Computer-tailored program increases smoking cessation rates


WESTPORT, CT (Reuters Health) – A computer-tailored smoking cessation intervention appears to boost the rate of abstinence at 7 months after entry into the program.

In a randomized, controlled trial, Dr. Jean-Francois Etter and Dr. Thomas Perneger from the University of Geneva, Switzerland, examined the effectiveness of a new computer-tailored smoking cessation program versus no intervention.

Potential participants were recruited by mail after being randomly selected from a general population register, the investigators explain, and 2934 daily cigarette smokers were randomized to either the program or no intervention. "A mean of 1.5 times per 6 months, participants in the active arm received by mail a computer-tailored counseling letter based on their answers to a questionnaire and stage-matched booklets," they report.

The letters were tailored to the subjects' stage of change (precontemplation, contemplation, or preparation), level of tobacco dependence, self-efficacy and personal characteristics, according to a report in the November 26th issue of the Archives of Internal Medicine. Self-reported abstinence (no smoking in past 4 weeks) 7 months after baseline was the main outcome measure.

The 4-week abstinence rate was 2.6 times greater in the intervention group patients than in the control group patients, at 5.8% and 2.2%, respectively (p < 0.001).

The investigators report that the program was effective in precontemplators who were not motivated to abstain from smoking before study entry. Among these subjects, 3.8% of the intervention group achieved smoking abstinence, compared with 0.8% of the control group (p = 0.001). The program was effective "regardless of perceived difficulty in quitting smoking at baseline," the authors note.

"In a multivariate model, statistically significant predictors of 4-week abstinence were participation in the program (odds ratio [OR] = 2.8), having made a quit attempt in the previous year (OR = 1.6), stage of change (OR = 2.0 per stage), and time to the first cigarette in the morning, an indicator of tobacco dependence (OR = 1.1 per hour) (p < 0.03 for all)," they report.

"Because it can reach a large number of smokers, this program can substantially contribute to disease prevention at a population level," Drs. Etter and Perneger conclude.

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