title: An Online Documentary Film to Motivate Quit Attempts Among Smokers in the General Population (4Weeks2Freedom): A Randomized Controlled Trial.
abstract: BACKGROUND
  Online motivational films to promote quit attempts could encourage large numbers of smokers to stop at low unit cost. We evaluated an online film documenting the experiences of smokers who recorded the first month of their successful attempts to quit (4Weeks2Freedom). The film was designed to boost motivation and self-efficacy and provide role-models to promote ex-smoker identities.
  
  
  METHODS
  This was a randomized trial with individual assignment to a no-intervention control (n = 1016), an informational film (n = 1004), or 4Weeks2Freedom (n = 999). The development of 4Weeks2Freedom was informed by PRIME theory and focus-group testing with smokers. The 90-minute film was available online to view in one sitting or as chapters over 4 weeks to coincide with the progress of an attempt. The primary outcome was a quit attempt in the 4 weeks between assignment and study endpoint by intent-to-treat.
  
  
  RESULTS
  Participants smoked a mean of 13 cigarettes per day and 31% reported not wanting to stop. At follow-up, 55% reported viewing the informational control film and 56% viewing 4Weeks2Freedom. There was no detectable effect compared with the no-intervention control (OR = 0.99, 95% CI = 0.81 to 1.21, 24.3% vs. 24.5%) or informational control film (OR = 0.99, 95% CI = 0.80 to 1.21, 24.3% vs. 24.6%). Calculation of Bayes factors ruled out insensitive data and indicated the intervention was no more effective than either the no-intervention control (Bayes factor = 0.20) or informational control film (Bayes factor = 0.27). The pattern of results was unchanged in sensitivity analyses that examined the effect among only those who viewed the films.
  
  
  CONCLUSIONS
  The online documentary film (4Weeks2Freedom) designed to boost motivation and self-efficacy and to promote ex-smoker identity does not appear to prompt quit attempts among smokers.
  
  
  CONCLUSIONS
  This trial found that an online documentary film (4Weeks2Freedom) designed to boost motivation and self-efficacy and to promote ex-smoker identity was ineffective in prompting quit attempts among an unselected panel of smokers from the UK. This approach appears unpromising as a means of raising the rate at which smokers attempt to quit and is a low priority for future research.
authors.affiliation: Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom; jamie.brown@ucl.ac.uk.
authors.forename: Jamie
authors.initials: J
authors.lastname: Brown
authors.affiliation: Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom; National Centre for Smoking Cessation and Training, London, United Kingdom;
authors.forename: Susan
authors.initials: S
authors.lastname: Michie
authors.affiliation: Public Health England, London, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Walmsley
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom; National Centre for Smoking Cessation and Training, London, United Kingdom;
authors.forename: Robert
authors.initials: R
authors.lastname: West
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009040:Motion Pictures; D009042:Motivation; D016540:Smoking Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000628:therapy*