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Time to quit: What’s the “call” on telephone support for smoking cessation?

The Bottom Line

  • Globally, over one billion people currently smoke, and over eight million die as a result of smoking each year. 
  • Telephone counselling—accessed through helplines/quitlines/hotlines or different health care settings—is one strategy that aims to help people quit smoking.
  • In-depth telephone counselling—in which a counsellor/health care provider connects with a person who smokes, usually over multiple sessions—may increase the chances of quitting in people who call ‘on-demand’ smoking helplines for single session support or receive other quitting support in different settings. 
  • Explore whether your local, regional, or national smokers' helpline offers in-depth telephone counselling services and consider registering, or discuss the addition of such techniques to your current treatment plan with your health care provider.     

From staying in touch with friends and family, to ordering-in on nights where we just can’t decide what’s for dinner...there are plenty of reasons why we pick up the phone to make a call. But for those who smoke, can accessing support over the phone help them in putting out their cigarettes for good?


Every year, around eight million people die as a result of smoking tobacco (1;2). Although a staggering statistic, many of us are familiar with the dangers of smoking—cancer, heart disease, pneumonia, chronic obstructive pulmonary disease, gum disease, stroke, cataracts, and the list goes on (3-7). In fact, lifetime smokers die an average of 10 years earlier than non-smokers (1;8;9). Fortunately, quitting smoking brings immediate and long-term health benefits (1;9)—such as fewer complications after a surgery, and a reduced risk of developing a chronic disease and premature death (1;9;10).


To the over one billion folks who smoke globally (1;2), the benefits of quitting, along with the wide variety of support strategies that are now available, should bring hope and motivation.


One strategy that aims to help those who smoke find success at the end of their quit journey is telephone counselling (3). Some telephone counselling services are ‘on-demand’, while others are more ‘in-depth’. Smoking helplines or quitlines can offer both levels of service. Their on-demand features allow individuals who smoke or their family members to call in and get information on smoking, or brief advice about quitting. Other, more in-depth, services include counsellors connecting with individuals and scheduling ongoing calls as needed, or the opportunity to register in structured programs with calls from a counsellor built in (3;12;13). In-depth telephone counselling can also be provided by other health care providers in different settings (3).


So, should people who smoke rush to the phone lines?


What the research tells us

One recent systematic review looked at telephone counselling as an approach for helping people who smoke—mainly adults in the general population—to quit.


The review’s authors made two key findings. First, the chances of quitting may be higher in people who receive continuing telephone support (e.g., one or more additional calls) from a counsellor after calling into a helpline, compared to people who call the helpline and then receive self-help materials and/or counselling limited to one call. In fact, the chances of stopping could be 20% to 60% higher in those getting ongoing phone support initiated by a counsellor. Second, telephone support initiated by a counsellor or health care provider in settings outside of helplines where folks are receiving other forms of quitting assistance (e.g., medication, self-help materials, etc.), may also increase the likelihood of successfully quitting. With this type of counselling, it's reported that the chances of quitting could be 15% to 35% higher.


At this time, more research on the effects of on-demand telephone counselling, as well as a better understanding of different aspects of telephone counselling programs—such as the number of phone calls received, timing of calls, and combination with other quitting strategies—is needed (3).


If you’re looking to quit smoking, consider checking out your local, regional, or national smoking helpline to see if you can register for in-depth telephone counselling services. Click on the following link for information on phone and online supports across Canada: https://www.canada.ca/en/health-canada/services/smoking-tobacco/quit-smoking/tips-help-someone-quit-smoking/you-can-quit-smoking-we-can-help.html. For those already receiving quitting services in different health care settings, discuss the possibility of adding telephone support to your treatment plan.


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References

  1. Tzelepis F, Paul CL, Williams CM, et al. Real‐time video counselling for smoking cessation. Cochrane Database Syst Rev. 2019; 10:CD012659. doi: 10.1002/14651858.CD012659.pub2.
  2. World Health Organization. WHO report on the global tobacco epidemic, 2019: Offer help to quit tobacco use. Geneva (CH); World Health Organization; 2019.
  3. Matkin W, Ordóñez-Mena JM, Hartmann-Boyce J. Telephone counselling for smoking cessation. Cochrane Database Syst Rev. 2019; 5:CD002850. doi: 10.1002/14651858.CD002850.pub4.
  4. World Health Organization. Tobacco: Key facts. 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/tobacco 
  5. U.S. Department of Health and Human Services. The health consequences of smoking—50 years of progress: A report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
  6. Cahill K, Lindson‐Hawley N, Thomas KH, et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2016; 5:CD006103. doi: 10.1002/14651858.CD006103.pub7.
  7. US Surgeon General. The health consequences of smoking: A report of the Surgeon General. 2004. Available from https://www.cdc.gov/tobacco/data_statistics/sgr/2004/index.htm
  8. Banks E, Joshy G, Weber MF, et al. Tobacco smoking and all‐cause mortality in a large Australian cohort study: Findings from a mature epidemic with current low smoking prevalence. BMC Medicine. 2015; 13:38. doi: 10.1186/s12916-015-0281-z. 
  9. Jha P, Ramasundarahettige C, Landsman V, et al. 21st‐century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013; 368(4):341‐350. doi: 10.1056/NEJMsa1211128.
  10. Rigotti N. Benefits and consequences of smoking cessation. 2020. [cited March 2020]. Available from https://www.uptodate.com/contents/benefits-and-consequences-of-smoking-cessation 
  11. Lichtenstein E, Glasgow RE, Lando HA. Telephone counseling for smoking cessation - Rationales and meta-analytic review of evidence. Health Educ Res. 1996; 11(2): 243-257.
  12. Zhu SH, Nguyen QB, Cummins S, et al. Non-smokers seeking help for smokers: A preliminary study. Tob Control. 2006; 15(2):107-113. doi: 10.1136/tc.2005.012401.  
  13. Government of Canada. You can quit smoking. We can help. 2020. [cited March 2020]. Available from https://www.canada.ca/en/health-canada/services/smoking-tobacco/quit-smoking/tips-help-someone-quit-smoking/you-can-quit-smoking-we-can-help.html

DISCLAIMER: Many of our Blog Posts were written before the COVID-19 pandemic and thus do not necessarily reflect the latest public health recommendations. While the content of these blogs identify activities that support optimal aging, it is important to defer to the most current public health recommendations such as social distancing and frequent hand washing. Some of the activities suggested within these blogs may need to be modified or avoided altogether to comply with current social distancing recommendations. To view the latest updates from the Public Health Agency of Canada, please visit their website.

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