A randomized controlled trial of Telephone Counseling with smokeless tobacco users: The ChewFree Minnesota study

Raymond G. Boyle, Chris Enstad, Stephen E. Asche, Merry J. Thoele, Nancy E. Sherwood, Herbert H. Severson, Jon Ebbert, Leif I. Solberg

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Although a considerable body of evidence supports telephone quit lines for smoking cessation, much less is known about the effectiveness of proactive Telephone Counseling with smokeless tobacco (ST) users. We conducted a randomized controlled trial comparing Telephone Counseling with the distribution of a self-help manual for ST cessation. We recruited 406 adult ST users throughout the state of Minnesota and randomized them to receive either: (a) a self-help manual (Manual only) or (b) a self-help manual plus proactive telephone-based cessation counseling (Telephone Counseling). The telephone-based treatment included up to four calls in support of quitting, and personalized various cognitive and behavioral strategies that are generally considered effective in tobacco cessation (such as setting a quit date, examining patterns of use, developing stress reduction skills, avoiding known triggers to use). Participants were surveyed by phone at 3 and 6 months to assess both point prevalence and continued abstinence. Prolonged abstinence from all tobacco was 6.8% and 30.9% (p<.001) at 3 months and 9.8% and 30.9% (p<.001) at 6 months in Manual only and Telephone Counseling, respectively. We found older age, lower dependency, and increased readiness predicted quitting success. Proactive telephone-based counseling is an effective strategy for improving cessation rates among ST users. Future research should determine the components contributing to the intervention success.

Original languageEnglish (US)
Pages (from-to)1433-1440
Number of pages8
JournalNicotine and Tobacco Research
Issue number9
StatePublished - 2008

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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