The proposed research is designed to develop more effective self-help models and interventions for smoking cessation. Although smoking is the most preventable cause of cancer, 50 million Americans continue to smoke. MOst smokers report that they would not attend formalized treatment programs but would use self-help materials. Consequently, there is an urgent need to develop and disseminate more effective models and interventions for individuals wishing to quit smoking on their own. The proposed research is a continuation of ten years of research on self-change approaches to smoking cessation funded by Grant CA27821. The proposed study will take stage-specific, self-help smoking cessation programs that have been most promising in Phase III research and transfer the technology for dissemination to a larger scale Phase IV defined population of smokers belonging to a Health Maintenance Organization. Our Phase I, II, and III research provides the foundation for investigation of and intervention with subjects at each stage of change: precontemplation, contemplation, ready for action, action, relapse and maintenance. This Phase IV sample of smokers will be recruited proactively, so that more precontemplators and contemplators will comprise this sample. This project will assess how our self-help, stage-specific interventions work by utilizing process-to- outcome measures. In Study I a factorial design will be used which crosses 1, 2, 3, and 6 serial contacts with both interactive, computer-based and non-interactive interventions. Comparisons across different serial contact conditions will clarify serial treatment effects. Planned comparisons will clarify whether interactive, computer-based interventions are more effective and cost-effective compared to non-interactive manuals. Study II compares two enhanced versions of our standard computer interactive program, one utilizing a nicotine fading, hand-held computer modality and the other a counselor calling modality. Data analyses will identify the most effective, cost effective, and generalizable elements of these smoking cessation interventions in preparation for dissemination to larger Phase V populations. This research is designed to contribute to cancer control by developing and evaluating more effective self-help models and interventions that have potential for providing interactive yet cost-effective self-help programs for entire populations of smokers.
