WISE INTERVENTIONS

People who smoked more than 5 cigarettes a day with relatively low incomes (more than $10,000 below the county mean) and who were undereducated (11% of those over 24 had graduated from college) were randomly assigned to a “community care” condition or a condition designed to support an autonomous decision to quit smoking. In the community care condition, participants received county-provided information about quitting smoking, their cholesterol test results, and a list of local smoking cessation programs. In addition to these materials, those in the autonomy-supportive condition met with a counselor four times over 6 months, an initial 50-minute meeting and three 20-minute follow-ups. Counselors were “trained to support the participants in making a clear and autonomous decision about whether or not to make a quit attempt.” They discussed the participants’ smoking history and attitudes, past quit attempts, health risks, and asked whether the participant wanted to stop. If they said yes, they developed a quit plan, “setting a quit date in the next 30 days, informed the patient about the expected time course of withdrawal, and discussed the medications recommended to reduce withdrawal symptoms.” As compared to those in the community care condition, people in the autonomy-supportive condition were more likely to have quit at a 6-month follow up (11.8% vs. 4.1%).