, 0.09 to 0.15) were comparable to those described in the literature for other self-help approaches in quitting smoking (0.14; 95% CI, 0.13 to 0.16).29 In addition, we noted that black callers had significantly lower

Acknowledgments

Author contributions: Drs. Sood and Verhulst contributed to the conception and design, data analysis and interpretation, drafting of the manuscript, statistical analysis, the obtaining of funding, and supervision. Ms. Andoh contributed to data analysis and interpretation, and statistical analysis. Ms. Ganesh and Ms. Edson were involved with data acquisition; critical revision of the manuscript for important intellectual content; and administrative technical, or material support. Dr.

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Funding/Support: This study was supported by American Lung Association grant CG-870-N. Dr. Sood was also supported by the University of New Mexico Clinical Translational Science Center Scholar Award and Department of Health and Human Services/National Institutes of Health/National Center for Research Resources/General Clinical Research Center grant No. 5M01 RR00997.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).

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