Helping smokers to decide on the use of efficacious smoking cessation methods: a randomized controlled trial of a decision aid (original) (raw)
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Asian Pacific Journal of Cancer Prevention
Objective: Addictions can be beaten if started off with a true motivation to quit it. Enhancing motivation is an important part of overall treatment for smoking cessation as it increases a smoker's courage and enthusiasm to quit smoke. This study aimed to assess effectiveness of various interventional methods to motivate unmotivated smokers with a focus on changing behavioural stage of smokers to quit. Methodology: A single blinded trial was conducted at the outpatient department of ITS dental college and hospital among precontemplation stage smokers allocated into 4 groups and given interventional therapies like general counselling only(group 1), counselling and intra oral camera assessment (Group 2), counselling as well as carbon monoxide monitoring(Group 3)whereas fourth group(Group 4) given a combination therapy of all of them. A baseline evaluation of nicotine dependence and behavioural stage of the smoker was assessed. The patients were then evaluated on presence on their scheduled follow up visits done at interval of 2 weeks and 4 weeks. Descriptive statistics were addressed and the association was evaluated using Pearson chi square test. Any p value less than 0.05 was considered statistically significant. Results: Majority of smokers were males(88%) and about 48.8% of them were highly dependent smokers. The change in precontemplation behavioural stage was assessed on basis of follow up visits after interventional therapy which was significantly higher in group 4 receiving combination therapy, followed by carbon monoxide therapy ,counselling and intra oral camera assessment and the least visits in behaviour counselling group (p<0.05). Conclusion: A combination of counselling and other motivational aids therapy is best way possible to help smokers focusing a change on the behavioural stage of the patient from precontemplation to preparation stage.
Impact of a Brief Motivational Smoking Cessation Intervention
American Journal of Preventive Medicine, 2009
BACKGROUND-Few studies have rigorously evaluated whether providing biologically-based health risk feedback increases smokers' motivation to quit and long-term abstinence above standard interventions.
Health Psychology, 1998
Tailoring information to a target individual's features is a promising line of development in self-help interventions. In this article, 752 smokers with explicit low intention to quit were randomly assigned to 1 of 5 conditions: (a) multiple tailored letters with self-help guide, (b) multiple tailored letters only, (c) a single tailored letter with a self-help guide, (d) a single tailored letter only, or (e) a nontailored intervention. Follow-up assessment took place 4 months after the intervention. Results indicated that the single tailored intervention only had no surplus value compared with a nontailored look-alike intervention. The addition of a self-help guide to a tailored intervention was only useful in highly dependent smokers, and multiple tailoring was more effective than single tailoring. It remains important to elucidate why and for whom certain tailored interventions are more effective.
Addiction, 2004
Aims Despite the existence of effective cessation methods, the vast majority of smokers attempt to quit on their own. To date, there is little evidence to explain the low adoption rates for effective forms of cessation assistance, including pharmaceutical aids. This study sought to assess smokers' awareness and perceived effectiveness of cessation methods and to examine the relationship of this knowledge to cessation behaviour. Design A random-digit-dial telephone survey (response rate = 76%) with 3month follow-up was conducted with 616 adult daily smokers in South-Western Ontario, Canada. Measurements A baseline survey assessed smoking behaviour, as well as smokers' awareness and perceived effectiveness of cessation assistance. A follow-up survey measured changes in smoking behaviour and adoption of cessation assistance at 3 months. Findings Participants demonstrated a poor recall of cessation methods: 45% of participants did not recall nicotine gum, 33% did not recall the nicotine patch and 57% did not recall bupropion. Also, many participants did not believe that the following cessation methods would increase their likelihood of quitting: nicotine replacement therapies (36%), bupropion (35%), counselling from a health professional (66%) and group counselling/quit programmes (50%). In addition, 78% of smokers indicated that they were just as likely to quit on their own as they were with assistance. Most important, participants who perceived cessation methods to be effective at baseline, were more likely to intend to quit (OR = 1.80, 95% CI: 1.12-2.90), make a quit attempt at follow-up (OR = 1.80, 95% CI: 1.03-3.16) and to adopt cessation assistance when doing so (OR = 3.62, 95% CI: 1.04-12.58). Conclusions This research suggests that many smokers may be unaware of effective cessation methods and most underestimate their benefit. Further, this lack of knowledge may represent a significant barrier to treatment adoption.
The modification of smoking behavior: Progress and problems
Addictive Behaviors, 1976
A review of recent controlled, experimental research on the modification of cigarette smoking behavior led to conclusions that (a) activity in the field is still vigorous, (b) some progress in terms of treatment effectiveness, research methodology, and target conceptualizations has been made during the past 6 yr, particularly by those adopting a social-learning approach, and (c)certain methodological and conceptual problems remain and must be eliminated if knowledge in the area is to continue to advance. 89 A.B. Vol. I, No ?-A *The general public may have reached this conclusion as well. A recent poll (Gallup, 1974) indicated that only 34% of smokers wishing to quit are interested in attending a clinic. The majority seem to prefer a "do-it-yourself" program (Schwartz & Dubitzky. 1968).
2008
This study was based on a ten-year follow-up of smokers who had participated in a randomized controlled trial of a behavioral self-help program for smoking cessation. The original sample was made up of 200 smokers assigned at random to two treatment groups. Ten years later 93.5% (n = 187) of the sample were successfully located (of the 13 not located, 6 had died), from whom information was obtained about their current state and the evolution of their smoking over the 10-year period. Reported abstinence at this follow-up was confirmed by carbon monoxide in expired air. Significant differences were found in the abstinence rates of the two groups at the follow-ups 1 year (14% vs. 28%) and 2 years (13% vs. 24%) after the end of the treatment. After 10 years 26% (n = 52) of the total sample were abstinent. Over the ten-year period, 62.0% tried to give up smoking at some point, the mean figure for attempts being 1.3. According to the results of the 10-year follow-up, low nicotine dependence at pretreatment is a major factor predicting long-term cessation in smokers.
2015
AimsTo screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit.DesignA balanced, 4-factor, randomized factorial experiment.SettingEleven primary care clinics in southern Wisconsin, USA.Participants517 adult smokers (63% women, 91% White) recruited during primary care visits who were willing to reduce their smoking but not quit.InterventionsFour factors contrasted intervention components designed to reduce smoking and promote abstinence: 1) nicotine patch vs. none; 2) nicotine gum vs. none; 3) motivational interviewing (MI) vs. none; and 4) behavioral reduction counseling (BR) vs. none. Participants could request cessation treatment at any point during the study.MeasurementsThe primary outcome was percent change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percent change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment.FindingsThere were few main effects, but a significant 4-way interaction at 26-weeks post-study enrollment (p=.01, β = .12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (p=.04), and nicotine gum, when used without MI, increased abstinence after a subsequent aided quit attempt (p=.01).ConclusionsMotivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit.
Interest in treatments to stop smoking
Journal of Substance Abuse Treatment, 2009
We surveyed 884 Vermont (VT) tobacco smokers by random digit dialing to determine past and future use of treatment. Among those who had recently attempted to quit, 61% had ever used a treatment, 21% had ever used a psychosocial treatment, and 57% had used a medication. Among those who planned to quit in the next month, 68% stated they would use a treatment, 35% would use a psychosocial treatment, and 62% would use a medication. The major predictors of past or future use of treatment were greater cigarettes per day, older age, being a woman, and seeing a health professional. Although this survey suggests many smokers have used or plan to use a smoking cessation treatment, program data indicate less than 10% of VT smokers who try to quit use the state quitline, counseling, or free medication provision. Why smokers do not use these treatments needs to be determined.
Clinical Cancer Research, 2014
Illnesses that are caused by smoking remain as the world's leading cause of preventable death. Smoking and tobacco use constitute approximately 30% of all cancer-related deaths and nearly 90% of lung cancerrelated deaths. Thus, improving smoking cessation interventions is crucial to reduce tobacco use and assist in minimizing the burden of cancer and other diseases in the United States. This review focuses on the existing research on framed messages to promote smoking cessation. Consistent with the tenets of prospect theory and recent meta-analysis, gain-framed messages emphasizing the benefits of quitting seem to be preferable when working with adult patients who smoke tobacco products. The evidence also suggests that moderators of treatment should guide framed statements made to patients. Meta-analyses have provided consistent moderators of treatment such as need for cognition, but future studies should further define the specific framed interventions that would be most helpful for subgroups of smokers. In conclusion, instead of using loss-framed statements like "Smoking will harm your health by causing problems like lung and other cancers, heart disease, and stroke," as a general rule, physicians should use gain-framed statements like "Quitting smoking will benefit your health by preventing problems like lung and other cancers, heart disease, and stroke." Clin Cancer Res; 20(2); 301-9. Ó2014 AACR.
Addiction (Abingdon, England), 2015
To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. A balanced, four-factor, randomized factorial experiment. Eleven primary care clinics in southern Wisconsin, USA. A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none; (2) nicotine gum versus none; (3) motivational interviewing (MI) versus none; and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. The primary outcome was percentage change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. There were few mai...