Learning Objectives: Explain the impact of telephone counseling on smoking cessation among depressed smokers in terms of some processes of change
Abstract: Previous studies have shown that cigarette smokers tend to be depressed and that depression may be related to difficulties in cessation. New data on this topic were gathered in a study by the American Cancer Society on the effectiveness of telephone counseling. From June 2000 through May 2001, over five thousand six hundred callers sought assistance in smoking cessation from the American Cancer Society's new telephone service. All current smokers, 18 and older, who were willing to make a serious quit attempt and who agreed to participate in the research protocol were randomized to receive either self-help materials through the mail or self-help materials and up to five sessions of telephone counseling. Analyses of the three-month and six-month follow-up data showed that telephone counseling approximately doubled the smokers' odds of achieving sustained cessation. Cases enrolled during the first phase of the trial were asked a single question to measure depression. Analyses found that 40% of the clients were depressed, much higher than the expected rate in the general population. Depressed clients had significantly lower quit rates than those who were not depressed (7.4% vs. 11.2%, p<0.01). Analyses of major processes of change showed that the lower rates of cessation were related to differences in self-efficacy and social support. However, the positive effect of telephone counseling effect was significant whether clients were depressed or not. These findings show that depression is a significant issue in smoking cessation and that telephone counseling can assist depressed smokers.
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