What do South Dakota and 32 other states have in common? The answer is surprisingly successful telephone hotlines that help smokers kick the habit.
That changed last July when Stewart, of Rapid City, S.D., saw an advertisement for a smoker's helpline that promised to double his chances of quitting. Skeptical at first, he called the toll-free number and enrolled in a state-sponsored telephone-counseling program that offered him free medication, self-help tools and a sympathetic ear to walk him through nicotine withdrawals.
"Making that phone call is one of the best things I've ever done in my whole life," Stewart said in an interview three months after quitting. "I don't have any desire at all for a cigarette."
South Dakota is one of 33 states to setup smoking "quit-lines" in recent years that provide convenient counseling over the telephone to smokers like Stewart who have trouble quitting on their own.
California started the first smokers' helpline in 1992, followed by Massachusetts and Arizona. But after the national tobacco settlement of 1998, quit-lines have proliferated in 30 other states, funded by the settlement.
A new study published in the New England Journal of Medicine this month found that using telephone counseling more than doubles smokers' chances of quitting permanently.
This is good news for 46 million U.S. smokers, 70 percent of whom say they wish they could quit.
While only 6 percent of smokers were able to quit "cold turkey," the study performed by researchers at the University of California at San Diego found that 13 percent of smokers quit successfully when using the quit-line.
States like telephone help-lines because they reach more people, are available at all hours, and are more cost effective than group programs, said Angela Geiger, director of quit-lines for the American Cancer Society.
"The reason why telephone counseling has come into the public eye is that we now know it's just as effective as face-to-face counseling, which used to be considered the best care. But it's more convenient for smokers and more economical for states," Geiger told Stateline.org.
ACS is contracted to operate quit-lines for 10 states, including the one that helped Stewart in South Dakota.
Quit-line counselors first assess the readiness of callers to quit smoking. The counselor helps the smoker determine the best strategy to face their "quit date", sends self-help information and recommends possible nicotine replacement medications.
The counselor calls back four or five times over a three month period to help the smoker deal with nicotine withdrawals and cravings. The smoker can call the helpline 24-hours a day if they need additional support.
California, Massachusetts and Arizona, states with the longest running quit-lines and strongest tobacco control programs, have experienced the largest decrease in smoking rates and lung cancer in the past decade, Geiger said.