Is telephone counselling a useful addition to physician advice and nicotine replacement therapy in helping patients to stop smoking? A randomized controlled trial

Background: The authors evaluated the incremental efficacy of telephone cou nselling by a nurse in addition to physician advice and nicotine replacemen t therapy in helping patients to stop smoking. Methods: The trial was conducted at the University of Ottawa Heart Institut e. A total of 396 volunteers who smoked 15 or more cigarettes daily were ra ndomly assigned to either of 2 groups: usual care (control group) and usual care plus telephone counselling (intervention group); the groups were stra tified by sex and degree of nicotine dependence. Usual care involved the re ceipt of physician advice on 3 occasions, self-help materials and 12 weeks of nicotine replacement therapy. Telephone counselling was provided by a nu rse at 2, 6 and 13 weeks after the target quit date. Point-prevalent quit r ates were determined at 52 weeks after the target quit date. Results: The point-prevalent quit rates at 52 weeks did not differ signific antly between the control and intervention groups (24.1% v. 23.4% respectiv ely). The quit rates did not differ significantly at the secondary measurem ent points of 4, 12 and 26 weeks. Interpretation: Brief physician assistance, along with nicotine replacement therapy, can help well-motivated smokers to quit. Three additional session s of telephone counselling by a nurse were ineffective in increasing quit r ates. This farm of assistance may be useful in the absence of physician adv ice or when self-selected by patients.