Effectiveness of Telephone Counselling and Quitlines in Tobacco Cessation: Systematic Review and Meta-analysis
1
Department of Pediatrics, PGIMER Chandigarh, Chandigarh, India
2
School of Public health, PGIMER, Chandigarh, India
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Telephone counselling, including quitlines, is a widely implemented strategy to support tobacco cessation; however, the strength and consistency of its effectiveness across diverse populations and real-world settings remain uncertain. This study aimed to evaluate the effectiveness of telephone counselling for tobacco cessation by synthesizing evidence from randomized controlled trials (RCTs) and observational studies, and to compare outcomes across study designs to better understand both trial efficacy and real-world performance.
METHODS:
We systematically searched PubMed, EMBASE, Scopus, Cochrane Library, and ScienceDirect for English-language studies (2002–2025). Eligible studies included RCTs, non-randomized trials, and observational studies of individuals using any form of tobacco. The primary outcome was continuous abstinence; secondary outcomes included 7-day and 30-day point prevalence abstinence. Risk of bias was assessed using the Cochrane RoB-2 and Newcastle-Ottawa Scale; certainty of evidence was rated with GRADE. PROSPERO registration: CRD42023418243.
RESULTS:
Thirty-six studies (RCTs=25; observational=11) were included. Across RCTs, telephone counselling increased continuous abstinence by 43% (RR = 1.43; 95% CI: 1.11–1.84; I² = 48%). 7-day PPA improved by 45% (RR = 1.45; 95% CI: 1.13–1.86; I² = 74%), while 30-day PPA (4 RCTs) also showed benefit (RR = 1.37; 95% CI: 1.14–1.65). Subgroup analyses demonstrated consistent effects across biochemical and self-reported verification. Observational studies reported 7-day PPA ranging from 2.6%–67.4%, 30-day PPA around 20.5%, and mean quit rates of 35.5%, with higher cessation among those completing ≥3 counselling sessions. Meta-regression indicated that differences between RCT and observational estimates were driven by follow-up duration, not study design.
CONCLUSIONS:
Telephone counselling significantly increases quit rates across populations, with evidence from both trial and real-world settings. Scaling up quitline services, particularly in low- and middle-income countries, should be prioritized to strengthen global tobacco control efforts.
Telephone counselling, including quitlines, is a widely implemented strategy to support tobacco cessation; however, the strength and consistency of its effectiveness across diverse populations and real-world settings remain uncertain. This study aimed to evaluate the effectiveness of telephone counselling for tobacco cessation by synthesizing evidence from randomized controlled trials (RCTs) and observational studies, and to compare outcomes across study designs to better understand both trial efficacy and real-world performance.
METHODS:
We systematically searched PubMed, EMBASE, Scopus, Cochrane Library, and ScienceDirect for English-language studies (2002–2025). Eligible studies included RCTs, non-randomized trials, and observational studies of individuals using any form of tobacco. The primary outcome was continuous abstinence; secondary outcomes included 7-day and 30-day point prevalence abstinence. Risk of bias was assessed using the Cochrane RoB-2 and Newcastle-Ottawa Scale; certainty of evidence was rated with GRADE. PROSPERO registration: CRD42023418243.
RESULTS:
Thirty-six studies (RCTs=25; observational=11) were included. Across RCTs, telephone counselling increased continuous abstinence by 43% (RR = 1.43; 95% CI: 1.11–1.84; I² = 48%). 7-day PPA improved by 45% (RR = 1.45; 95% CI: 1.13–1.86; I² = 74%), while 30-day PPA (4 RCTs) also showed benefit (RR = 1.37; 95% CI: 1.14–1.65). Subgroup analyses demonstrated consistent effects across biochemical and self-reported verification. Observational studies reported 7-day PPA ranging from 2.6%–67.4%, 30-day PPA around 20.5%, and mean quit rates of 35.5%, with higher cessation among those completing ≥3 counselling sessions. Meta-regression indicated that differences between RCT and observational estimates were driven by follow-up duration, not study design.
CONCLUSIONS:
Telephone counselling significantly increases quit rates across populations, with evidence from both trial and real-world settings. Scaling up quitline services, particularly in low- and middle-income countries, should be prioritized to strengthen global tobacco control efforts.
| eISSN: | 2654-1459 |
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