J. Med. Internet Res. - Internet-based photoaging within Australian pharmacies to promote smoking cessation: randomized controlled trial.

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Resumo

CKGROUND: Tobacco smoking leads to death or disability and a drain on national resources. The literature suggests that cigarette smoking continues to be a major modifiable risk factor for a variety of diseases and that smokers aged 18-30 years are relatively resistant to antismoking messages due to their widely held belief that they will not be lifelong smokers.OBJECTIVE: To conduct a randomized controlled trial (RCT) of a computer-generated photoaging intervention to promote smoking cessation among young adult smokers within a community pharmacy setting.METHODS: A trial was designed with 80% power based on the effect size observed in a published pilot study; 160 subjects were recruited (80 allocated to the control group and 80 to the intervention group) from 8 metropolitan community pharmacies located around Perth city center in Western Australia. All participants received standardized smoking cessation advice. The intervention group participants were also digitally photoaged by using the Internet-based APRIL Face Aging software so they could preview images of themselves as a lifelong smoker and as a nonsmoker. Due to the nature of the intervention, the participants and researcher could not be blinded to the study. The main outcome measure was quit attempts at 6-month follow-up, both self-reported and biochemically validated through testing for carbon monoxide (CO), and nicotine dependence assessed via the Fagerstr?m scale.RESULTS: At 6-month follow-up, 5 of 80 control group participants (6.3%) suggested they had quit smoking, but only 1 of 80 control group participants (1.3%) consented to, and was confirmed by, CO validation. In the intervention group, 22 of 80 participants (27.5%) reported quitting, with 11 of 80 participants (13.8%) confirmed by CO testing. This difference in biochemically confirmed quit attempts was statistically significant ((2) 1=9.0, P=.003). A repeated measures analysis suggested the average intervention group smoking dependence score had also significantly dropped compared to control participants (P<.001). These differences remained statistically significant after adjustment for small differences in gender distribution and nicotine dependence between the groups. The mean cost of implementing the intervention was estimated at AU $5.79 per participant. The incremental cost-effectiveness ratio was AU $46 per additional quitter. The mean cost that participants indicated they were willing to pay for the digital aging service was AU $20.25 (SD 15.32).CONCLUSIONS: Demonstrating the detrimental effects on facial physical appearance by using a computer-generated simulation may be both effective and cost-effective at persuading young adult smokers to quit.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12609000885291; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12609000885291 (Archived by WebCite at http://www.webcitation.org/6F2kMt3kC).

Resumo Limpo

ckground tobacco smoke lead death disabl drain nation resourc literatur suggest cigarett smoke continu major modifi risk factor varieti diseas smoker age year relat resist antismok messag due wide held belief will lifelong smokersobject conduct random control trial rct computergener photoag intervent promot smoke cessat among young adult smoker within communiti pharmaci settingmethod trial design power base effect size observ publish pilot studi subject recruit alloc control group intervent group metropolitan communiti pharmaci locat around perth citi center western australia particip receiv standard smoke cessat advic intervent group particip also digit photoag use internetbas april face age softwar preview imag lifelong smoker nonsmok due natur intervent particip research blind studi main outcom measur quit attempt month followup selfreport biochem valid test carbon monoxid co nicotin depend assess via fagerstrm scaleresult month followup control group particip suggest quit smoke control group particip consent confirm co valid intervent group particip report quit particip confirm co test differ biochem confirm quit attempt statist signific p repeat measur analysi suggest averag intervent group smoke depend score also signific drop compar control particip p differ remain statist signific adjust small differ gender distribut nicotin depend group mean cost implement intervent estim au per particip increment costeffect ratio au per addit quitter mean cost particip indic will pay digit age servic au sd conclus demonstr detriment effect facial physic appear use computergener simul may effect costeffect persuad young adult smoker quittrial registr australian new zealand clinic trial registri actrn httpswwwanzctrorgautrialregistrationtrialreviewaspxactrn archiv webcit httpwwwwebcitationorgfkmtkc

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