Harvard Health Letter

In Brief: Calling it quits

In Brief

Calling it quits

Often it's not easy, but people do it. According to national health surveys, just over half of all Americans who were ever smokers are now ex-smokers.

Some can tough it out and snuff the habit out on their own. Others need help. Studies have shown that even minimal counseling by doctors (talking to patients less than three minutes) has a notable effect. Doctors are supposed to follow the five A's (ask about tobacco use, advise the person to quit, assess willingness to quit, assist in quitting, and arrange for a follow-up) at every visit by a patient who has indicated a willingness to quit. They're also supposed to steer smokers to one of the standard smoking cessation therapies, which include sustained-release bupropion (Zyban) and the various nicotine products (patches, gum, lozenges, etc.)

Another proven strategy is giving smokers some encouragement with regular phone calls as they work on quitting. Researchers in Minnesota tested whether adding timely telephone calls might make other counseling and cessation services more effective. They divided about 830 smokers who were patients at Veteran Affairs medical centers into two treatment groups: standard cessation services or standard services plus telephone counseling (seven calls over two months). The results were published in the March 13, 2006, Archives of Internal Medicine. After a year, 13% (53 of 414) of those who received phone calls hadn't lit up in six months, compared with just 4% (17 of 416) who received standard services. That's not a huge difference, but given the horrendous health effects of smoking, even a modest gain is significant, especially one as simple as making a few phone calls.

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