title: Enhancing Quit & Win contests to improve cessation among college smokers: a randomized clinical trial.
abstract: OBJECTIVE
  Quit & Win contests (in which smokers pledge to quit smoking for a defined period in exchange for the chance to win a prize) may be well-suited for college smokers. We tested the effectiveness of multiple versus single Quit & Win contests and that of added counseling versus no counseling in smoking cessation.
  
  
  METHODS
  A two-by-two, randomized controlled trial with 6-month follow-up.
  
  
  METHODS
  Nineteen institutions in Minnesota, Texas, Ohio and Wisconsin.
  
  
  METHODS
  College student smokers (n = 1217) were randomized within site to four conditions: single (n = 306), multiple contests alone (n = 309), single contest plus counseling (n = 296) or multiple contests with counseling (n = 306).
  
  
  METHODS
  Participants in the standard contest condition (T1 and T2) were asked to abstain from all tobacco products for a 30-day period; those with confirmed abstinence were eligible for a lottery-based prize. Participants assigned to the multiple contest conditions (T3 and T4) participated in the 30-day contest and were enrolled automatically into two additional contest periods with an escalating prize structure. Participants randomized into the counseling conditions (T2 and T4) received up to six telephone-administered Motivation and Problem Solving (MAPS) counseling sessions over the 12-week treatment period.
  
  
  METHODS
  The primary outcome was biochemically verified 30-day point prevalence (PP) abstinence rate at 6 months. Secondary outcomes were the same abstinence at end of treatment (4 months) and a proxy measure of 6-month verified continuous abstinence rate. Outcomes were based on all participants randomized.
  
  
  RESULTS
  We found no evidence of an interaction between number of contests and counseling. Abstinence rates for multiple (13.5%) and single (11.7%) contests were not significantly different at 6 months [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 0.84-1.66]. The addition of counseling did not improve 6-month abstinence significantly (13.7 versus 11.6%, OR = 1.21, 95% CI = 0.86-1.70). Multiple contests increased abstinence at 4 months (19.3 versus 10.3%, OR = 2.09, 95% CI = 1.50-2.91) and continuous abstinence at 6 months (7.8 versus 3.8%, OR = 2.14, 95% CI = 1.28-3.56).
  
  
  CONCLUSIONS
  Multiple Quit & Win contests may increase smoking abstinence rates in college students more than single contests, but it is not clear whether adding counseling to these interventions produces any additional benefit.
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Thomas
authors.affiliation: School of Public Health, Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA.|University of Minnesota Masonic Cancer Center, Minneapolis, MN, USA.
authors.forename: Xianghua
authors.initials: X
authors.lastname: Luo
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Bengtson
authors.affiliation: Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Winta
authors.initials: W
authors.lastname: Ghidei
authors.affiliation: School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: John
authors.initials: J
authors.lastname: Nyman
authors.affiliation: Boynton Health Service, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Lust
authors.affiliation: Center for Health Communications Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: An
authors.affiliation: M. D. Anderson Cancer Center, University of Texas, Houston, TX, USA.
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
authors.affiliation: Pediatrics; Epidemiology and Environmental Health, University of Buffalo, Buffalo, NY, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Epstein
authors.affiliation: Rutgers School of Public Health, New Jersey, USA.
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D001363:Awards and Prizes; D003376:Counseling / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009042:Motivation; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods* / Q000523:psychology; D000074606:Smoking Prevention; D013781:Texas / Q000453:epidemiology; D016896:Treatment Outcome; D014922:Wisconsin / Q000453:epidemiology
keywords: College students; financial incentives; smoking cessation