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Enhancing Quit & Win contests to improve cessation among college smokers: a randomized clinical trial
Author(s) -
Thomas Janet L.,
Luo Xianghua,
Bengtson Jill,
Wang Qi.,
Ghidei Winta,
Nyman John,
Lust Katherine,
An Lawrence,
Wetter David W.,
Epstein Leonard,
Ahluwalia Jasjit S.
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13144
Subject(s) - randomized controlled trial , abstinence , contest , smoking cessation , medicine , quitline , lottery , physical therapy , demography , psychiatry , pathology , statistics , mathematics , sociology , political science , law
Background and Aims Quit & Win contests (in which smokers pledge to quit smoking for a defined period in exchange for the chance to win a prize) may be well‐suited for college smokers. We tested the effectiveness of multiple versus single Quit & Win contests and that of added counseling versus no counseling in smoking cessation. Design A two‐by‐two, randomized controlled trial with 6‐month follow‐up. Setting Nineteen institutions in Minnesota, Texas, Ohio and Wisconsin. Participants College student smokers ( n = 1217) were randomized within site to four conditions: single ( n = 306), multiple contests alone ( n = 309), single contest plus counseling ( n = 296) or multiple contests with counseling ( n = 306). Intervention Participants in the standard contest condition (T1 and T2) were asked to abstain from all tobacco products for a 30‐day period; those with confirmed abstinence were eligible for a lottery‐based prize. Participants assigned to the multiple contest conditions (T3 and T4) participated in the 30‐day contest and were enrolled automatically into two additional contest periods with an escalating prize structure. Participants randomized into the counseling conditions (T2 and T4) received up to six telephone‐administered Motivation and Problem Solving (MAPS) counseling sessions over the 12‐week treatment period. Measures The primary outcome was biochemically verified 30‐day point prevalence (PP) abstinence rate at 6 months. Secondary outcomes were the same abstinence at end of treatment (4 months) and a proxy measure of 6‐month verified continuous abstinence rate. Outcomes were based on all participants randomized. Findings We found no evidence of an interaction between number of contests and counseling. Abstinence rates for multiple (13.5%) and single (11.7%) contests were not significantly different at 6 months [odds ratio (OR) = 1.18, 95% confidence interval (CI) = 0.84–1.66]. The addition of counseling did not improve 6‐month abstinence significantly (13.7 versus 11.6%, OR = 1.21, 95% CI = 0.86–1.70). Multiple contests increased abstinence at 4 months (19.3 versus 10.3%, OR = 2.09, 95% CI = 1.50–2.91) and continuous abstinence at 6 months (7.8 versus 3.8%, OR = 2.14, 95% CI = 1.28–3.56). Conclusion Multiple Quit & Win contests may increase smoking abstinence rates in college students more than single contests, but it is not clear whether adding counseling to these interventions produces any additional benefit.