A controlled trial of a Quit and Win contest. Predictors of smoking cessation in an incentive-based community intervention. Effect of a community action program on adult quit smoking rates in rural australian towns: the CART project. Using a low-cost, prize-drawing incentive to improve recruitment rate at a work-site smoking cessation clinic. A trial of church-based smoking cessation interventions for rural African Americans. Concurrent quit & win and nicotine replacement therapy voucher giveaway programs: participant characteristics and predictors of smoking abstinence. Efficacy of an anti-tobacco community education program in India. Interest in an online smoking cessation program and effective recruitment strategies: results from Project Quit. Media and community campaign effects on adult tobacco use in Texas.
To evaluate the impact of a state-of-the-art Quit and Win contest on tobacco quit rates at 3, 6, and 12 months after the 30-day quit period.
                Quasi-experimental with a volunteer sample of 494 Quit and Win contest registrants (treatment group) and 512 randomly selected tobacco users not exposed to the promotional media campaign (control group). Intervention included a 30-day quit period to be eligible for large cash prizes; provider advice via weekly mailings; online and telephone quit assistance; media campaign; and community support.
                Community-based intervention in Kentucky.
                A total of 1006 adult tobacco users.
                Quit rates were measured using 7-day point prevalence for tobacco use. Urine cotinine measurements confirmed self-reported quitting.
                Treatment group participants were significantly more likely than controls to experience quitting during the 1-year follow-up, as determined by both self-report and urine confirmation. After adjusting for baseline differences in demographics, tobacco use, and stage of change, those in the treatment group had 2.6 times the odds of reporting quitting in the postintervention period and 5.3 times the odds of experiencing quitting confirmed by urine cotinine, relative to controls. Women, minorities, and low-income tobacco users had equal odds of quitting as men, whites, and those with higher incomes.
                That the contest was minimally intensive and yielded a relatively high, quit rate demonstrates the potential effectiveness of the intervention. 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. This article describes one outcome of a randomized controlled trial of community action for cancer prevention. The aims of this article were to (a) explore the effectiveness of a community action program in decreasing community smoking rates in rural Australian towns and (b) describe the relationship between adult smoking quit and uptake rates and demographic variables.
                In 1992, 20 towns were selected for randomization. Community action involved formation of community committees and utilization of access point networks to initiate and maintain intervention strategies. At post-test, outcomes were proportion of "quitters" from a cohort of self-described smokers, proportion of "uptakers" from a cohort of self-described nonsmokers, and "net effect."
                Differences in quit rate, uptake rate, and net effect for intervention compared to control condition favored the intervention in all cases, although mainly nonsignificant. Significantly more male smokers quit in intervention towns than in control towns [7.0% (95% CI: 0.6, 13.5)].
                Given that CART utilized and improved upon strategies argued as effective in the literature, the limited success of the project in reducing adult smoking, considered in combination with COMMIT findings, suggests the need for further innovation in the field.
                Copyright American Health Foundation and Academic Press. A major obstacle in promoting smoking cessation programs through work sites is recruiting adequate numbers of smokers. We used a quasi-experimental design to evaluate the effect of a low-cost incentive (a prize drawing) for attracting participants to a smoking cessation clinic offered at multiple work sites. Sixty-eight automobile dealerships were randomized to either a "prize" or control group. Smokers employed at work sites in the prize group were offered a chance to win a dinner for two for participating in a smoking cessation clinic. In November 1986, a questionnaire assessing tobacco use habits was sent to 3432 employees of the 68 work sites. A cohort of 844 smokers was identified from a total of 1986 employees who returned surveys. All smokers received registration materials to participate, free of charge, in one of three smoking cessation programs held in June 1987. The overall employee participation rate in the smoking cessation program was 6.6% (n = 56) with an overall work-site participation rate of 37.3% (n = 25). The rate was nearly identical in the "prize" and control groups (employee rate: 6.3% versus 6.7%; work-site rate: 39.4% versus 35.3%, respectively). The Alliance of Black Churches Health Project was begun in an effort to address the health problems of the African-American residents of two rural Virginia counties. Smoking cessation was chosen as the principal target behavior in one county. Church coalitions were chosen as the principal organizations through which to implement the interventions.
                A smoking cessation program was designed that combined one-on-one counseling with self-help materials and community-wide activities. To provide these services, up to two smoking cessation counselors were trained from participating churches. To evaluate the impact, population-based cohorts of smokers were assembled in each county using a door-to-door survey. Respondents were recontacted after 18 months. Smoking cessation (1-month continuous abstinence), stages of change, and exposure to the interventions were assessed.
                The overall smoking prevalence at baseline was 25.8%. At follow-up, the smoking cessation rate in the intervention county was 9.6% and in the control county 5.4% (P = 0.18). Among those attending church once a month or more, the respective quit rates were 10.5% and 5.9% (P = 0.20). There was significantly more progress along the stages of change in the intervention than in the control county. There was also higher awareness of and contact with smoking cessation programs in the former compared with the latter.
                Smoking cessation interventions for African Americans can be successfully implemented through a church coalition. The interventions were associated with significant progress along the stages of cessation. Although the quit rate was higher in the intervention community, the difference was not significant. 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. In a study on 'Assessment of Efficacy of an Anti-Tobacco Community Education Program' on Kolar District of Karnataka, India, an experimental and two control areas were chosen based on comparable population, health, and socioeconomic parameters. The two main objectives were to prevent individuals from taking up the tobacco habit among those who currently did not smoke or chew tobacco, and to stop the tobacco habit in those who did smoke or chew tobacco. A baseline tobacco-habit survey of the population was followed by anti-tobacco education of the community in the experimental area only. Two years later, a repeat survey of the population was conducted, followed by a final survey after a further three years. Methods of health education of the community included screening of films, exhibits, and personal contact with a display of photographs of the harmful effects of tobacco. The results were evaluated through changes in prevalence rates, quitters' rates, and initiation rate. The final survey showed that in the experimental area, the decline in the prevalence rate in the combined sample compared with the baseline rates was 10.2 percent in males and 16.3 percent in females, with a corresponding quitter's rate of 26.5 percent in males and 36.7 percent in females. Among men, a higher proportion (30.2 percent) had given up chewing compared with smoking (20.4 percent). The Internet is a promising venue for delivering smoking cessation treatment, either as a stand-alone program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online smoking cessation services or how best to recruit smokers to Internet-based programs.
                Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies.
                Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations).
                An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees.
                Smokers were interested in receiving online smoking cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this program were comparable to those seen when smokers are advised to quit and are referred to other forms of smoking cessation treatment. In this sample, proactive mailings were the best method for recruiting smokers to Project Quit. The present study reports on the effects on adult tobacco cessation of a comprehensive tobacco-use prevention and cessation program in the state of Texas. Differences in cessation rates across treatment conditions were measured by following a panel of 622 daily smokers, recruited from the original cross-sectional sample, from baseline to follow-up. The adult media campaign combined television, radio, newspaper and billboard advertisements featuring messages and outreach programs to help adults avoid or quit using tobacco products. The ads also promoted quitting assistance programs from the American Cancer Society Smokers' Quitline, a telephone counseling service. The cessation component of the intervention focused on increasing availability of and access to cessation counseling services and pharmacological therapy to reduce nicotine dependence. Both clinical and community-based cessation programs were offered. Treatment areas which combined cessation activities with high level media campaigns had a rate of smoking reduction that almost tripled rates in areas which received no services, and almost doubled rates in areas with media campaigns alone. Analyses of the dose of exposure to media messages about smoking cessation show greater exposure to television and radio messages in the areas where high level media was combined with community cessation activities than in the other areas. Results also show that exposure to media messages was related to processes of change in smoking cessation and that those processes were related to the quitting that was observed in the group receiving the most intensive campaigns.
Quit and win contests at local and regional level appear to deliver quit rates above baseline community rates, although the population impact of the contests seems to be relatively low. Contests may be subject to levels of deception which could compromise the validity of the intervention. International contests may prove to be an effective mechanism, particularly in developing countries, but a lack of well-designed comparative studies precludes any firm conclusions.