In-person and telephone treatment of tobacco dependence: a comparison of treatment outcomes and participant characteristics.

Abstract

We compared participant characteristics and abstinence outcomes of smokers who chose in-person or telephone tobacco dependence treatment. We provided the same treatment content to 7267 smokers in Arkansas between 2005 and 2008 who self-selected treatment modality; examined demographic, clinical, environmental, and treatment utilization differences between modalities; and modeled outcomes and participants' choice of modality with logistic regression. At end of treatment, in-person participants were more likely to be abstinent than telephone participants, and smokers of higher socioeconomic status (SES) were more likely to be abstinent with telephone treatment than lower-SES smokers. Long term, modality had no effect on treatment outcomes. Higher-SES smokers and smokers exposed to more treatment content were more likely to achieve long-term abstinence, regardless of modality. Men and more recalcitrant smokers were more likely to choose in-person treatment; lower-SES, ethnic minority, and more dependent smokers were more likely to choose telephone treatment. Treatment modality attracts different groups of smokers, but has no effect on long-term abstinence. Multiple treatment modalities are needed to provide treatment to a heterogeneous population of smokers. More research is needed to understand the influences on treatment choice.