Department of Psychiatry, Yale University School of Medicine, 1 Long Wharf Dr, Box 18, New Haven, CT 06511, USA.
J Natl Cancer Inst. 2010 Jan 20;102(2):96-106. doi: 10.1093/jnci/djp468. Epub 2010 Jan 7.
Smoking accounts for a large proportion of cancer-related mortality, creating a need for better smoking cessation efforts. We investigated whether gain-framed messages (ie, presenting benefits of quitting) will be a more persuasive method to encourage smoking cessation than standard-care messages (ie, presenting both costs of smoking [loss-framed] and benefits of quitting).
Twenty-eight specialists working at the New York State Smokers' Quitline (a free telephone-based smoking cessation service) were randomly assigned to provide gain-framed or standard-care counseling and print materials. Smokers (n = 2032) who called the New York State Smokers' Quitline between March 10, 2008, and June 13, 2008, were exposed to either gain-framed (n = 810) or standard-care (n = 1222) messages, and all medically eligible callers received nicotine replacement therapy. A subset of 400 call recordings was coded to assess treatment fidelity. All treated smokers were contacted for 2-week and 3-month follow-up interviews. All statistical tests were two-sided.
Specialists providing gain-framed counseling used gain-framed statements statistically significantly more frequently than those providing standard-care counseling as assessed with frequency ratings for the two types of gain-framed statements, achieving benefits and avoiding negative consequences (for achieving benefits, gain-framed mean frequency rating = 3.9 vs standard-care mean frequency rating = 1.4; mean difference = -2.5; 95% confidence interval [CI] = -2.8 to -2.3; P < .001; for avoiding negative consequences, gain-framed mean frequency rating = 1.5 vs standard-card mean frequency rating = 1.0; mean difference = -0.5; 95% CI = -0.6 to -0.3; P < .001). Gain-framed counseling was associated with a statistically significantly higher rate of abstinence at the 2-week follow-up (ie, 99 [23.3%] of the 424 in the gain-framed group vs 76 [12.6%] of the 603 in the standard-care group, P < .001) but not at the 3-month follow-up (ie, 148 [28.4%] of the 522 in the gain-framed group vs 202 [26.6%] of the 760 in the standard-care group, P = .48).
Quitline specialists can be trained to provide gain-framed counseling with good fidelity. Also, gain-framed messages appear to be somewhat more persuasive than standard-care messages in promoting early success in smoking cessation.
吸烟是导致癌症相关死亡的主要原因之一，因此需要更好的戒烟措施。我们研究了收益框架信息（即，呈现戒烟的益处）是否比标准护理信息（即，同时呈现吸烟的成本[损失框架]和戒烟的益处）更能有效地鼓励戒烟。
28 名在纽约州吸烟者戒烟热线（一个免费的基于电话的戒烟服务）工作的专家被随机分配提供收益框架或标准护理咨询和印刷材料。2008 年 3 月 10 日至 2008 年 6 月 13 日期间拨打纽约州吸烟者戒烟热线的吸烟者（n=2032）暴露于收益框架（n=810）或标准护理（n=1222）信息，所有符合医学条件的来电者都接受尼古丁替代疗法。对 400 个通话记录的子集进行编码以评估治疗的一致性。所有接受治疗的吸烟者都在 2 周和 3 个月时进行随访访谈。所有统计检验均为双侧检验。
提供收益框架咨询的专家使用收益框架陈述的频率明显高于提供标准护理咨询的专家，这可以通过两种类型的收益框架陈述的频率评分来评估，即实现收益和避免负面后果（实现收益，收益框架的平均频率评分=3.9，而标准护理的平均频率评分=1.4；平均差异=-2.5；95%置信区间[CI]=-2.8 至-2.3；P<0.001；避免负面后果，收益框架的平均频率评分=1.5，而标准卡的平均频率评分=1.0；平均差异=-0.5；95%CI=-0.6 至-0.3；P<0.001）。收益框架咨询与 2 周随访时更高的戒烟率相关（即，收益框架组的 424 人中 99 人[23.3%]，而标准护理组的 603 人中 76 人[12.6%]，P<0.001），但与 3 个月随访时的戒烟率无关（即，收益框架组的 522 人中 148 人[28.4%]，而标准护理组的 760 人中 202 人[26.6%]，P=0.48）。
戒烟热线专家可以接受提供收益框架咨询的良好培训。此外，与标准护理信息相比，收益框架信息在促进戒烟早期成功方面似乎更有说服力。
