Recycling of Chronic Smokers to Sustained Abstinence

DESIGN NARRATIVE:

A total of 1,083 chronic smokers were randomly assigned either to a traditional state-of-the-art smoking cessation clinic or to the clinic supplemented by telephone support for recycling. Telephone outreach consisted of three separate rounds of intervention three months, nine months, and 21 months after the targeted date for quitting in the smoking cessation clinics.

Telephone calls to abstinent subjects reinforced success and offered advice and support in coping with difficult situations. Calls to relapsers and nonabstainers debriefed concerning the relapse episode (as appropriate) and encouraged subjects to initiate concrete action toward quitting including setting a quit date. Subjects were offered self-help materials as well as referrals to more intensive programs.

Follow-up data collection was separate from recycling contacts and occured six, 12, 24, and 34 months after the initial smoking cessation clinics. Projected longterm sustained abstinence rates were 35 percent for recycling and 25 percent for the clinic only comparison. If results were as predicted, an effective low-cost telephone outreach protocol was made available that could dramatically assist in smoking cessation and thereby substantially reduce cardiovascular disease.