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Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
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Figure 1

Methodological quality summary: review authors' judgements about each methodological quality item for each included study.

Comparison 3. Interventions for callers to quitlines. Cessation at longest follow‐up
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Figure 2

Comparison 3. Interventions for callers to quitlines. Cessation at longest follow‐up

Comparison 4. Interventions for smokers not calling quitlines ‐ subgroups by baseline support. Cessation at longest follow‐up
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Figure 3

Comparison 4. Interventions for smokers not calling quitlines ‐ subgroups by baseline support. Cessation at longest follow‐up

Comparison 1 Interventions for callers to quitlines ‐ effect of additional proactive calls, Outcome 1 Cessation at longest follow‐up.
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Analysis 1.1

Comparison 1 Interventions for callers to quitlines ‐ effect of additional proactive calls, Outcome 1 Cessation at longest follow‐up.

Comparison 2 Interventions for callers to quitlines ‐ comparison of different support during a single call, Outcome 1 Cessation at longest follow‐up.
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Analysis 2.1

Comparison 2 Interventions for callers to quitlines ‐ comparison of different support during a single call, Outcome 1 Cessation at longest follow‐up.

Comparison 3 Offer of counselling via quitlines/helplines/hotlines, Outcome 1 Long term cessation.
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Analysis 3.1

Comparison 3 Offer of counselling via quitlines/helplines/hotlines, Outcome 1 Long term cessation.

Comparison 4 Interventions for smokers not calling quitlines ‐ subgroups by baseline support, Outcome 1 Cessation at longest follow‐up ‐ All trials, subgroups by amount of control group support.
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Analysis 4.1

Comparison 4 Interventions for smokers not calling quitlines ‐ subgroups by baseline support, Outcome 1 Cessation at longest follow‐up ‐ All trials, subgroups by amount of control group support.

Comparison 5 Interventions for smokers not calling quitlines ‐ subgroups by intensity: 1‐2, 3‐6, >6 calls, Outcome 1 Cessation at longest follow‐up.
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Analysis 5.1

Comparison 5 Interventions for smokers not calling quitlines ‐ subgroups by intensity: 1‐2, 3‐6, >6 calls, Outcome 1 Cessation at longest follow‐up.

Comparison 6 Interventions for smokers not calling quitlines ‐ subgroups by motivation, Outcome 1 Long‐term cessation.
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Analysis 6.1

Comparison 6 Interventions for smokers not calling quitlines ‐ subgroups by motivation, Outcome 1 Long‐term cessation.

Summary of findings for the main comparison. Interventions for callers to quitlines ‐ effect of additional proactive calls for smoking cessation

Interventions for callers to quitlines ‐ effect of additional proactive calls for smoking cessation

Patient or population: callers to quitlines
Intervention: additional proactive calls

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Additional proactive calls

Smoking cessation
self reported abstinence (majority)
Follow‐up: 6+ months

Study population

RR 1.38
(1.28 to 1.49)

30182
(12 studies)

⊕⊕⊕⊝
moderate2,3

76 per 10001

105 per 1000
(97 to 113)

Low

50 per 10001

69 per 1000
(64 to 75)

High

150 per 10001

207 per 1000
(192 to 224)

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Low control rate reflects lower end of range evident in trials; 4/12 had control rates < 5%. High control rate likely to be applicable for people also using pharmacotherapy
2 Estimated effect not sensitive to inclusion of studies judged at risk of bias
3 Heterogeneity evident; two UK studies had point estimates suggesting no effect of intervention.

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Summary of findings for the main comparison. Interventions for callers to quitlines ‐ effect of additional proactive calls for smoking cessation
Summary of findings 2. Proactive telephone counselling for smokers not calling quitlines

Proactive telephone counselling for smokers not calling quitlines

Patient or population: smokers not calling quitlines
Intervention: proactive telephone counselling

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Proactive telephone counselling

Cessation at longest follow‐up ‐ All trials, subgroups by amount of control group support
Self reported abstinence (majority)
Follow‐up: 6+ months

97 per 10001

123 per 1000
(116 to 132)

RR 1.27
(1.2 to 1.36)

30246
(51 studies)

⊕⊕⊕⊝
moderate2,3

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 Based on crude average of events/total, with participants lost to follow‐up assumed to be smoking. Interquartile range in trials 6‐20%. Higher baseline cessation rates typical amongst motivated populations receiving pharmacotherapy and some support Relative addtional benefit of telephone intervention may be smaller in this setting.
2 Effect estimate not sensitive to exclusion of studies without biochemical validation of abstinence.
3 In subgroup analyses, evidence of effect was clear when the control group received usual care, or brief advice or face to face counselling. Effect smaller and less certain when all participants received pharmacotherapy.

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Summary of findings 2. Proactive telephone counselling for smokers not calling quitlines
Comparison 1. Interventions for callers to quitlines ‐ effect of additional proactive calls

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cessation at longest follow‐up Show forest plot

12

30182

Risk Ratio (M‐H, Fixed, 95% CI)

1.38 [1.28, 1.49]

Figuras y tablas -
Comparison 1. Interventions for callers to quitlines ‐ effect of additional proactive calls
Comparison 2. Interventions for callers to quitlines ‐ comparison of different support during a single call

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cessation at longest follow‐up Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Reactive counselling vs self‐help materials

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Stage‐based counselling versus general information

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Tailored counselling versus standard counselling

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 2. Interventions for callers to quitlines ‐ comparison of different support during a single call
Comparison 3. Offer of counselling via quitlines/helplines/hotlines

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Long term cessation Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

1.1 Hotline and self‐help materials compared to self help only

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 Hotline and self‐help materials for cessation maintenance compared to nothing

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.3 Reactive or proactive counselling vs provider counselling

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figuras y tablas -
Comparison 3. Offer of counselling via quitlines/helplines/hotlines
Comparison 4. Interventions for smokers not calling quitlines ‐ subgroups by baseline support

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cessation at longest follow‐up ‐ All trials, subgroups by amount of control group support Show forest plot

51

30246

Risk Ratio (M‐H, Fixed, 95% CI)

1.27 [1.20, 1.36]

1.1 Self‐help or minimal intervention control

30

19134

Risk Ratio (M‐H, Fixed, 95% CI)

1.34 [1.22, 1.46]

1.2 Adjunct to brief intervention or counselling

11

3520

Risk Ratio (M‐H, Fixed, 95% CI)

1.41 [1.20, 1.66]

1.3 Adjunct to pharmacotherapy

11

7592

Risk Ratio (M‐H, Fixed, 95% CI)

1.14 [1.03, 1.27]

Figuras y tablas -
Comparison 4. Interventions for smokers not calling quitlines ‐ subgroups by baseline support
Comparison 5. Interventions for smokers not calling quitlines ‐ subgroups by intensity: 1‐2, 3‐6, >6 calls

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cessation at longest follow‐up Show forest plot

51

30490

Risk Ratio (M‐H, Fixed, 95% CI)

1.28 [1.20, 1.36]

1.1 Two sessions or fewer

9

6274

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.91, 1.26]

1.2 3‐6 sessions

34

19736

Risk Ratio (M‐H, Fixed, 95% CI)

1.32 [1.23, 1.42]

1.3 7 sessions or more

9

4480

Risk Ratio (M‐H, Fixed, 95% CI)

1.29 [1.11, 1.50]

Figuras y tablas -
Comparison 5. Interventions for smokers not calling quitlines ‐ subgroups by intensity: 1‐2, 3‐6, >6 calls
Comparison 6. Interventions for smokers not calling quitlines ‐ subgroups by motivation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Long‐term cessation Show forest plot

51

30246

Risk Ratio (M‐H, Fixed, 95% CI)

1.28 [1.20, 1.36]

1.1 Selected for motivation/ interest in quitting

16

10612

Risk Ratio (M‐H, Fixed, 95% CI)

1.30 [1.19, 1.42]

1.2 Not selected by motivation

35

19634

Risk Ratio (M‐H, Fixed, 95% CI)

1.26 [1.16, 1.38]

Figuras y tablas -
Comparison 6. Interventions for smokers not calling quitlines ‐ subgroups by motivation