The 13th World Conference on Tobacco OR Health

Objective: Relapse prevention interventions focus on teaching skills to resist cravings with the result that treatments are effective in reducing relapse over the short-term but not over the longer term. Once cravings subside, exsmokers face a second task of adjusting to a non-smoking lifestyle. This RCT tested whether a program of 4-6 extra “integration” callbacks designed to facilitate this second task could reduce relapse rates compared to Quitline's standard callback service which offers four post-quitting calls.

Methods: First, the 2 tasks framework was introduced to the Quitline service. 1443 Quitline callers were then recruited into the study at the time they accepted callbacks and at that point were randomised: 733 control and 710 intervention. 46% (n=340) of callers randomised to the standard service reached the study eligibility criterion of quitting for at least one week compared to 50% (n=352) of callers randomised to receive integration callbacks (p=.23). Baseline data was collected at this point and participants were recontacted 4 and 12 months later.

Results: Between baseline and 4 months 40% of callers relapsed (38.1% intervention; 40.3% control) and only a further 10% relapsed by 12 month follow-up (11.2% intervention; 9.7% control). The extra callbacks were not effective in reducing relapse. However, the overall quit rates at 12 months were over 50% better compared to an earlier trial. This suggests service improvement in relapse prevention. The findings indicate the utility of the 2 tasks framework, but provide no evidence of any benefit of extra sessions to assist with the second task.