Abstract
Background
Low participation rates reduce the public health impact of smoking cessation programs. Two barriers for improving participation are the cost of media campaigns and the proportion of smokers motivated to quit smoking. The objective of this study was to examine the feasibility of using classified newspaper ads and messages aimed at each stage of change to enhance participation in smoking cessation programs.
Methods
Three classified ads were run concurrently in a local daily newspaper for five consecutive days. The ads were designed to engage smokers in each of Prochaska’s five stages of change. Each ad invited smokers or former smokers to call the local health department to participate in a paid focus group to design a new health department program.
Results
Calls were received from 181 eligible smokers, including 124 who provided data for the study. Thirty-seven, 34, and 29 percent of smoking respondents were in precontemplation, contemplation and preparation respectively. Half of ex-smokers were in the action stage. Ads cost $174 (Cdn), thus the cost per recruit was less than a dollar.
Conclusion
Classified ads can recruit smokers from all stages of change. Compared to traditional mass media, classified ads may also be a highly cost-efficient promotional strategy. Results provide justification for further research.
Résumé
Contexte
De faibles taux de participation réduisent l’effet des programmes de renoncement au tabac sur la santé publique. Deux obstacles à l’amélioration de la participation sont le coût des campagnes de publicité dans les médias et la proportion des fumeurs motivés à cesser de fumer. Nous avons cherché à déterminer la possibilité de recourir aux annonces classées dans les journaux et à des messages axés sur chaque étape du changement pour rehausser la participation aux programmes de renoncement au tabac.
Méthode
Trois annonces classées ont paru simultanément dans un quotidien local pendant cinq jours d’affilée. Elles visaient à recruter des fumeurs aux cinq étapes du changement énoncées dans le modèle de Prochaska. Chaque annonce invitait des fumeurs ou d’anciens fumeurs à appeler leur service de santé local pour participer à un groupe de discussion rémunéré et aider à concevoir un nouveau programme pour le service de santé.
Résultats
On a reçu des appels de 181 fumeurs admissibles, dont 124 ont fourni des données pour l’étude. Respectivement 37%, 34% et 29% des répondants fumeurs en étaient à l’étape de la pré-réflexion, de la réflexion et de la préparation. La moitié des anciens fumeurs en étaient à l’étape de l’action. Les annonces ont coûté 174 $CAN, soit moins de 1 $ par recrue. p ]Conclusion: Les annonces classées permettent de recruter des fumeurs à toutes les étapes du changement. Comparées aux médias de masse traditionnels, elles peuvent s’avérer une stratégie promotionnelle très rentable. Les résultats obtenus justifient que l’on pousse la recherche dans cette direction.
References
- 1.Okene JK. Are we pushing the limits of public health interventions for smoking cessation? Health Psychol. 1992;11:277–79. doi: 10.1037/0278-6133.11.5.277. [DOI] [PubMed] [Google Scholar]
- 2.Prochaska JO. A stage paradigm for integrating clinical and public health approaches to smoking cessation. Addict Behav. 1996;2:721–32. doi: 10.1016/0306-4603(96)00031-7. [DOI] [PubMed] [Google Scholar]
- 3.Schar EH, Gutierrez KK. Smoking Cessation Media Campaigns from Around the World. Recommendations from Lessons Learned. Copenhagen: World Health Organization, Regional Office for Europe; 2001. [Google Scholar]
- 4.McDonald PW. Population-based recruitment for quit-smoking programs: An analytic review of communication variables. Prev Med. 1999;28:545–57. doi: 10.1006/pmed.1998.0479. [DOI] [PubMed] [Google Scholar]
- 5.Muddle AN, de Vries H, Strecher VJ. Cost effectiveness of smoking cessation modalities: Comparing apples with oranges? Prev Med. 1996;25:708–16. doi: 10.1006/pmed.1996.0110. [DOI] [PubMed] [Google Scholar]
- 6.Schmid TL, Jeffery RW, Hellerstedt WL. Direct mail recruitment to home-based smoking and weight control programs: A comparison of strategies. Prev Med. 1989;18:503–17. doi: 10.1016/0091-7435(89)90009-1. [DOI] [PubMed] [Google Scholar]
- 7.Shipley RH, Hartwell TD, Austin WD, Clayton AC, Stanley LC. Community stop-smoking contests in the COMMIT trial: Relationship of participation to costs. Prev Med. 1995;24:286–92. doi: 10.1006/pmed.1995.1046. [DOI] [PubMed] [Google Scholar]
- 8.NADbank. Market analysis of print media in Windsor-Essex. 2002. [Google Scholar]
- 9.Health Canada . The Canadian Tobacco Use Monitoring Survey. 2002. [Google Scholar]
- 10.Velicer WF, Fava JL, Prochaska JO, Abrams DB, Emmons KM, Pierce JP. Distribution of smokers by stage in three representative samples. Prev Med. 1995;24:401–11. doi: 10.1006/pmed.1995.1065. [DOI] [PubMed] [Google Scholar]
- 11.Prochaska JO, DiClemente CC, Velicer WF, Rossi JS. Standardized, individualized, interactive, and personalized self-help programs for smoking cessation. Health Psychol. 1993;1:399–405. doi: 10.1037/0278-6133.12.5.399. [DOI] [PubMed] [Google Scholar]
- 12.Rogers EM. Diffusion of Innovations. fourth edition. New York: Free Press; 1995. [Google Scholar]
- 13.Maibach EW, Cotton D. Moving people to behavior change. A staged social cognitive approach to message design. In: Maibach E, Parrott RL, editors. Designing Health Messages. Thousand Oaks, CA: Sage; 1995. [Google Scholar]
- 14.Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviours. Am Psychol. 1992;47:1102–14. doi: 10.1037/0003-066X.47.9.1102. [DOI] [PubMed] [Google Scholar]
- 15.McDonald PW. Enhancing the dissemination of population-based smoking cessation programs: A study of selected communication variables [dissertation] Waterloo (Canada): University of Waterloo; 1997. [Google Scholar]
- 16.Bains N, Pickett W, Hoey J. The use and impact of incentives in population-based smoking cessation programs: A review. Am J Health Prom. 1998;12:307–20. doi: 10.4278/0890-1171-12.5.307. [DOI] [PubMed] [Google Scholar]
- 17.Matson DM, Lee JW, Hopp JW. The impact of incentives on participation and quit rates in worksite smoking cessation programs. Am J Health Prom. 1993;7:270–80. doi: 10.4278/0890-1171-7.4.270. [DOI] [PubMed] [Google Scholar]