Many Quitlines establish specific protocols for working with different subgroups of callers. Protocols also vary with respect to how to manage a session: do the counselors follow a script and how fully scripted is this contact. How closely counselors are required to follow the scripts and what level of spontaneity is allowed will be determined by treatment fidelity expected. Historically, most Quitline protocols developed as a result of primary contact with male adult smokers in Asian Pacific settings. However, recently, gender and age specific protocols are being developed in the region for women and adolescent smokers as we are confronted with increasing smoking prevalence among these groups in Asia Pacific region. Development of protocols for patients with chronic diseases such as cancer, respiratory disease, and circular diseases, pregnant women, and group of smokers at specific high risks should be considered to reflect their health and social situation and needs.

For example, although adolescents are generally less motivated to quit smoking and show relatively low rates of ‘spontaneous’ quit attempts, the high prevalence of smoking in this section of society makes it vital that you develop and implement youth-led smoking cessation programs for adolescents. Protocols should reflect diversity of type of tobacco used in the region. The needs and characteristics of cigarette users and chewing tobacco users may be different and the contents of your counseling session should reflect this in your counseling protocol.

Some programs also target tobacco hard-core users who are not yet ready to quit. Public Quitlines must consider whether they will offer counseling to those who are not ready to quit in the near future. There is some evidence that telephone counseling can benefit even those who, at baseline, are not planning to quit.

You also need to have a protocol to help smokers who have very low motivation and self-efficacy to quit.