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Introduction: Understanding the characteristics of smokers who enroll in a trial of quitline support and those who decline could guide recruitment approaches and service delivery to better engage smokers and increase successful quitting. However, it is unknown whether factors such as smokers' perceived effectiveness of using quitting aids or self-exempting beliefs are associated with quitline uptake. We compared the sociodemographic characteristics, smoking behaviours, perceived effectiveness of using quitting aids, and self-exempting beliefs of participants and nonparticipants who were actively telephoned and offered quitline support as part of a randomized controlled trial., Methods: Overall, 48,014 telephone numbers were randomly selected from the electronic telephone directory and contacted. A total of 3,008 eligible smokers were identified and invited to participate in a trial of quitline support. Consenting trial participants (n = 1,562) and nonparticipants (n = 500) completed a baseline interview., Results: Multivariate analysis showed that the following factors were associated with trial participation: consumption of 21 or more cigarettes per day (odds ratio [OR] = 1.45 [1.07-1.99]), readiness to quit within 30 days (OR = 4.45 [3.20-6.19]) or 6 months (OR = 3.22 [2.46-4.23]), perceiving that calling the quitline was definitely (OR = 2.34 [1.62-3.39]) or partly effective (OR = 2.15 [1.63-2.83]), believing that using self-help materials was partly effective (OR = 1.50 [1.16-1.94]), thinking that nicotine replacement therapy was partly effective (OR = 1.38 [1.04-1.84]), perceiving that using willpower alone was partly (OR = 1.99 [1.48-2.67]) or not effective (OR = 2.60 [1.95-3.46]), and not holding a self-exempting belief (OR = 1.45 [1.11-1.89])., Conclusions: Increasing smokers' utilization of quitlines is likely to require changing their perceptions of the effectiveness of quitting strategies compared with using willpower alone and addressing self-exempting beliefs.

Aims: Active recruitment of smokers increases the reach of quitlines; however, some quitlines restrict proactive telephone counselling (i.e. counsellor-initiated calls) to smokers ready to quit within 30 days. Identifying characteristics associated with successful quitting by actively recruited smokers could help to distinguish those most likely to benefit from proactive telephone counselling. This study assessed the baseline characteristics of actively recruited smokers associated with prolonged abstinence at 4, 7 and 13 months and the proportion achieving prolonged abstinence that would miss out on proactive telephone counselling if such support was offered only to smokers intending to quit within 30 days at baseline., Design: Secondary analysis of a randomized controlled trial in which the baseline characteristics associated with prolonged abstinence were examined., Setting: New South Wales (NSW) community, Australia., Participants: A total of 1562 smokers recruited at random from the electronic NSW telephone directory., Measurements: Baseline socio-demographic and smoking-related characteristics associated with prolonged abstinence at 4, 7 and 13 months post-recruitment., Findings: Waiting more than an hour to smoke after waking and intention to quit within 30 days at baseline predicted five of the six prolonged abstinence measures. If proactive telephone counselling was restricted to smokers who at baseline intended to quit within 30 days, 53.8-65.9% of experimental group participants who achieved prolonged abstinence would miss out on telephone support., Conclusions: Less addicted and more motivated smokers who are actively recruited to quitline support are more likely to achieve abstinence. Most actively recruited smokers reported no intention to quit within the next 30 days, but such smokers still achieved long-term abstinence., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

Introduction: Only 1%-7% of smokers use quitlines annually. Active telephone recruitment ("cold calling") can enroll about 50% of community smokers to quitline services. However, whether cold-called smokers' characteristics differ from traditional quitline clients is unknown. To assess whether active telephone recruitment reaches new groups of smokers, New South Wales (NSW) Quitline callers were compared with cold-called smokers who received telephone counseling as part of a randomized controlled trial., Methods: Data were extracted from the NSW Quitline database from September 13, 2005, to April 10, 2007, to coincide with the trial's recruitment period. Records (n = 18,584) of first-time quitline callers, who smoked daily, resided in NSW, Australia, and received telephone counseling were included. Cold-called participants who received telephone counseling (n = 695) were recruited by telephone from the electronic NSW telephone directory. Eligibility requirements were daily tobacco use, aged 18 or older, NSW resident, and English speaking. Smokers were eligible regardless of their quitting intention., Results: Male smokers, older age groups, those living in nonmetropolitan areas, smokers who took longer to smoke their first cigarette after waking, consumed fewer cigarettes per day, and were less motivated to quit had greater odds of being referred to the quitline through cold calling., Conclusions: Active telephone recruitment enrolls new groups of smokers to quitlines. The reach of quitlines could be improved if quitlines incorporated cold calling into their recruitment strategies.

Issue Addressed: Little research has examined issues surrounding employee smoking outside smoke-free workplaces. The study's aims were to: 1) document the proportion of NSW indoor employees covered by total workplace smoking bans; 2) examine community perceptions of employee smoking during working hours; 3) identify the characteristics of having a supportive attitude toward tobacco control in the workplace; and 4) describe relationships between smoking relapse and workplace-related smoking., Methods: Two cross-sectional, computer-assisted telephone interview surveys of randomly selected adults were conducted. Consent rates were 49.1% in 2004 and 45.8% in 2006, with sample sizes of 1,158 and 2,393 respectively., Results: Total workplace bans were reported by 92.9% of indoor employees. Community attitudes to smoking in working hours were highly negative: 77.7% agreed smoking breaks waste too much time and 85.1% opposed smoking near workplace doorways. Being female, born in Australia and a non-smoker were associated with more negative attitudes. A higher proportion of smokers (78.3%) perceived smoking was more common outside their place of work or study than at five other locations: rail/bus stop (60.2%), friends' houses (59.3%), own street (35.2%), parks (34.3%), and outside school (22.6%). Of smokers making a quit attempt in the past year, 42.1% relapsed at home, 22.1% at licensed premises and 18.7% at work., Conclusions: Findings emphasise the low support for smoking during or near work. Smoking outside workplaces is highly visible. Data on relapse suggest a modest relationship with workplace-related smoking.

Objectives: Active telephone recruitment ('cold calling') can enroll almost 45 times more smokers to cessation services than media. However, the effectiveness of proactive telephone counselling with cold-called smokers from the broader community is unknown. This study examined whether proactive telephone counselling improved abstinence, quit attempts and reduced cigarette consumption among cold-called smokers., Methods: From 48,014 randomly selected electronic telephone directory numbers, 3008 eligible smokers were identified and 1562 (51.9%) smokers recruited into the randomised controlled trial. Of these, 769 smokers were randomly allocated to proactive telephone counselling and 793 to the control (ie, mailed self-help) conditions. Six counselling calls were offered to intervention smokers willing to quit within a month and four to those not ready to quit. The 4-month, 7-month and 13-month follow-up interviews were completed by 1369 (87.6%), 1278 (81.8%) and 1245 (79.9%) participants, respectively., Results: Proactive telephone counselling participants were significantly more likely than controls to achieve 7-day point prevalence abstinence at 4 months (13.8% vs 9.6%, p=0.005) and 7 months (14.3% vs 11.0%, p=0.02) but not at 13 months. There was a significant impact of telephone counselling on prolonged abstinence at 4 months (3.4% vs 1.8%, p=0.02) and at 7 months (2.2% vs 0.9%, p=0.02). At 4 months post recruitment, telephone counselling participants were significantly more likely than controls to have made a quit attempt (48.6% vs 42.9%, p=0.01) and reduced cigarette consumption (16.9% vs 9.0%, p=0.0002)., Conclusions: Proactive telephone counselling initially increased abstinence and quitting behaviours among cold-called smokers. Given its superior reach, quitlines should consider active telephone recruitment, provided relapse can be reduced., Trial Registration: Australian New Zealand Clinical Trial Registry; ACTRN012606000221550.

Introduction: Levels of hospital smoking cessation care are less than optimal. This study aimed to synthesize the evidence regarding the effectiveness of interventions in increasing smoking cessation care provision in hospitals., Methods: A review identified relevant studies published between 1994 and 2006. A description of studies, including methodological quality, was undertaken. Intervention effectiveness in increasing smoking cessation care practices was examined for controlled studies using meta-analysis. Care practices examined were assessment of smoking status; advice to quit; counseling or assistance to quit; advising, offering, or providing nicotine replacement therapy (NRT); and follow-up or referral., Results: Of the 25 identified studies, 18 were U.S. based and in inpatient settings. Of the 10 controlled trials, 4 addressed cardiac patients, 5 measured one smoking cessation care practice, and 9 implemented multistrategic interventions (e.g., combining educational meetings with reminders and written resources). The methodology described in these studies was generally of poor quality. Meta-analysis of controlled trials demonstrated a significant intervention effect for provision of assistance and counseling to quit (pooled risk difference = 16.6, CI = 4.9-28.3) but not for assessment of smoking status, advice to quit, or the provision or discussion of NRT. Statistical heterogeneity was indicated for all smoking cessation care practices. An insufficient number of studies precluded the use of meta-analysis for follow-up or referral for further assistance., Discussion: Interventions can be effective in increasing the routine provision of hospital smoking cessation care. Future research should use more rigorous study design, examine a broader range of smoking cessation care practices, and focus on hospital-wide intervention implementation.

Objective: To assess community attitudes towards smoking bans, tobacco availability, promotion and product regulation, tobacco industry donations to political parties, and government spending on tobacco control activities. To compare public preferences on these issues with policies of the NSW and Commonwealth governments., Method: Anonymous, computer assisted telephone interviews of adults from randomly selected households in the NSW Electronic White Pages conducted in 2004. All subjects completed a core question set and subsequently, one of three sub-sets., Results: Overall 49.1% of eligible subjects consented. Data from two sub-samples containing 1,191 and 1,158 subjects are reported. Majority support existed for smoking bans in all six settings assessed: children's playgrounds (89%), sports stadia (77%), licensed premises (72%), outdoor dining (69%), beaches (55%) and motor vehicles carrying children (55%). Respondents nominated vastly higher tobacco control budgets than current levels of government expenditure. On a scale assessing support for tobacco control (maximum score = 13), the mean scores of both non-smokers (10.4) and smokers (8.0) were high. Of seven variables tested, only two: living with a smoker and personal smoking status were independent predictors of having a high pro-tobacco control score., Conclusion: There is strong community support for additional government regulation mandating smoke-free provision and other counter tobacco measures., Implications: Continued advocacy campaigns are required to align government tobacco control agenda more closely with public preferences.

Objective: To explore the information received by NRT users; whether patterns of NRT use are in accordance with recommendations; and to identify the characteristics of those using NRT products., Methods: A cross-sectional, omnibus telephone survey of 1,509 community members was conducted in New South Wales, Australia in 2000. The survey identified 215 current and former smokers who completed additional questions regarding their most recent quit attempt., Results: Of the 215 current and former smokers, 67 (31.2%) had used NRT on their most recent quit attempt. The majority of NRT use (61%) lasted for less than two weeks. More than 40% of NRT users reported receiving no instructions from a doctor or pharmacist on how to use the product. Approximately one-third of NRT use was associated with concomitant smoking, with 10% of NRT use being associated with little or no reduction in reported daily cigarette consumption, Only 41.8% of NRT users reported a doctor had recommended using the product., Conclusions: Despite the small size of the sample, the data suggest a level of inappropriate use of NRT products in the community., Implications: Wider use and effective provision of support and advice to NRT users in the community must be addressed if this product is to achieve its optimal potential in aiding smoking cessation.

Introduction:: Passive recruitment strategies relying on smoker-initiated contact probably contribute to particular groups of smokers using quitlines. Compared with the smoking population, smokers who call quitlines are more likely to be female, younger, higher educated, more addicted, quit previously, and motivated to quit. Quitlines could adopt new recruitment approaches such as active telephone recruitment involving recruiter-initiated contact, since this may enroll a broader representation of smokers. This study explored acceptability of active telephone recruitment to quitline support, smokers’ use, and acceptability of assistance and predictors of acceptability. [ABSTRACT FROM PUBLISHER]