Effectiveness of a computer-tailored smoking cessation program: a randomized trial.
BACKGROUND
From a public health perspective, prevention of cancer and cardiovascular diseases requires effective smoking cessation programs that can be used on a large scale.


OBJECTIVE
To test the effectiveness of a new computer-tailored smoking cessation program vs no intervention.


METHODS
Randomized controlled trial, in the French-speaking part of Switzerland, September 20, 1998, to December 31, 1999. Potential participants were randomly selected from a general population register and recruited by mail. Daily cigarette smokers who wished to participate (N = 2934) 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. The counseling letters were tailored to the participants' stage of change (categorized as precontemplation [no intention of quitting smoking in the next 6 months], contemplation [seriously considers quitting in the next 6 months], or preparation [has decided to quit in the next 30 days]), level of tobacco dependence, self-efficacy, and personal characteristics. The outcome measure was self-reported abstinence (no puff of tobacco smoke in the past 4 weeks) 7 months after entry into the program.


RESULTS
Abstinence was 2.6 times greater in the intervention group than in the control group (5.8% vs 2.2%, P<.001). The program was effective in "precontemplators" who were not motivated to quit smoking at baseline (intervention vs control, 3.8% vs 0.8%; P =.001) and was effective regardless of perceived difficulty in quitting smoking at baseline.


CONCLUSIONS
The program was effective in increasing smoking cessation rates. Because it can reach a large number of smokers, this program can substantially contribute to disease prevention at a population level.
Etter
J F
JF
Institute of Social and Preventive Medicine, University of Geneva, CMU, case postale, CH-1211 Geneva 4, Switzerland. etter@cmu.unige.ch
Perneger
T V
TV
D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015397:Program Evaluation; D012044:Regression Analysis; D016540:Smoking Cessation / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome