Seasonal variations in stage of change among Quitline clients: Figure 1

Telephone counselling is an effective smoking cessation intervention and over the past decade smoking cessation quitlines have rapidly proliferated across North America, Europe, Asia, and elsewhere.1–8 Despite the increase in quitlines, the published data are limited and tend to focus on call volume, demographic breakdown of callers, and/or overall abstinence rates.1,4–6 Numerous factors, including but not limited to dependence, self efficacy, and stage of change, are predictive of quit attempts and abstinence. Recent research suggests that cigarette smoking behaviours have a strong seasonal component,9–11 with higher consumption and initiation in summer months and lower consumption and higher cessation in winter months. Possible …