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. 1995 Feb;85(2):193–200. doi: 10.2105/ajph.85.2.193

Community intervention trial for smoking cessation (COMMIT): II. Changes in adult cigarette smoking prevalence.

PMCID: PMC1615297  PMID: 7856778

Abstract

OBJECTIVES. COMMIT (Community Intervention Trial for Smoking Cessation) investigated whether a community-level multichannel intervention would decrease the prevalence of adult cigarette smoking and increase quitting, with heavy smokers (> or = 25 cigarettes per day) receiving the highest priority. METHODS. One community within each of 11 matched community pairs (10 in the United States, 1 in Canada) was randomly assigned to intervention. Baseline (1988) and final (1993) telephone surveys sampled households to determine prevalence of smoking behavior. RESULTS. Among the target population aged 25 to 64 years, there was no intervention effect on heavy smoking prevalence, which decreased by 2.9 percentage points in both intervention and comparison communities. Overall smoking prevalence decreased by 3.5 in intervention communities vs 3.2 in comparison communities, a difference not statistically significant, while the mean quit ratios were 0.198 versus 0.185, respectively, a difference of 0.013 (90% test-based confidence interval = -0.003, 0.028). CONCLUSIONS. Results are consistent with the cohort analysis reported separately, although the more powerful cohort design showed a statistically significant intervention effect upon light-to-moderate smokers. This community-based intervention did not have a significant impact on smoking prevalence beyond the favorable secular trends. In future efforts, additional strategies should be incorporated and rigorously evaluated.

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Selected References

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  1. Carleton R. A., Lasater T. M., Assaf A., Lefebvre R. C., McKinlay S. M. The Pawtucket Heart Health Program: I. An experiment in population-based disease prevention. R I Med J. 1987 Dec;70(12):533–538. [PubMed] [Google Scholar]
  2. Farquhar J. W., Fortmann S. P., Flora J. A., Taylor C. B., Haskell W. L., Williams P. T., Maccoby N., Wood P. D. Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Project. JAMA. 1990 Jul 18;264(3):359–365. [PubMed] [Google Scholar]
  3. Feldman H. A., McKinlay S. M. Cohort versus cross-sectional design in large field trials: precision, sample size, and a unifying model. Stat Med. 1994 Jan 15;13(1):61–78. doi: 10.1002/sim.4780130108. [DOI] [PubMed] [Google Scholar]
  4. Fortmann S. P., Taylor C. B., Flora J. A., Jatulis D. E. Changes in adult cigarette smoking prevalence after 5 years of community health education: the Stanford Five-City Project. Am J Epidemiol. 1993 Jan 1;137(1):82–96. doi: 10.1093/oxfordjournals.aje.a116605. [DOI] [PubMed] [Google Scholar]
  5. Freedman L. S., Green S. B., Byar D. P. Assessing the gain in efficiency due to matching in a community intervention study. Stat Med. 1990 Aug;9(8):943–952. doi: 10.1002/sim.4780090810. [DOI] [PubMed] [Google Scholar]
  6. Gail M. H., Byar D. P., Pechacek T. F., Corle D. K. Aspects of statistical design for the Community Intervention Trial for Smoking Cessation (COMMIT). Control Clin Trials. 1992 Feb;13(1):6–21. doi: 10.1016/0197-2456(92)90026-v. [DOI] [PubMed] [Google Scholar]
  7. Koepsell T. D., Martin D. C., Diehr P. H., Psaty B. M., Wagner E. H., Perrin E. B., Cheadle A. Data analysis and sample size issues in evaluations of community-based health promotion and disease prevention programs: a mixed-model analysis of variance approach. J Clin Epidemiol. 1991;44(7):701–713. doi: 10.1016/0895-4356(91)90030-d. [DOI] [PubMed] [Google Scholar]
  8. Luepker R. V., Murray D. M., Jacobs D. R., Jr, Mittelmark M. B., Bracht N., Carlaw R., Crow R., Elmer P., Finnegan J., Folsom A. R. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota Heart Health Program. Am J Public Health. 1994 Sep;84(9):1383–1393. doi: 10.2105/ajph.84.9.1383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. McLaughlin J. K., Dietz M. S., Mehl E. S., Blot W. J. Reliability of surrogate information on cigarette smoking by type of informant. Am J Epidemiol. 1987 Jul;126(1):144–146. doi: 10.1093/oxfordjournals.aje.a114647. [DOI] [PubMed] [Google Scholar]
  10. Mittelmark M. B., Luepker R. V., Jacobs D. R., Bracht N. F., Carlaw R. W., Crow R. S., Finnegan J., Grimm R. H., Jeffery R. W., Kline F. G. Community-wide prevention of cardiovascular disease: education strategies of the Minnesota Heart Health Program. Prev Med. 1986 Jan;15(1):1–17. doi: 10.1016/0091-7435(86)90031-9. [DOI] [PubMed] [Google Scholar]
  11. Murray D. M., Hannan P. J. Planning for the appropriate analysis in school-based drug-use prevention studies. J Consult Clin Psychol. 1990 Aug;58(4):458–468. doi: 10.1037//0022-006x.58.4.458. [DOI] [PubMed] [Google Scholar]
  12. Puska P., Salonen J. T., Nissinen A., Tuomilehto J., Vartiainen E., Korhonen H., Tanskanen A., Rönnqvist P., Koskela K., Huttunen J. Change in risk factors for coronary heart disease during 10 years of a community intervention programme (North Karelia project). Br Med J (Clin Res Ed) 1983 Dec 17;287(6408):1840–1844. doi: 10.1136/bmj.287.6408.1840. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Puska P., Tuomilehto J., Salonen J., Neittaanmäki L., Maki J., Virtamo J., Nissinen A., Koskela K., Takalo T. Changes in coronary risk factors during comprehensive five-year community programme to control cardiovascular diseases (North Karelia project). Br Med J. 1979 Nov 10;2(6199):1173–1178. doi: 10.1136/bmj.2.6199.1173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Siemiatycki J., Campbell S., Richardson L., Aubert D. Quality of response in different population groups in mail and telephone surveys. Am J Epidemiol. 1984 Aug;120(2):302–314. doi: 10.1093/oxfordjournals.aje.a113893. [DOI] [PubMed] [Google Scholar]
  15. Wacholder S., Silverman D. T., McLaughlin J. K., Mandel J. S. Selection of controls in case-control studies. II. Types of controls. Am J Epidemiol. 1992 May 1;135(9):1029–1041. doi: 10.1093/oxfordjournals.aje.a116397. [DOI] [PubMed] [Google Scholar]

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