title: Relapse-Prevention Booklets as an Adjunct to a Tobacco Quitline: A Randomized Controlled Effectiveness Trial.
abstract: BACKGROUND
  Relapse prevention (RP) remains a major challenge to smoking cessation. Previous research found that a set of self-help RP booklets significantly reduced smoking relapse. This study tested the effectiveness of RP booklets when added to the existing services of a telephone quitline.
  
  
  METHODS
  Quitline callers (N = 3458) were enrolled after their 2-week quitline follow-up call and randomized to one of three interventions: (1) Usual Care: standard intervention provided by the quitline, including brief counseling and nicotine replacement therapy; (2) Repeated Mailings (RM): eight Forever Free RP booklets sent to participants over 12 months; and (3) Massed Mailings: all eight Forever Free RP booklets sent upon enrollment. Follow-ups were conducted at 6-month intervals, through 24 months. The primary outcome measure was 7-day-point-prevalence-abstinence.
  
  
  RESULTS
  Overall abstinence rates were 61.0% at baseline, and 41.9%, 42.7%, 44.0%, and 45.9% at the 6-, 12-, 18- and 24-month follow-ups, respectively. Although RM produced higher abstinence rates, the differences did not reach significance for the full sample. Post-hoc analyses of at-risk subgroups revealed that among participants with high nicotine dependence (n = 1593), the addition of RM materials increased the abstinence rate at 12 months (42.2% vs. 35.2%; OR = 1.38; 95% CI = 1.03% to 1.85%; P = .031) and 24 months (45% vs. 38.8%; OR = 1.31; 95% CI = 1.01% to 1.73%; P = .046).
  
  
  CONCLUSIONS
  Sending self-help RP materials to all quitline callers appears to provide little benefit to deterring relapse. However, selectively sending RP booklets to callers explicitly seeking assistance for RP and those identified as highly dependent on nicotine might still prove to be worthwhile.
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL;
authors.forename: Marina
authors.initials: M
authors.lastname: Unrod
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL;
authors.forename: Vani N
authors.initials: VN
authors.lastname: Simmons
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL;
authors.forename: Steven K
authors.initials: SK
authors.lastname: Sutton
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC;
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.affiliation: Department of Health Behavior Roswell Park Cancer Institute, Buffalo, NY;
authors.forename: Paula
authors.initials: P
authors.lastname: Celestino
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL;
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Craig
authors.affiliation: Department of Internal Medicine University of New Mexico Cancer Center, Albuquerque, NM.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL;
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Meltzer
authors.affiliation: Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL; Department of Psychology, University of South Florida, Tampa, FL; thomas.brandon@moffitt.org.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
mesh_terms: D000328:Adult; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015277:Hotlines; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods*; D012907:Smoking / Q000523:psychology / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
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