Enhancing Quit & Win contests to improve cessation among college smokers: a randomized clinical trial
Janet L Thomas1, Xianghua Luo2,3, Jill Bengtson1
1Department of Medicine, Division of General Internal Medicine, University of Minnesota, Minneapolis, MN, USA.
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.
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