Quitlines and Other Cessation Support Resources

Quitlines are effective, evidence-based treatments for smoking cessation. The evidence base for tobacco cessation quitlines was established through numerous clinical trials and meta-analyses. After an exhaustive review of the randomized clinical trial research literature, the 2008 update to the Public Health Service’s Clinical Practice Guideline Treating Tobacco Use and Dependence concluded that quitlines increase 6-month smoking cessation quit rates compared with no intervention (the Guideline reported quit rates among quitline users of 12.7% for counseling alone and 28.1% for counseling plus medication) and therefore recommended the use of quitlines to help tobacco users quit.² Quitlines have been shown to be a cost-effective intervention.³

Yes. All 50 U.S. states, the District of Columbia, Puerto Rico, and Guam operate quitlines that can be accessed through the 1-800-QUIT-NOW quitline (operated by the National Cancer Institute). This toll-free number automatically transfers callers to their state quitline. This easy-to-remember number allows for national promotion of quitline services. Healthcare professionals can refer patients who are interested in quitting to 1-800-QUIT-NOW.

When patients call the quitline, they will be asked about their tobacco use, previous quit attempts, how they heard about the quitline, and some basic demographic questions, including gender, age, race/ethnicity, and education level. Citizenship documentation is not asked. This initial process usually takes about 10 minutes. All information collected is kept strictly confidential and is treated as protected health information.

Callers then receive information about the services the quitline offers. If a caller is interested in receiving mailed self-help materials, an address is taken and materials are typically shipped within 24 hours. If a caller would like referrals to local cessation services or information on Web-based cessation help, that information is provided. If a caller is interested in receiving cessation counseling, he/she is typically transferred to a tobacco cessation counselor. Cessation counselors are highly trained professionals who are skilled in motivational interviewing and delivering client-centered interventions. The counseling session may focus on creating a tailored quit plan, providing medication or decision support in choosing medications, and discussing tips and tools for overcoming everyday urges to smoke.

It is important to note that during times of heavy call volume (especially during national media campaigns that promote 1-800-QUIT-NOW), a cessation counselor may not be immediately available. In these cases, the quitline will schedule an appropriate call-back time with the caller.

The majority of states do not have eligibility criteria for providing quitline counseling beyond being a state resident. Many states also require that callers be interested in quitting tobacco in the next 30 days. However, some states may have more detailed eligibility criteria or may prioritize multiple call services or free medications for those meeting specific criteria (e.g., uninsured, Medicaid insured, etc.). For specific details on your state quitline’s eligibility criteria, visit the NAQC Quitline Map. Click on your state to view the quitline profile page.

After asking if a patient uses tobacco and advising them to quit if they do, you will need to determine if they are ready to quit. For those patients who are not ready to quit, remind them that you have resources to help them quit when they are ready.

If a patient is ready to quit, you can refer them to your state quitline in one of two ways:

• Provide your patient with the 1-800-QUIT-NOW number and briefly explain what will happen when they call. This referral method requires your patient to make the initial call to the quitline. For example, you might say:
  “I am happy to hear you are ready to quit and I want you to know that help is available. Our state has a telephone-based tobacco quitline that is free and offers help to people who want to quit. When you call you will be asked a few questions about yourself and your tobacco use and then you will have the opportunity to talk to a person who has been trained to help you develop a quit plan.”
• Use your state quitline’s proactive referral system. This referral method prompts the quitline to call your patient directly to start services. In most states, healthcare providers can send a referral with the patient’s contact information to the state quitline through a fax or an electronic health record. This typically involves briefly explaining to the patient what will happen when the quitline calls, obtaining the patient’s written consent to be contacted by the quitline, and faxing or electronically submitting the referral form. Many quitline referral programs offer feedback to referring providers to track patients’ progress. To learn more about the healthcare provider referral program in your state, visit the NAQC Quitline Map. Click on your state to view the quitline profile page.

To learn more about conducting brief tobacco interventions, see this Medscape video.

The majority of funding for state quitlines comes from state Master Settlement Agreement funds, state general funds, and state tobacco taxes. In addition, some quitlines have partnerships with health insurance plans and/or employers to offer qualifying callers with expanded quitline and cessation services. To learn more about how your state quitline is funded, visit Quitline Administration and Financing.

You can refer Spanish-speaking patients who want to quit to 1-855-DÉJELO-YA (1-855-335-3569), which means “Quit it now.” This Spanish-language quitline, which is operated by the National Cancer Institute, functions similarly to 1-800-QUIT-NOW, with callers being automatically routed to their state quitline where they can receive services in Spanish.

The Asian Smokers’ Quitline, which is operated by the Moores Cancer Center at the University of California, San Diego, with funding from the Centers for Disease Control and Prevention, offers free nationwide telephone assistance for Chinese, Korean, and Vietnamese speakers who want to quit smoking.

To learn more about languages supported by your state’s quitline, including services provided to those who are deaf and hard-of-hearing, visit the NAQC Quitline Map. Simply click on your state to view the quitline profile page.

1. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf [PDF – 9.8 MB]
2. Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, 2008. https://www.ahrq.gov/prevention/guidelines/tobacco/clinicians/update/index.html
3. 2012 Task Force on Community Preventive Services review on Quitline Interventions. https://www.thecommunityguide.org/sites/default/files/assets/Tobacco-Quitlines.pdf [PDF – 550 KB]