ESCAPE trial: characteristics of smokers prompted to change their behaviour after receiving tailored feedback reports.

Smoking remains a major public health problem and has an adverse effect on
society. Although the government has invested in initiatives to help smokers quit,
NHS stop smoking services, approximately 70% of smokers have no intention to
quit in the near future and less than 5% use the stop smoking services. Computer
interventions which generate tailored advice reports for one specific person can
reach large sections of the population at a reasonable cost, and are reported to be
more effective in promoting behaviour change than standard materials. The aim of
the ESCAPE study is to assess the effect of computer-tailored reports sent to
smokers recruited through primary care with different levels of motivation and
readiness to quit. Smokers were identified through GP records of 123 MRC GPRF
practices via a proactive recruitment strategy and were randomly allocated to a
control or intervention group, to receive standard information or individually tailored
reports, adapted to reading ability, after returning their baseline questionnaire.
Approximately four weeks later those in the intervention group also received
a progress report based on answers to a follow-up assessment. Abstinence rates,
cognitive change and perceptions of the feedback reports are assessed at a sixmonth
follow-up. To date 6,543 smokers have been recruited, and a large proportion
(87%) have no plans to quit in the near future. Approximately 2770 (76%) in
the intervention group completed a one-month follow-up assessment, of which
6.4% were abstinent at the time. Abstinence was 1.7 times greater for those who
smoked more than 2 hours after waking when compared to those who smoked
within 30 minutes (p=0.012). Also, although those with plans to quit were significantly
more likely to be abstinent (p<0.001), the intervention was successful in
encouraging quit attempts in those with no plans to quit. Proactive recruitment is
an effective way of delivering smoking cessation advice to smokers with varying
motivation levels and in particular reaching those with no plans to quit. Individual
tailored feedback may be an effective way of prompting a quit attempt in smokers.
Cancer Research UK.