Monday, October 24, 10:30
a.m.-noon
Appealing to Concern About Appearance To Encourage
Tobacco-Free Lifestyles
Authors
P.E. Hysert1; A.L. Mirand2; G.A. Giovino1;
K. Cummings1; A. Hyland1; K.A. Donohue1.
1Roswell Park Cancer Institute, Buffalo, NY;
2Frontier
Science and Technologies, Kenmore, NY.
Background
The Task Force for Tobacco-Free Women and Girls
provides computerized demonstrations to illustrate how the
premature wrinkling caused by smoking will look on peoples' own
faces. The program was originally developed as a tobacco
prevention tool for teenagers, but a new version is valid for
pre-teen to beyond middle age participants. The program was
developed at the urging of students who advised the Task Force
to show the effects of tobacco use on appearance in response to
the question, "What would help a girl be tobacco-free?" Several
students specifically recommended computer morphing.
Methods
The Task Force sponsored adaptation of existing age
progression software for the creation of this demonstration. It
is used in schools, colleges and at community events to
encourage people to be tobacco-free – to quit smoking or never
start. Each participant is photographed and her/his picture is
immediately processed. The resulting pair of side-by-side images
gradually becomes older, with one image illustrating normal
aging and the other adding the premature wrinkles typical in
smokers at the same age. A live demonstration will be part of
this presentation at the conference.
Results
Evaluation date will be presented. Pre-and
post-intervention surveys completed by 456 participants were
analyzed to determine their experience with/attitudes about
tobacco and to assess changes in attitude. Data show significant
change on the questions: "Do you think that people risk harming
themselves if they smoke one or less than one cigarette per
day?" and "Does concern about your appearance affect the choices
you make from day to day?"
Discussion
This intervention often evokes strong reactions,
including shrieks, laughter and exclamations of "I'm never going
to look like that!" Smokers have been motivated to quit after
seeing their projected future appearance. Many participants
comment that their "aged" pictures resemble older relatives,
supporting validity of the age projection.
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Put It Out Rockland—A Successful Cessation Program
Authors
U. Diffley1; M. Ferrara1; L. Lieberman1.
1Rockland County Department of Health, Pomona, NY.
Background
Consistent with a strong context of tobacco
programming, Rockland County enjoys declining rates of current
adult smoking, 15.4% among Rockland respondents to the May
2003 random digit dial survey and 13.4% in May 2005. Nearly
half of Rockland smokers (47%) have made at least one serious
quit attempt in the past year. Smoking rates for low-income
and underserved sub-groups are considerably higher than these
countywide rates. Data support the need for the "Put It Out
Rockland" (PIOR) program, a free, comprehensive, adult
cessation program which specifically targets certain
underserved groups. An innovative achievement in government
and community collaboration, the Health Department's
comprehensive tobacco initiative placed Rockland among the few
government entities in NYS to proactively dedicate significant
tobacco settlement monies directly to cessation. PIOR is now
maintained with county and STEPS funding. PIOR has helped meet
increased demand for cessation services since passage of NY's
tough smokefree worksite legislation in 2003.
Methods
The county's financial commitment to rigorous
evaluation has enabled an ongoing study using pretest and
post-test surveys and 3, 6, and 12 month telephone followup.
Results
In two years, 578 smokers registered for the PIOR
program, with 412 (71%) of them completing the program. First
year data suggested that tailored patch dosing and longer term
patch use (10 weeks instead of 8) yielded higher long-term
quit rates. Thus patch dosing and duration were modified in
the second year. Telephone follow-ups were achieved for 90% of
all program completers at three months, 81% at 6 months, and
64% at one year. Among those reached, there was a 56% quit
rate at 3 months, 42% at six months, and 46% at one year.
Discussion
The data suggest that the PIOR program, with its
unique tailored NRT dosing, yields higher than average quit
rates, even among heavy and long-term smokers.
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Tobacco Provider Systems Change
Authors
T. Peterson1; L. Adams1.
1Steps to a HealthierNY, Jamestown, NY.
Background
The Chautauqua County Steps to a HealthierNY
program collaborated with the Tobacco Control Program and WCA
Hospital to change hospital policy to ask all patients if they
use tobacco products and refer them to the NYS Smokers
Quitline.
Methods
Due to involvement in the Steps Consortium, the WCA
Hospital Wellness Coordinator became aware of the need to
educate and enforce policies regarding addressing tobacco use
with all patients. The Wellness Coordinator worked with the
Tobacco Control Coordinator and the Steps Program to change
hospital policy regarding questioning all patients about
tobacco use. The new policy includes asking about tobacco use
and following a two-minute intervention strategy. The WCA
Wellness Coordinator and the Tobacco Control Coordinator
attended nurse manager meetings to share the policy change
protocol and clipboards were distributed with the NYS Smokers
Quitline phone number and the question, "Have you quit smoking
yet?" Both Wellness and Tobacco Control Coordinators will
deliver a brief training on the two-minute intervention and
distribute clipboards to all remaining staff by September
2005.
Results
The policy was changed so that hospital staff will
use the two-minute intervention strategy to ask each patient
about tobacco use and refer them to the NYS Smokers Quitline.
Discussion
The use of internal personnel is necessary to make
widespread policy change. The policy has greater
administrative buy-in when written and approached by
institutional insiders. In addition, employing a two-minute
intervention using 5 A's strategy is in the Clinical Practice
Guidelines as an effective cessation technique.
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Computer-Based Smoking Cessation Interventions
Author
L. Swartz, Oregon Center for Applied Science, Eugene, OR.
Background
Traditional smoking cessation interventions range
from the individualized physician-initiated interventions, or
group and individual counseling, to the broader population-based
pamphlets and public message campaigns. Drawbacks to these
methods include the high cost of delivery as well as a lack of
specificity to the smoker's individual needs. Computer-based
smoking cessation interventions hold promise; they can be
inexpensive to deliver; fidelity of implementation can be
maintained; and messages may be tailored to the individual.
Methods
Over the past 10 years, we have developed three
computer-based smoking cessation interventions, including
Internet-delivered interventions. Program materials were
tailored on a variety of variables including Prochaska's Stage
of Change, demographics (race/ethnicity, gender, age), smoking
habits, and previous quitting experience. Program time frames
ranged from a single-visit, a repeatable browser experience, to
a guided 21-day intervention with project staff contact and
automated feedback. All were heavily video-based with narration
and testimonials from smokers. Development phases for each
project included extensive focus groups, and each was evaluated
in a randomized clinical trial.
Results
Results from each prior project influenced the content
and development of the subsequent project. All of the
interventions showed promising results in attitudinal measures
and self-reported behavior. Although the structured 21-day
program is still in evaluation (12-month follow-up data is still
being collected), this program appears to be the most successful
of the three approaches in helping smokers maintain abstinence.
Discsussion
Issues around accessing and acceptability of
computer-based interventions are still developing, and
evaluating Internet programs can be challenging. However,
well-designed, evidence-based computer-based interventions offer
a promising means for assisting smokers to quit.
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