title: Does offering more support calls to smokers influence quit success?
abstract: BACKGROUND
  Previous studies have found that offering additional callback counseling support to smokers calling a telephone quit line increases quit rates. However, what is less certain is the most cost-efficient protocol for offering such a service.
  
  
  OBJECTIVE
  This study compares the efficacy of offering 2 versus 4 counseling callbacks after an initial call from Medicaid/uninsured adult smokers contacting the New York State Smokers' Quit Line (NYSSQL). Outcomes compared are the 7- and 30-day nonsmoker prevalence rates measured at 3-month follow-up and the cost per quit.
  
  
  METHODS
  A 2-group randomized trial was conducted.
  
  
  METHODS
  The study population included 1923 adult (18+ years) Medicaid/uninsured current smokers (10+ cigarettes per day) who called the NYSSQL between February and March 2009 seeking help to stop smoking. At the time of the study, the NYSSQL provided Medicaid/uninsured callers with up to 6 weeks of free nicotine medications and up to 4 counseling callbacks. Half the subjects were randomized to standard care with up to 4 counseling callbacks with the remaining subjects offered only 2 counseling callbacks. All participants were sent a minimum of a 2-week supply of nicotine replacement therapy, with some receiving up to 6 weeks. Participants were recontacted 3 months after enrollment in the study to assess smoking status.
  
  
  METHODS
  Quit rates, total counseling callbacks completed, reductions in cigarette consumption, and cost per quit measures.
  
  
  RESULTS
  There was not a significant difference between study groups in the number of callbacks completed. There was also no difference in 7- or 30-day nonsmoker prevalence rates measured after 3 months' follow-up or reported use of the free nicotine replacement therapy between those assigned to either the 2- or 4-callback protocols. The cost per quit was essentially the same in both groups (2 callbacks--$442 per quit vs 4 callbacks--$445 per quit).
  
  
  CONCLUSIONS
  There was no advantage in terms of quit success or cost to offering up to 4 callbacks instead of 2 callbacks.
authors.affiliation: New York State Smokers' Quitline, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Carlin-Menter
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.forename: Paula
authors.initials: P
authors.lastname: Celestino
authors.forename: Andrew
authors.initials: A
authors.lastname: Hyland
authors.forename: Martin C
authors.initials: MC
authors.lastname: Mahoney
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Willett
authors.forename: Harlan R
authors.initials: HR
authors.lastname: Juster
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015277:Hotlines; D006801:Humans; D008297:Male; D008484:Medicaid; D009518:New York; D009538:Nicotine / Q000627:therapeutic use; D012907:Smoking / Q000523:psychology; D016540:Smoking Cessation; D014481:United States
chemical_list: D009538:Nicotine