Randomized trial: Quitline specialist training in gain-framed vs standard-care messages for smoking cessation

Abstract

Background Smoking accounts for a large proportion of cancer-related mortality, creating a need for better smoking cessation efforts. We investigated whether gain-framed messages (ie, presenting benefits of quitting) will be a more persuasive method to encourage smoking cessation than standard-care messages (ie, presenting both costs of smoking [loss-framed] and benefits of quitting).MethodsTwenty-eight specialists working at the New York State Smokers' Quitline (a free telephone-based smoking cessation service) were randomly assigned to provide gain-framed or standard-care counseling and print materials. Smokers (n = 2032) who called the New York State Smokers' Quitline between March 10, 2008, and June 13, 2008, were exposed to either gain-framed (n = 810) or standard-care (n = 1222) messages, and all medically eligible callers received nicotine replacement therapy. A subset of 400 call recordings was coded to assess treatment fidelity. All treated smokers were contacted for 2-week and 3-month follow-up interviews. All statistical tests were two-sided. ResultsSpecialists providing gain-framed counseling used gain-framed statements statistically significantly more frequently than those providing standard-care counseling as assessed with frequency ratings for the two types of gain-framed statements, achieving benefits and avoiding negative consequences (for achieving benefits, gain-framed mean frequency rating = 3.9 vs standard-care mean frequency rating = 1.4; mean difference =-2.5; 95% confidence interval [CI] =-2.8 to-2.3; P