A Randomized Controlled Trial of Multiple Tailored Messages for Smoking Cessation Among Callers to the Cancer Information Service

Abstract

Self-help materials computer-tailored to the specific needs of smokers have shown promise as a high-reach, low-cost intervention for smoking cessation. Adding tailored cessation materials to telephone-based cessation counseling may be a way of generating greater efficacy in promoting and maintaining cessation. The objective of this study is to assess the efficacy of adding different types of behavioral smoking cessation materials to brief telephone-based cessation counseling.A total of 1,978 smokers calling the National Cancer Institute's (NCI's) Cancer Information Service (CIS) for help in quitting smoking initially received brief cognitive-behavioral cessation counseling from a CIS information specialist. Following a baseline interview administered by the information specialist, subjects were randomly assigned to one of four conditions, each delivered by U.S. mail: a single, untailored smoking cessation guide (SU); a single, tailored smoking cessation guide (ST); a series of four (multiple) printed materials tailored only to baseline data (MT); and a series of four (multiple) printed materials tailored to baseline as well as retailored using 5-month interim progress data (MRT). The primary outcome measure was 7-day point prevalence abstinence rates assessed using a computer-assisted telephone interview (CATI) at 12-month follow-up.At 12-month follow-up, using intent-to-treat, imputed, and per-protocol analyses, no differences were found among the four experimental conditions (linear trend), or when the ST, MT, and MRT groups were compared with the control (SU) group. Participants in the two multiple message group conditions combined (MT + MRT), however, had significantly higher abstinence rates than participants in the two single message group conditions combined (SU + ST). Moreover, among subjects who reported quitting at the 5-month follow-up, participants receiving the MRT materials reported higher abstinence rates at 12 months than the other three groups combined (SU + ST + MT). The results of this study support the effectiveness, over and above a single telecounseling interaction, of multiple tailored print material contacts on cessation. These effects, however may be due to tailoring, or the longitudinal nature of the two multiple tailored conditions, or both. The strongest evidence for tailoring occurred in the MRT condition for relapse prevention, suggesting that print materials tailored to interim progress may be especially effective in this context. The qualities of specific psychosocial and communication elements in tailored materials should receive attention in future research.

Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.

“…Overall, 30 studies 34,[36][37][38][39][40][42][43][44]46,48,49,53,[55][56][57][58]61,66,69,72,75,80,88,91,96,97,109,110 that randomised between 72 and 3627 participants and followed up between 3 and 30 months evaluated the effect of tailored printed materials. In the meta-analysis, computer-generated, tailored printed materials were effective in increasing smoking cessation compared with no intervention or generic self-help materials.…”

“…Loss to follow-up ranged from as low as 11% at 6 months 44 to 56% at 12 months. 75 Six studies 39,43,49,55,57,115 reported significant difference between intervention groups at baseline.…”

“…Strecher et al 75 compared the effectiveness of the following four interventions when added to a brief cognitive-behavioural cessation telephone counselling: (a) a single, untailored smoking cessation guide; (b) a single, computer-tailored smoking cessation guide; (c) a series of four printed materials tailored only to baseline data; and (d) a series of four printed materials initially tailored to baseline data and subsequently retailored to follow-up data at 5 months. Point prevalence abstinence at 12 months was 8.1%, 7.2%, 10.3% and 10.5% for groups a, b, c and d, respectively.…”

“…Four studies 48,49,58,88 included pharmacotherapy as a co-intervention in each of the study arms; two studies 75,97 included telephone counselling as a co-intervention, while another study 61 included brief advice. Seven studies, 36,46,49,58,61,66,97 including four mentioned above, 49,58,61,97 had generic self-help material as a co-intervention in each of the study arms.…”

Smoking cessation: Next steps for special populations research and innovative treatments.

“…Researchers can use computer algorithms, online coaching, and proactive e-mail prompts to tailor treatment, or users can self-tailor by the use of chat rooms and selective browsing. E-Health can be used as a stand-alone treatment or as a treatment adjunct (Strecher et al, 2005). Research is needed to identify the active ingredients of this modality, as well as the efficacy of such emerging platforms as text messaging, social networking, and Twitter (e.g., Riley et al, 2008).…”