Comparing Computer-Tailored, Internet-Based Smoking Cessation Counseling Reports with Generic, Untailored Reports: A Randomized Trial

To assess and compare the impact on quit attempts of online computer-tailored smoking cessation counseling reports and untailored reports, we performed a randomized controlled trial on a smoking cessation website in 2007–2008. After answering a questionnaire, current and former smokers were randomly assigned to immediately receiving either an online, individually tailored counseling report or a personalized but untailored generic report. Participants were invited by e-mail to report any smoking in the previous 24 hours, 48 hours after baseline. We used an intention-to-treat analysis, where nonrespondents at follow-up were counted as smokers. There were 2,872 participants at baseline and 2,226 at follow-up (78%). At baseline, there were 76% of current smokers (mean = 18 cigarettes/day) and 24% of recent quitters (median = 7 days of abstinence). The same proportion of smokers in both study groups had made a 24-hour quit attempt at follow-up (12.1%, P = 1.0). In baseline recent quitters, lapse/relapse rates at follow-up were similar in both groups (tailored: 25.1%, untailored: 23.5%, P = 0.64). We conclude that untailored reports were as effective as tailored reports in the short term. Even though these particular computer-tailored reports were not more effective than untailored reports, meta-analyses show that computer-tailored documents are in general more effective than untailored ones.

[1]  W F Velicer,et al.  Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. , 1993, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[2]  Leslie Lenert,et al.  Research Paper: Automated E-mail Messaging as a Tool for Improving Quit Rates in an Internet Smoking Cessation Intervention , 2004, J. Am. Medical Informatics Assoc..

[3]  S. Shiffman,et al.  Randomized controlled trial of a web-based computer-tailored smoking cessation program as a supplement to nicotine patch therapy. , 2005, Addiction.

[4]  Yi Tsong,et al.  Some fundamental issues with non‐inferiority testing in active controlled trials , 2002, Statistics in medicine.

[5]  T V Perneger,et al.  Distributions of smokers by stage: international comparison and association with smoking prevalence. , 1997, Preventive medicine.

[6]  T. Perneger,et al.  A comparison of cigarette smokers recruited through the Internet or by mail. , 2001, International journal of epidemiology.

[7]  Sarah M. Greene,et al.  Web-based smoking-cessation programs: results of a randomized trial. , 2008, American journal of preventive medicine.

[8]  L. Stead,et al.  Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library , 2000, BMJ : British Medical Journal.

[9]  M. Fiore,et al.  Treating tobacco use and dependence: an evidence-based clinical practice guideline for tobacco cessation. , 2002, Chest.

[10]  Jean-François Etter,et al.  Administering an effective health intervention for smoking cessation online: the international users of Stop-Tabac. , 2004, Preventive medicine.

[11]  J. Prochaska,et al.  In Search of How People Change: Applications to Addictive Behaviors , 1992, The American psychologist.

[12]  L. Stead,et al.  Self-help interventions for smoking cessation. , 2005, The Cochrane database of systematic reviews.

[13]  V. Strecher.  Computer-tailored smoking cessation materials: a review and discussion. , 1999, Patient education and counseling.

[14]  J. Brug,et al.  The impact of a computer-tailored nutrition intervention. , 1996, Preventive medicine.

[15]  A. Washton,et al.  Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors , 1986 .

[16]  N. Benowitz.  Cigarette smoking and nicotine addiction. , 1992, The Medical clinics of North America.

[17]  Dennis M. Donovan,et al.  Relapse prevention: Maintenance strategies in the treatment of addictive behaviors, 2nd ed. , 2005 .

[18]  Sid J. Schneider,et al.  Computerized communication as a medium for behavioral smoking cessation treatment: controlled evaluation , 1990 .

[19]  Ehud Reiter,et al.  Lessons from a failure: Generating tailored smoking cessation letters , 2003, Artif. Intell..

[20]  T V Perneger,et al.  Effectiveness of a computer-tailored smoking cessation program: a randomized trial. , 2001, Archives of internal medicine.

[21]  T V Perneger,et al.  Validity of the Fagerström test for nicotine dependence and of the Heaviness of Smoking Index among relatively light smokers. , 1999, Addiction.

[22]  Jean-François Etter,et al.  Nicotine replacement therapy for long-term smoking cessation: a meta-analysis , 2006, Tobacco Control.

[23]  T V Perneger,et al.  On quitting smoking: development of two scales measuring the use of self-change strategies in current and former smokers (SCS-CS and SCS-FS). , 2000, Addictive behaviors.

[24]  Majid Ezzati,et al.  Estimates of global mortality attributable to smoking in 2000 , 2003, The Lancet.

[25]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[26]  Russel L. Thompson,et al.  A Meta-Analysis of Response Rates in Web- or Internet-Based Surveys , 2000 .

[27]  A Dijkstra,et al.  Tailoring information to enhance quitting in smokers with low motivation to quit: three basic efficacy questions. , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[28]  T. Perneger,et al.  Development and validation of the Attitudes Towards Smoking Scale (ATS-18). , 2000, Addiction.

[29]  J. Etter.  Using New Information Technology to Treat Tobacco Dependence , 2002, Respiration.

[30]  R. Glasgow,et al.  Evaluating the public health impact of health promotion interventions: the RE-AIM framework. , 1999, American journal of public health.

[31]  Jean-François Etter,et al.  Comparing the Efficacy of Two Internet-Based, Computer-Tailored Smoking Cessation Programs: A Randomized Trial , 2005, Journal of medical Internet research.

[32]  S. Noar,et al.  Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. , 2007, Psychological bulletin.

[33]  J. Brug,et al.  Computer-tailored interventions motivating people to adopt health promoting behaviours: introduction to a new approach. , 1999, Patient education and counseling.

[34]  T. Brandon,et al.  Tailored interventions for motivating smoking cessation: using placebo tailoring to examine the influence of expectancies and personalization. , 2005, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[35]  Paul Aveyard,et al.  Cluster randomised controlled trial of expert system based on the transtheoretical (“stages of change”) model for smoking prevention and cessation in schools , 1999, BMJ.

[36]  T. Brandon,et al.  Expectancy priming of smoking cessation messages enhances the placebo effect of tailored interventions. , 2007, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[37]  T. Perneger,et al.  Development and validation of a scale measuring self-efficacy of current and former smokers. , 2000, Addiction.

[38]  Beth Bock,et al.  Smoking cessation treatment on the Internet: content, quality, and usability. , 2004, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.