National Minimum Quitline™ Standards

Telephone quitlines provide an effective form of behavioural intervention for smoking cessation when used alone or in combination with smoking cessation medications, such as nicotine replacement therapy formulations, Champix (varenicline) or Zyban (bupropion).^1,2 Using a multi-session behavioural intervention, such as that provided by quitline, as an adjunct to smoking cessation medications increases cessation rates compared to pharmacotherapy use alone.^3,4

As with any behavioural intervention, the effectiveness of quitlines may vary between services, depending on factors such as the intensity of the interventions, the level of resourcing provided and the quality and fidelity of counselling. However, people wanting support to quit, health and other professionals who refer to the service and funders should, and do, expect that all quitlines meet standards that ensure high quality and effective clinical care.

Cancer Council Victoria developed the first quitline in the world, and quitlines have now been widely adopted throughout Australia, United States, Canada and Europe⁵. Quitlines are described in Article 14 of the Framework Convention on Tobacco Control (FCTC), Demand reduction measures concerning tobacco dependence and cessation, as an integral component of a tobacco-dependence treatment system.⁶

The goal of the National Minimum Quitline™ Standards (NMQS) is to ensure that all Australians who smoke have access to a high quality, effective and inclusive multi-session behavioural intervention for smoking cessation provided under the Cancer Council’s trademark, Quitline™.

These NMQS were developed using both evidence-based and evidence-informed approaches. The Standards were reviewed and approved by an external Expert Advisory Group (see below) whose members have extensive experience in delivering and/or evaluating best practice quitlines and counselling or related services.

Methodology to develop National Minimum Quitline™ Standards

The strength of the approach used to develop the NMQS was bringing together a thorough examination of the published evidence with the expertise and practical experience of clinicians and other experts to develop minimum standards that can be implemented in real world situations.

There were three parts to the development of the NMQS:

1. A literature review, Evidence for smoking quitlines: an Evidence Check rapid review was commissioned by the Sax Institute (on behalf of the Cancer Council) and undertaken by the University of SA to assess the evidence of effectiveness for quitlines.⁷ This literature review, plus key documents relevant to contact centres (including the Australian Standards for Australian Health Contact Centres⁸) were used to develop draft NMQS.
2. The Expert Advisory Group convened to discuss, amend and add to the draft NMQS based on evidence from the published literature and their own expertise.
3. Feedback from stakeholders, including funders and operators, was sought on the draft NMQS and used to finalise the NMQS in consultation with the Expert Advisory Group.

The following contributors developed the NQMS on behalf of Cancer Council Victoria:

• Dr Donita Baird, Quality Consultant to Quitline Victoria
• Ms Emma Dean, clinical pharmacist and Population Health Lead, Alfred Health
• Ms Kate Purcell, Consultant to Quit Victoria
• Dr Catherine Segan, Behavioural Scientist, Quit Victoria
• Mr Lindsay Whelan, Quitline Manager, Quit Victoria
• Dr Sarah White, Director, Quit Victoria

The NQMS were reviewed and approved by an Expert Advisory Group composed of:

• Professor Amanda Baker, University of Newcastle, and President of the Australian Association of Cognitive and Behavioural Therapy
• Professor Ron Borland, University of Melbourne
• Ms Jacinta Connor, Senior Policy Officer, Australian Psychological Society
• Mr Rick Loos, Manager, DirectLine (alcohol counselling service)
• Professor Hayden McRobbie, Professor of Public Health Interventions at Barts and The London School of Medicine and Dentistry, Queen Mary University of London (UK)
• Mr AJ Williams-Tchen, accredited mental health social worker and Aboriginal (Wiradjuri / Wotjobulak) counsellor

The NMQS were published in January 2021. For information on the NMQS, please email quitline@cancervic.org.au

References

1. Matkin W, Ordonez-Mena JM, Hartmann-Boyce J. Telephone counselling for smoking cessation. Cochrane Database Syst Rev 2019; 5: CD002850.
2. Services USDoHaH. Smoking Cessation. A Report of the Surgeon General. In: Centres for Disease Control and Prevention UDoHaHS, editor. Atlanta, GA: U.S. Department of Health and Human Services; 2020.
3. Kotz D, Brown J, West R. Prospective cohort study of the effectiveness of smoking cessation treatments used in the "real world". Mayo Clin Proc 2014; 89(10): 1360-7.
4. Hartmann-Boyce J, Hong B, Livingstone-Banks J, Wheat H, Fanshawe TR. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev 2019; 6(6): CD009670-CD.
5. Anderson CM, Zhu SH. Tobacco quitlines: looking back and looking ahead. Tobacco control 2007; 16 Suppl 1(Suppl 1): i81-i6.
6. World Health Organization. Guidelines for implementation of Article 14. In: Control FfCoT, editor. Geneva: World Health Organisation; 2010.
7. Carson-Chahhoud KZ, Kopsaftis Z, Sharrad K, Esterman A. Evidence for smoking quitlines: an Evidence Check rapid review brokered by the Sax Institute for the Cancer Council Victoria, 2019. Sydney, NSW: The Sax Institute, 2019.
8. Standards Australia. Australian Health Contact Centres AS5205. Sydney, NSW: Standards Australia; 2019.