Telephone counseling for smoking cessation: Effects of single-session and multiple-session interventions.

Abstract

Smokers (N = 3,030) were randomized to receive 1 of 3 interventions: (a) a self-help quit kit, (b) a quit kit plus 1 telephone counseling session, or (c) a quit kit plus up to 6 telephone counseling sessions, scheduled according to relapse probability. Both counseling groups achieved significantly higher abstinence rates than the self-help group. The rates for having quit for at least 12 months by intention to treat were 5.4% for self-help, 7.5% for single counseling, and 9.9% for multiple counseling. The 12-month continuous abstinence rates for those who made a quit attempt were 14.7% for self-help, 19.8% for single counseling, and 26.7% for multiple counseling. A dose-response relation was observed, as multiple sessions produced significantly higher abstinence rates than a single session. The first week after quitting seems to be the critical period for intervention.Telephone counseling has attracted increasing interest as an alternative system for delivery of services in the field of smoking cessation (e.g., Anderson, Duffy, Hallet, & Marcus, 1992;Curry, McBride, Louie, Grothaus, & Wagner, 1992;DeBusk et al., 1994; Lando, Hellerstedt, Pirie, & McGovern, 1992;Orleans et al., 1991;Ossip-Klein et al., 1991;Prochaska, DiClemente, Velicer, & Rossi, 1993;Shiffman, Read, Maltese, Rapkin, & Jarvik, 1985). From the smoker's standpoint, its main attractions are accessibility and convenience. There are no transportation difficulties and fewer scheduling conflicts than in most other cessation programs. Also, receiving counseling in the privacy of one's home provides treatment access to individuals who might not normally seek "counseling" to quit smoking. These factors encourage smokers to use the service (Zhu etal., 1995 cantly increases the success rate (e.g., Orleans et al., 1991;Ossip-Klein et al., 1991), others report only a short-term effect, with the long-term outlook no better than that of selfhelp(e.g., Curry etal., 1992; Lando etal., 1992). Those studies that have shown a significant intervention effect for telephone counseling, however, did not include a randomized design to test for a dose-response relation between the number of sessions and the treatment effect.The present study examined the effects of two levels of telephone counseling and compared them with the effects of a selfhelp approach. The lower intensity counseling consisted of one session before quitting. The higher intensity counseling included the same pre-quit session plus up to five sessions after the smoker had quit. We tested two hypotheses: (a) that counseling would produce a higher abstinence rate than a self-help quit kit, and (b) that multiple sessions of counseling would produce a higher abstinence rate than a single session.

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.…”

“…20 Variability has been found in results for individual applications of proactive calls. Efficacy has been demonstrated when proactive telecounseling is used as the primary intervention [21][22][23][24][25] and to augment hospital initiated interventions for cardiac patients 26,27 or general hospitalized patients. 28,29 There seems to be a dose response effect, with multiple calls producing higher abstinence relative to a single call.…”

The Effectiveness of Telemental Health Applications: A Review

“…Five studies found that the TMH interventions used were successful, with use of telemedicine providing better outcomes than alternative approaches. [72][73][74][75][76] In the remaining study, the telemedicine intervention was unsuccessful, possibly associated with the approach taken to counselling. 77…”

Addressing challenges in adolescent smoking cessation: Design and baseline characteristics of the HS Group-Randomized trial

“…MI was chosen for its early promise in reducing adult smoking (Zhu et al, 1996;Britt et al, 1994;Curry et al, 1995), and its nonjudgmental, nonprescriptive style is appropriate for adolescent smokers (Lawendowski, 1998).…”