title: Protocol for the Proactive Or Reactive Telephone Smoking CeSsation Support (PORTSSS) trial.
abstract: BACKGROUND
  Telephone quit lines are accessible to many smokers and are used to engage motivated smokers to make quit attempts. Smoking cessation counselling provided via telephone can either be reactive (i.e. primarily involving the provision of evidence-based information), or proactive (i.e. primarily involving repeated, sequenced calls from and interaction with trained cessation counsellors). Some studies have found proactive telephone counselling more effective and this trial will investigate whether or not proactive telephone support for smoking cessation, delivered through the National Health Service (NHS) Smoking Helpline is more effective or cost-effective than reactive support. It will also investigate whether or not providing nicotine replacement therapy (NRT), in addition to telephone counselling, has an adjunctive impact on smoking cessation rates and whether or not this is cost effective.
  
  
  METHODS
  This will be a parallel group, factorial design RCT, conducted through the English national NHS Smoking Helpline which is run from headquarters in Glasgow. Participants will be smokers who call the helpline from any location in England and who wish to stop smoking. If 644 participants are recruited to four equally-sized trial groups (total sample size = 2576), the trial will have 90% power for detecting a treatment effect (Odds Ratio) of 1.5 for each of the two interventions: i) proactive versus reactive support and ii) the offer of NRT versus no offer. The primary outcome measure for the study is self-reported, prolonged abstinence from smoking for at least six months following an agreed quit date. A concurrent health economic evaluation will investigate the cost effectiveness of the two interventions when delivered via a telephone helpline.
  
  
  CONCLUSIONS
  The PORTSSS trial will provide high quality evidence to determine the most appropriate kind of counselling which should be provided via the NHS Smoking Helpline and also whether or not an additional offer of cost-free NRT is effective and cost effective for smoking cessation.
authors.affiliation: Division of Primary Care and UK Centre for Tobacco Control Studies, University of Nottingham, Nottingham, UK. tim.coleman@nottingham.ac.uk
authors.forename: Tim
authors.initials: T
authors.lastname: Coleman
authors.forename: Andy
authors.initials: A
authors.lastname: McEwen
authors.forename: Linda
authors.initials: L
authors.lastname: Bauld
authors.forename: Janet
authors.initials: J
authors.lastname: Ferguson
authors.forename: Paula
authors.initials: P
authors.lastname: Lorgelly
authors.forename: Sarah
authors.initials: S
authors.lastname: Lewis
mesh_terms: D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D015277:Hotlines / Q000191:economics; D006801:Humans; D008297:Male; D009042:Motivation; D009313:National Health Programs; D018722:Nicotinic Agonists / Q000191:economics / Q000627:therapeutic use*; D010353:Patient Education as Topic; D012107:Research Design; D016540:Smoking Cessation / Q000191:economics / Q000379:methods*; D013689:Telephone / Q000191:economics; D014029:Tobacco Use Disorder / Q000191:economics / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D018722:Nicotinic Agonists