***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 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 At two chest clinics 1206 cigarette smokers referred by their general practitioners for chest radiography only either were dealt with in the normal way or in addition were given a How to Stop Smoking booklet by the clinic receptionist or nurse . Follow up one year later showed that 3.2 % of all patients had successfully given up smoking , older patients doing better than younger ones and men doing better than women . Overall 3.9 % of the group receiving a booklet were successful compared with 2.7 % of the controls ( p = 0.14 ) . At one clinic the groups were not well matched for age but at the other , where there was no such imbalance , there was a suggestion that the booklet group did better than the controls ( 6.5 % v 2.7 % success ) , although the difference did not achieve conventional statistical significance ( p = 0.09 ) . If this can be confirmed as a real effect then this cheap , simple strategy could easily be applied on a large scale Face to face advice for smoking cessation is effective,1 but few smokers are willing to attend smoking cessation clinics , and many do not receive smoking cessation advice from their physician . Self help smoking cessation material s may not be very effective,2 but computer technology can be used to produce effective individualised self help smoking cessation material s and disseminate them widely at a low cost per participant.2 Most studies assessed the effect of computer tailored programmes on smoking cessation after one year or less.2 Only one programme was evaluated during 18 and 24 months.3 These programmes usually produced quit rates<5 % higher than in control groups who received st and ard self help material s or no intervention.2 Because over one third of ex-smokers who achieve 12 months of abstinence eventually relapse five years later,4 it is not yet known whether computer tailored programmes have a long term impact on smoking abstinence . We showed previously that a computer tailored programme doubled the odds of quitting smoking , after seven months.5 In this study , we tested whether this effect was maintained 24 months after entry in the programme — that is , 12 months after the end of the intervention . In 1998 , we sent the baseline question naire to a representative ( r and om ) sample of 20 000 residents aged 18–60 in French speaking Switzerl and . We sent out follow up question naires six and 23 months later to the 2934 baseline participants . We r and omly assigned participants to the intervention or control group ( fig 1 ) . Figure 1 Flow chart of participants in the r and omised controlled trial . The intervention consisted of personal counselling letters , written by a To further develop tailored interventions , their working mechanisms must be identified . In the present study , three tailored messages that each contained one potential working mechanism -- personalization , adaptation or feedback -- were compared with a st and ard information condition .  Two hundred and two students who smoked tobacco daily were r and omly divided over four conditions . After the computer pre-test question naire , they read the information in their condition and filled in the immediate post-test . After 4 months , they were sent a follow-up question naire assessing their quitting activity . The data show that personalization ( 44.5 % ) and feedback ( 48.7 % ) , but not adaptation ( 28.6 % ) , led to significantly more quitting activity after 4 months than did the st and ard information ( 22.9 % ) . Moreover , the effect of condition on quitting activity was completely mediated by individuals ' evaluations of the tailoring This study evaluated the effectiveness of nicotine chewing gum in  smoking cessation  , when incorporated into a behaviorally oriented self-help program . One hundred ninety-seven patients were r and omly assigned to nicotine gum with a self-help manual , a self-help manual without gum , or a control condition , but received no further treatment from the prescribing physician . At six weeks , the nicotine gum group was superior to both the self-help and control conditions . By one year , many gum patients had relapsed , and the treatment effect was no longer significant . Patients who were able to quit initially were most likely to remain ex-smokers in the self-help condition . The clinical importance of these findings is discussed Self-Instructional behavior-change programs for reducing risks to health are potentially widely available , acceptable and cost-effective . This paper reports outcomes of a smoking cessation program administered by mail . Two hundred and eight smokers were allocated systematic ally to a  quit kit control condition ( n = 40 ) , to a  st and ard correspondence course  ( n = 86 ) and to a personalized correspondence course prepared with the aid of a microcomputer ( n = 82 ) . There were significantly higher rates of abstinence after the course for correspondence course participants compared to controls , but these differences did not persist at three-month and nine-month follow-ups . There were no differences between the personalized and st and ard courses on abstinence rates , number of cigarettes smoked per day , or return of feedback forms on each lesson . There were associations between self-efficacy strength and reduced rates of smoking , and active participation in the course was associated with lower smoking rates Forty smokers and 47 overweight individuals were recruited for a home correspondence program for either smoking cessation or weight loss . Participants were assigned to one of four programs for changing their respective health behaviors : ( 1 ) a home correspondence program conducted entirely by mail , ( 2 ) the mail program with supplemental financial contigency contracts tied to completion of written homework , ( 3 ) the correspondence programs supplemented both by homework contracts and by regular calls to a telephone answering system , and ( 4 ) a st and ard behavioral group program which acted as a comparison condition . Results showed that all three correspondence approaches produced significant changes in health behaviors equal to the changes experienced by participants in the st and ard group program . The implication of these findings for development of low cost programs for disease prevention are discussed The present study examined mechanisms underlying the effectiveness of tailored interventions for motivating  smoking cessation . The study used a placebo-tailoring design to test whether the efficacy of tailoring was due , in part , to personalized features in addition to the theoretically based content . Two hundred forty adult smokers were r and omized to 1 of 3 conditions : st and ard booklet , minimally personalized booklet , or extensively personalized booklet . The interventions varied in their degree of ostensible tailoring , yet the actual smoking-related content of the booklets was identical . A dose-response relationship was hypothesized , with the greatest apparent tailoring producing the most positive outcomes . This pattern was found for evaluation of the booklets , with trends for readiness to change and self-efficacy increases . Moreover , as hypothesized , the effect of the interventions on readiness was moderated by participants ' expectancies about tailoring AIM To assess the effectiveness of a program of computer-generated tailored advice for callers to a telephone helpline , and to assess whether it enhanced a series of callback telephone counselling sessions in aiding smoking cessation . DESIGN R and omized controlled trial comparing : ( 1 ) untailored self-help material s ; ( 2 ) computer-generated tailored advice only , and ( 3 ) computer-generated tailored advice plus callback telephone counselling . Assessment surveys were conducted at baseline , 3 , 6 and 12 months . SETTING Victoria , Australia . PARTICIPANTS A total of 1578 smokers who called the Quitline service and agreed to participate . MEASUREMENTS Smoking status at follow-up ; duration of cessation , if quit ; use of nicotine replacement therapy ; and extent of participation in the callback service . FINDINGS At the 3-month follow-up , significantly more ( chi2(2 ) = 16.9 ; P < 0.001 ) participants in the computer-generated tailored advice plus telephone counselling condition were not smoking ( 21 % ) than in either the computer-generated advice only ( 12 % ) or the control condition ( 12 % ) . Proportions reporting not smoking at the 12-month follow-up were 26 % , 23 % and 22 % , respectively ( NS ) for point prevalence , and for 9 months sustained abstinence ; 8.2 , 6.0 , and 5.0 ( NS ) . In the telephone counselling group , those receiving callbacks were more likely than those who did not to have sustained abstinence at 12 months ( 10.2 compared with 4.0 , P < 0.05 ) . Logistic regression on 3-month data showed significant independent effects on cessation of telephone counselling and use of NRT , but not of computer-generated tailored advice . CONCLUSION Computer-generated tailored advice did not enhance telephone counselling , nor have any independent effect on cessation . This may be due to poor timing of the computer-generated tailored advice and poor integration of the two modes of advice OBJECTIVE To compare two self-help smoking cessation booklets distributed to callers to a Quitline telephone service in Queensl and ( Australia ) . DESIGN Callers were r and omised to receive either a structured 14-day quit programme ( Time to quit ) or another booklet that described four broad stages of quitting ( Can quit ) . Approximately one month later , these callers were interviewed by telephone . MAIN OUTCOME MEASURES Self-reported smoking status at one month and recent quit attempts together with process measures . RESULTS Altogether , 521 callers ( 78.3 % ) were interviewed . They were heavier smokers when compared with all Queensl and smokers : on average they had smoked for more than 15 years , smoked nearly 25 cigarettes per day , and almost two-thirds had attempted to quit smoking in the past year . In each group , significant proportions either did not begin to use the booklet ( 50.5–56.0 % ) , or did not complete its use ( 77.4–82.3 % ) . There were no differences in the self-reported quit rates at one month ( 17.0%vs 16.1 % ; p = 0.93 ) . In an ordinal regression modelling procedure involving age , sex , number of recent quit attempts , number of cigarettes smoked per day , smoking status of partner , number of five closest friends who smoke , education , and booklet received , only the number of cigarettes smoked per day was significantly related to smoking status at one month . CONCLUSIONS Callers to telephone Quitline services are typically heavier smokers than the general smoking population , and simple strategies , such as self-help booklets , appear to achieve relatively high success . Nevertheless , there is potential to improve the effectiveness of these material s by making a range of material s available and encouraging callers to make a serious attempt to quit smoking Smokers requesting self-help material s for  smoking cessation ( N = 2,021 ) were r and omized to receive ( a ) an experimental self-quitting guide emphasizing nicotine fading and other nonaversive behavioral strategies , ( b ) the same self-quitting guide with a support guide for the quitter 's family and friends , ( c ) self-quitting and support guides along with four brief counselor calls , or ( d ) a control guide providing motivational and quit tips and referral to locally available guides and programs .  Subjects were predominantly moderate to heavy smokers with a history of multiple previous quit attempts and treatments . Control subjects achieved quit rates similar to those of smokers using the experimental quitting guide , with fewer behavioral prequitting strategies and more outside treatments . Social support guides had no effect on perceived support for quitting or on  
    Output:
    
Four further trials in which the control group received alternative written material s did not show evidence for an effect of the smoking self-help material s. We failed to find evidence of benefit from adding self-help material s to face-to-face advice , or to nicotine replacement therapy .
St and ard self-help material s may increase quit rates compared to no intervention , but the effect is likely to be small .
We failed to find evidence that they have an additional benefit when used alongside other interventions such as advice from a healthcare professional , or nicotine replacement therapy .
There is evidence that material s that are tailored for individual smokers are effective , and are more effective than untailored material s , although the absolute size of effect is still small