For the first time, Hutchinson Center researchers have demonstrated that it is possible to successfully recruit and retain a large number of adolescent smokers into a smoking intervention study and, through personalized, proactive telephone counseling, significantly impact rates of six-month continuous quitting.
These findings, by the Public Health Sciences Division’s Dr. Art Peterson, Kathleen Kealey, Dr. Jonathan Bricker, Sue Mann, Patrick Marek and Jingmin Liu, were reported in a pair of papers in the Oct. 12 online edition of the Journal of the National Cancer Institute.
“When this study started, despite decades of research and dozens of intervention trials, there was no proven way to reach teens from the general population and recruit them into smoking cessation programs, and there was no proven way to help these teens quit,” said Peterson, lead author of the paper that reported the results of the Hutchinson Study of High School Smoking, the largest randomized trial of teen smoking cessation ever conducted.
The trial, funded by the National Institutes of Health, involved 2,151 teenage smokers from 50 high schools in Washington. Half of the schools were randomly assigned to the experimental intervention; teens in these schools were invited to take part in confidential, personalized telephone counseling designed to help motivate them to quit. The remaining 25 schools served as a comparison group; teen smokers from these schools did not participate in the telephone intervention. The study also included 745 nonsmokers to ensure that contacting students for participation in the trial would not reveal a participant’s smoking status.
At the completion of the study, which also involved researchers at the Group Health Research Institute, 21.8 percent of all smokers (daily and less than daily) in the counseling group had achieved continuous quitting for six months, as compared to 17.7 percent of those in the comparison group. Additionally, the one-month and seven-day quit rates among the smokers who received telephone counseling were roughly three times higher than those reported in nearly 50 previous adolescent smoking-cessation trials over the past two decades.
Types of counseling
The telephone counseling intervention integrated two types of counseling: motivational interviewing, which emphasizes building motivation and confidence for quitting, and cognitive behavioral skills training, which gives smokers the tools they need to learn how to quit.
“Motivational interviewing is very caring, nonjudgmental and respectful. It is non-confrontational. A counselor would never say, ‘I want you to quit smoking.’ Instead the counselor would ask what the behavior means to the participant. What do they like about it? What don’t they like about it?” explained Kealey, first author of the companion paper, which describes in detail the design and implementation of the telephone counseling intervention.
“These results are critically important for supporting and stimulating our nation’s search to find successful ways to help reduce smoking by teens and young adults,” Peterson said. “An important message from this study for teens and young adult smokers—really for all smokers—is that personalized telephone counseling can help one be successful with quitting smoking.” Such help is available through the nation’s network of quit lines, such as 1-800-QUIT-NOW offered through the Washington State Department of Health.
[Adapted from a Hutchinson Center news release.]