Effectiveness of Personalized Risk Info and Invites to Smoking Cessation Sessions

Study Questions:

Do tailored letters with invitations to attend initial Stop Smoking sessions improve participation in smoking cessation courses and increase smoking cessation?


This was a randomized controlled trial of 18 National Health Service (NHS) Stop Smoking Service centers in England, conducted between January 31, 2011, and July 12, 2014. Participants were current smokers ≥16 years of age, who were identified through medical records from 99 general practices and who were invited to participate from their general practitioner. Participants had to report being motivated to quit, and not having attended a NHS stop smoking program in the past 12 months. Participants were then randomized to receive an individually tailored letter detailing their personal risk related to smoking and an invitation to attend a no-commitment introductory session run by the local Stop Smoking Services. The control group received a generic letter advertising the local Stop Smoking Services. The primary outcome was attendance at the first session of the Stop Smoking Service session within 6 months of randomization. The major secondary outcome was 7-day point-prevalent abstinence at 6 months (validated by salivary cotinine).


A total of 4,384 smokers were randomized to the intervention group (tailored letters) and 1,748 smokers were randomized to the control group. Compared to those who did not participate in the trial, there were fewer male participants, and participants were older than nonparticipants. Attendance at the first session of a Stop Smoking Services course was significantly higher in the intervention group than in the control group (458 [17.4%] vs. 158 [9.0%] participants for an unadjusted odds ratio of 2.12 [95% confidence interval, 1.75-2.57]; p < 0.0001). Participants in the intervention group also had higher rates of 7-day point-prevalent abstinence at 6 months.


The authors concluded that delivery of personalized risk information alongside an invitation to an introductory session more than doubled the odds of attending a Stop Smoking session compared with a standard generic invitation to contact the service. This result suggests that a more proactive approach, combined with an opportunity to experience local services, can reduce patient barriers to receiving treatment, and has high potential to increase uptake.


This study supports the use of tailored messaging to smokers to initiate participation in smoking cessation programs.

Clinical Topics: Prevention, Smoking

Keywords: Advertising as Topic, Cotinine, General Practitioners, National Health Programs, Primary Prevention, Risk Assessment, Smoking, Smoking Cessation, Tobacco Use Cessation Products

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