Comparison of text and video computer-tailored interventions for smoking cessation: Randomized controlled trial

Background: a wide range of effective smoking cessation interventions have been developed to help smokers to quit. smoking rates remain high,especially among people with a lower level of education. multiple tailoring adapted to the individual's readiness to quit and the use of visual messaging may increase smoking cessation. objective: the results of video and text computer tailoring were compared with the results of a control condition. main effects and differential effects for subgroups with different educational levels and different levels of readiness to quit were assessed. methods: during a blind randomized controlled trial,smokers willing to quit within 6 months were assigned to a video computer tailoring group with video messages (n=670),a text computer tailoring group with text messages (n=708),or to a control condition with short generic text advice (n=721). after 6 months,effects on 7-day point prevalence abstinence and prolonged abstinence were assessed using logistic regression analyses. analyses were conducted in 2 samples: (1) respondents (as randomly assigned) who filled in the baseline questionnaire and completed the first session of the program,and (2) a subsample of sample 1,excluding respondents who did not adhere to at least one further intervention session. in primary analyses,we used a negative scenario in which respondents lost to follow-up were classified as smokers. complete case analysis and multiple imputation analyses were considered as secondary analyses. results: in sample 1,the negative scenario analyses revealed that video computer tailoring was more effective in increasing 7-day point prevalence abstinence than the control condition (or 1.45,95% ci 1.09-1.94,p=.01). video computer tailoring also resulted in significantly higher prolonged abstinence rates than controls among smokers with a low (ready to quit within 4-6 months) readiness to quit (or 5.13,95% ci 1.76-14.92,p=.003). analyses of sample 2 showed similar results,although text computer tailoring was also more effective than control in realizing 7-day point prevalence abstinence. no differential effects were found for level of education. complete case analyses and multiple imputation yielded similar results. conclusions: in all analyses,video computer tailoring was effective in realizing smoking cessation. furthermore,video computer tailoring was especially successful for smokers with a low readiness to quit smoking. text computer tailoring was only effective for sample 2. results suggest that video-based messages with personalized feedback adapted to the smoker's motivation to quit might be effective in increasing abstinence rates for smokers with diverse educational levels. trial registration: netherlands trial register: ntr3102; http://www.trialregister.nl/trialreg/admin/rctview.asp?tc= 3102 (archived by webcite at http://www.webcitation.org/6ns8xhzuv). © holly o witteman.