Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
To the Editor: The article by Dr Hughes and
colleagues1 summarizing the recent advances in the
pharmacotherapy of smoking was a much-needed update to the medical
literature and provided valuable information for clinical physicians.
However, an aspect that needs clarification is the most efficacious
implementation strategy for adjunctive counseling used in a tobacco
cessation program. Hughes et al suggest that behavioral therapy
strategies with patients by telephone can be used rather than
traditional face-to-face counseling. The Agency for Health Care Policy
and Research meta-analytic review of tobacco cessation programs clearly
stated that there is a dose-response relationship between the duration
and length of counseling, and suggested a 20 min/wk session for at
least 4 weeks. Lichtenstein et al2 suggest that telephone
counseling can be effective but do not suggest it is as effective as
face-to-face counseling. To our knowledge, there is no published
empirical evidence directly comparing the 2 modalities for smoking
Deagle III EA, Berigan TR. Adding Behavioral Therapy to Medication for Smoking Cessation. JAMA. 1999;281(21):1983–1985. doi:10.1001/jama.281.21.1983
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