Targeting Smokers with Low Readiness to Change with Tailored and Nontailored Self-Help Materials

doi:10.1006/pmed.1998.0407

Preventive Medicine

Volume 28, Issue 2, February 1999, Pages 203-211

https://doi.org/10.1006/pmed.1998.0407 Get rights and content

Abstract

Background.Few smoking cessation self-help materials are available for smokers who are not planning to quit. However, computer-tailored interventions can be designed specifically for these smokers.

Methods.In a large randomized field trial (N= 843), two different tailored smoking cessation self-help interventions (multiple tailoring and single tailoring) and one standardized smoking cessation self-help guide were compared with a no-information control group and with each other. The contents of the tailored interventions were adapted to individuals' self-reported stage of change, outcome expectations, self-efficacy levels, and smoking behavior.

Results.The primary outcome measure was forward stage transition. The standardized self-help guide had no effect. Among smokers who were not planning to quit within the next 5 years the multiple-tailored intervention was more effective than the single-tailored in tervention. This pattern was supported by the cognitive changes caused by the interventions. Among smokers who were planning to quit within the next 5 years but not within the next 6 months, none of the self-help materials had any effect.

Conclusion.The present results show that the self-help material currently available in the Netherlands, the standardized self-help guide, was not effective among smokers with low readiness to change. However, computer-generated tailored interventions seem a promising means of communicating information on smoking and smoking cessation to these smokers.

References (49)

WF Velicer et al.
An expert system intervention for smoking cessation
Addict Behav
(1993)
SL McFall et al.
The effects and use of maintenance newsletters in a smoking cessation intervention
Addict Behav
(1993)
JO Prochaska et al.
Predicting change in smoking status for self-changers
Addict Behav
(1985)
H De Vries et al.
Self-efficacy as an important determinant of quitting among pregnant women who smoke
Prev Med
(1994)
WF Velicer et al.
Distribution of smokers by stage in three representative samples
Prev Med
(1995)
WF Velicer et al.
A criterion measurement model
Addict Behav
(1996)
A Dijkstra et al.
Subtypes within a precontemplating sample of smokers: a preliminary extension of the stages of change
Addict Behav
(1997)
JL Fava et al.
Applying the transtheoretical model to a representative sample of smokers
Addict Behav
(1995)
JL Kristeller et al.
Processes of change in smoking cessation: a cross-validation study in cardiac patients
J Subst Abuse
(1992)
KM Cummings et al.
Format and quitting instructions as factors influencing the impact of a self-administered quit smoking program
Health Educ Q
(1988)

TJ Glynn et al.

Essential elements of self-help/minimal intervention strategies for smoking cessation

Health Educ Q

(1990)

E Lichtenstein et al.

Smoking cessation: what have we learned over the past decade

J Consult Clin Psychol

(1992)

AN Mudde et al.

Publieksevaluatie van de actie: volwassen bevolking [Public evaluation of the project: the adult population]

(1994)

H De Vries et al.

Voorlichting op maat: een nieuwe interactieve voorlichtingsmethode [Tai lored education: a new interactive method of health education]

Tijdschr Gezondheidsbevord

(1995)

VJ Strecher et al.

The effect of computer-tailored smoking cessation messages in family practice settings

J Fam Pract

(1994)

SJ Curry et al.

A randomized trial of self-help materials, personalized feedback, and telephone counseling with nonvolunteer smokers

J Consult Clin Psychol

(1995)

MK Campbell et al.

Improving dietary behavior: the effectiveness of tailored messages in primary care settings

Am J Public Health

(1994)

MW Kreuter et al.

Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial

Health Educ Res

(1996)

A Dijkstra et al.

Long-term effectiveness of computer-generated tailored feed-back in smoking cessation

Health Educ Res

(1998)

DH Ershoff et al.

A randomized trial of serialized self-help smoking cessation program for pregnant women in an HMO

Am J Public Health

(1989)

JO Prochaska et al.

Standardized, individualized, and personalized self-help programs for smoking cessation

Health Psychol

(1993)

AL Davis et al.

Self-help smoking cessation and maintenance programs: a comparative study with 12-month follow-up by the American Lung Association

Am J Public Health

(1984)

A Dijkstra et al.

Tailored interventions to communicate stage-matched information to smokers in different motivational stages

J Consult Clin Psychol

(1998)

CS Skinnerm et al.

Physicians' recommendations for mammography: do tailored messages make a difference

Am J Public Health

(1994)

Cited by (82)

A review of research on cigarette smoking in Preventive Medicine in recognition of the journal's 50th anniversary
2022, Preventive Medicine
Citation Excerpt :
Another body of research focused on improving cessation rates among pregnant women including innovations around the use of financial incentives (e.g., Secker-Walker et al., 1998; Ferreira-Borges, 2005; Higgins et al., 2014; Kurti et al., 2020). Other innovations focused on the use of computer tailoring around the transtheoretical model of behavior change and motivational interviewing for reducing multiple risk behaviors including smoking (e.g., Dijkstra et al., 1999; Prochaska et al., 2001; Prochaska et al., 2008a; Stanczyk et al., 2016). A major innovation discernible among these treatment studies is a body of work on nicotine replacement therapy (NRT), starting with early seminal studies demonstrating the efficacy of nicotine gum (e.g., Fagerström, 1984; Sutton and Hallett, 1988), development of transdermal NRT (Allen et al., 1994), matching of transdermal NRT dose to smoking level (e.g., Solomon et al., 2000), combined use of short- and long-acting NRT (e.g., Kornitzer et al., 1995), and extending the safety profile of NRT to populations with co-morbid medical conditions (e.g., Wiggers et al., 2005).
This report reviews the literature on cigarette smoking published in Preventive Medicine over the past 50 years. The goal is twofold. First, to acknowledge the 50th anniversary of Preventive Medicine and its role in disseminating research on cigarette smoking by providing an abridged summary of smoking research published in the journal from inception through June 23, 2022. Second, to review experimental reports to identify contributions to innovations in tobacco control and regulatory efforts to reduce cigarette smoking. We searched PubMed using the search terms cigarette/cigarettes, tobacco products, smoking, smoking cessation, Preventive Medicine. Titles and abstracts were reviewed in duplicate, excluding reports not addressing cigarette smoking. Included reports were categorized by study type (original study, commentary, review). Experimental articles were assessed for impact using iCite, a National Institutes of Health web application that provides bibliometric information for articles in defined topic areas. The review identified 1181 articles on cigarette smoking: 1018 original studies (86.2%), 107 literature reviews (9.1%), and 56 commentaries (4.7%); 166 of the 1018 original studies (16%) were experimental reports. In the iCite analysis these 166 experimental articles received 6366 total citations, a mean (standard error) citation rate/article of 38.35 (±3.21) and mean relative citation ratio of 1.85 (±0.17) which is at the 73rd percentile for NIH-funded field- and time-normalized reports. Overall, this review demonstrates an ongoing and impactful contribution of Preventive Medicine to efforts to reduce cigarette smoking, the most preventable cause of premature death.
Tailored information helps people progress towards reducing their beef consumption
2017, Journal of Environmental Psychology
Citation Excerpt :
Rakowski et al. (1998) found that a tailored approach motivated significantly more women to take a mammography as compared to a standard information package. Dijkstra, De Vries, and Roijackers (1999) found that stage-tailored intervention packages increased the likelihood of smokers to initiate a smoke abstinence. Several literature reviews report some positive, but also contradictive or disappointing results for stage based intervention approaches in promoting physical activity (Adams & White, 2003; Hutchison, Breckon, & Johnston, 2008) or health behavior (Bridle et al., 2005).
Stage-based theories of behavior change predict that people should have a different need for information in various stages. We tested this assumption in three studies on reduction of beef consumption on Norwegian samples. An information website was developed providing information on why and how to reduce beef consumption. In Study 1 (N=389), user behavior on this website was analyzed depending on the stage of change. It was found that people try to self-tailor the information, but do not fully succeed. In Study 2 (N=869) and Study 3 (N=3508) a randomized field experiment was conducted, comparing the effect of giving access to the section of the website matching the stage, to a control group with no access, a group with access to all information, and a group with a randomly selected stage-mismatched information. The tailored information outperformed the other conditions significantly. For reduction of beef consumption itself, the results were inconclusive.
Socioeconomic variation in recall and perceived effectiveness of campaign advertisements to promote smoking cessation
2011, Social Science and Medicine
Citation Excerpt :
For instance, relative to smokers at later stages, precontemplators have higher levels of nicotine dependence, fewer previous quit attempts and lower self-efficacy for quitting (Prochaska & DiClemente, 1983). The theory has been used to develop targeted communication strategies designed to maximize success in smoking cessation, taking into account the cognitions and behaviors that characterize smokers at each stage of the behavior change continuum (e.g., Dijkstra, De Vries, & Roijackers, 1999; Rimer, Orleans, Cristinzio, Telepchak, & Keintz, 1994). Recently, Veer, Tutty, and Willemse (2008) compared responses to different types of cessation ads among smokers in different stages of change.
There are large disparities in cigarette smoking rates by socioeconomic status (SES) in many countries. There is mixed evidence about the relative effectiveness of smoking cessation media campaigns in promoting quitting between lower and higher SES populations, and studies suggest that some types of ad content may have differential effects by SES. We analyzed data from five waves of the New York Media Tracking Survey Online (MTSO), a web survey involving over 7000 adult smokers conducted between 2007 and 2009, to assess SES variation in response to smoking cessation ads. Smokers with low levels of education and income less often recalled ads focused on how to quit, and perceived them as less effective, than ads using graphic imagery or personal testimonials to convey why to quit. Contrary to predictions offered by the Stages of Change Model, we found no evidence that variation in readiness to quit smoking explained patterns of response by education. Results offer guidance for theorists and campaign planners in developing campaigns that are likely to promote cessation among less educated populations.
Message framing effects on food consumption: A social marketing perspective
2021, Australian Journal of Management
Barriers and Pathways to Changing Smoking and Risky Drinking in Primary Care Patients With Chronic Conditions Who Failed to Respond to Brief Advice
2021, Primary Care Companion for CNS Disorders
Print-based self-help interventions for smoking cessation
2019, Cochrane Database of Systematic Reviews

View all citing articles on Scopus

^☆: This research was supported by a grant from the Dutch Cancer Society.

^☆☆: Baan, BBreteler, MH, MVan Der Rijt, GA, J

²: To whom correspondence and reprint requests should be addressed at the Department of Clinical and Health Psychology, Leiden University, P.O. Box 9555, 2300 RB Leiden, The Netherlands. E-mail:[email protected].

View full text

Regular ArticleTargeting Smokers with Low Readiness to Change with Tailored and Nontailored Self-Help Materials☆,☆☆

Abstract

Addict Behav

Addict Behav

Addict Behav

Prev Med

Prev Med

Addict Behav

Addict Behav

Addict Behav

J Subst Abuse

Format and quitting instructions as factors influencing the impact of a self-administered quit smoking program

Health Educ Q

Essential elements of self-help/minimal intervention strategies for smoking cessation

Health Educ Q

Smoking cessation: what have we learned over the past decade

J Consult Clin Psychol

Publieksevaluatie van de actie: volwassen bevolking [Public evaluation of the project: the adult population]

Voorlichting op maat: een nieuwe interactieve voorlichtingsmethode [Tai lored education: a new interactive method of health education]

Tijdschr Gezondheidsbevord

The effect of computer-tailored smoking cessation messages in family practice settings

J Fam Pract

A randomized trial of self-help materials, personalized feedback, and telephone counseling with nonvolunteer smokers

J Consult Clin Psychol

Improving dietary behavior: the effectiveness of tailored messages in primary care settings

Am J Public Health

Do tailored behavior change messages enhance the effectiveness of health risk appraisal? Results from a randomized trial

Health Educ Res

Long-term effectiveness of computer-generated tailored feed-back in smoking cessation

Health Educ Res

A randomized trial of serialized self-help smoking cessation program for pregnant women in an HMO

Am J Public Health

Standardized, individualized, and personalized self-help programs for smoking cessation

Health Psychol

Self-help smoking cessation and maintenance programs: a comparative study with 12-month follow-up by the American Lung Association

Am J Public Health

Tailored interventions to communicate stage-matched information to smokers in different motivational stages

J Consult Clin Psychol

Physicians' recommendations for mammography: do tailored messages make a difference

Am J Public Health

Regular Article
Targeting Smokers with Low Readiness to Change with Tailored and Nontailored Self-Help Materials☆,☆☆