RECYCLING OF CHRONIC SMOKERS TO SUSTAINED ABSTINENCE

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The major goal of the proposed research is to develop and to test a brief telephone intervention following clinic treatment for smoking cessation. Cigarette smoking is a major cause of cardiovascular disease and disability. Based upon prior results, the substantial majority of clinic participants will relapse within the first year following treatment. The telephone intervention is relatively low cost and should be effective in recycling clinic relapsers into renewed abstinence. One thousand chronic smokers will be randomly assigned either to a traditional state-of-the-art smoking cessation clinic or to the clinic supplemented by telephone support for recycling. Telephone outreach will consist of three separate rounds of intervention 3 months, 9 months, and 21 months after the targeted date for quitting in the smoking cessation clinics. Telephone calls to abstinent subjects will reinforce success and will offer advice and support in coping with present or anticipated difficult situations. Calls to relapsers and nonabstainers will debrief concerning the relapse episode (as appropriate) and will encourage subjects to initiate concrete action toward quitting including setting a quit date. Subjects will be offered self-help materials as well as referrals to more intensive programs. Follow-up data collection will be separate from recycling contacts and will occur 6, 12, 24, and 34 months after the initial smoking cessation clinics. Projected longterm sustained abstinence rates are 35% for recycling and 25% for the clinic only comparison. If results are as predicted, an effective low-cost telephone outreach protocol will be available that could dramatically assist in smoking cessation and thereby substantially reduce cardiovascular disease.