This study explored the relationship between smoking and significant pain. It was hypothesized that readiness to quit smoking would be negatively affected by pain issues. A cross-sectional design was used in this phone-based survey with randomly selected adult smokers. A total of 307 adult participants in the control group from a larger Quit and Win Study participated in the interview. Participants were contacted at home and completed a 20-min phone survey including measures of pain, stress, depressive symptoms, social support, tobacco use status, and readiness to quit smoking. A total of 28% reported significant pain in the past week. Participants who experienced significant pain smoked more cigarettes per day than those who did not report significant pain. However, pain was not associated with readiness to quit. More than half (58%) of those with significant pain were in the contemplation stage of change or higher. The fact that smokers with pain were just as likely as those without significant pain to be ready to quit demands that each individual patient with pain be assessed for readiness to quit so that a tailored approach can be adopted either to motivate the patient to quit or to assist the patient with evidence-based tobacco dependence treatment strategies if he or she wants such treatment. Placing formal tobacco dependence treatment programs within pain clinics and addressing pain in smoking cessation programs is recommended.
This study compares the participant characteristics, program costs, and outcomes of a Quit & Win contest and a nicotine replacement therapy (NRT) voucher giveaway promotion. Both programs were conducted simultaneously so that smokers could enroll in either one program alone (n = 849 and 690, respectively) or both programs (Combination group; n = 230). A follow-up telephone survey of a random sample of participants was conducted 4 to 7 months after enrollment to evaluate smoking status. At enrollment, participants in the three groups were comparable on most smoking and demographic variables, although Quit & Win participants were, on average, younger than those who signed up to get the NRT voucher. Compared with the characteristics of smokers in the region, those who enrolled in the intervention programs were heavier smokers and had more years of formal education. At follow-up, the self-reported quit rates were similar across the three intervention groups, ranging between 25 percent and 30 percent. The only evidence for a higher quit rate among those in the Combination group was among younger smokers. On a simple estimated cost per quit basis, the Quit & Win (130 dollars) and NRT (179 dollars) voucher interventions appear roughly comparable. In all groups, abstinence rates were higher among lighter smokers (<21 cigarettes per day), participants who did not live with another smoker, and those who were married. Both the Quit & Win and NRT voucher giveaway programs were effective in recruiting smokers to make a quit attempt, although combining both interventions did not generally increase abstinence rates.
BACKGROUND: In a two-group quasi-experimental study, we evaluated the impact of a quit and win contest on quitting among low-income tobacco users and identified contest elements used by successful quitters. Low-income tobacco users have been largely untouched by tobacco cessation approaches. METHODS: A volunteer sample of 248 low-income tobacco users were recruited from quit and win contest registrants (treatment group). A random sample of 290 low-income tobacco users who had not entered the contest were recruited using random digit dialing (control group). Telephone interviews were conducted with both groups at baseline, 3, 6, and 12 months. Seven-day point prevalence measured self-reported quitting and urine cotinine assessed confirmed quitting. RESULTS: On average, quit and win study participants were 3.5 times more likely than controls to self-report quitting and 12.8 times more likely to demonstrate confirmed quitting after controlling for baseline differences in stage of change, age, education, and marital status. The use of specific contest elements was not related to successful quitting. CONCLUSIONS: The overall quit rates in the treatment group were higher than those in the control group. The results are promising given that low-income tobacco users are generally less likely to succeed in quitting.
ABSTRACT : Cigarette smoking is a major contributor to the East–West health gap in Europe, a situation which is particularly evident in comparisons of mortality and health behavior in Finnish and Russian Karelia. With technical assistance from the North Karelia Project in Finland, a Quit and Win smoking cessation contest was organized in the district of Pitkäranta in Russian Karelia. Local health care workers organized media publicity and community support, including news about competition winners and participants, and distribution of leaflets featuring stories about how local people were able to stop smoking during the Quit and Win contests. The Pitkäranta campaign was evaluated in a quasi-experimental study in which panels of 176 and 202 smokers, identified in a random population sample survey at the outset, were followed for 1 year in Pitkäranta and a comparable neighboring district. Cessation rates were estimated to be 7–26% in Pitkäranta and 1–2% in the comparison area, a statistically significant indication of experimental effects. These findings demonstrate that community campaigns can effectively reduce smoking in the present difficult conditions in Russia.
The Quit and Win Challenge, an incentive-based intervention, was implemented in two counties in Eastern Ontario to encourage adult smokers to quit smoking. Participants (n = 231) were compared with adult smokers selected at random (n = 385) from a larger, four-county area. Baseline characteristics were assessed by telephone interview, including socio-demographic and smoking-related factors. Follow-up interviews were also conducted by telephone. Initial and follow-up response rates were high (over 84%) in both groups. Compared with the random survey group, Quit and Win participants tended to be younger, more educated, employed and heavier smokers, with fewer friends or co-workers who smoked. After one year, 19.5% of them reported that they were smoke-free, whereas less than 1% of the random group had achieved cessation. This translates into an impact rate of 0.17%, affecting 1 in 588 adult smokers. With the exception of the smokers' baseline "stage of change," none of the socio-demographic or smoking factors was predictive of cessation. We conclude that this intervention achieved only limited success and attracted certain sectors of the community disproportionately, i.e. smokers who were highly motivated to quit. We argue that increased access to proven cessation therapies would improve the impact of such interventions.
OBJECTIVES: 1) To describe the distribution of adult smokers in an existing cohort according to stages of change theory; and 2) to compare movements of these smokers through the stages of change. DESIGN: Secondary analysis of existing cohort data. SETTING: Eastern Ontario. PARTICIPANTS: Adult smokers who: 1) enrolled in a Quit & Win Challenge, or 2) received smoking cessation information (Quit Kit) from their area health unit, or 3) were randomly selected by telephone survey. RESULTS: 706 smokers were recruited and followed for one year. Only 2% of the adult smokers selected by random telephone survey were in the "action" stage at baseline, compared with 14% of the Quit and Win Challenge participants, and 14% of the Quit Kit recipients. Variations in movement through the stages of change were observed between groups upon follow-up. CONCLUSIONS: The results suggest a need to use stage-matched approaches when developing population-based smoking cessation interventions.
The current study evaluated the effectiveness of widely used self-help materials for quitting smoking. Five hundred and seventy smokers volunteered during a baseline survey to participate in the evaluation. After random assignment, 200 were mailed National Cancer Institute (NCI) "Quit for Good" materials, 200 the Minnesota "Quit and Win" program, and the remaining 170 were assigned to a nonintervention control condition. Results at 7-month follow-up failed to indicate treatment effects either for abstinence or for reported quit attempts. A number of smokers quit prior to the mailing of self-help materials, suggesting that a telephone prompt in itself may have been an important stimulus to cessation. Overall abstinence at follow-up was 10%. Contrary to expectation, successful participants were less likely to use a number of specific preparation strategies for quitting. The results are instructive in providing a large-scale assessment of self-help materials in a population of smokers that was not specifically seeking treatment.
This study explored the relationship between smoking and significant pain. It was hypothesized that readiness to quit smoking would be negatively affected by pain issues. A cross-sectional design was used in this phone-based survey with randomly selected adult smokers. A total of 307 adult participants in the control group from a larger Quit and Win Study participated in the interview. Participants were contacted at home and completed a 20-min phone survey including measures of pain, stress, depressive symptoms, social support, tobacco use status, and readiness to quit smoking. A total of 28% reported significant pain in the past week. Participants who experienced significant pain smoked more cigarettes per day than those who did not report significant pain. However, pain was not associated with readiness to quit. More than half (58%) of those with significant pain were in the contemplation stage of change or higher. The fact that smokers with pain were just as likely as those without significant pain to be ready to quit demands that each individual patient with pain be assessed for readiness to quit so that a tailored approach can be adopted either to motivate the patient to quit or to assist the patient with evidence-based tobacco dependence treatment strategies if he or she wants such treatment. Placing formal tobacco dependence treatment programs within pain clinics and addressing pain in smoking cessation programs is recommended.
