When combined with a popular smoking cessation medication, telephone-based counseling was more successful in helping smokers quit than individualized mailings, a new study has found.

Overall, participants randomly assigned to the telephone program were 23 percent less likely to smoke after one year, compared to those enrolled in the mailing plan, say Gary E. Swan, Ph.D., of the Center for Health Sciences at SRI International in Menlo Park, Calif., and colleagues.

The study appears in the journal Nicotine & Tobacco Research, of which Swan is editor in chief.

All 1,524 smokers were prescribed bupropion SR, an antidepressant medication previously proven to help smokers quit. The research team tested two dosages of bupropion and two intensities of counseling to see which combination of drug therapy and counseling would be more helpful in getting smokers to kick the habit.

Drug treatment lasted eight weeks. Participants reported whether they were smoking at three months and at 12 months after their target stop-smoking date.

The less-intensive counseling program relied on mailed information and support to participants. The mailings were individually tailored to smokers, based on information they provided in questionnaires.

They also got a five- to 10-minute call the day after they planned to quit and had access to a 24-hour automated support line maintained by the drug manufacturer.

The more intensive program, a telephone counseling program, was based on smoking-cessation plans recommended by the U.S. Public Health Service. Participants received up to five telephone calls and had access to a toll-free support line for a year.

All participants received printed self-help materials. Other materials went to the smokers' families and friends, to encourage their support for the participants.

Although more participants on the lower dose of bupropion SR reported at the three-month mark that they were still smoking, at 12 months there was no difference between the two dose levels in the number of participants reporting that they still smoked.

At the 12-month follow-up point, Swan says, the type of counseling program was strongly associated with a greater likelihood of smoking.

"Use of the pro-active telephone counseling program appears to have resulted most consistently in a reduced chance of smoking over the course of follow-up," he says.

Several individual factors predicted a greater likelihood of smoking among participants. Smoking risk was higher for women compared to men. Younger people, those who smoked more cigarettes each day and people with depressive symptoms also found it harder to quit. Failure to sustain a prior attempt to quit for more than six months increased the odds of smoking at one year.

This study was supported by a grant from the National Cancer Institute.

Health Behavior News Service: (202) 387-2829 or www.hbns. Interviews: Contact Gary E. Swan at (650) 859-5322 or gary.swansri. Nicotine & Tobacco Research: Contact Gary E. Swan, Ph.D., at (650) 859-5322.

Center for the Advancement of Health
Contact: Ira R. Allen
Director of Public Affairs
202.387.2829
presscfah