Effectiveness of telephone-based follow-up support delivered in combination with a multi-component smoking cessation intervention in family practice: A cluster-randomized trial

ObjectiveTo determine whether telephone-based smoking cessation follow-up counseling (FC), when delivered as part of a multi-component intervention program is associated with increased rates of follow-up support and smoking abstinence.MethodsA cluster randomized controlled-trial was conducted within family medicine practices in Ontario, Canada. Consecutive adult patients who smoked were enrolled at two time points, the baseline period (2009) and the post-intervention period (2009–2011). Smoking abstinence was determined by telephone interview 4 months following enrollment. Both groups implemented a multi-component intervention program. Practices randomized to the FC group could also refer patients to a follow-up support program which involved 5 telephone contacts over a 2-month period.ResultsEight practices, 130 providers, and 928 eligible patients participated in the study. No statistically significant difference in 7-day point-prevalence abstinence was observed between intervention groups. There was a significant increase in referral to follow-up in both intervention groups. Significantly higher rates of smoking abstinence [25.7% vs. 11.3%; adjusted OR 3.1 (95% CI: 1.1, 8.6), p < 0.05] were documented among the twenty-nine percent of FC participants who were referred to the follow-up support program compared to the MC group.ConclusionAccess to external follow-up support did not increase rates at which follow-up support was delivered.

► Both intervention groups increased rates that follow-up support was delivered.
► Patients exposed to the telephone follow-up support quit at higher rates.
► Only 28% of participants were referred to the telephone follow-up support.
► Future research should examine strategies for increasing referral to follow-up.