State-of-the-Art Synthesis of Interventions to Promote Quit Intentions and Smoking Cessation

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Project Summary Most people who smoke have no intention of quitting in the next 6 months or beyond, which begs critical questions of the field of cancer prevention and control: How can tobacco cessation be promoted among these smokers? What are the best ways to increase quit intentions? And how effective is changing quit intentions in promoting smoking cessation? Despite the conceptual and practical importance of these questions, we lack evidence-based answers – because a comprehensive test of the effectiveness of the hundreds of trials on quit intentions and smoking cessation has yet to be undertaken. This project is a novel research synthesis that is designed to answer these questions. In Aim 1, we will meta-analyze ~400 randomized controlled trials to (a) discover how effective are interventions in promoting quit intentions, and (b) quantify the impact of changing quit intentions on cessation rates. In Aim 2, we will determine what are the “active ingredients” of interventions that lead to increased quit intentions and successful smoking cessation. We will contact trial authors to obtain the original program materials and code the behavior change techniques that were deployed using the Behavior Change Technique Taxonomy–v1 (Michie et al., 2013). For each randomized trial, we will also code features of the sample, methodology, measurement of intention, and intervention (e.g., number of sessions, duration, mode and source of delivery, use of pharmacotherapy, risk of bias) and assess associations with effect sizes. A novel analytic strategy called Iterative Meta-Regression Analysis will be used to model how behavior change techniques and other modifiable intervention strategies (e.g., delivery mode, intensity) combine to generate the largest changes in quit intentions and the greatest improvements in cessation rates. The project will offer a landmark synthesis of research on smoking cessation that quantifies the effectiveness of interventions in promoting quit intentions and transforming quit intentions into smoking cessation – and specifies ‘what works.’ Moreover, in Aim 3, we will generate a database of effective, research-tested program materials that researchers, policy makers, and practitioners can access via the project website (www.SmokingCessationTrials.info). Our project will thus offer a theoretically based and empirically derived roadmap for future research and practice that contributes to reducing the leading cause of cancer.