To test the effectiveness of a risk communication program in moving smokers from precontemplation to further stages of change as compared to brief advice.
Randomized controlled study. Risk communication program consisted of graphical representations of numerical data regarding risk of lung cancer and chronic obstructive lung disease (COPD), and the benefits of smoking cessation.The stage of smoking cessation, knowledge levels and risk perceptions were evaluated at baseline and 3 weeks after the intervention.
Of the 148 smokers recruited for the study, 132 smokers completed the study. The majority of participants were white women ≤ 50 years of age, with ≤12 years of education and in a precontemplation or contemplation stage. The median duration of counseling was 5 and 7 minutes in the brief advice and the risk communication groups respectively. Both the risk communication group and the brief advice group progressed from a precontemplation to a further stage after the intervention without any statistically significant difference between the groups. None of the variables that were tested predicted stage progression. Both groups had low levels of knowledge about lung cancer and COPD, and the benefits of smoking cessation at baseline. There was no improvement in the knowledge level or risk perceptions of lung disease 3 weeks after each intervention in either of the groups.CONCLUSIONS: The majority of the smokers in a primary care setting were in an earlier stage of change. Providing risk information using graphical representations was only as effective as brief advice in moving smokers from an earlier to a later stage of change.
The majority of the smokers encountered in clinical settings are in earlier stages of change and unlikely to accept the more traditional action oriented smoking cessation interventions such as pharmacological treatments or referral to a smoking cessation clinic. Therefore, brief advice remains the most important form of counseling these smokers. The content of brief advice needs to be studied further to increase its effectiveness.
N. Uysal, None.