Offering smokers who want to quit the habit free nicotine patches and more intensive, proactive telephone counselling makes no difference to how well they succeed, it was claimed today.
The results of a major trial, published in the British Medical Journal, concluded that while telephone quitlines were useful, extra support for smokers did not work.
The University of Nottingham’s UK Centre for Tobacco Control Studies looked at the efficacy of the tried and tested support from the English NHS Smoking Helpline to see if it could be improved to help more people stop smoking.
It also looked at if the offer of free nicotine replacement therapy made to quitline callers increased the numbers of smokers who gave up.
Professor Tim Coleman of UKCTCS, said while the trial, which enrolled 2,591 participants over 12 months, showed the usefulness of telephone quitlines, it demonstrated that the extra support failed to offer any benefits.
“On the basis of this study, giving out free nicotine patches and more intensive telephone counselling through the English national quitline just doesn’t seem to work,” he says.
“It brings into sharp relief the need to find other ways of using quitlines help smokers give up and so to reduce the terrible effects smoking has on people’s lives and the costly burden to the NHS.”
A parallel four group (2×2), randomised controlled trial, which was funded by the Department of Health and UK Centre for Tobacco Control Studies (UKCTCS), was carried out among the 2,591 non-pregnant smokers who called the English NHS smoking helpline between February 2009 and February 2010.
Each smoker was randomly assigned to one of four groups: standard support (NHS Stop Smoking Services advice and access to helpline); standard support with free nicotine replacement therapy (NRT); proactive support, which comprised extra and regular scheduled telephone and message support from helpline staff; proactive support with free NRT.
The proactive groups were contacted by counsellors before their agreed quit date, on the day itself, and then at three, seven, 14 and 21 days after stopping smoking.
Counsellors were trained to use specially designed motivational interviewing techniques, which were tailored to each stage of the quitting process. The support closely monitored the two proactive groups’ progress, and offered counselling, encouragement and congratulations.
A market research company followed-up the trial and collected data by telephone at one and six months after quit dates.
At six months after quitting, 18.9 per cent of the 59 per cent of participants who were contacted said they had managed not to smoke. Nearly 80 per cent of these agreed to give a breath test for carbon monoxide to validate their claim and 80 per cent of the tests proved they had quit successfully.
Those whom the researchers were not able to contact were assumed to be smoking.
There were no significant differences in success rates between quit rates in the standard and proactive counselling groups or between those offered and not offered NRT.
Prof Coleman said further research should be carried out to test other methods of providing cessation support to quitline callers.
Offering smokers who want to quit the habit free nicotine patches and more intensive, proactive telephone counselling makes no difference to their success rate, a major trial has concluded.
The results of the study, published today in the British Medical Journal, concluded that while telephone quitlines were useful, extra support for smokers did not work.
British Medical Journal March 23 2012
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