Methods

Country: Canada
Setting: Four counties in Eastern Ontario; entrants to a 1995 Q&W contest in 2 counties (Frontenac, Lennox and Addington), and a random sample of non‐entrant smokers from all 4 counties (Frontenac, Lennox and Addington, Hastings, Prince Edward)
Design: Quasi‐randomized; Intervention group were all entrants to the Q&W contest; controls were selected by random telephone dialling (full details obtained from authors).

Participants

231 Intervention participants, 385 control smokers. All had to be 18+, daily smokers of at least 10 cpd. Baseline differences: Int group higher %female (59.4% vs 54%), younger, more highly educated, more likely to be employed, more likely to be in a professional or semi‐professional job. Significant differences also in av cpd, av years smoking, quit attempts in past year, number of smoking friends, working in a smoke‐free workplace, number of smoking co‐workers, and stage of change.

Interventions

1. Intervention: Entry into a locally publicised Q&W contest. 'Quit Kit' supplied to each entrant (letter of encouragement, cessation info, list of local cessation programmes, tips on maintenance, fridge magnet with health unit info phone number).
2. Control: No cessation support, only baseline and 1 year telephone interview

Outcomes

Contest winners (smoke‐free for month prior to the draw) not biochemically validated; verification was from 'buddy' testimony. Unvalidated self report of 6 months continuous abstinence at 1 year follow up

Notes

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

High risk

C ‐ Inadequate

Methods

Country: USA
Setting: Bluegrass Kentucky 2001 quit and win contest
Design: two‐group quasi‐randomized study

Participants

1. Intervention: 494 registrants in a quit and win contest in Lexington‐Fayette county (56% of all entrants); av age 38, 68% female, 47% married, 89% white, 65% college education, 48% earning >$25,000, 98% smoked cigarettes
2. Control: 512 current smokers selected by random digit dialling from outside the contest area (=8.5% of contacted households). av age 42.8, 56% female, 54% married, 91% white. 37% college education, 39% >$25,000, 92% smoked cigarettes.
All participants had to be 18+ and using tobacco within last 30 days

Interventions

1. Intervention: Community quit date; weekly gender‐specific cessation information by post throughout contest; online quit assistance; toll‐free phone quit assistance; media campaign; support through worksites, physicians, health professionals, community leaders. Registrants declared tobacco status, and nominated a tobacco‐free 'buddy'. Lottery draw for cash prizes (grand prize US$2500 and 5 prizes of US$500) for all validated quitters.
2. Controls: baseline and follow‐up surveys only
Telephone interviews at baseline, and at 3, 6 and 12m.

Outcomes

7‐day PP. Abstinence at contest end validated by 'buddy' testimony. Follow‐up interviews at 3m, 6m and 12m, with urinary cotinine test for all quitters at all follow‐up points.

Notes

In 2005 version of our review, this trial reported on low‐income smokers only. The current version reports full trial data.
ITT analysis, with missing or non‐negative urines and drop‐outs counted as continuing smokers.

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

High risk

C ‐ Inadequate

Methods

Country: USA
Setting: New York (Erie and Niagara counties) 2003 quit and win contest
Design: three‐group non‐randomized study; daily smokers could enter the Q&W contest, or take up free NRT vouchers, or do both. No active control group, but 524 smokers took part in a 2‐wave telephone survey (Oct/Nov 2002 and March/May 2004) to provide a population estimate.

Participants

1. 849 entered the Q&W contest; mean cpd 21, mean age 40, 63% F, 23% ethnic minority, 37% married, 62% > high school education
2. 690 took up free NRT; mean cpd 21, mean age 43, 58% F, 20% ethnic minority, 43% married, 57% > high school education
3. 230 took free NRT and entered the contest ; mean cpd 20, mean age 41, 64% F, 30% ethnic minority, 41% married, 60% > high school education
Participants in Groups 2 and 3 had to be 18+ years, smoking at least 10 cpd; women had to declare themselves not pregnant

Interventions

1. Q&W contest, 1m beginning January 1st 2003, for prize draw of US$1000, plus other prizes
2. NRT group screened via NYS Quitline, community stop smoking programmes and local pharmacies, and given a voucher for 2‐wk supply of NRT patches or gum.
3. Combination group took up both components

Outcomes

7‐day PP abstinence, assessed 4m‐7m post‐quit date. 62% of Q&W group random sample (204), 60% of NRT group random sample (179) and 64% Combination group random sample (143) gave follow‐up interviews.

Notes

new for 2008 update. Campaign particularly targeted ethnic minority smokers, i.e. African American, Latino.

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

D ‐ Not used

Methods

Country: USA
Setting: Mankato, Minnesota, in 1986 as part of the MHHP
Design: Randomized controlled trial

Participants

570 adult smokers. av age 42, av cpd 20, married 76%; 53% of the marrieds had a smoking spouse, and 24% were married to an ex‐smoker. 39.7% had no more than a high school education, 39.6% had college or vocational training, 20.7% completed college or higher. 16% professional, 39% clerical, 30% blue‐collar, 15% not working for pay.

Interventions

1. Intervention 1; 200 people: NCI 'Quit for Good' programme, cessation and maintenance/relapse prevention booklets.
2. Intervention 2; 200 people: MHHP 'Quit and Win' programme. A detailed brochure, more structured than 'Quit for Good', on quitting and maintenance.
3. Control group: 170 people: No intervention.
Follow‐up telephone interviews on smoking status (self report only), and recollection and use of the materials.

Outcomes

PP at 7 months, results given as ITT and also excluding non‐responders; analysis also offered on those who quit only after receiving the materials. All claims of abstinence were unconfirmed biochemically.

Notes

Follow up was often only 3‐4 months after receipt of materials, rather than the planned 7 months.
No prizes were offered to the Q&W group; the intervention being tested was simply the self‐help cessation materials

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

Unclear risk

B ‐ Unclear

Methods

Country: Russia
Setting: Pitkaranta and Suojarvi, a comparable neighbouring district, both in Russian Karelia
Design: quasi‐experimental panel study in 1996, with baseline and 1‐year smoking surveys

Participants

176 daily smokers in Pitkaranta (experimental) and 202 in Suojarvi (control). Baseline comparisons not discussed, but communities reportedly 'very similar'. Smoking prevalence estimated to be 47% for men and 6.3% for women in Pitkaranta, and 55% and 8.3% respectively in Suojarvi.

Interventions

1. Intervention: 6 month rolling Q&W contest, monthly draws for holidays for quitters and their nominated supporters. Newspaper and leaflet support throughout the campaign.
2. Control: Surveys only, no cessation programme or contest.

Outcomes

PP at 12 month on ITT basis, and on responders‐only basis. CO validation for potential winners

Notes

Baseline measure was taken from a large international study of adult populations in different countries in Eastern and Western Europe. One‐year follow up was an ad hoc survey by the McAlister study team.

Risk of bias

Bias

Authors' judgement

Support for judgement

Allocation concealment (selection bias)

High risk

C ‐ Inadequate