A prospective, randomised, controlled trial of smoking cessation through personalised intervention

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Smoking remains a major preventable risk factor for cardiovascular disease. This research proposal builds on 2 observations; firstly, experiencing a heart attack is a teachable moment that enables up to 60% smokers to abruptly quit once they have experienced a heart attack; and secondly, we have demonstrated in a pilot study that it is feasible to induce smoking cessation through subjects watching a DVD containing images of him/herself, his/her partner and family digitally superimposed into a scenario depicting the person having a heart attack as a result of smoking, and the potential consequences to the partner and family. Using this novel approach, which we describe as a personalized simulated teachable moment, 7 of 13 smokers (53%) were abstinent at 6 months (published in Am J Cardiol 2010). We have since completed 20 subjects of whom 12 (60%) were abstinent at 12 months. In the current proposal, we will evaluate the simulated teachable moment hypothesis in a prospective randomized controlled study. We will compare smoking cessation rates using the personalized DVD with the same video using actors. In addition, we will evaluate the psychological impact of the personalized video. If this study demonstrates an additive effect of the personalized simulated teachable moment in smoking cessation, its use would be supported as an adjunct to smoking cessation, which in turn would have major health benefits in our society. We will conduct the study in selected General Practices and Pharmacies to investigate its broad applicability and ability to be disseminated widely.

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