DESCRIPTION (provided by applicant): A substantial body of evidence shows that telephone counseling for smoking cessation is more effective than less intense interventions. Moreover, Prospect Theory suggests that because smoking cessation is a prevention behavior with a fairly certain outcome (i.e., quitting is clearly linked to preventing health problems), messages framed in terms of potential gains (i.e., benefits), in contrast to potential losses, should be more persuasive in motivating smoking cessation. Indeed, pilot data from four previous studies shows that gain-framed messages are more effective in encouraging smoking cessation. Thus, building on a decade of research focused on optimizing messages for cancer prevention, we intend to compare New York State Smokers' Quitline counseling and print messages that are either exclusively gain-framed (e.g., you will live longer if you quit smoking) to standard care, which has elements of both gain-framed and loss-framed (e.g., you will die sooner if you continue to smoke) messages. Because this study will compare 2 different types of counseling, no callers to the quitline will be refused services, removing an important barrier to research on quitlines. This study will have two phases. In Phase I, a Pre-Pilot Study will be conducted to: 1) develop the gain-framed counseling protocol and print materials, and 2) train Quitline Specialists such that those in the exclusively gain-framed condition provide primarily gain-framed messages. In Phase II, a randomized pilot clinical trial will be conducted with 2,500 Quitline callers to compare exclusively gain-framed counseling + gain-framed print materials (GF condition) to standard care Quitline counseling + standard print materials (SC condition). Efficacy data from this trial will be used to determine effect size estimates for both 1-week and 3-month self- reported point prevalence abstinence rates. Approximately 60% of callers will receive short-term nicotine replacement therapy. Mediators of message framing effects will also be examined. It is our hope that findings from this study will allow us to develop effective counseling and print materials that can be used for a large- scale, R01 research grant to fund a study testing the effectiveness of gain-framed counseling and print materials for smoking cessation amongst callers to multiple state quitlines. If message framing is shown to enhance treatment outcome in a large-scale study, message framing interventions with quitline counselors could be translated for use by the entire NY state quitline and other quitlines across the country. This would provide a cost-effective method for increasing the effectiveness of a moderate intensity intervention for smoking cessation that has the potential to reach millions of smokers, thereby bolstering tobacco and cancer control efforts across the United States. Studying ways to improve telephone quitline counseling for smokers may improve tobacco control interventions by enhancing quit rates of callers to quitlines. As telephone quitlines have the potential to reach millions of smokers annually, better interventions can greatly impact tobacco and cancer control efforts in the United States.
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