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Evidence summaries

Interventions for Recruiting Smokers into Cessation Programmes

Personal and tailored interventions, and recruitment strategies that are proactive and intensive in nature may enhance recruitment of participants into smoking cessation programmes. Level of evidence: "C"

Comment: The quality of evidence is downgraded by study limitations (lack of blinding in half of the studies and selective reporting) and by inconsistency (unexplained variability in results).

Summary

A Cochrane review [Abstract] 1 included 19 studies with a total of 14 890 subjects. Three studies made head-to-head comparisons of different types of recruitment strategies. Of these, only one study detected a significant effect, finding that a personal phone call was more effective than a generic invitation letter (RR 40.73, 95% CI 2.53 to 654.74). Results from interventions using the same delivery modes but different content showed that tailored messages through an interactive voice response system resulted in a higher recruitment rate than assessment of smoking status alone using the same system (RR 8.64, 95% CI 4.41 to 16.93; 1 trial, n=521), and that text messages indicating scarcity of places available were more effective than generic text message reminders (RR 1.45, 95% CI 1.07 to 1.96; 1 trial, n=1862). Comparing unrestricted vs restricted number of phone calls to reach potential participants resulted in better recruitment (RR 1.87, 95% CI 1.61 to 2.18; 1 trial, n=1444). Finally, 10 studies investigated the effect of adding a recruitment mode to existing recruitment strategies. Adding a text message reminder or real quotes from participants to a personal phone call improved recruitment of participants (RR 3.38, 95% CI 1.26 to 9.08; 1 trial, n=937 and RR 29.07, 95% CI 1.74 to 485.70; 1 trial, n=811, respectively); that adding a personal phone call to an existing newsletter can also increase recruitment rates (RR 65.12, 95% CI 4.06 to 1045.4; 1 trial, n=469); that a reactive-proactive recruitment phase is more effective than a proactive phase alone (63.8% versus 47.5%, RR not available); and that active recruitment at schools is more effective than passive recruitment (p < 0.001). Out of the 19 included studies, only 4 reported on the effect of recruitment strategy on smoking cessation at 6 months or longer. Only one of them showed a significant difference in the levels of smoking cessation that favoured the enhanced recruitment strategy.

In an RCT 2 smokers planning to quit (n=1070) were randomly assigned to 27 tailored cessation emails (deluxe), 3 to 4 tailored emails with links to downloadable booklets (basic) or a single non-tailored email (single). Self-reported 7-day point-prevalence abstinence was assessed at 1 month, 3 months and 6 months postenrolment.Across follow-ups, abstinence was significantly greater for smokers in the deluxe proup (34%) compared with the single group (25.8%; OR=1.47, 95% CI 1.07 to 2.02, p=0.02) but there was no difference between the basic (30.8%) and the single group (p=0.13). Results were independent of baseline cigarettes per day, interest in quitting, smoker in household, use of nicotine replacement therapy (NRT) or varenicline, and gender.

Date of latest search: 2020-04-12

    References

    • Marcano Belisario JS, Bruggeling MN, Gunn LH et al. Interventions for recruiting smokers into cessation programmes. Cochrane Database Syst Rev 2012;(12):CD009187. [PubMed]
    • Westmaas JL, Bontemps-Jones J, Hendricks PS et al. Randomised controlled trial of stand-alone tailored emails for smoking cessation. Tob Control 2018;27(2):136-146. [PubMed]

Primary/Secondary Keywords