Effects of social support and relapse prevention training as adjuncts to a televised smoking-cessation intervention.

Smokers registering for a televised cessation program who also expressed interest in joining a support group and who had a nonsmoking buddy were randomly assigned to 3 conditions: no-contact control, discussion, and social support. All Ss received a self-help manual and were encouraged to watch the daily TV program. Ss in the discussion and social support conditions were scheduled to attend 3 group meetings (one with a buddy). Social support Ss and buddies received training in support and relapse prevention. A 4th analysis group was composed of Ss who failed to attend any of the scheduled meetings (no shows). There were strong group effects at the end of treatment. Abstinence rates were highest in the social support group, followed, in order, by the discussion group, no shows, and no-contact controls. The social support group improved outcome by increasing both the level of support and program material use (reading the manual and watching TV).

Characteristics of participants in a televised smoking cessation intervention.

Participants in various components of a televised self-help smoking cessation program, based on the American Lung Association's Freedom From Smoking in 20 Days, are compared with a sample of the population of smokers to whom the intervention was addressed. Over 325,000 smokers in the target population were exposed to the program at some level. Most watched televised segments. Approximately 75,000 manuals were distributed and about 55,000 were used. Comparisons between participants and the targeted smoking population indicate that the intervention attracted those in the smoking population who are expected to be the majority of smokers by the Year 2000-blacks, females, and those with incomes under $13,000 per year. Participants with these characteristics were most likely to view the televised segments. Heavy smokers, females, and those with the most education were most likely to refer to the manual at least twice a week during the intervention. Older, nonblack participants and those with incomes of $13,000 or more per year were most likely to attend group support sessions outside the home. Overall, the patterns of association indicate that although a televised smoking cessation program can attract individuals similar to those projected to be smokers in 2000, participation in various components of the intervention will vary by demographic characteristics.

A televised, self-help, cigarette smoking cessation intervention.

A televised, self-help cigarette smoking cessation intervention was conducted and evaluated. During the 20-day program, reports were broadcast daily on the evening news programs of the local affiliate station of a national television network. Two samples of smokers who requested self-help manuals were interviewed by telephone immediately following the conclusion of the program and again 3 months later concerning their demographic characteristics, participation in the program, and smoking and quitting experiences. In one sample heavier smokers who expressed a greater desire to quit were more likely to participate in the program and, at the three-month followup, 21% reported being abstinent compared to 10% of those who did not participate. Smokers in the other sample were invited to attend three weekly support meetings during the program. More of those who attended meetings (35%) reported quitting during the program than those who did not attend (23%), but this difference did not persist for 3 months. A greater percentage of the meeting sample (27%) than the other sample (21%) reported abstinence initially, but this difference did not persist for three months either. Intervention outcomes are compared with several standards.

Factors in smoking cessation among participants in a televised intervention.

This paper analyzes factors associated with smoking cessation during a 1-year period following a televised, self-help intervention among a sample of smokers who registered and participated in the program. Factors examined include readiness to quit smoking, extent of use of self-help materials, degree of exposure to the televised intervention, and environmental support for quitting from within the smoker's household. Behavioral response immediately following the intervention appeared to persist over the year of observation. Of those who reported stopping smoking immediately following the intervention, fewer than half (about 10% of the total sample that was followed) were continuously abstinent at 12 months. The results indicate that environmental support when the individual is attempting to quit smoking is very important in differentiating between those who successfully quit and those who attempt but fail to sustain their abstinence. The results also suggest that an approach combining television and self-help may reach large populations of smokers and induce a substantial number to quit and remain abstinent.

One year follow-up of the Chicago televised smoking cessation program.

We compared the relative effectiveness of four different conditions of self-help and social support provided to people attempting to quit smoking in conjunction with a televised cessation program: Smokers ready to quit were able to request written manuals from hardware stores to accompany a televised program. At worksites we provided the written manual to all workers. At a random half of the worksites, we also provided training to discussion leaders who subsequently led discussions among smokers attempting to quit with the program. At health maintenance organization sites we invited smokers who had requested program materials to participate in similar group discussions at health centers. In this paper we report one year follow-up results for the above four groups and compare them with previously reported results of a self-help manual alone. Results for the television plus manual condition were better than those of past studies (25 percent nonsmoking prevalence and 10 percent continuous cessation one year after the program) and considerably better than the manual alone. None of the other conditions designed to supplement the manual plus television produced better long-term outcomes; we explore the reasons for this. The program did encourage and help over 50,000 Chicago smokers to attempt quitting with the American Lung Association manual, 100 times as many as would have done so without the televised program. At least 15 other similar programs implemented since 1984 multiply this effect.

Using a community model in media-based health promotion interventions.

Over the past few years, a number of media-based health promotion interventions have been broadcast in the Chicago area. The interventions focused on helping viewers stop smoking, better deal with stress, and improve nutrition and weight management. For each of these interventions, from 50,000 to 175,000 self-help manuals were distributed. These large-scale media interventions were made possible by the collaboration of university researchers, a variety of community agencies, and several television stations. The process by which this unique series of interventions was developed is described and the implications of mounting such large-scale health promotion programs are presented.

Effects of a televised smoking cessation intervention among low-income and minority smokers.

In November 1985, a television smoking cessation program was broadcast for 20 days on the noon and 9 p.m. news. Smokers in West Garfield Park, an inner-city impoverished area of Chicago, were randomly assigned either to a comprehensive intervention or to a no-intervention control condition. Although 100,000 self-help manuals had been distributed throughout Chicago, none of the controls in this low-income area had obtained a manual. The intervention consisted of providing the smokers a self-help manual, the televised broadcast, weekly support meetings, and supportive phone calls. At a 4-month follow-up, 20% of treatment participants were abstinent compared to 9% of controls. The results indicated that intensive supplementary opportunities enhanced participation by low-income smokers in a media smoking cessation program.

Work site group meetings and the effectiveness of a televised smoking cessation intervention.

At the work site, smoking accounts for increased health care expenses and worker absenteeism due to smoking-related illness and reduced productivity and lost wages. Developing comprehensive and accessible smoking cessation programs at the work site is an important objective for health care professionals. In this study, employees of 43 corporations participated in a televised smoking cessation program accompanied by self-help manuals. The media component involved presenting a smoking cessation program on a network television affiliate station during the 4:30 p.m. and 10:00 p.m. news for 20 days. Employees at half the corporations also had access to semiweekly self-help group meetings. Adding self-help support groups to a program involving self-help manuals and the media reports was found to significantly increase abstinence and its maintenance over time. The implications of using the media, self-help groups, and work site locations in large-scale community-based interventions are discussed.

Effects of biochemical validation of self-reported cigarette smoking on treatment success and on misreporting abstinence.

Many investigators have reported that cigarette smokers who are trying to quit often falsely report being abstinent at the end of treatment. Unfortunately, much of the previous research designed to investigate this problem has been flawed, making the results difficult to interpret. We attempted to avoid these flaws and to investigate the measurement of alveolar carbon monoxide (CO) levels to validate self-reported smoking rates at the end of treatment. Participants in behavioral cessation clinics were randomly assigned to one of three conditions that varied in timing of exposure to information regarding CO measurement: at the beginning of treatment (demonstration of CO measurement, discussion of smoking effects on CO levels, and notification that individual CO levels would be measured at the conclusion of the clinic), at the end of treatment (demonstration, discussion, and notification of CO measurement prior to self-reports of smoking levels), or at the end of treatment (demonstration and discussion of CO measurement subsequent to self-reports of smoking levels). CO levels of all participants were measured at the end of treatment after they reported their current smoking levels. Only 16% of self-reports of abstinence were not verified by CO measurement. Smokers who observed the CO demonstration at the beginning of treatment were significantly more likely than the other two groups to achieve abstinence at the end of treatment and significantly less likely to misreport abstinence. Clinical and research implications of these results are discussed.