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A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial.

Brendryen H, Drozd F, Kraft P - J. Med. Internet Res. (2008)

Bottom Line: Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group.However, neither coping planning nor self-efficacy mediated long-term treatment effect.For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychology, Postboks 1094 Blindern, 0317 Oslo, Norway. haavabre@psykologi.uio.no

ABSTRACT

Background: Happy Ending (HE) is an intense 1-year smoking cessation program delivered via the Internet and cell phone. HE consists of more than 400 contacts by email, Web pages, interactive voice response, and short message service technology. HE includes a craving helpline and a relapse prevention system, providing just-in-time therapy. All the components of the program are fully automated.

Objective: The objectives were to describe the rationale for the design of HE, to assess the 12-month efficacy of HE in a sample of smokers willing to attempt to quit without the use of nicotine replacement therapy, and to explore the potential effect of HE on coping planning and self-efficacy (prior to quitting) and whether coping planning and self-efficacy mediate treatment effect.

Methods: A two-arm randomized controlled trial was used. Subjects were recruited via Internet advertisements and randomly assigned to condition. Inclusion criteria were willingness to quit on a prescribed day without using nicotine replacement and being aged 18 years or older. The intervention group received HE, and the control group received a 44-page self-help booklet. Abstinence was defined as "not even a puff of smoke, for the last seven days" and was assessed by means of Internet surveys or telephone interviews 1, 3, 6, and 12 months postcessation. The main outcome was repeated point abstinence (ie, abstinence at all four time points). Coping planning and self-efficacy were measured at baseline and at the end of the preparation phase (ie, after 2 weeks of treatment, but prior to cessation day).

Results: A total of 290 participants received either the HE intervention (n=144) or the control booklet (n=146). Using intent-to-treat analysis, participants in the intervention group reported clinically and statistically significantly higher repeated point abstinence rates than control participants (20% versus 7%, odds ratio [OR] = 3.43, 95% CI = 1.60-7.34, P = .002). Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group. However, neither coping planning nor self-efficacy mediated long-term treatment effect. For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect.

Conclusions: This 12-month trial documents a long-term treatment effect of a fully automated smoking cessation intervention without the use of nicotine replacement therapy. The study adds to the promise of using digital media in supporting behavior change.

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Related in: MedlinePlus

Flowchart of participants
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figure1: Flowchart of participants

Mentions: The flow of participants is depicted in Figure 1. Six of the 296 subjects were excluded after randomization because it was discovered that they did not fulfill the inclusion criteria: two were signed up by another person and hence did not intend to quit, and four reported already having quit smoking at the point of randomization. These subjects are referred to erroneous allocations in Figure 1. Consequently, the final number of participants was 290. Cumulative loss (loss to follow-up on at least one of the previous follow-ups) is shown in curly brackets. Also note that participants who discontinued the intervention were approached for data collection.


A digital smoking cessation program delivered through internet and cell phone without nicotine replacement (happy ending): randomized controlled trial.

Brendryen H, Drozd F, Kraft P - J. Med. Internet Res. (2008)

Flowchart of participants
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2630841&req=5

figure1: Flowchart of participants
Mentions: The flow of participants is depicted in Figure 1. Six of the 296 subjects were excluded after randomization because it was discovered that they did not fulfill the inclusion criteria: two were signed up by another person and hence did not intend to quit, and four reported already having quit smoking at the point of randomization. These subjects are referred to erroneous allocations in Figure 1. Consequently, the final number of participants was 290. Cumulative loss (loss to follow-up on at least one of the previous follow-ups) is shown in curly brackets. Also note that participants who discontinued the intervention were approached for data collection.

Bottom Line: Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group.However, neither coping planning nor self-efficacy mediated long-term treatment effect.For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychology, Postboks 1094 Blindern, 0317 Oslo, Norway. haavabre@psykologi.uio.no

ABSTRACT

Background: Happy Ending (HE) is an intense 1-year smoking cessation program delivered via the Internet and cell phone. HE consists of more than 400 contacts by email, Web pages, interactive voice response, and short message service technology. HE includes a craving helpline and a relapse prevention system, providing just-in-time therapy. All the components of the program are fully automated.

Objective: The objectives were to describe the rationale for the design of HE, to assess the 12-month efficacy of HE in a sample of smokers willing to attempt to quit without the use of nicotine replacement therapy, and to explore the potential effect of HE on coping planning and self-efficacy (prior to quitting) and whether coping planning and self-efficacy mediate treatment effect.

Methods: A two-arm randomized controlled trial was used. Subjects were recruited via Internet advertisements and randomly assigned to condition. Inclusion criteria were willingness to quit on a prescribed day without using nicotine replacement and being aged 18 years or older. The intervention group received HE, and the control group received a 44-page self-help booklet. Abstinence was defined as "not even a puff of smoke, for the last seven days" and was assessed by means of Internet surveys or telephone interviews 1, 3, 6, and 12 months postcessation. The main outcome was repeated point abstinence (ie, abstinence at all four time points). Coping planning and self-efficacy were measured at baseline and at the end of the preparation phase (ie, after 2 weeks of treatment, but prior to cessation day).

Results: A total of 290 participants received either the HE intervention (n=144) or the control booklet (n=146). Using intent-to-treat analysis, participants in the intervention group reported clinically and statistically significantly higher repeated point abstinence rates than control participants (20% versus 7%, odds ratio [OR] = 3.43, 95% CI = 1.60-7.34, P = .002). Although no differences were observed at baseline, by the end of the preparation phase, significantly higher levels of coping planning (t(261) = 3.07, P = .002) and precessation self-efficacy (t(261) = 2.63, P = .01) were observed in the intervention group compared with the control group. However, neither coping planning nor self-efficacy mediated long-term treatment effect. For point abstinence 1 month after quitting, however, coping planning and self-efficacy showed a partial mediation of the treatment effect.

Conclusions: This 12-month trial documents a long-term treatment effect of a fully automated smoking cessation intervention without the use of nicotine replacement therapy. The study adds to the promise of using digital media in supporting behavior change.

Show MeSH
Related in: MedlinePlus