Evaluating the effectiveness of proactive telephone counselling for smoking cessation in a randomized controlled trial

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Abstract
Aim To evaluate the effectiveness of repeated‐contact proactive telephone counselling for smoking cessation in a UK setting. Design Randomized controlled trial. Setting The Quitline®, an established national telephone counselling service available throughout the UK. Participants and intervention A total of 1457 callers to the Quitline in 2000 and 2001 were allocated randomly to a Control group to receive usual care or to a Repeated Contact group to be offered five proactive calls in addition to usual care. Measurements Prolonged abstinence and 24‐hour point‐prevalent abstinence 6 and 12 months after recruitment, quit attempts and 24‐hour periods of abstinence in non‐quitters. Findings No significant differences were found between the Repeated Contact and Control groups on prolonged or point‐prevalent abstinence. On an intention‐to‐treat basis, 9.5% of the Control group were abstinent for longer than 6 months at the 12‐month follow‐up, compared with 9.3% of the Repeated Contact group; 18.9% and 20.2%, respectively, were point‐prevalent abstinent at the 6‐month follow‐up. Significantly more non‐quitters in the Control group made a quit attempt in the first 6 months following recruitment than in the Repeated Contact group (62.6%/56.1%, P < 0.05). Conclusions Proactive telephone counselling did not significantly increase abstinence rates, and appeared to decrease quit attempts, in callers to the Quitline. A non‐structured, client‐led counselling protocol and insufficient pre‐quit motivational counselling could account for the lack of effect.