In 2004, about one in five adults in the US were smoking . An estimated 70% of these smokers said that they wanted to quit. People who quit smoking can reduce their risk of developing cancer, heart disease, ]]>stroke]]> , and early death. Quitting can be difficult and may take several trials, but with the help of medications, counseling, and other cessation techniques, smokers can successfully kick the habit for good.

A new study in the July 19, 2006 issue of the Cochrane Database of Systematic Reviews reviewed a group of studies that assessed the effectiveness of telephone counseling as part of a smoking cessation program. The researchers found that telephone counseling can increase the odds of quitting smoking, and that programs that included more than two calls were most effective.

About the Study

Researchers identified 48 controlled trials that measured the benefits of telephone counseling for smoking cessation. The studies included over 36,000 smokers or recent quitters. Most of the studies (44) used proactive calls, in which a counselor contacted the participants, not vice versa. The number of calls ranged from 1-12. The researchers determined whether the participants had stopped smoking at each study’s most recent follow-up, which was a minimum of six months after the start of the intervention.

Participants who received proactive telephone counseling were 33% more likely to quit than those who did not receive the counseling. Among the participants who contacted smoking cessation helplines on their own, those who received additional calls increased the odds of quitting by 41% compared to those who were sent self-help materials and/or simply received brief counseling during the initial call.

Compared with participants who received 1-2 telephone sessions, participants who received 3-6 sessions were 38% more likely to quit. In the 10 studies that specifically recruited smokers who wanted to quit, the telephone counseling increased the odds of quitting by 64%, compared with an increase of 15% among participants who were not selected based on their desire to quit.

This study is limited because it included few studies that provided reactive telephone counseling, which consists of helplines that take calls from smokers or their friends and family. It is difficult to assess the effects of reactive counseling in a randomized controlled trial, since some callers would have to be refused support. Also, it did not assess the long-term benefits of counseling, which is the real challenge for smokers who wish to quit.

How Does This Affect You?

These findings suggest that telephone counseling helps smokers quit. This is encouraging, since telephone counseling is easier to deliver to large numbers of people than face-to-face counseling, which is more expensive and time-consuming for both smokers and counselors. More research is needed to determine the timing, type, and frequency of telephone counseling that is most effective, and how it can reach the largest number of people.

Successful smoking “quitlines” have been established in Scotland, Australia, England, Sweden, and Hong Kong. The US Department of Health and Human Services has introduced a national quitline number that serves as a single access point to a national network of quitlines (1-800-QUITNOW).