• Taghrid Asfar, Jon O Ebbert, Robert C Klesges, and James L Klosky.
• Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 735, Memphis, TN 38105, USA.
• Addict Behav. 2012 Apr 1; 37 (4): 583-6.

IntroductionTobacco quitlines (QLs) are efficacious and have assisted many smokers in achieving tobacco abstinence. However, most smokers are not able to achieve tobacco abstinence with QL services. QL counseling interventions for smokers who do not quit on their target quit date (TQD) and decline to set a new TQD after missing their TQD have not been systematically evaluated.MethodsA telephone survey of tobacco QLs in the United States (US) was conducted to examine systematic approaches used with smokers who do not quit on their TQD and decline to set a new TQD. Tobacco QLs service providers were identified through the North American Quitline Consortium (NAQC).ResultsFourteen service providers managing QLs of all 50 US states were identified and completed the voluntary survey. All providers recommended setting a new quit TQD if smokers did not achieve smoking cessation by their initial TQD. Six percent of US state QLs used brief motivational interviewing utilizing the "5R's" (relevance, risk, rewards, roadblocks, repetition). However, 90% of QLs had intervention protocols emphasizing smoking rate reduction.ConclusionAlthough some US QLs utilized the "5Rs," the majority provided smoking reduction interventions for smokers not achieving tobacco cessation by their initial TQD and declining to set a new TQD. Research is needed to evaluate the efficacy of smoking rate reduction methods implemented through QLs for increasing smoking abstinence rates.Copyright © 2012 Elsevier Ltd. All rights reserved.

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