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Clinical Trial
. 2001 Jun 9;322(7299):1396.
doi: 10.1136/bmj.322.7299.1396.

Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled trial

A S Lennox  1 , L M Osman, E Reiter, R Robertson, J Friend, I McCann, D Skatun, P T Donnan
Affiliations
Clinical Trial

Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled trial

A S Lennox et al. BMJ. .

Abstract

Objectives: To develop and evaluate, in a primary care setting, a computerised system for generating tailored letters about smoking cessation.

Design: Randomised controlled trial.

Setting: Six general practices in Aberdeen, Scotland.

Participants: 2553 smokers aged 17 to 65.

Interventions: All participants received a questionnaire asking about their smoking. Participants subsequently received either a computer tailored or a non-tailored, standard letter on smoking cessation, or no letter.

Main outcome measures: Prevalence of validated abstinence at six months; change in intention to stop smoking in the next six months.

Results: The validated cessation rate at six months was 3.5% (30/857) (95% confidence interval 2.3% to 4.7%) for the tailored letter group, 4.4% (37/846) (3.0% to 5.8%) for the non-tailored letter group, and 2.6% (22/850) (1.5% to 3.7%) for the control (no letter) group. After adjustment for significant covariates, the cessation rate was 66% greater (-4% to 186%; P=0.07) in the non-tailored letter group than that in the no letter group. Among participants who smoked <20 cigarettes per day, the cessation rate in the non-tailored letter group was 87% greater (0% to 246%; P=0.05) than that in the no letter group. Among heavy smokers who did not quit, a 76% higher rate of positive shift in "stage of change" (intention to quit within a particular period of time) was seen compared with those who received no letter (11% to 180%; P=0.02). The increase in cost for each additional quitter in the non-tailored letter group compared with the no letter group was pound 89.

Conclusions: In a large general practice, a brief non-tailored letter effectively increased cessation rates among smokers. A tailored letter was not effective in increasing cessation rates but promoted shift in movement towards cessation ("stage of change") in heavy smokers. As a pragmatic tool to encourage cessation of smoking, a mass mailing of non-tailored letters from general practices is more cost effective than computer tailored letters or no letters.

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Figures

Figure
Figure
Flow of participants through the study
See this image and copyright information in PMC

References

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