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

A. S. Lennox; Liesl Marten Osman; Ehud Baruch Reiter; Roma Robertson; James Friend; I. McCann; Diane Skatun; P. T. Donnan

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, Liesl Marten Osman, Ehud Baruch Reiter, Roma Robertson, James Friend, I. McCann, Diane Skatun, P. T. Donnan

Research output: Contribution to journal › Article › peer-review

67 Citations (Scopus)

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 die 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.

Original language	English
Pages (from-to)	1396-1400
Number of pages	4
Journal	British Medical Journal
Volume	322
Issue number	7299
DOIs	https://doi.org/10.1136/bmj.322.7299.1396
Publication status	Published - Jun 2001

Bibliographical note

Funding The Chief Scientist Office, Scottish Executive Health Department, with additional funding from the Engineering and Physical Sciences Research Council. The Health Economics Research Unit is funded by the Chief Scientist Office. The views expressed in this paper are those of the authors and not those of the funding bodies.

Keywords

CIGARETTE-SMOKING
ADVICE
SYSTEM
MODEL

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@article{17c43bcc47e8479aa5f3d5ae1adf5cd3,

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

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 die 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 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.",

keywords = "CIGARETTE-SMOKING, ADVICE, SYSTEM, MODEL",

author = "Lennox, {A. S.} and Osman, {Liesl Marten} and Reiter, {Ehud Baruch} and Roma Robertson and James Friend and I. McCann and Diane Skatun and Donnan, {P. T.}",

note = "Funding The Chief Scientist Office, Scottish Executive Health Department, with additional funding from the Engineering and Physical Sciences Research Council. The Health Economics Research Unit is funded by the Chief Scientist Office. The views expressed in this paper are those of the authors and not those of the funding bodies. ",

year = "2001",

month = jun,

doi = "10.1136/bmj.322.7299.1396",

language = "English",

volume = "322",

pages = "1396--1400",

journal = "British Medical Journal",

issn = "0959-8146",

publisher = "BMJ Publishing Group",

number = "7299",

}

TY - JOUR

T1 - Cost effectiveness of computer tailored and non-tailored smoking cessation letters in general practice: randomised controlled trial

AU - Lennox, A. S.

AU - Osman, Liesl Marten

AU - Reiter, Ehud Baruch

AU - Robertson, Roma

AU - Friend, James

AU - McCann, I.

AU - Skatun, Diane

AU - Donnan, P. T.

N1 - Funding The Chief Scientist Office, Scottish Executive Health Department, with additional funding from the Engineering and Physical Sciences Research Council. The Health Economics Research Unit is funded by the Chief Scientist Office. The views expressed in this paper are those of the authors and not those of the funding bodies.

PY - 2001/6

Y1 - 2001/6

N2 - 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 die 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 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.

AB - 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 die 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 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.

KW - CIGARETTE-SMOKING

KW - ADVICE

KW - SYSTEM

KW - MODEL

U2 - 10.1136/bmj.322.7299.1396

DO - 10.1136/bmj.322.7299.1396

M3 - Article

SN - 0959-8146

VL - 322

SP - 1396

EP - 1400

JO - British Medical Journal

JF - British Medical Journal

IS - 7299

ER -

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

Abstract

Bibliographical note

Keywords

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