Introduction: With evidence to support the use of text messaging for smoking cessation, some quitlines in North America have incorporated text messaging into their service offerings.

Aims: This study sought to evaluate whether integrated phone counselling and text messaging services are acceptable to quitline callers, and to identify strategies for improving text messaging services in the context of a quitline.

Methods: Thirty-five adult callers of the New Mexico state quitline who had enrolled in multi-call phone counselling and Text2Quit, a text messaging programme, were interviewed by phone. Interviews assessed use and acceptability of the phone counselling and text messaging interventions.

Results: Use of phone counselling and text messaging was generally high among participants. While most participants reported that they would highly recommend Text2Quit (75.8%) or phone counselling (78.8%) individually, a relatively higher proportion indicated they would highly recommend the combined services (93.9%). Suggestions for improvement focused on increased customisation and personalisation.

Conclusions: This study provides preliminary evidence for the acceptability of integrated phone counselling and text messaging services. Research is needed that explores the impact of these widely-used integrated services on smoking cessation.

Detailed descriptions of effective intervention protocols for Asian smokers are uncommon which makes it difficult for others to successfully implement a protocol that has been proven to be effective. This article fills a gap by detailing such a protocol, specifically a telephone counselling intervention for Asian smokers. The protocol was tested in a large randomised trial with Chinese-, Korean-, and Vietnamese-speaking smokers and was shown to significantly increase quit rates. The article describes the approach used to develop the protocol and critical components of the intervention. In addition, the paper compares data on programme participation and satisfaction among Chinese-, Korean-, and Vietnamese-speaking smokers with those for English- and Spanish-speaking smokers from two studies conducted in the US and shows that the former are no less likely to engage in counselling and no less likely to be satisfied with the process.

Objective: To evaluate the extent to which a client's successful tobacco quit attempt and subsequent improvement in life satisfaction depend on the quitline counsellor assigned to provide the cessation counselling. Methods: A retrospective review of 2,944 Arizona Smokers’ Helpline client records was conducted on enrolment, follow-up, and programme treatment data. Seven month post-enrolment quit rates were calculated on an intent-to-treat sample for 30-day point prevalence during follow-up surveys. A variance components model was used to estimate counsellor effects, that is, the amount of variability in outcomes explained by individual counsellor differences. Similar analysis was done to detect presence of counsellor effects in clients’ Outcome Rating Scale (ORS) scores (Miller et al., 2003) ‒ a proxy measure of life satisfaction ‒ as they change from intake date to exit date. Results: Statistically significant differences in quit rates (2%) and ORS change scores (2%) were attributable to counsellor effects. Conclusions: The results suggest that counsellor effects have an impact on quitline outcomes that otherwise might have been overlooked if one assumed that only treatment factors and extraneous factors contributed significantly to outcomes. Additional research is required to determine the sources of counsellor effects, as well as whether additional efforts to eliminate these counsellor effects can be justified.

Objectives: The cost-effectiveness of the Swedish quitline, a nation-wide, free of charge service, is assessed.

Methods: The study was based on data of a sample of 1,131 callers enrolled from February 1, 2000 to November 30, 2001. Outcome was measured as cost per quitter and cost per year of life saved. Cost per quitter was based on a calculation of the total cost of the quitline divided by the number of individuals who reported abstinence after 12 months. The cost per life year saved (LYS) was calculated by the use of data from the literature on average life expectancy for smokers versus quitters, the total cost of the quitline, and the cost of pharmacological treatment.

Results: The number of smokers who used the quitline and reported abstinence after 1 year was 354 (31 percent). The accumulated number of life years saved in the study population was 2,400. The cost per quitter was 1,052–1,360 USD, and the cost per life year saved was 311–401 USD. A sensitivity analysis showed that, for outcomes down to an abstinence rate of 20 percent, the cost per LYS rose modestly, from 311 to 482 USD. Discounting the cost per LYS showed the cost to be 135 USD for 3 percent and 283 USD for 5 percent.

Conclusions: The Swedish quitline is a cost-effective public health intervention compared with other smoking cessation interventions.