Using Group Commitment for Smoking Cessation

Not Applicable

Completed

Conditions: Smoking

Interventions: Behavioral: Smoking cessation education and counseling
Behavioral: Group commitment contract

Registration Number: NCT01311115

Lead Sponsor: University of California, Berkeley

Brief Summary: This study proposes a novel behavioral intervention to help smokers in Thailand to achieve their goals of quitting. Smoking treatment programs are rare throughout most of Asia and unlikely to meet the impending demand for quitting that tobacco control regulations is stimulating. New approaches are needed.

The present study is a randomized controlled trial to test the effectiveness of a novel, scalable approach to smoking cessation that is targeted toward rural Southeast Asian communities. Thailand is used as a test case to explore if pairs of smokers quit successfully after making financially-backed commitments and receiving cash incentives to quit. The control group receives education and counseling about quitting. In addition to education and counseling about quitting, the intervention includes two key components:

1. Each participant is encouraged to deposit his "cigarette money" on a weekly basis, to be returned only if the smoker quits successfully within three months. Such commitment contracts, based on theory from behavioral economics, are designed to help a person to maintain self-control and motivation in the face of temptation.

2. Each participant is paired with another study participant. If both quit, each receives a cash bonus. The joint incentives are designed to lead partners to support each other throughout the quit attempt.

Thus, group commitment contracts marshal a robust blend of elements: financial commitment, social support, peer pressure, and monetary rewards. A larger, follow-up evaluation will clarify the relative importance of each of these elements.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 201

Inclusion Criteria

Current smoker of at least 10 cigarettes per week and at least 100 cigarettes over the course of a lifetime
Residents of the study area in Nakhon Nayok province, which includes the six subdistricts of Klong Yai, Chumpon, Bueng San, Pak Phli, Khao Phoem, or Ongkharak

Exclusion Criteria

Pregnant
Plans to leave the study area within the next 12 months

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Education and counseling	Smoking cessation education and counseling	Participants in this group receive educational pamphlets about quitting smoking and one-time, group counseling from a nurse trained in smoking cessation counseling.
Group commitment contracts	Group commitment contract	In addition to education and counseling, the intervention includes the following components: 1. Each participant is encouraged to deposit his "cigarette money" on a weekly basis, to be returned only if the smoker quits successfully within three months. 2. The project gives a series of two matching contributions of 150 baht each to participants who meet certain deposit requirements. 3. Each participant is paired with another study participant. If both quit, each receives a cash bonus of 1,200 baht. At enrollment, pairs receive brief counseling on ways to support each other during the quit attempt.
Group commitment contracts	Smoking cessation education and counseling	In addition to education and counseling, the intervention includes the following components: 1. Each participant is encouraged to deposit his "cigarette money" on a weekly basis, to be returned only if the smoker quits successfully within three months. 2. The project gives a series of two matching contributions of 150 baht each to participants who meet certain deposit requirements. 3. Each participant is paired with another study participant. If both quit, each receives a cash bonus of 1,200 baht. At enrollment, pairs receive brief counseling on ways to support each other during the quit attempt.

Primary Outcome Measures

Name	Time	Method
Smoking Status at 6 Months	6 months after enrollment	7-day point prevalence of smoking abstinence measured 6 months after enrollment, using a NicCheck urine cotinine test. Participants who self-report having smoked in the last 7 days, as part of the follow-up survey, are considered to be continuing smokers.

Secondary Outcome Measures

Name	Time	Method
Concordance of Smoking Status Between Partners at 6 Months	6 months after enrollment	The concordance of smoking status among randomly assigned pairs: both abstain, both smoke, or one abstains and one smokes, measured using 7-day point-prevalence abstinence at 6 months after enrollment, measured using self-reported abstinence and urine cotinine testing. Participants in the control condition are assigned to a pair, but their partner's identity is never revealed during the study.
Smoking Status at 3 Months	3 months after enrollment	7-day point prevalence of smoking abstinence measured 3 months after enrollment, using a NicCheck urine cotinine test. Participants who self-report having smoked in the last 7 days, as part of the follow-up survey, are considered to be continuing smokers.
Concordance of Smoking Status Between Partners at 3 Months	3 months after enrollment	The concordance of smoking status among randomly assigned pairs: both abstain, both smoke, or one abstains and one smokes, measured using 7-day point-prevalence abstinence at 3 months after enrollment, measured using self-reported abstinence and urine cotinine testing. Participants in the control condition are assigned to a pair, but their partner's identity is never revealed during the study.
Smoking Status at 14 Months	14 months after enrollment	7-day point prevalence of smoking abstinence measured 6 months after enrollment, using a NicCheck urine cotinine test. Participants who self-report having smoked in the last 7 days, as part of the follow-up survey, are considered to be continuing smokers.