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Clinical guidelines

Supporting smoking cessationA guide for health professionals

Telephone counselling and quitlines

Telephone counselling provides advice, encouragement and support by specialist counsellors to smokers who want to quit, or who have recently quit. Counsellors can call the client (a proactive service) usually several times over the period leading up to, and the month following, their quit attempt or the client can call the service (a reactive service). There is stronger evidence that the proactive form of support is more effective,147–150 in part because most smokers do not make the call to Quitline often enough to get the full benefit, yet they readily accept and appreciate proactive calls. Telephone counselling, also known as Quitline, is provided in each state and territory. A review in New Zealand of the cost effectiveness of a variety of interventions found quitlines, particularly when they include the use of pharmacotherapy, to be among the highest rated.35

Adding Quitline counselling to pharmacotherapy and minimal intervention increases abstinence rates (RR 1.29; 95% CI: 1.20–1.38).147

Evidence

Telephone callback counselling services are effective in assisting cessation for smokers who are ready to quit. Level II

Recommendation

Referral to such services should be considered for this group of smokers. Strength A

 

Quitline services in Australia

Quitline (13 7848) (13 QUIT) exists in all Australian states and territories. Quitline can provide a free Quit pack and telephone counselling assistance. Quitline can also assist in linking callers into community programs. Counsellors can help callers find a course and email the link to them.

Calls are charged at the cost of a local call (about 25 cents, mobile telephone extra) from both rural and metropolitan areas.

All Quitline services in Australia have agreed to national minimum standards of service delivery.

  • In most states and territories, smokers are offered free proactive telephone counselling. Proactive or callback counselling protocols usually allow up to two sessions pre-quit and four post-quit over the first month, with two in the first week, but vary from state to state
  • Fax referral to Quitline (smokers can be referred by all health professionals to the Quitline for extended support using the fax referral sheet). Services provide feedback to health professionals regarding patients referred to a Quitline (see Appendix 2 for fax referral form)
  • Processes for online referral to Quitline through patient management software are available in some states
  • Quitline counsellor, course leader or coach
  • Adolescent protocols
  • Indigenous counsellors or Indigenous liaison people are available at Quitline Australia wide
  • Self-help books.
Services for those from culturally and linguistically diverse backgrounds:
  • In some states, bilingual educators conduct information sessions in a number of community languages. For example Quit Victoria at www.quit.org.au.
  • Community language specific Quitline telephone numbers available (see below)

Web-based material:

More resources are available on the Australian Government website at www.quitnow.gov.au.

References

  1. Shearer J, Shanahan M. Cost effectiveness analysis of smoking cessation interventions. Aust NZ J Public Health 2006;30:428–34.
  2. Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database Syst Rev 2006, Issue 3. Art. no. CD002850.
  3. Lancaster T, Stead LF. Self-help interventions for smoking cessation. Cochrane Database Syst Rev 2005, Issue 3. Art. no. CD001118.
  4. Tzelepis F, Paul CL, Walsh RA, et al. Active telephone recruitment to quitline services: are nonvolunteer smokers receptive to cessation support? Nicotine Tob Res 2009;11:1205–15.
  5. Young JM, Girgis S, Bruce TA, Hobbs M, Ward JE. Acceptability and effectiveness of opportunistic referral of smokers to telephone cessation advice from a nurse: a randomised trial in Australian general practice. BMC Fam Pract 2008;9:16.
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