INTRODUCTION
Structured support and advice during a quit attempt increases the likelihood of maintaining abstinence from smoking, up to 15–20% independent of any effect of pharmacotherapy [1]. However, high-intensity behavioural interventions such as face-to-face or telephone counselling have low reach [2] and are expensive. Webbased automated programs have the potential to add to the range of cessation services available [3–5] and to service a proportion of the smoking population in a cost-effective manner [6,7].
Other forms of technology can also be utilized to deliver automated, tailored cessation assistance. Mobile phones and similar devices have been shown to be effective for this purpose [8,9]. These interventions deliver brief snippets of advice via the short message service (SMS; text-messaging),which can help to keep the person on track, and the messages can be tailored to where the smoker is in their quitting trajectory. Such programs may be even more effective as a complement to those that provide detailed advice, at least when delivered by a relatively passive mode such as the internet [10,11]. This paper reports on the findings of a randomized controlled trial (RCT) designed to evaluate the probable population impact of offering a demonstrably effective [12] automated personalized advice program delivered via the internet (the QuitCoach), as well as a newly developed program of structured, tailored SMS messaging (onQ). The QuitCoach has been available to the public at http://www.quitcoach.org.au. Users are typically of moderate dependence, and most are preparing to quit [13]. We hypothesized that offering each intervention (Quit Coach and onQ) would be more effective than a minimal treatment control, and expected some additional benefit of offering both. We were also interested in whether offering the two interventions as a choice of options or as an integrated package would affect uptake and/or efficacy, as this might affect both uptake and the extent to which the two interventions were used together. We recruited from two sources: those having recently sought cessation assistance (mainly Quitline callers wanting self-help materials) and from a cold-contacted sample, enabling us to explore possible effects of the interventions by recent interest in seeking assistance to quit. This was not a typical RCT, as participants were not pre-committed to consider using the intervention(s) they were offered. Because a considerable proportion of those in the intervention groups do not take up the offered
interventions, between-group comparisons underestimate intervention efficacy. We propose a method to estimate more accurately the true magnitude of effects amongthosewho use the interventions to a criterion level. The aims of this paper are to:
• Determine whether an offer of the interventions increased quit success; and
• Whether the effects were similar for the QuitCoach and onQ programs.
• Test for an interactive or additive benefit of the integrated program (QuitCoach onQ); and
• Whether the way the two interventions were offered affected outcomes.
• Estimate the impacts of the interventions among those who used them to a criterion level; and
• Whether the effects were similar for those recruited after seeking information about cessation versus those cold-contacted.
แนะนำโครงสร้างสนับสนุนและคำแนะนำในระหว่างความพยายาม quit เพิ่มโอกาสของการรักษาโมทนาพระคุณจากบุหรี่ ค่าการอิสระ 15 – 20% ของผลใด ๆ ของ pharmacotherapy [1] อย่างไรก็ตาม การแทรกแซงพฤติกรรมของความเข้มสูงเช่นลมี หรือโทรศัพท์ให้คำปรึกษาได้ต่ำถึง [2] และมีราคาแพง Webbased โปรแกรมอัตโนมัติมีศักยภาพในการเพิ่มช่วงของการยุติบริการว่าง [3-5] และบริการสัดส่วนของประชากรที่สูบบุหรี่อย่างมีประสิทธิภาพ [6,7]Other forms of technology can also be utilized to deliver automated, tailored cessation assistance. Mobile phones and similar devices have been shown to be effective for this purpose [8,9]. These interventions deliver brief snippets of advice via the short message service (SMS; text-messaging),which can help to keep the person on track, and the messages can be tailored to where the smoker is in their quitting trajectory. Such programs may be even more effective as a complement to those that provide detailed advice, at least when delivered by a relatively passive mode such as the internet [10,11]. This paper reports on the findings of a randomized controlled trial (RCT) designed to evaluate the probable population impact of offering a demonstrably effective [12] automated personalized advice program delivered via the internet (the QuitCoach), as well as a newly developed program of structured, tailored SMS messaging (onQ). The QuitCoach has been available to the public at http://www.quitcoach.org.au. Users are typically of moderate dependence, and most are preparing to quit [13]. We hypothesized that offering each intervention (Quit Coach and onQ) would be more effective than a minimal treatment control, and expected some additional benefit of offering both. We were also interested in whether offering the two interventions as a choice of options or as an integrated package would affect uptake and/or efficacy, as this might affect both uptake and the extent to which the two interventions were used together. We recruited from two sources: those having recently sought cessation assistance (mainly Quitline callers wanting self-help materials) and from a cold-contacted sample, enabling us to explore possible effects of the interventions by recent interest in seeking assistance to quit. This was not a typical RCT, as participants were not pre-committed to consider using the intervention(s) they were offered. Because a considerable proportion of those in the intervention groups do not take up the offeredinterventions, between-group comparisons underestimate intervention efficacy. We propose a method to estimate more accurately the true magnitude of effects amongthosewho use the interventions to a criterion level. The aims of this paper are to:• Determine whether an offer of the interventions increased quit success; and• Whether the effects were similar for the QuitCoach and onQ programs.• Test for an interactive or additive benefit of the integrated program (QuitCoach onQ); and• Whether the way the two interventions were offered affected outcomes.• Estimate the impacts of the interventions among those who used them to a criterion level; and• Whether the effects were similar for those recruited after seeking information about cessation versus those cold-contacted.
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