Comparative evaluation of American Cancer Society and American Lung Association smoking cessation clinics.

We compared the effectiveness of American Cancer Society, FreshStart, American Lung Association, Freedom from Smoking, and laboratory clinic methods in subjects (N = 1041) from three communities. Three-month follow-up results favored the laboratory method over the two public service approaches on both a prevalence and a sustained abstinence measure. At one-year follow-up, treatment effects for smoking prevalence were no longer significant. However, sustained abstinence results at one-year remained highly significant and favored the more intensive laboratory and Freedom from Smoking clinics over the FreshStart method. FreshStart fared less well than the other interventions both in producing initial quit attempts and in sustaining abstinence among initial quitters. It should be noted, however, that FreshStart requires considerably less facilitator contact than do the other approaches. Unexpected outcome effects occurred for treatment location. Future clinic programs should include a specific target date for quitting and should place more emphasis upon recycling participants who fail to sustain abstinence.     

An evaluation of a home video weight loss program

Two samples of 99 and 63 subjects more than 15% overweight (mean preweights 200 and 189 Ib) utilized a 30 segment home video weight loss program and were followed over a 4–5 month period. During a one-month waiting period, 54.7% of the second sample gained weight. Within 4–5 weeks after receiving the program by mail, 97% of those in the first sample who viewed half or more of the video reported losing weight. At 4 months follow-up, 63% continued to lose weight, and 85% of the sample lost a mean of 9.0 Ib; 40% lost 10 or more pounds. The dropout rates (viewing less than half the program) were 31 % and 37% for the two samples.     

Effectiveness evaluation of the N-O-T smoking cessation program for adolescents

OBJECTIVE: To evaluate the effectiveness of the Not-On-Tobacco Program. METHODS: Forty-four high schools implemented the program (n=241 students), with 27 comparison schools (n=251 students). Students reported smoking in the last 7 and 30 days at baseline and follow-up. RESULTS: Those in the program had an increased likelihood of reporting 30-day abstinence at end of program (OR = 4.2) but not at 6 or 12 months. For 7-day abstinence there was no significant difference for any time point. CONCLUSIONS: In this effectiveness evaluation the N-O-T Program increased quitting during the program, but the effects were not present at 6 or 12 months.     

A nurse-managed smoking cessation program for hospitalized smokers.

OBJECTIVES: This study evaluated a nurse-managed smoking cessation program for smokers hospitalized for a variety of conditions. METHODS: Hospitalized patients who smoked prior to hospitalization and who were motivated to quit (n = 660) were randomized to intervention or usual-care groups and followed for the next year. The intervention included a meeting with the nurse-case manager; the use of a videotape, workbook, relaxation audiotape, and nicotine replacement therapy; and nurse-initiated phone contacts after discharge. RESULTS: The 12-month confirmed cessation rates were 21% and 31% for, respectively, the usual-care and intervention groups (odds ratio = 1.7; 95% confidence interval = 1.1, 2.3). CONCLUSIONS: A nurse-managed smoking cessation intervention can significantly increase cessation rates for hospitalized patients.     

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.     

Effects of a community-wide smoking cessation program

The evaluation of a low-cost community-wide smoking cessation campaign conducted in a major metropolitan area demonstrated a major impact on the number of people smoking, amount of cigarettes smoked, and expenses associated with smoking. The American Lung Association's 20-day self-conducted Freedom From Smoking program was used in conjunction with TV coverage. Standard telephone survey techniques determined that 5300 stopped and 26,500 reduced smoking. Major features of the program were evaluated and important differences were analyzed between males and females, users and non-users of the program manual, and success groups. Behavioral factors as opposed to historical factors appeared to be most important for success.     

A smoking cessation incentive program for chemical employees: design and evaluation

Worksite smoking cessation intervention programs have become increasingly popular, although program evaluations are often unavailable. In 1984, the Texas Operations of Dow Chemical USA offered a Smoking Cessation Incentive Program (SCIP) to its employees. SCIP was a highly publicized, upbeat program that had the active support of management and union. Altogether, 7,516 employees (95.4% of all employees) were surveyed about their smoking habits; 28.3% identified themselves as smokers. A total of 1,113 employees voluntarily enrolled in SCIP from March 1, 1984, through March 1, 1985. Smoking cessation methods included a buddy program, nicotine-containing chewing gum, American Lung Association self-help material and group clinics, and incentive prizes. SCIP registrants, compared to employees identified as smokers in a pre-program survey who did not participate in SCIP, were significantly (P less than .01) more often females, whites, administrators, professionals, heavier smokers, and smokers who had tried to quit at least two times prior to SCIP. There were 326 (29.3%) SCIP participants who quit smoking for at least one month during SCIP. A total of 265 (23.8%) succeeded at quitting for at least six months and remained ex-smokers at the end of the program. Logistic regression analysis showed administrators had significantly higher six-month or more rates of quitting than did professionals, craftsmen, operators or clerical workers.(ABSTRACT TRUNCATED AT 250 WORDS)     

A 5-year evaluation of a smoking cessation incentive program for chemical employees

BACKGROUND. This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. RESULTS. We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long-term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. CONCLUSIONS. The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program.     

A smoking cessation program at a public antenatal clinic.

OBJECTIVES: A randomized trial evaluated the impact of smoking cessation interventions on point prevalence and consecutive quit rates at an Australian public prenatal clinic. METHODS: Self-reports and urine cotinine tests confirmed patients' smoking status at the midpoint and end of pregnancy and 6 weeks postpartum. RESULTS: At all points, validated abstinence rates were significantly higher in the experimental group than in the control group. The rate of failed biochemical validation was significantly higher in the control group than in the experimental group. CONCLUSIONS: Prenatal clinic staff can significantly increase quit rates by using cognitive-behavioral strategies. Brief advice appears to be ineffective.     

National TV smoking cessation program and contest in Finland.

BACKGROUND. In the fall of 1986 the North Karelia Project in cooperation with Finnish TV 2 arranged an eight-part nationwide smoking cessation TV program. The Project, also arranged a smoking cessation contest coinciding with the TV program in cooperation with four major voluntary public health organizations and the national health service. The TV program featured two studio groups of local volunteers: one from Turku (southwestern Finland) and the other from North Karelia, where there was more intensive community support for the activity. RESULTS: Based on a national survey of a representative population sample, the reported viewing rates (at least one part) of the working-age population (15-64 years, smokers and nonsmokers) were 64% in North Karelia, 45% in Turku, and 46% nationally (P less than 0.001). Among smokers who had watched at least one session of the TV program, 7.7% reported to have tried to quit smoking in North Karelia, 4.1% in Turku, and 7.5% nationally. Altogether, 16,089 smokers participated in the contest; again the highest participation rate was in North Karelia. The 6-month success rate among the smokers who participated in the contest was 22% in North Karelia, 18% in Turku, and 17% nationally (P less than 0.05). Men were more likely to succeed in quitting: among men the 6-month success rate was 22% and among women 15% (P less than 0.001). CONCLUSIONS: The results and experiences indicate high viewing and participation and a beneficial cost-effect ratio. They also stress the importance of community support activities in enhancing the effects of a media-based health promotion program.     

Evaluation of a multicomponent group smoking cessation program

BACKGROUND. Participants who had completed a multicomponent group smoking cessation program were interviewed to determine their smoking status and satisfaction with the program. METHODS. The follow-up interviews occurred an average of 20 months after entry to the program, with a response rate of 80% (89 out of 111 enrollees). Most individuals interviewed (82%) were able to quit for at least 24 hr; 25% were able to maintain nonsmoking status for 1 year or longer. RESULTS. Initial quit rates were comparable for both men and women, but women were more than twice as likely to have relapsed by the time of the follow-up interview. Participants rated self-monitoring as the most helpful of 10 program components, including nicotine fading, nicotine gum, group support, health information, and talks by ex-smokers. Ratings for the program overall were higher than the rating of any individual component. CONCLUSIONS. Since earlier studies have found that successful quitters use more coping strategies than relapsers, multicomponent programs offer participants an opportunity to learn a variety of techniques and choose the combination that works best for them.     

Outcomes of American Lung Association-Indiana Lung Centers asthma program.

The American Lung Association of Indiana (ALA-I), in conjunction with participating Indiana hospitals, developed the Lung Center concept as a mechanism to provide standardized delivery of lung health education. The goal of this pilot study was to evaluate initial experience with the Lung Center program "Overcoming Your Asthma," a two-session asthma education program, and identify areas needing improvement. A total of 305 participants responded to a 31-item questionnaire at baseline (immediately prior to program exposure) and again at 1 month (n = 75) and 6 months (n = 30) after participation. Overall, delivery of the ALA-I Lung Center asthma education program improved respondents' experience with asthma. At one month after the educational session, the program improved participant knowledge about asthma. This was associated with modest improvements in treatment behaviors, economic outcomes and asthma symptoms such as reduced breathing difficulties, wheezing and asthma exacerbations, and improvement in sleep. Improvements were not uniformly sustained at 6 months. In summary, the Lung Center asthma education program appears to benefit patients with asthma. The results provide preliminary evidence to support continued delivery of asthma education in Lung Centers. Future efforts should emphasize education to improve treatment attitudes and behaviors.