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. 2019 Dec 6;2019(12):CD011207. doi: 10.1002/14651858.CD011207.pub2

Burford 2013.

Methods Design: RT
Groups: intervention (photo‐aging smoking cessation); control group (usual care)
Participants Pharmacies: 8
Pharmacy worker: not reported
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Pharmacy users: 160 smokers
  • mean age: intervention 24.2 ± 4.1 years; control 25.1 ± 4.1 years

  • % female: intervention 68.7%; control 56.2%


Setting: urban
Country: Perth, Australia
Interventions Pharmacy worker‐directed intervention: not reported
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Pharmacy user‐directed intervention: standard 2‐minute smoking cessation advice from the pharmacist plus participants were digitally photo‐aged so they could preview images of themselves as a lifelong smoker and as a nonsmoker, and were invited to view the age‐processed images, received smoking cessation advice, and were screened for body dysmorphia.
  • Delivered by: unclear whether pharmacist or researcher delivered the intervention

  • Type: behaviour change/smoking cessation

  • Mode of delivery: individual face‐to‐face

  • TDF: knowledge, beliefs about consequences

  • Duration: unclear – probably a single session with email of image sent to client. Not clear if there was further support from pharmacist.

  • Follow‐up: 6 months


Pharmacy user control: standard 2‐minute smoking cessation advice from the pharmacist.
Outcomes Pharmacy worker: not assessed
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Pharmacy user:
  • Clinical: carbon monoxide (CO) breath test

  • Psychological health: not assessed

  • Behavioural: Fagerström Smoking Dependence scale

  • Quality of life: not assessed

  • Process: study designed questions concerning: attitudes toward personal appearance, opinions about health risks associated with smoking, and perceived barriers to quitting smoking; willingness to pay (WTP) for the digital aging service.

  • Cost: estimated cost per participant; cost‐effectivenes

Notes Study/intervention name: none given
Funding source: not reported
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Randomisation by researcher on alternate weeks
Allocation concealment (selection bias) High risk Quote: "Allocation to groups was not performed as eligible participants were recruited, but according to the treatment being used at the pharmacy during that week."
Baseline outcome measures similar Low risk Quote: "there were no significant differences between the control and intervention group on demographic or smoking dependence at baseline"
Baseline characteristics similar Unclear risk There were differences between groups for concern about physical appearance, and the belief that facial wrinkles are associated with smoking.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Few participants lost
Blinding of outcome assessment (detection bias) 
 All outcomes High risk Quote: "Because of the nature of the intervention, the participants and researcher could not be blinded to the study group."
Protection against contamination Unclear risk Allocation to group dependent on week to avoid contamination, but unclear if successful
Selective reporting (reporting bias) Low risk All outcomes appear to have been reported.
Other bias Unclear risk Low numbers of control groups self report quit status was verified with objective carbon monoxide measurement
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Quote: "Because of the nature of the intervention, the participants and researcher could not be blinded to the study group."