***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This article evaluates the effects and use of adjuncts to a televised smoking cessation program , based on the American Lung Association 's " Freedom From Smoking in 20 Days . " Subjects were r and omized to maintenance and control conditions . The maintenance condition received newsletters with information and support addressing different stages in the cessation process and information about a telephone hotline . The maintenance condition did not increase cessation at any wave of interviewing , assessed by multiple point or point prevalence of abstinence . Those abstinent at 6 months and those who had made an attempt to stop smoking by that time were more likely to have used the newsletters and were more likely to have used the sections relevant to their cessation stage . Rates of use of the telephone hotline were low . The newsletters appear to be useful to smokers who are predisposed to use written material Objective : To assess the efficacy of an innovative smoking cessation intervention targeted to a multiethnic , economically disadvantaged HIV-positive population . Design : A two-group r and omized clinical trial compared a smoking cessation intervention delivered by cellular telephone with usual care approach . Methods : Current smokers from a large , inner city HIV/AIDS care center were recruited and r and omized to receive either  usual care or  a  cellular telephone intervention . The usual care group received brief physician advice to quit smoking , targeted self-help written material s and nicotine replacement therapy . The cellular telephone intervention received eight counseling sessions delivered via cellular telephone in addition to the usual care components .  Smoking-related outcomes were assessed at a 3-month follow-up . Results : The trial had 95 participants and 77 ( 81.0 % ) completed the 3-month follow-up assessment . Analyses indicated biochemically verified point prevalence smoking abstinence rates of 10.3 % for the usual care group and 36.8 % for the cellular telephone group ; participants who received the cellular telephone intervention were 3.6 times ( 95 % confidence interval , 1.3 - 9.9 ) more likely to quit smoking compared with participants who received usual care ( P = 0.0059 ) . Conclusions : These results suggest that individuals living with HIV/AIDS are receptive to , and can be helped by , smoking cessation treatment . In addition , smoking cessation treatment tailored to the special needs of individuals living with HIV/AIDS , such as counseling delivered by cellular telephone , can significantly increase smoking abstinence rates over that achieved by usual care BACKGROUND Previous research has demonstrated the efficacy of an interactive expert system intervention for  smoking cessation for a general population . The intervention provides individualized feedback that guides participants through the stages of change for cessation . Enhancing the expert system by adding proactive telephone counseling or a stimulus control computer design ed to produce nicotine fading could produce preventive programs with greater population impacts . METHODS Four interventions were compared : ( a ) the interactive expert system intervention ; ( b ) the expert system intervention plus counselor calls ; ( c ) the expert system intervention plus the stimulus control computer ; and ( d ) an assessment only condition . A 4 ( intervention ) x 4 ( occasions ) ( 0,6,12 , and 18 months ) design was used . Smokers were contacted at home via telephone or mail . The initial subject pool was the 24,178 members of a managed care company . Screening was completed for 19,236 members ( 79.6 % ) , of whom 4,653 were smokers ; 85.3 % of the smokers were enrolled . RESULTS Thirty-eight percent were in the precontemplation stage , 45 % in the contemplation stage , and only 17 % in the preparation stage . At 18 months , the expert system result ed in 23.2 % point prevalence abstinence , which was 33 % greater than that of assessment only . The counselor enhancement produced increased cessation at 12 months but not at 18 months . The stimulus control computer produced no improvement , result ing in 20 % worse cessation rates than the assessment only condition . CONCLUSIONS The enhanced conditions failed to outperform the expert system alone . The study also demonstrated the ability of the interactive expert system to produce significantly greater cessation in a population of smokers than assessment alone Mounting evidence suggests that smokers living with HIV/AIDS have a significantly increased risk of numerous adverse health outcomes ( both AIDS- and non-AIDS-related ) compared with HIV-positive nonsmokers . Therefore , efforts to design and implement effective cessation programs for this ever-growing special population are warranted . The present study assessed the effects of a cell phone intervention ( CPI ) on hypothesized mediators ( i.e. , changes in depression , anxiety , social support , and self-efficacy ) demonstrated to influence cessation outcomes in other population s. Ninety-five participants from an inner-city AIDS clinic were r and omized to receive either the CPI or recommended st and ard of care ( RSOC ) smoking cessation treatment . Participants r and omized to the RSOC group ( n=47 ) received brief advice to quit , a 10-week supply of nicotine patches , and self-help material s. Participants r and omized to the CPI group ( n=48 ) received RSOC components plus a series of eight proactive counseling sessions delivered via cell phones . A series of regression analyses ( linear and logistic ) was used to assess the relationships between treatment group , the hypothesized mediators , and biochemically confirmed smoking cessation outcomes . Results indicated that the CPI group experienced greater reductions in anxiety and depression , and increases in self-efficacy compared with the RSOC group . Further , changes in depression , anxiety , and self-efficacy weakened the association between treatment group and cessation outcome . The mediator hypothesis , however , for social support was rejected , as the difference score was not significantly associated with treatment group . These results suggest that the efficacy of the CPI is at least partially mediated by its ability to decrease symptoms of distress while increasing self-efficacy BACKGROUND This study was conducted to determine the efficacy of the nicotine patch in smoking cessation when combined with self-help material s , three brief visits , and telephone counseling . METHODS One hundred fifty-nine healthy volunteers who smoked at least one pack of cigarettes per day and desired to quit smoking were enrolled in a double-blind trial with 6-week treatment and 6-month follow-up periods . After review of self-help material s , subjects were r and omly assigned to regimens of nicotine or placebo patches . Subjects wore two patches per day for 4 weeks ( 25 mg of nicotine per 24 hours ) , then one patch per day for 2 weeks . Return visits were at the ends of weeks 4 and 6 . Telephone counseling was given during weeks 1 , 2 , 3 , and 5 . Abstinence at 6 weeks was defined as zero cigarettes smoked for the previous 28 days , verified by exhaled carbon monoxide less than 8 ppm at 4 weeks and 6 weeks . Abstinence at 3 and 6 months was defined as self-report of zero cigarettes since the previous contact , verified by carbon monoxide value at 6 months . RESULTS Abstinence rates at 6 weeks , 3 months , and 6 months were 29.5 % , 21.8 % , and 20.5 % in the active group , and 8.8 % , 3.8 % , and 2.5 % in the placebo group ( P < or = .001 for each comparison ) , respectively . Skin irritation was the main side effect , causing 1.3 % to drop out . CONCLUSION The nicotine patch is efficacious in smoking cessation over a 6-month period , when combined with only self-help material s , three brief visits , and telephone counseling This study was based on a ten-year follow-up of smokers who had participated in a r and omized controlled trial of a behavioral self-help program for smoking cessation . The original sample was made up of 200 smokers assigned at r and om to two treatment groups . Ten years later 93.5 % ( n=187 ) of the sample were successfully located ( of the 13 not located , 6 had died ) , from whom information was obtained about their current state and the evolution of their smoking over the 10-year period . Reported abstinence at this follow-up was confirmed by carbon monoxide in expired air . Significant differences were found in the abstinence rates of the two groups at the follow-ups 1 year ( 14 % vs. 28 % ) and 2 years ( 13 % vs. 24 % ) after the end of the treatment . After 10 years 26 % ( n=52 ) of the total sample were abstinent . Over the ten-year period , 62.0 % tried to give up smoking at some point , the mean figure for attempts being 1.3 . According to the results of the 10-year follow-up , low nicotine dependence at pretreatment is a major factor predicting long-term cessation in smokers Background Smoking is more prevalent among lower-income individuals and certain racial/ethnic minorities . Addressing tobacco cessation among diverse population s is an urgent public health priority . As Internet use continues to rise among all segments of the US population , Web-based interventions have enormous potential to reach priority population s. Conducting Web-based smoking cessation research in priority population s requires psychometrically sound measurement instruments . To date , only one published study has examined the psychometric properties of Internet-administered measures commonly used in Web-based cessation trials . However , the sample was homogeneous with regard to race/ethnicity and income . We sought to replicate and extend these findings in a more diverse sample of smokers . Objective The aim was to examine the internal consistency and test-retest reliability of measures commonly used in smoking cessation clinical trials among racial/ethnic minorities and smokers with lower income . Methods Participants were enrolled in a r and omized trial of the efficacy of an Internet smoking cessation program between June 2005 and September 2006 . Following a baseline telephone assessment and r and omization into the parent trial , participants were recruited to the reliability sub study . In phase I of recruitment , all participants in the parent trial were recruited to the sub study ; in phase II , all consecutive racial/ethnic minority participants in the parent trial were recruited . Race and ethnicity were assessed via self-report using two st and ard items from the US Office of Management and Budget . An email was sent 2 days after the telephone assessment with a link to the Internet survey . Measures examined were quit methods , perceived stress , depression , social support , smoking temptations , alcohol use , perceived health status , and income . Internal consistency and test-retest reliability of Internet- versus telephone-administered measures were examined within four strata defined by race/ethnicity ( non-Hispanic White , racial/ethnic minority ) and annual household income ( US $ 40,000 or less , more than $ 40,000 ) . Results Of the 442 individuals invited , 319 participated ( 72 % response rate ) : 52.4 % were non-Hispanic White , 22.9 % Black , 11.6 % Hispanic , 7.8 % Asian , 4.4 % American Indian / Alaska Native , and 1 % Native Hawaiian / Other Pacific Isl and er . About half ( 49.4 % ) reported an annual household income of US $ 40,000 or less , and 25.7 % had a high school degree or less . Test-retest reliability was satisfactory to excellent across all strata for the majority of measures examined : 9 of 12 continuous variables had intraclass correlation coefficients ≥ 0.70 , and 10 of 18 binary variables and both ordinal variables had kappa coefficients ≥ 0.70 . Test-retest reliability of several quit methods varied across strata . Conclusions Race/ethnicity and income do not affect the psychometric properties of most Internet-administered measures examined . This knowledge adds to the confidence of conducting Web-based smoking cessation research and strengthens the scientific rigor of collecting information via the Internet on racial/ethnic minority and low-income subgroups . Trial registration clinical trials.gov NCT00282009 ( parent trial Abstract Objective To compare the hazards of cigarette smoking in men who formed their habits at different periods , and the extent of the reduction in risk when cigarette smoking is stopped at different ages . Design Prospect i ve study that has continued from 1951 to 2001 . Setting United Kingdom . Participants 34 439 male British doctors . Information about their smoking habits was obtained in 1951 , and periodically thereafter ; cause specific mortality was monitored for 50 years . Main outcome measures Overall mortality by smoking habit , considering separately men born in different periods . Results The excess mortality associated with smoking chiefly involved vascular , neoplastic , and respiratory diseases that can be caused by smoking . Men born in 1900 - 1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers . Cessation at age 60 , 50 , 40 , or 30 years gained , respectively , about 3 , 6 , 9 , or 10 years of life expectancy . The excess mortality associated with cigarette smoking was less for men born in the 19th century and was greatest for men born in the 1920s . The cigarette smoker versus non-smoker probabilities of dying in middle age ( 35 - 69 ) were 42 % ν24 % ( a twofold death rate ratio ) for those born in 1900 - 1909 , but were 43 % ν 15 % ( a threefold death rate 
    Output:
    
There was clearer evidence of benefit in the subgroup of trials recruiting smokers motivated to quit .
Proactive telephone counselling helps smokers interested in quitting .
Three or more calls increases the odds of quitting compared to a minimal intervention such as providing st and ard self-help material s , brief advice , or compared to pharmacotherapy alone .
Telephone quitlines provide an important route of access to support for smokers , and call-back counselling enhances their usefulness