Motivating smokers to quit using computer-generated letters that target either reduction or cessation: A population-based randomized controlled trial among smokers who do not intend to quit. (1st September 2016)

• Record Type: Journal Article
• Authors: Meyer, Christian; Ulbricht, Sabina; Haug, Severin; Broda, Anja; Bischof, Gallus; Rumpf, Hans-Jürgen; John, Ulrich
• Is Part Of: Drug and alcohol dependence. Volume 166(2016)
• Page Start: 177
• Page End: 186
• Publication Date: 2016-09-01
• Subjects: Smoking cessation -- Reduced smoking -- Computer expert system -- Self-help intervention -- Population-based interventions; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2016.07.009
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: Proactive interventions can reach general population smokers not intending to quit. Computer-based tailoring of counseling letters enables large scale implementation. Brief interventions are capable to trigger behavior change over 24 months. Targeting reduced smoking is effective in promoting smoking cessation. Abstract: Background: This study examined the long-term efficacy of individualized counseling letters that targeted either smoking abstinence or reducing the number of cigarettes smoked per day to promote future cessation. Methods: A nationwide random-digit-dialing telephone sample was used to identify smokers from the general adult population (participation proportion: 54.5%). In total, 1462 participants (48% female) who did not intend to quit within the next six months and who smoked ten or more cigarettes a day were randomized to one of two intervention groups or an assessment-only control condition. The interventions consisted of three tailored letters that were sent after baseline and follow-up assessments after three and six months. Follow-up data on smoking status were provided by 82% and 77% of the participants 12 and 24 months after study inclusion, respectively. Generalized estimation equation (GEE) models adjusted for potential baseline confounders and multiple imputation of missing follow-up data were used to estimate intervention effects. Results: At 24-month follow-up prevalence of 7-day point abstinence was 8.4%, 12.9% and 14.7% in the control, abstinence intervention and reduction intervention condition, which corresponds to a number needed to treat of 22 (95%-CI: 11–707) and 16 (95%-CI: 9–53). Adjusted GEE analyses revealed that the smoking reduction intervention (ORadj = 2.3, p < 0.01) but not the abstinence intervention (ORadj = 1.4, p = 0.20) increased the odds of 6-month prolonged abstinence compared with the control condition. No significant differences appear when directly comparing both intervention groups. Conclusion: Smoking reduction should be considered as an alternative intervention goal for smokers who are unable or unwilling to quit.