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Computers Help Combat Smoking

09/03/00

SUNDAY, Sept. 3 (HealthSCOUT) -- If you smoke and can also chew gum and type at the same time, you now have a new way to quit.

Smokers who followed a personalized computer-help program while using a nicotine gum showed a 56 percent increase in quitting compared to those who only used the gum and an audio tape, according to a recently published University of Pittsburgh study. "The results [of the computerized program] were remarkably robust for all the different groups, including men and women, light and heavy smokers," says Saul Shiffman, the study's author and director of the Smoking Research Group at the University of Pittsburgh. "These tailored materials make a difference in a person's ability to quit smoking." The results of the study, which was funded by SmithKline Beecham Consumer Healthcare, the manufacturer of Nicorette gum, were published in a recent issue of Archives of Internal Medicine. The study consisted of 3,627 smokers who had called the Nicorette hotline to ask for the free computerized quitting program, called the Committed Quitters program. The researchers divided them into three, equal-size groups to test the efficacy of the program. The first group followed the simplest nicotine gum program, which consists of the gum and an audio taped user's guide that comes with the gum. The second group, in addition to the gum and the audio tape, received the Committed Quitters materials. And the third group received all the materials plus a phone call two days after their quitting date to see how they were doing. "The active phone call had no effect whatsoever, but the computer-tailored program had a substantial effect over and above the user guide," Shiffman says. Six weeks after stopping the program, 36.2 percent of the smokers who had used the personalized program were still not smoking compared to 24.7 percent of those who used the gum and audio tape. At 12 weeks, the figures were still significant, says Shiffman: 27.6 percent of those who used the computerized program were still smoke-free compared to 17.7 percent of the other group, which is 56 percent more for the computer group than the other group. These figures are very encouraging, Shiffman says. "Addictions are hard to quit. To give you some perspective, among people who quit on their own, without any treatment, 97 percent fail in six months," he says. The American Lung Association reports the same low success rates for smokers who quit cold turkey, without help. But lung association spokesman Alex Steinberg of New York's Hudson Valley says that smokers who sign on with one of his organization's stop-smoking programs do as well, if not better, than those in the Nicorette study. Among participants "in ALA-sponsored programs in New York State, approximately 40 percent stop smoking ... forever," he says. "These are time-tested professional techniques used in medical settings." One-quarter of U.S. adults still smoke Smoking is still a national problem, however. Although smoking rates have declined steadily since the 1960s, there are still 48 million smokers in the United States, almost one-quarter of the adult population, according to 1997 lung association statistics. The participants in the Nicorette study were heavy smokers. Almost equally divided among men and women, they had an average age of 41, and had smoked for an average of 22 years. Ninety-one percent had tried to quit before, an average of five times. Before quitting they'd averaged 26 cigarettes a day and had the first one about 15 minutes after waking up, which is an indicator of tobacco dependence. The personalized program, developed by Shiffman and fellow researchers at the University of Pittsburgh, combined a smoker's personal information with behavioral approaches to smoking cessation. In a phone interview, smokers were asked about a dozen questions, including their gender, age, smoking history, estimated quit date and the difficulties they expected to face when they stopped. They then received a packet of materials including a six-week calendar with specific information about their target quit date, personalized health information and week-by-week advice for staying free of cigarettes. "A woman in her 40s, for instance might be told that menopause starts earlier in women who smoke," says Shiffman, or, if money was an issue, "she might be given an estimate of how much she had spent on cigarettes [in the last year] and how much she would spend in the next year if she kept smoking." "Deep computer tailoring takes into account all the differences," he says, "and each group gets what they need." He thinks this method of reaching smokers could be more effective than current smoking clinics. "I teach clinics," he says, "but people don't like clinics. The process is uncomfortable. Getting something in the privacy of your own home is an advantage." "The American Lung Association would certainly endorse the idea that one size doesn't fit all," Steinberg says. "Tobacco addiction affects people differently." The association's numerous stop-smoking programs emphasize the power of education, he adds. "The more you know the risks involved, the less likely you are to damage your body," he says. What To Do If you're interested in the personalized computer help program, you can find out more at Committed Quitters. For more help in stopping smoking, see the Mayo Clinic. And a wealth of smoking statistics can be found by going to the American Lung Association.

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