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Randomized Controlled Trial
. 2012 Sep 5:12:740.
doi: 10.1186/1471-2458-12-740.

The Pap smear screening as an occasion for smoking cessation and physical activity counselling: effectiveness of the SPRINT randomized controlled trial

Giuseppe Gorini  1 , Giulia Carreras, Livia Giordano, Emanuela Anghinoni, Anna Iossa, Alessandro Coppo, Fiorella Talassi, Maurizio Galavotti, Elisabetta Chellini; SPRINT Working Group
Affiliations
Randomized Controlled Trial

The Pap smear screening as an occasion for smoking cessation and physical activity counselling: effectiveness of the SPRINT randomized controlled trial

Giuseppe Gorini et al. BMC Public Health. .

Abstract

Background: The organized Cervical Cancer Screening Programme (CCSP) in Italy might represent an occasion to deliver smoking cessation (SC) counselling to women attending the Pap test examination. Evidence of effectiveness of physical activity (PA) promotion and intervention in adjunct to SC counselling is not strong.Objective of the SPRINT trial was to evaluate the effectiveness of a standard SC counselling intervention delivered by trained midwives in the CCSP, and whether the adjunct of a PA counselling to the SC counselling might increase quit rates.

Methods/design: We undertook a randomized controlled trial of 1,100 women undergoing the Pap examination in the three study centres Florence, Turin, and Mantua: 363 were randomly assigned to the SC counselling arm, 366 to the SC + PA counselling arm, and 371 to the control group. The intervention was a standard brief SC counselling combined with a brief counselling on increasing PA, and was tailored according to the Di Clemente-Prochaska motivational stages of change for SC and/or PA. Primary outcomes were quit rates, improvement in the motivational stages of change for SC, and reduced daily cigarette consumption. Analysis was by intention to treat.

Results: Participants randomized in both intervention arms and in the preparation stage of change for SC doubled their likelihood of quitting at 6-month follow-up in comparison to controls (odds ratio [OR]=2.1, 95% confidence interval [95% CI]:1.0-4.6). Moreover, participants in the intervention arms and in the contemplation stage were more likely to reduce their daily cigarette consumption after the intervention (OR=1.8, 95% CI:1.1-3.0). Our study did not show any effect of PA counselling on various outcomes.

Conclusions: Smoking cessation counselling delivered by midwives to smokers in preparation and contemplation stages of change during the Pap-smear screening was effective and should be recommended, given the high number of women attending the cervical cancer screening programme in Italy. Moreover, the daily number of women invited for the Pap-smear examination should be slightly lowered, in order to let midwives deliver SC counselling to smokers.

Trial registration: Current Controlled Trials ISRCTN52660565.

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Figures

Figure 1
Figure 1
Flow chart of the enrolment of women attending the National Cervical Cancer Screening Programme in Florence, Turin, and Mantua.
Figure 2
Figure 2
Crude prevalence of study outcomes at 6-month follow-up.
See this image and copyright information in PMC

References

    1. International Agency for Research on Cancer (IARC) IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. 83. Lyon: Tobacco Smoke and Involuntary Smoking; 2004. - PMC - PubMed
    1. Italian Institute of Statistics (ISTAT) Multipurpose Surveys 1986–2009. 2009. http://www.istat.it.
    1. World Health Organization. Geneva: Framework Convention on Tobacco Control; 2003.
    1. US Department of Health and Human Services. Women and smoking: A Report of the Surgeon General. Atlanta; 2001. http://www.surgeongeneral.gov/library/reports/
    1. Mamme libere da fumo. http://www.mammeliberedalfumo.org/

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