Effects of practitioner-delivered brief counseling and computer-generated tailored letters on cigarettes per day among smokers who do not quit-A quasi-randomized controlled trial

Background: It is still unclear how brief counseling for smoking cessation, combined with proactive recruitment of participants, impacts on those smokers not reaching the primary treatment goal of tobacco abstinence. Thus, within a quasi-randomized controlled trial, we examined the effects of (1) practitioner-delivered brief advice and (2) computer-generated tailored letters on cigarettes per day (CPD) among participants not succeeding in quitting. Methods: A total of 34 general practices (participation rate 87%) were randomly selected in a German region. Within these practices, 1499 daily smoking patients aged 18-70 years (participation rate 80%) agreed to participate in a smoking cessation intervention trial. Allocation to study condition was based on time of practice attendance. Latent growth analyses were performed on the subsample of 1334 (89%) smokers who did not reach 6-month prolonged abstinence within the 2-year follow-up period. CPD was assessed at baseline and at 6-, 12-, 18-, and 24-month follow-ups. Results: Both interventions led to small but significant reductions in CPD, and they did not differ in efficacy. Treatment effects occurred within the first 6 months and could be sustained by the continuing smokers until the 24-month follow-up. Conclusions: Present results complement earlier findings of increased abstinence rates in the total sample. It can be concluded that, even if applied to unselected samples of smokers, from which only a minority initially intends to change, both brief counseling strategies are able to significantly decrease tobacco consumption. They hence appear to provide a means to reducing tobacco-related disease among general medical practice patients.