Telephone counseling as adjuvant treatment for nicotine replacement therapy in a "real-world" setting

Background. Physicians prescribing nicotine replacement therapy (NRT), or h ealth plans covering NRT, often want their patients to receive adjuvant beh avioral treatment. However, how to do that in a "real world" is unclear, Th is paper reports results from a public health program that uses proactive t elephone counseling as support for physician advice and provides adjuvant t reatment for NRT users. Methods, Participants were NRT users (N = 8,832) who called the California Smokers' Helpline, a statewide cessation service that provides proactive co unseling, one session before NRT use and multisessions after the smokers re ceived NRT, After receiving NRT, some participants discontinued the counsel ing while others continued with follow-up sessions, A subset of the 8,832 p articipants (n = 664) was interviewed 13 months later for quitting status. Results, After receiving NRT, 79% of the participants continued with counse ling and received 4.2 sessions on average, while 21% of them received only one session. Overall, 82.8% of all participants made a quit attempt. Nicoti ne patch users were more likely to make an attempt than nicotine gum users (85.2% vs 66.3%), but the relapse probability was the same for these attemp ts. Those who received multiple counseling were more likely to make an atte mpt than those receiving single counseling (84.4% vs 77.1%) and were more l ikely to stay quit for 1 year (25.6% vs 16.1%). Conclusions. Proactive telephone counseling is a promising adjuvant treatme nt for NRT users in a "real-world') setting: a convenient referral service for supporting health plans or physicians who advise their patients to quit smoking. (C) 2000 American Health Foundation and Academic Press.