Education on the Dangers of Secondhand Smoke: New Treatment for Nondaily Smokers

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DESCRIPTION (provided by candidate): Nondaily smoking (smoking on some days but not every day) is increasing, representing up to one quarter of current tobacco users. Nondaily smokers tend to minimize the health risks associated with their tobacco use but are concerned about the impact their smoking has upon others. Therefore, standard cessation counseling that focuses on personal health risks may not motivate nondaily smokers to quit. There are observational data that support counseling nondaily smokers on the dangers that their secondhand smoke poses to others as a promising alternative cessation message. We hypothesize that successful clinical treatment of nondaily smoking can be achieved with counseling that stresses the dangers of secondhand smoke to others as opposed to counseling that focuses on personal health risks. The primary aim of this study is to test a pilot intervention for nondaily smokers using individual counseling that compares the harms to self with harm to others as a smoking cessation strategy. The primary outcome will be an increase in readiness to quit, a factor predictive of future success with cessation. Secondary outcomes will include (1) a treatment based change in attitudes about the dangers that secondhand smoke poses to the nonsmoker and (2) a decrease in personal cigarette consumption. The proposed study will recruit and randomize nondaily smokers to receive either (1)15 minutes of standard counseling (personal health risk) or (2) 15 minutes of experimental counseling (the harms secondhand smoke poses to the nonsmoker). At baseline, subjects will complete questionnaires that measure (1) readiness to quit smoking as determined by their scores on The Contemplation Ladder and (2) smoking behavior as reported by monthly cigarette use and urinary cotinine levels. These measures will be compared with those at 3 month follow-up visits. Nondaily smoking is increasing in prevalence and carries significant health risks. While nondaily smokers minimize the consequences of their habit, they fear the impact their smoking has upon others. The results from this research application will inform health care professionals about new ways to treat nondaily smokers; education on the dangers of secondhand smoke may be a more effective cessation strategy for this group.