title: Self-help educational booklets for the prevention of smoking relapse following smoking cessation treatment: a randomized controlled trial.
abstract: OBJECTIVE
  Most people who quit smoking for a short term will return to smoking again in 12 months. We tested whether self-help booklets can reduce relapse in short-term quitters after receiving behavioural and pharmacological cessation treatment.
  
  
  METHODS
  A parallel-arm, pragmatic individually randomized controlled trial.
  
  
  METHODS
  Smoking cessation clinics in England. Participants People who stopped smoking for 4 weeks after receiving cessation treatment in stop smoking clinics.
  
  
  METHODS
  Participants in the experimental group (n=703) were mailed eight booklets, each of which taught readers how to resist urges to smoke. Participants in the control group (n=704) received a leaflet currently used in practice.
  
  
  METHODS
  The primary outcome was prolonged, carbon monoxide-verified abstinence from months 4 to 12. The secondary outcomes included 7-day self-reported abstinence at 3 and 12 months. Mixed-effects logistic regression was used to estimate treatment effects and to investigate possible effect modifying variables.
  
  
  RESULTS
  There were no statistically significant differences between the groups in prolonged abstinence from months 4 to 12 (36.9% versus 38.6%; odds ratio 0.93, 95% confidence interval 0.75-1.16; P=0.524). In addition, there were no significant differences between the groups in any secondary outcomes. However, people who reported knowing risky situations for relapse and using strategies to handle urges to smoke were less likely to relapse.
  
  
  CONCLUSIONS
  In people who stop smoking successfully with behavioural support, a comprehensive self-help educational programme to teach people skills to identify and respond to high-risk situations for return to smoking did not reduce relapse.
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Maskrey
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Annie
authors.initials: A
authors.lastname: Blyth
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Brown
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.|Norwich Clinical Trial Unit, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Garry R
authors.initials: GR
authors.lastname: Barton
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Notley
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Aveyard
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Holland
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Max O
authors.initials: MO
authors.lastname: Bachmann
authors.affiliation: Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Sutton
authors.affiliation: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Leonardi-Bee
authors.affiliation: Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Brandon
authors.affiliation: Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Norwich, Norfolk, UK.
authors.forename: Fujian
authors.initials: F
authors.lastname: Song
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D011446:Prospective Studies; D012044:Regression Analysis; D055502:Secondary Prevention / Q000379:methods; D012648:Self Care / Q000379:methods; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D016896:Treatment Outcome
keywords: Behavioural support; coping skills; educational booklets; smoking relapse