This study will create longitudinally-tailored print materials for smoking cessation and compare the efficacy of multiple messages tailored on baseline data vs. retailored on new data among callers to the Cancer Information Service.

cancer prevention, tobacco, cessation, quit smoking, Cancer Information Service, CIS, print, expert tailored, retailoring, dissemination, telecounseling

1. Design, develop, and implement four educational interventions to promote smoking cessation.
2. Design, develop, and implement a media outreach strategy that increases the total number of smokers calling the participating Cancer Information Service offices for assistance in quitting smoking.
3. Test for efficacy and cost-effectiveness the use of tailored print material to promote behavior change.

1,978 smokers who call the national Cancer Information Service.

Smokers calling the National Cancer Institute's (NCI) Cancer Information Service (CIS) for help in quitting smoking initially received brief cognitive-behavioral cessation counseling from a CIS information specialist. Following a baseline interview administered by the information specialist, subjects were randomly assigned to one of four conditions, each delivered by U.S. mail:

1. a single, untailored smoking cessation guide (SU)
2. a single, tailored smoking cessation guide (ST)
3. a series of four (multiple) printed materials tailored only to baseline data (MT)
4. a series of four (multiple) printed materials tailored to baseline as well as retailored using 5-month interim progress data (MRT).

The primary outcome measure was 7-daypoint prevalence abstinence rates assessed using a computer-assisted telephone interview (CATI) at12-month follow-up.

At12-monthfollow-up,using intent-to-treat, imputed ,and per-protocol analyses, no differences were found among the four experimental conditions (linear trend),or when the ST, MT, and MRT groups were compared with the control (SU) group. Participants in the two multiple message group conditions combined (MT+MRT), however, had significantly higher abstinence rates than participants in the two single message group conditions combined (SU+ST). Moreover, among subjects who reported quitting at the 5-month follow-up, participants receiving the MRT materials reported higher abstinence rates at 12 months than the other three groups combined (SU +ST+MT).

The results of this study support the effectiveness, over and above a single telecounseling interaction, of multiple tailored print material contacts on cessation. These effects, however may be due to tailoring, or the longitudinal nature of the two multiple tailored conditions, or both. The strongest evidence for tailoring occurred in the MRT condition for relapse prevention, suggesting that print materials tailored to interim progress may be especially effective in this context. The qualities of specific psychosocial and communication elements in tailored materials should receive attention in future research.

Strecher VJ, Marcus A, Bishop K, Fleisher L, Stengle W, Levinson A, Fairclogh DL, Wolfe P, Morra M, Davis S, Warnecke R, Heimendinger J, and Nowak M. A randomized controlled trial of multiple tailored messages for smoking cessation among callers to the Cancer Information Service. Journal of Health Communication, 2005 10(Supplement 1): 105-118.