Summary of “Smoking Cessation Quitlines: An Underrecognized Intervention Success Story”

In their article "Smoking Cessation Quitlines: An Underrecognized Intervention Success Story," Lichtenstein, Zhu, and Tedeschi discuss the conception of smoking cessation quitlines and their evolution into a common, contemporary practice. Additionally, the authors provide insight into the effectiveness of quitlines, components of the practice that call for further research, and how the quitline model can be applied to other forms of rehabilitation. The heart of the matter is that, despite the great rates of success among smokers who have ventured to give quitlines a try, this method of treatment continues to be an unsung hero of substance abuse intervention.

The first quitlines were operated primarily as "reactive quitlines," meaning that counselors were not responsible for initiating calls: the client was held solely accountable for maintaining his or her contact with the quitline counselor. While this method was certainly not a failure, the implementation of proactive counseling throughout the mid to late 90s contributed greatly to the effectiveness of the modern smoking cessation quitline. Proactive counseling, a method in which the counselor is also at liberty to initiate calls, continues to be the current protocol for quitlines all over the world. This method generates so much success because it increases follow-up rates. Maintaining follow-up sessions with a counselor is of the utmost importance to a smoker hoping to curb his or her addiction, as it is throughout these sessions that the counselor is able to cement the principles of motivation, self-efficacy, and social support.

The annual percentage of American smokers who rely on quitlines as a form of intervention seems quite small in the grand scheme of things: a mere 1%. However, some states and large cities have been capable of reaching up to 5% of their smoking populations in short periods of time thanks to sufficient funding and publicity. It is possible that the lack of proper funding in some areas is due to the fact that, even today, some researchers and practitioners do not see quitline counseling as a form of legitimate therapy. For example, time spent as a quitline counselor is not recognized by California's Board of Psychology as valid professional experience, and some definitions of psychotherapy are limited only to counseling that takes place in person. Another reason why some may refuse to attribute authenticity to the practice is because of the vast number of counseling positions occupied by "paraprofessionals." This term refers to individuals who have not yet obtained a degree or are not interested in counseling as their primary profession.

Despite the naysayers, there is still a significant amount of evidence that favors smoking cessation quitlines. One of the most surprising and interesting facts about quitlines is their popularity among inadequately served communities in the U.S. Data from California has shown that African Americans utilize quitlines more than any other ethnic group. Additional studies have shown that Asian language speakers are also among those who are most likely to turn to quitlines for smoking cessation help.

Another group that is unexpectedly overlooked, specifically in the realm of smoking interventions, consists of those with mental illnesses and/or substance abuse problems. Unfortunately, the positive effects of participating in quitline interventions are not as widespread in this community. Smoking rates among individuals in this category are markedly higher than the general population; conversely, psychologists have generally been tentative about offering tobacco dependence treatment -- quitlines or otherwise as the ills of tobacco sometimes warrant a trade-off for better mental health. Dentists and physicians, on the other hand, have been much more proactive about referring patients to quitlines for follow-up tobacco treatment, perhaps because they are not wasting time arguing over the true definition of "counseling."

Work Cited

Lichtenstein, Edward, Shu-Hong Zhu, and Gary J. Tedeschi. "Smoking Cessation Quitlines: An Underrecognized Intervention Success Story." American Psychologist vol. 65 no. 4 (2010): 252.