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Telephone counseling for smokers using pharmacotherapy

Institution: University of California, San Diego
Investigator(s): Shu-Hong Zhu, Ph.D.
Award Cycle: 2000 (Cycle 9) Grant #: 9RT-0205 Award: $774,971
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
Drug treatments (called pharmacotherapies), such as a nicotine skin patch or a drug called Bupropion (taken as a pill) have become very important in helping people to quit smoking cigarettes. These drugs help the smoker’s body adjust to life without cigarettes. A recent survey in California showed that about 70% of smokers who used some kind of help to quit smoking used a pharmacotherapy by itself or combined it with counseling by a doctor or a psychologist. Pharmacotherapy has been shown to work in many carefully controlled experiments. Unfortunately, there is a practical problem for the large number of people who are not in experiments and who want to use pharmacotherapy in the “real world.” Most health insurance plans will not pay for the pharmacotherapy, unless the smoker gets counseling from a trained professional on how to stop smoking. This is difficult for most smokers because too often it is not easy to find or to participate in a professional counseling program. Most smokers who try to quit, in fact, do not take part in counseling. This project will test whether telephone counseling can be used as a way to provide professional help for the many smokers in the “real world” who are using pharmacotherapy to quit. Telephone counseling has gained much popularity as a way to help smokers quit because it is convenient and easy to use. Many states and large health insurance companies are setting up telephone counseling programs to help smokers quit. The smokers to be studied in this research will come from people who call the California Smokers’ Helpline, a statewide telephone counseling program which gets about 3,000 calls each month. About 43% of all the smokers calling the Helpline say they will use a pharmacotherapy to help them quit. The callers usually have heard about the Helpline from television or radio advertisements or their doctor or friends have told them about the program. This means that these callers will be representative of those smokers in the “real world” who are using pharmacotherapy to quit.

The goals of this project are to:

1) test whether telephone counseling actually helps smokers who use pharmacotherapy. 2) study the costs and benefits of providing just one counseling session versus many counseling sessions for the smokers who use pharmacotherapy. 3) provide scientific information on the use of telephone counseling for users of pharmacotherapy, information which may be used by other state programs like the California Smokers’ Helpline or by large health insurance companies that want to use telephone counseling programs. 4) study whether the benefits of telephone counseling for users of pharmacotherapy depend on differences between smokers in their addiction to cigarettes or in their confidence in being able to quit smoking. 5) test whether the telephone counseling works equally well for the different groups of smokers who choose to use different pharmacotherapies to quit: only the nicotine patch, only Bupropion or both of these drugs at the same time.