Proactive Telephonic Follow-up Calls by a Tobacco Cessation Clinic (TCC): Optimization for the Number of Calls.

Abstract

Background: Despite specific national effort for over a decade, in published reports on tobacco cessation from India, the quit rate has ranged from 2.6% to 28.6%. One of their challenges has been an inability to follow-up all those treated comprehensively. Objective: It was to determine an optimum number of follow-up telephonic calls to be made proactively post the cessation treatment. Methods: This study was conducted for a period of one year w.e.f. 5th September 2017 at a Tobacco Cessation Clinic (TCC) of a private health sector tertiary care hospital to 296 patients currently using tobacco treated by counselling with/ without pharmacotherapy; and integration of the quitline methodology with follow ups at 3rd and 7th days, and thereafter at the end of 1st, 3rd, 6th and 12th months respectively, i.e., until 4th September 2019. Results: As per study protocol, the TTC could follow up 91.2% patients telephonically to achieve a quit rate of 42.9% while those who failed to quit and relapsed were 37.7% and 19.9% respectively. Staying on with the quit date set at the outset and adequacy of three follow-up calls have emerged as the statistically significant outcomes for p values of 0.000 and 0.001 respectively. Conclusion: Achieving a quit rate of 42.9% through the proactive follow-up calls reinforces its perceived utility in tobacco cessation. Making at least 3 follow-up calls after primary intervention (on 3rd, 7th and at 1 month) is recommended to achieve a satisfying outcome. For an optimal outcome, the study recommends follow-ups until 6 months. Keywords Tobacco, Cessation, Follow up, Telephonic calls, Quitline, Smoking, Smokeless tobacco