Telephone-Based Tobacco-Cessation Treatment

Re-Enrollment Among Diverse Groups


      Telephone quitlines are utilized by diverse individuals and represent an effective tobacco-cessation modality. Quitlines allow tobacco users to seek support for multiple quit attempts. Little is known about how frequently tobacco users take advantage of this opportunity. No studies have been conducted to determine how communication strategies affect quitline re-enrollments. This study aimed to determine the rates of quitline re-enrollment and to compare the responses of people of varying racial/ethnic identities to invitations utilizing different communication strategies.


      Four-cell RCT.

      Setting/ participants

      Random sample of 2400 tobacco users who enrolled into services during 2006, with oversampling of ethnic populations.


      Between November 2006 and January 2007, participants received either no invitation to re-enroll or were invited to re-enroll into services via a letter, a letter with ethnic-specific content, or a letter and a telephone call.

      Main outcome measures

      Re-enrollment into quitline services.


      Analysis of the 252 days prior to the intervention resulted in a spontaneous re-enrollment rate of 0.54% per 30 days. Recruitment using mailers did not significantly change this rate; the addition of telephone calls increased re-enrollment to 6.93% per 30 days. No significant differences were found among the subpopulations studied. Invalid addresses (16%); invalid telephone numbers (29.1%); and the inability to reach subjects after five call attempts (37.9%) were barriers to recruitment.


      For those who have previously called quitlines for help, proactive re-enrollment can be one way to initiate a new quit attempt after relapse. This study has shown that it is feasible to re-enroll former quitline participants, making the test of effectiveness the next logical step.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Fiore M.C.
        • Bailey W.C.
        • Cohen S.J.
        • Dorfman S.F.
        • Goldstein M.G.
        • Gritz E.R.
        Treating tobacco use and dependence.
        USDHHS, Public Health Service, Washington DC2000 (AHRQ Publication No.: 000032)
        • Stead L.F.
        • Perera R.
        • Lancaster T.
        Telephone counseling for smoking cessation.
        Cochrane Database Syst Rev. 2006; 3 (CD002850)
        • Cummins S.E.
        • Bailey L.
        • Campbell S.
        • Koon-Kirby C.
        • Zhu S.H.
        Tobacco cessation quitlines in North America: a descriptive study.
        Tob Control. 2007; 16: i9-i15
        • USDHHS
        The health consequences of smoking: nicotine addiction: a report of the Surgeon General.
        U.S. Government Printing Office, Washington DC1988 (DHHS Publication No. CDC 88-8416)
        • Zhu S.H.
        • Rosbrook B.
        • Anderson C.
        • Gilpin E.
        • Sadler G.
        • Pierce J.P.
        The demographics of help-seeking for smoking cessation in California and the role of the California Smokers' Helpline.
        Tob Control. 1995; 4: S9-S15
        • Halperin A.C.
        • Bush T.
        • Yepassis-Zembrou P.
        • McAfee T.
        Differential quitline use, satisfaction and effectiveness: African American experience.
        (Proceedings of the National Conference on Tobacco or Health)2005 (May 2–6, 2005; Chicago IL)
        • Fagan P.
        • Moolchan E.T.
        • Lawrence D.
        • Fernander A.
        • Ponder P.K.
        Identifying health disparities across the tobacco continuum.
        Addiction. 2007; 102: 5-29
        • Miller W.R.
        • Rollnick S.
        Motivational interviewing: preparing people to change addictive behavior.
        Guilford Press, New York1991
        • Joseph A.M.
        • Rice K.
        • An L.C.
        • Mohiuddin A.
        • Lando H.
        Recent quitters' interest in recycling and harm reduction.
        Nicotine Tob Res. 2004; 6: 1075-1077
        • Lando H.A.
        • Pirie P.L.
        • Roski J.
        • McGovern P.G.
        • Schmid L.A.
        Promoting abstinence among relapsed chronic smokers: the effect of telephone support.
        Am J Public Health. 1996; 86: 1786-1790
        • Tonnesen P.
        • Norregaard J.
        • Urbain S.
        • Simonsen K.
        Recycling with nicotine patches in smoking cessation.
        Addiction. 1993; 88: 533-539
        • Gourlay S.G.
        • Forbes A.
        • Marriner T.
        • Pethica D.
        • McNeil J.J.
        Double blind trial of repeated treatment with transdermal nicotine for relapsed smokers.
        BMJ. 1995; 311: 363-366
        • Zhu S.H.
        Increasing cessation in the population: quit attempts vs. successful quit attempts.
        (Proceedings of the 13th World Conference on Tobacco or Health)2006 (Jul 12–15; Washington DC)