Quit and win smoking cessation contests: how should effectiveness be evaluated?

BACKGROUND

In societies where there are both multiple influences on smoking cessation and a downward secular cessation trend, the attribution of cessation effects to particular interventions poses challenging evaluation problems. Quit smoking lotteries are gaining popularity as mass-reach smoking cessation strategies. Most published evaluations of the lotteries have reported impressive cessation rates within samples of entrants. However, none has considered the possibility that the lotteries merely concentrate a secular quitting trend around a researched event or whether they increase the cessation rate of the whole community from which entrants derive.

RESULTS

Results from a lottery run in a smoking population (n = 101,277) are presented. Of the 1,167 people who entered, 29.2% self-reported being smoke-free at 4 months. These results are considered against a prediction that the campaign might increase the cumulative background 4-month quit rate (708/101,277 or 0.7%) by a minimum of 10%.

CONCLUSION

It is concluded that such a realistic hope, even if achieved, could in practice never be measured. Implications for evaluating the impact of discrete health promotion evaluations in large communities are discussed in terms of the dilemmas posed by the case study.

"Bread: it's a great way to go". Increasing bread consumption decreases laxative sales in an elderly community

OBJECTIVE

To test the effects on laxative sales of two methods of promoting increased consumption of wholemeal/wholegrain bread by the elderly.

DESIGN

Community intervention trials were carried out in two test communities and one control community on the mid-north coast of New South Wales.

PARTICIPANTS

Small retirement communities with a high proportion of the population aged over 55 years.

INTERVENTIONS

A community organisation strategy (COS) involving the media, community activities and social marketing principles using the theme "Bread: It's a Great Way to Go" was compared with a patient education strategy (PES) through local doctors and a control community (CON).

MAIN OUTCOME MEASURES

Wholemeal/wholegrain bread sales and laxative sales.

RESULTS

There was a 49% decrease in laxative sales corresponding to a 58% increase in sales of wholemeal/wholegrain bread in the COS community but no significant changes in either the PES or CON communities.

CONCLUSIONS

The study suggests a positive, cost effective approach for increasing fibre intake and improving gastrointestinal problems in the elderly.