Proactive Telephone Smoking Cessation Treatment in a VA Mental Health Population: Preliminary Treatment Engagement and Cessation Outcomes

Background: It is unclear whether telephone-based treatment is acceptable and effective for smokers with a mental health diagnosis. We evaluated a telephone program for VA smokers with mental illness. Methods: Mental health providers referred patients to the program. Patients were contacted by phone to offer enrollment. Participants were offered self-help materials, smoking cessation medications, and proactive, multi-call telephone counseling. Participants were randomized to receive counseling from their state Quitline or a VA counselor who had received specialized training on smokers with mental illness. Smoking status was assessed via phone at two months. Patients who did not enroll in treatment were given the option of completing the follow-up call only. Results: This report describes the first 272 patients referred to the program. We reached 214 (79%) patients by phone to offer enrollment. Of those, 71% enrolled in treatment (76 VA, 75 Quitline), 6% enrolled in the follow-up survey only, 10% were ineligible and 13% declined participation. 100% of participants in both treatment arms scheduled an appointment to begin counseling, and 90% were interested in using smoking cessation medications. 91% of VA and 85% of Quitline counseling participants completed at least one counseling session. Seventy participants have completed a two-month assessment (88% of those due). 24% (9/37) of VA and 21% (7/33) of Quitline counseling participants reported 30-day smoking abstinence at two months. Conclusion: Telephone programs are effective at engaging persons with mental illness into smoking cessation treatment and at producing short-term abstinence rates comparable to those seen in non-mental health populations.