Re-examining phone counseling for smoking cessation: Does the evidence apply to low-SES smokers?
Rachel Garg, Amy McQueen, Ebuwa I Evbuoma-Fike and 1 others
PMID 34815137WHAT IT FOUND
Phone counseling evidence for smoking cessation is weaker for low-income or less-educated smokers: only 18 of 65 U.S. trials analyzed outcomes by income, education, employment, or insurance, and most did not target these groups.
Key findings
01Only 18 of 65 reviewed U.S. telephone counseling trials used socioeconomic status indicators when analyzing smoking cessation outcomes.
02Of the nine trials that specifically recruited low-SES participants, one found telephone counseling more effective than control at 6 months, three found effects at 3 months, and five found no significant differences, including three pilot studies.
03In the eight trials that reported attrition by socioeconomic status, all found low-education participants were more likely to be lost to follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The review excluded non-U.S. studies, studies of pregnant women, and studies of adolescents, so it does not address those groups. It did not combine results into one effect estimate; it mapped reporting and evidence gaps. Only 18 of 65 studies analyzed cessation outcomes by SES, and 13 reported whether SES was significant, so many trials were uninformative. The nine low-SES recruitment studies used different definitions of low SES, and three were pilot studies not powered to detect differences. Most studies did not report SES effects on uptake or attrition; attrition evidence came from only eight studies. Seven of the low-SES recruitment studies were judged to have a high risk of detection bias in the Cochrane review because cessation was self-reported or participants were not blinded to treatment.
Declared interests
The authors declared no competing financial interests or personal relationships. The article's publication types indicate NIH extramural research support, but the text does not name the funder.
The easy way to misread this
Do not conclude that phone counseling alone fails for low-income or less-educated smokers. Quitlines may also provide nicotine replacement therapy, print materials, text or web coaching, and most studies did not test or report effects by income, education, employment, or insurance.