Smoking: telephone counselling may help smokers quit

Clinical bottom line (level 2a-)

  1. Smokers who receive telephone counselling compared with standard care were more likely not to be smoking after 6 months.
  2. Adding telephone counselling to face-to-face counselling or nicotine replacement does not clearly increase abstinence.
Stead and Lancaster: Cochrane Library 2001; 2 : -
Expires May 2004

The study

Systematic review of all randomised or quasi-randomised controlled trials of
  • Patients: smoker or recent quitters
  • Intervention: proactive or reactive telephone support compared with standard care
  • Outcome: abstinence from smoking after at least 6 months follow-up

Articles found in ?all languages using Cochrane Tobacco Addiction Group Trials, to August 2000 (search terms: detailed in text )

Selection criteria: by 1 reviewer and checked by another
Appraisal criteria: by 1 reviewer and checked by another: based on method of recruitment, randomisation
Articles excluded if:
  • less than 6 months follow-up
  • combined telephone and face-to-face counselling
23 studies found - 10 comparing proactive counselling calls with minimal intervention. 4 comparing proactive counselling and face-to-face intervention with face-to-face intervention alone.
Study outcomes were assessed for heterogeneity.

The evidence

Outcome Time to outcome CER OR
(95% CI)		 NNT
(95% CI)
abstinence: proactive call + face-to-face v. face-to-face alone 6 months 231/1075
(21.5%)		 1.08
(0.87 to 1.33) 		75
(NNT = 19 to infinity;
NNH = 44 to infinity)
abstinence: proactive calling + nicotine replacement v. nicotine replacement alone 6 months 128/771
(16.6%)		 1.08
(0.82 to 1.43) 		91
(NNT = 18 to infinity;
NNH = 39 to infinity)

  • Proactive telephone counselling helped increase abstinence, but significant heterogeneity prevented calculation of effect sizes.

Citation

  1. Stead LF, and Lancaster T: telephone counselling for smoking cessation. Cochrane Library 2001; 2 : -
Search Terms: smoking and cessation in Cochrane Library
Contributor: Chris Ball, May 2002
Reviewer:

Clinical Question.
Patient smoker
Intervention or Exposure telephone counselling
Comparison standard care, other interventions
Outcome quit smoking at 6 months