Quit and Win contests for smoking cessation

 

Abstract

Background

Quit and Win contests were developed in the 1980s by the Minnesota Heart Health Program, and have been widely used since then as a population-based smoking cessation intervention at local, national and international level. Since 1994 an international contest has been held every two years in as many as 80 countries (2002).

Objectives

To determine whether quit and win contests can deliver higher long-term quit rates than baseline community quit rates.
To assess the impact of such programmes, we considered both the quit rates achieved by participants, and the population impact, which takes into account the proportion of the target population entering the contest.

Search methods

We searched the Cochrane Tobacco Addiction Group Specialized Register, with additional searches of MEDLINE, EMBASE, CINAHL, PsycINFO and Google Scholar. Search terms included competition*, quit and win, quit to win, contest*, prize*. Most recent search date was November 2007.

Selection criteria

We considered randomized controlled trials, allocating individuals or communities to experimental or control conditions. We also considered controlled studies with baseline and post-intervention measures.

Data collection and analysis

Data were extracted by one author and checked by the second. We contacted study authors for additional data where necessary. The main outcome measure was abstinence from smoking for at least six months from the start of the intervention. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. We decided against performing a meta-analysis, because of the heterogeneity of the included studies, and the small number of scientifically valid studies.

Main results

Five studies met our inclusion criteria. Three demonstrated significantly higher quit rates (8% to 20%) for the quit and win group than for the control group at the 12-month assessment. However, the population impact measure, where available, suggests that the effect of contests on community prevalence of smoking is small, with fewer than one in 500 smokers quitting because of the contest. Levels of deception, where they could be quantified, were high. Although surveys suggest that international quit and win contests may be effective, especially in developing countries, the lack of controlled studies precludes any firm conclusions from this review.

Authors' conclusions

Quit and win contests at local and regional level appear to deliver quit rates above baseline community rates, although the population impact of the contests seems to be relatively low. Contests may be subject to levels of deception which could compromise the validity of the intervention. International contests may prove to be an effective mechanism, particularly in developing countries, but a lack of well-designed comparative studies precludes any firm conclusions.

 

Plain language summary

Do Quit and Win contests encourage people to give up smoking

Controlled trials suggest that quit and win contests may help some smokers to quit, but they have little effect on community smoking rates. Fewer than one smoker in 500 quits because of the contests. Deception levels, where they can be measured, are often high. International quit and win contests are often well supported, especially in developing countries, but there is no clear evidence from trials that they are effective.

 

摘要

背景

戒菸競賽

戒菸競賽在1980年代由Minnesota Heart Health Program發展的，而且廣泛的使用在以社區、國家或國際間以人口為基礎的戒菸處遇。從1994年開始國際戒菸競賽每2年舉行一次，且在多達80個國家舉行(2002).

目標

決定是否戒菸比賽比起社區戒菸率基線能提供更高的長期戒菸率。為了評估這些方案的影響，我們考慮完成比賽受試的戒菸率和全人口的影響的戒菸率(特別是那些加入比賽的比例)。

搜尋策略

我們搜尋Cochrane Tobacco Addiction Group specialized register, with additional searches of MEDLINE (January 1966 to September 2004), EMBASE (180 to 2004/8), CINAHL (1982 to 2004/8) and PsycINFO (1872 to 2004/6). 搜索範圍包括競爭*，戒菸和獲勝，因戒菸而贏，比賽*，獎賞。

選擇標準

我們考量隨機對照試驗，分配個人或社區的實驗或控制的條件。我們還考慮控制組研究的基準線和處遇後的測量。

資料收集與分析

由一名作者摘錄資料，另一名作者檢查。如果需要額外資料，我們與研究的第一作者接觸。主要結果測量是從開始處遇後至少六個月停止吸菸。在每一個試驗中，我們使用最嚴格的戒菸標準，生化的驗證率。我們決定不執行後設分析，因為研究的異質性，以及只有少數的科學有效的驗證率。

主要結論

4篇研究符合納入標準。3篇的研究中顯示在12個月的評估，戒菸率在實驗組顯著的高於控制組(8% to 20%)。然而，在可得的全人口的影響的測量上建議比賽對社區吸菸盛行率的效果小，而且比500吸菸者不到1人戒菸還小。在可測量到的欺騙率仍相當高。雖然調查顯示，在國際間戒菸競賽比賽可能有效，特別是在發展中國家，但缺乏控制對照的研究，因此本文排除了任何可靠的結論。

作者結論

儘管對全人口比賽的影響似乎是相對較低，在區域層級的戒菸競賽所呈現的戒菸率高於一般社區戒菸率。比賽可能會受到受試的欺騙而可能危害處遇的有效性。國際間比賽可能被證明是一種有效的機制，特別是在發展中國家，但缺乏精心設計的比較研究，因此排除了任何可靠的結論。

翻譯人

本摘要由彰化基督教醫院胡淑惠翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

戒菸競賽對社區的吸菸率可能只有很小的影響，但也缺乏隨機對照試驗的證據。由對照試驗顯示，戒菸比賽可以幫助一些吸菸者戒菸，但對社區的吸菸率成效甚微。在500人的競賽中，少於一人戒菸。而測量到欺騙的水平，往往很高。但國際間戒菸競賽往往得到很好的支持，特別是在發展中國家，但沒有明確的證據證明試驗是有效。