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Multiple call-back and other forms of follow-up counseling improves success rates of long-term cessation.
(see also Key Finding 32)

Research has demonstrated that the most effective quitlines are those that offer comprehensive, proactive, multisession behavior modification counseling programs, rather than brief reactive services Quitlines, when implemented correctly, have been shown to be effective in increasing success rates for quitting, including long-term abstinence. 

In the US, proactive (call-back and texting) telephone counseling is a cost-effective intervention for smoking cessation. The low cost of proactive counseling along with the health-care cost savings associated with successful smoking cessation make investment in proactive telephone counseling programs a particularly cost-effective population level strategy. Proactive callback strategies have been found, on average, to increase the odds of smoking cessation success by 37% (95% CI 26%-50%) compared to a strategy without such callbacks. Call-back counselling provided in Australia achieved net cost savings due to the cost offsets being greater than the cost of the intervention. Further, the combination of quitline counseling with physicians’ advice increases the reach of quitlines and significantly increases cessation among the smokers seen by these physicians.

A recent meta-analytic review of SMS-based interventions for individual smoking cessation concluded that they achieved a 36% higher quit rate compared to the control group. Given the relatively wide reach and low cost of this method, SMS text messaging is a promising way to improve smoking cessation outcomes.

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Pbert L. Enhancing the effect of telephone quitline counseling through proactive call-back counseling. Chest. 2009; 136(5): 1199-1200.

Borland R, Balmford J, Bishop N, Segan C, Piterman L, McKay-Brown L, Kirby C, Tasker C. In-practice management versus quitline referral for enhancing smoking cessation in general practice: a cluster randomized trial. Fam Pract. 2008; 25(5): 382-389.

Stead LF, Hartmann-Boyce J, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2013 Aug 12;8:CD002850.pub3.

Free C, Knight R, Robertson S, Whittaker R, Edwards P, Zhou W, Rodgers A, Cairns J, Kenward MG, Roberts I. Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial. Lancet. 2011; 378: 49–55.

Anderson CM, Zhu SH. Tobacco quitlines: looking back and looking ahead. Tob Control. 2007; 16(Suppl 1): i81-86.

Pine-Abata H, McNeill A, Murray R, Bitton A, Rigotti N, Raw M. A survey of tobacco dependence treatment services in 121 countries. Addiction. 2013; 108: 1476-1484.

Stead LF, Hartmann-Boyce J, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2013 Aug 12;8:CD002850.

Lal A, Mihalopoulos C, Wallace A, Vos T. The cost-effectiveness of call-back counseling for smoking cessation. Tob Control. 2014; 23: 437–442.

Spohr SA, Nandy R, Gandhiraj D, Vemulapalli A, Anne S, Walters ST. Efficacy of SMS Text Message Interventions for Smoking Cessation: A Meta-Analysis. J Subst Abuse Treat. 2015; 56: 1-10. logo
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