Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation
ABSTRACT A stage-matched expert system intervention was evaluated on 4144 smokers in a two-arm randomized control trial with four follow-ups over 24 months. Smokers were recruited by random digit-dial calls, and 80.0% of the eligible smokers were enrolled. Individualized and interactive expert system computer reports were sent at 0, 3, and 6 months. The reports provided feedback on 15 variables relevant for progressing through the stages. The primary outcomes were point prevalence and prolonged abstinence rates. At 24 months, the expert system resulted in 25.6% point prevalence and 12% prolonged abstinence, which were 30% and 56% greater than the control condition. Abstinence rates at each 6-month follow-up were significantly greater in the Expert System (ES) condition than in the comparison condition with the absolute difference increasing at each follow-up. A proactive home-based stage-matched expert system smoking cessation program can produce both high participation rates and relatively high abstinence rates.
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ABSTRACT: The present longitudinal study investigates baseline assessments of static and dynamic variables, including demographic characteristics, smoking severity, and Transtheoretical Model of Behavior Change (TTM) effort variables (Decisional Balance (e.g. Pros and Cons), Situational Temptations, and Processes of Change) of relapse among individuals who were abstinent at 12-months. The study sample (N = 521) was derived from an integrated dataset of four population-based smoking cessation interventions. Several key findings included: Participants who were aged 25-44 and 45-64 (OR = .43, p = .01 and OR = .40, p = .01, respectively) compared to being aged 18-24 were less likely to relapse at follow-up. Participants in the control group were more than twice as likely to relapse (OR = 2.17, p = .00) at follow-up compared to participants in the treatment group. Participants who reported higher Habit Strength scores were more likely to relapse (OR = 1.05, p = .02). Participants who had higher scores of Reinforcement Management (OR = 1.05, p = .04) and Self-Reevaluation (OR = 1.08, p = .01) were more likely to relapse Findings add to one assumption that relapsers tend to relapse not solely due to smoking addiction severity, but due to immediate precursor factors such as emotional distress. One approach would be to provide additional expert guidance on how smokers can manage stress effectively when they enroll in treatment at any stage of change.Addictive Behaviors 03/2015; 42. · 2.02 Impact Factor
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ABSTRACT: Tobacco addiction: The impact of health education and clinical treatment on the total population of smokers Health education and clinical treatment are two different approaches to tobacco control. This paper reviews the literature with respect to the effectiveness and population impact of both approaches. Health education has the strongest population impact through mass media campaigns that stimulate quit attempts among smokers. Both why-to-quit and how-to-quit campaigns can be effective. Clinical treatment through either pharmacotherapy or behavioural therapy is highly efficacious on the individual level, especially if they are provided to smokers in tandem. However, they play a marginal role in reaching population targets. This paper further explores how the population reach of efficacious treatment can be improved. An important avenue is to try to change smokers' perceptions of treatment. It is concluded that smokers need to be educated on the availability and effectiveness of various treatment options. Moreover, misperceptions about the role of willpower and motivation need to be addressed. Another route is through the health care sector. Physicians have a crucial role to play, but this role has not yet been fully realized. It is argued that clinical treatment of tobacco addiction is crucial in a comprehensive tobacco control policy, because it offers smokers who cannot quit on their own, much needed support. While mass media anti-tobacco campaigns and further regulation of tobacco use augment quitting activity in population, they marginalize smokers in more deprived socio-economic groups, further increasing the social gradient in smoking prevalence. The government has a moral obligation to invest more money in providing effective treatment pro-actively to lower SES smokers.Gedrag & gezondheid 09/2010; 38(3).
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ABSTRACT: Goodridge, D., Quinlan, E., Venne, R., Hunter, P.V., & Surtees, D. (2013). Planning for Serious Illness by the General Public: A Population-Based Survey. Family Practice, 2013, 1-8.Family Practice 12/2013; 2013:1-8. · 1.83 Impact Factor