The goal is to measure the impact of a self-help smoking cessation program upon a population of women cigarette smokers who have not volunteered for treatment. We will empanel a large, randomly selected sample (approximately 1,5000) of adult women cigarette smokers who are members of the Maxicare HMO in Southern California in a long-term smoking cessation study. The subjects will be aware of their participation in a UCLA study of """"""""preventive health behavior"""""""", but not alerted to the focus on smoking cessation. The study population will be divided into an experimental group and a usual group control. Women in the experimental group will receive from Maxicare a mailed, unsolicited self-help smoking cessation program designed to address the specific needs and concerns of women smokers. Women in the usual care control condition will receive only routine Maxicare services. All empanelled women in the """"""""preventive health behavior"""""""" study will provide baseline information regarding smoking behavior and attitudes, cessation attempts, and current motivation to quit embedded in an assessment of a variety of preventive health behaviors such as seat belt use, nutrition, weight control and exercise. All subjects will be interviewed by telephone periodically over a two-year period. Interviews will cover changes in smoking status, motivation/intention to quit, etc. as well as changes in other health behaviors. Self-reported smoking cessation will be validated by continine analysis of saliva samples collected during home visits. Outcome measures will include comparisons between intervention and control conditions on a variety of smoking behaviors, such as short- and long-term cessation rates, changes in motivation to quit, etc. The involvement of Maxicare Health Plans in this study offers important advantages, including their ongoing emphasis on preventive health care and their ability to generate objective health outcome data in a non-volunteer population. Findings from this study can also be readily exported and utilized in other population settings.
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