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Telephone-Based Coaching: A Comparison of Tobacco Cessation Programs in an Integrated Health Care System
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  • Description:

    Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations.


    Retrospective cohort study comparing wellness coaching participants with two groups of controls.


    Kaiser Permanente, Northern California (KPNC), a large integrated health care delivery system.


    241 patients who participated in telephonic tobacco cessation coaching from 1/1/2011–3/31/2012, and two control groups: propensity-score matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing based coaching sessions that engage the patient, evoke their reason to consider quitting and help them establish a quit plan.


    Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up.


    Logistic regressions adjusting for age, gender, race/ethnicity, and primary language.


    After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, P<0.001) and comparable to class attendees (31% vs. 29%, P=0.28). Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, P<0.001).


    Telephonic wellness coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

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  • Funding:
    K01 DK099404/DK/NIDDK NIH HHS/United States
    P30 DK092924/DK/NIDDK NIH HHS/United States
    U58 DP002721/DP/NCCDPHP CDC HHS/United States
    PHS HHS/United States
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