Format and Quitting Instructions as Factors Influencing the Impact of a Self-Administered Quit Smoking Program

Abstract

This article presents results from an experimental study designed to evaluate the effects of two features of self-help smoking cessation booklets, format (i.e., day-by- day plan for quitting versus a less structured menu format) and quitting instructions (i.e., "cold turkey" versus gradual reduction) on smoking cessation. Four separate self- help booklets were developed for comparison in this study. Each varied on a combina tion of the two study factors, but were similar in content, length, style, and readabil ity. The four booklets provided similar advice on how to quit smoking, emphasizing behavioral self-management principles. In addition to the experimental booklets, a fifth control booklet provided general information about smoking and its adverse effects, but no specific advice on quitting. Study subjects included 1,534 adult cigar ette smokers who called a stop smoking hotline in Buffalo, New York seeking informa tion on how to quit. Subjects were followed up by phone one month and six months after enrollment to assess changes in smoking behavior. Overall, 18% of subjects re ported being off cigarettes for at least one week at the time of the six month follow-up interview. The format of the booklet and quitting instructions had no effect on smoking cessation rates. In addition, the four booklets emphasizing behavioral self- management skills were no more effective than the control booklet (6 month non- smoking prevalence rate: 17% versus 19%). It is recommended that future self-help quit smoking booklets include information aimed at motivating cessation and focus less attention on teaching strategies for quitting.

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References

National Cancer Institute. The Smoking Digest: Progress Report On a Nation Kicking the Habit. Bethesda, Maryland. National Institutes of Health, Publication No. 79-1549, 1979.

Schachter S. : Recidivism and self-care of smoking and obesity . American Psychologist 37:436-444, 1982.

Schwartz JL , Dubitzky M. : Expressed willingness of smokers to try 10 smoking withdrawal methods. Pub Health Rep 82:855-861, 1967.

Glasgow RE , Rosen GM : Behavioral bibliotherapy: a review of behavior therapy manuals. Psych Bull 85:1-23, 1978.

Davis AL , Faust R. , Ordentlich M. : Self-help smoking cessation and maintenance programs: a comparative study with 12-month follow-up. Am J Pub Health 74: 1212-1217, 1984.

Erickson AC , Lieberman S. : Evaluation of alternative methods of helping smokers quit. UICC Tech Rep Series 64:22-31, 1982.

Windsor RA , Cutter G. , Morris J., et al. : The effectiveness of smoking cessation methods for smokers in public health maternity clinics: a randomized trial. Am J Pub Health 75:1389-1392, 1985.

Leventhal H. : Findings and theory in the study of fear communications. Adv Exp Soc Psych 5:119-186, 1970.

Bandura A. : Self-efficacy: toward a unifying theory of behavior change. Psych Bull 84:191-215, 1977.

10.

Levinson BL , Shapiro D. , Schwartz GE, et al. : Smoking elimination by gradual reduction. Behavior Therapy 2:477-487, 1971.

11.

Flaxman J. Quitting smoking now or later: gradual, abrupt, immediate, and delay quitting . Behavior Therapy 9:260-270, 1978.

12.

National Cancer Institute. Pretesting in Health Communications: Methods, Examples, and Resources for Improving Health Messages and Materials. Bethesda, Maryland : National Institutes of Health, Publication No. 84-1493, 1984.

13.

Kanfer F. : Self-management methods. In: F Kanfer, A Goldstein (eds). Helping People Change. New York, Pergamon Press, 1975.

14.

Perri MG , Richards CS , Schulthesis KR : Behavioral self-control and smoking cessation : a study of self-initiated attempts to reduce smoking. Behavior Therapy 8: 360-365, 1977.

15.

Lichenstein E. , Brown RA : Smoking cessation methods: review and recommendations . In WR Miller (ed). The Addictive Behaviors: Treatment of Alcoholism, Drug Abuse, and Smoking. Oxford , Pergamon Press, 1980.

16.

Neter J. Wasserman W. Applied Linear Statistical Models. Homewood, Illinois , Richard D Irwin, Inc, 1974.

17.

Prochaska JO , DiClemente CC Stages and processes of self-change of smoking: toward an integrative model of change. J of Consult Clinical Psych 51:390-395, 1983.

18.

Warner KE : Selling Smoke: Cigarette Advertising and Public Health. Washington, DC: American Public Health Association , 1986.

19.

Meyers ML , Iscoe C. , Jennings C., et al : Staff Report on The Cigarette Advertising Investigation. Washington, DC, Federal Trade Commission, May, 1981.