Quitlines provide behavioral counseling to tobacco users who want to quit. Cessation specialists schedule follow-up calls after the specialist or tobacco user makes initial contact using a proactive quitline; reactive quitlines rely solely on tobacco users to make future contact. Some quitlines provide additional interventions such as mailed materials, web-based support, text messaging, or tobacco cessation medications (CG-Tobacco use). Many quitlines offer services in multiple languages (NAQC-US)
Expected Beneficial Outcomes (Rated)
Increased quit rates
Evidence of Effectiveness
There is strong evidence that proactive quitlines increase tobacco cessation (CG-Tobacco use, West 2015, Cochrane-Stead 2013a*, Klesges 2015, AHA-Mozaffarian 2012, Mottillo 2009). State- (CG-Tobacco use) and community-sponsored quitlines have demonstrated effects on cessation (AHA-Mozaffarian 2012).
Proactive counseling is more effective than reactive counseling and three or more counseling sessions appear more effective than fewer sessions (Cochrane-Stead 2013a*). Combining quitlines with other interventions such as mass communication campaigns and efforts to encourage health care providers to refer patients to quitlines increases quitline use and tobacco cessation (CG-Tobacco use). Combining quitlines with technology-based efforts (e.g., internet- or cell phone-based services) (Danielsson 2014*) and providing counseling in multiple languages (Cummins 2015*) can also support cessation.
Providing tobacco cessation medication such as nicotine replacement therapy (NRT) with quitline services increases quit rates (CG-Tobacco use, Smith 2013*) and call volume (CG-Tobacco use). Telephone counseling with NRT increases smoking quit rates more than medication alone (Cochrane-Stead 2015*). Quitlines combined with NRT have been shown to increase quit rates for active military personnel, veterans, and their dependents (Klesges 2015), and smokers with low incomes (Bernstein 2016*). Telephone counseling may also increase smokeless tobacco cessation (Cochrane-Ebbert 2015*).
Quitlines are considered cost effective (CG-Tobacco use).
Impact on Disparities
All fifty states have quitlines. Most quitlines proactively call and counsel clients multiple times and offer free tobacco cessation medication (NAQC-Quitline facts).
NAQC-US - North American Quitline Consortium (NAQC). Promoting evidence based quitline services across diverse communities in North America. United States profiles.
NAQC-Quitline - North American Quitline Consortium (NAQC). Promoting evidence based quitline services across diverse communities in North America.
Smokefree.gov-Quitline - US Department of Health and Human Services (US DHHS). Smokefree.gov. Speak to an expert.
CDC-Quitlines 2004 - Centers for Disease Control and Prevention (CDC). Telephone quitlines: A resource for development, implementation, and evaluation. Atlanta: Office on Smoking and Health, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); 2004.
Citations - Evidence
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CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco.
West 2015 - West R, Raw M, McNeill A, et al. Health-care interventions to promote and assist tobacco cessation: A review of efficacy, effectiveness and affordability for use in national guideline development. Addiction. 2015;110(9):1388-1403.
Cochrane-Stead 2013a* - Stead LF, Hartman-Boyce J, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database of Systematic Reviews. 2013;(3):CD002850.
Klesges 2015 - Klesges RC, Ebbert JO, Talcott GW, et al. Efficacy of a tobacco quitline in active duty military and TRICARE beneficiaries: A randomized trial. Military Medicine. 2015;180(8):917-925.
AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63.
Mottillo 2009 - Mottillo S, Filion KB, Bélisle P, et al. Behavioural interventions for smoking cessation: A meta-analysis of randomized controlled trials. European Heart Journal. 2009;30(6):718-30.
Danielsson 2014* - Danielsson AK, Eriksson AK, Allebeck P. Technology-based support via telephone or web: A systematic review of the effects on smoking, alcohol use and gambling. Addictive Behaviors. 2014;39(12):1846-1868.
Cummins 2015* - Cummins SE, Wong S, Bonnevie E, et al. A multistate Asian-language tobacco quitline: Addressing a disparity in access to care. American Journal of Public Health. 2015;105(10):2150-2155.
Smith 2013* - Smith TJ. One Stop Service Center Initiative: Strategies for serving persons with disabilities. Journal of Rehabilitation. 2013;79(1):30-36.
Cochrane-Stead 2015* - Stead LF, Koilpillai P, Lancaster T. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews. 2012;(12):CD009670.
Bernstein 2016* - Bernstein SL, Weiss J-M, Toll B, Zbikowski SM. Association between utilization of quitline services and probability of tobacco abstinence in low-income smokers. Journal of Substance Abuse Treatment. 2016;71:58-62.
Cochrane-Ebbert 2015* - Ebbert J, Elrashidi M, Stead LF. Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews. 2015;(2):CD004306.
Citations - Implementation Examples
* Journal subscription may be required for access.
NAQC-Quitline facts - North American Quitline Consortium (NAQC). What is a Quitline: factsheets, materials, and world quitline map.
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