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Tobacco quitlines

Health Factors: Tobacco Use
Decision Makers: State Government
Evidence Rating: Scientifically Supported
Population Reach: 50-99% of WI's population
Impact on Disparities: Likely to decrease disparities

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Quitlines provide behavioral counseling to tobacco users who want to quit. Cessation specialists for proactive quitlines schedule follow-up calls after the specialist or tobacco user makes initial contact; reactive quitlines, by contrast, rely solely on tobacco users to make contact. Some quitlines provide additional interventions such as mailed materials, web-based support, text messaging, or tobacco cessation medications (CG-Tobacco use).

Expected Beneficial Outcomes

Increased quit rates

Evidence of Effectiveness

There is strong evidence that proactive quitlines increase tobacco cessation (CG-Tobacco use, AHA-Mozaffarian 2012, Mottillo 2009). Both state (CG-Tobacco use) and community quitlines have demonstrated effects (AHA-Mozaffarian 2012). Three or more counseling sessions appear more effective than fewer sessions (Cochrane-Stead 2006).

Combining quitlines with other interventions such as mass communication campaigns and efforts to encourage health care providers to refer patients to quitlines increase quitline use and tobacco cessation (CG-Tobacco use). Providing tobacco cessation medication (usually nicotine replacement therapy) along with quitline services also increases call volume and quit rates (CG-Tobacco use). Telephone counseling with tobacco cessation medication also increases smoking quit rates (Cochrane-Stead 2012) and smokeless tobacco cessation (Cochrane-Ebbert 2011) more than such medication alone.

Quitlines are considered quite cost effective; they have been shown to cost about $2000 per quality adjusted life year (QALY) saved, and additional tobacco cessation medication about $800 per QALY (CG-Tobacco use).


United States

All fifty states have quitlines. Most quitlines proactively call and counsel clients multiple times, and offer free tobacco cessation medication (NAQC-Quitline facts). 


Wisconsin’s quitline offers single-session telephone counseling, free cessation medication in the form of patches, lozenges, or gum, and web-based services. Clients may get multiple counseling sessions if they initiate calls themselves (NAQC-Wisconsin).

Implementation Resources

CDC-Quitlines 2004 - Centers for Disease Control and Prevention (CDC). Telephone quitlines: A resource for development, implementation, and evaluation. Atlanta: Office on Smoking and Health, Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP); 2004. Accessed on December 7, 2015
NAQC-Quitline - North American Quitline Consortium (NAQC). Promoting evidence based quitline services across diverse communities in North America. Accessed on March 1, 2016

Citations - Description

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco. Accessed on April 3, 2017

Citations - Evidence

AHA-Mozaffarian 2012 - Mozaffarian D, Afshin A, Benowitz NL, et al. Population approaches to improve diet, physical activity, and smoking habits: a scientific statement from the American Heart Association (AHA). Circulation. 2012;126(12):1514–63. Accessed on February 6, 2017
CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco. Accessed on April 3, 2017
Cochrane-Ebbert 2011* - Ebbert J, Montori VM, Erwin PJ, Stead LF. Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews. 2011;(2):CD004306. Accessed on December 10, 2015
Cochrane-Stead 2006* - Stead LF, Perera R, Lancaster T. Telephone counselling for smoking cessation. Cochrane Database of Systematic Reviews. 2006;(3):CD002850. Accessed on February 1, 2016
Cochrane-Stead 2012* - Stead LF, Lancaster T. Behavioural interventions as adjuncts to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews. 2012;(12):CD009670. Accessed on December 8, 2015
Mottillo 2009 - Mottillo S, Filion KB, Bélisle P, et al. Behavioural interventions for smoking cessation: A meta-analysis of randomized controlled trials. European Heart Journal. 2009;30(6):718-30. Accessed on March 1, 2016

Citations - Implementation

NAQC-Quitline facts - North American Quitline Consortium (NAQC). What is a Quitline: factsheets, materials, and world quitline map. Accessed on March 29, 2016
NAQC-Wisconsin - North American Quitline Consortium (NAQC). Wisconsin. Accessed on March 3, 2016

Page Last Updated

December 12, 2013

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