Commentary

Smoking kills about 3 million adults worldwide each year.¹ Although most people stop smoking on their own, various self help materials have been developed to facilitate this process. The article by Lancaster and Stead provides a summary of current research on the effectiveness of self help materials, which they define as those that provide structured approaches to smoking cessation. Their finding that self help materials alone have a minimal effect on smoking cessation is consistent with previous reviews.²

The effectiveness of self help methods is usually measured by looking at cessation rates ≥6 months after the intervention. Cessation rates are one indicator of intervention success; in “stage based” approaches to cessation, however, movement through stages may be a more accurate measure of success. Using the transtheoretical, or “stages of change” model,³ people are characterised as being in precontemplation, contemplation, or action phases of smoking cessation. Action oriented materials are unlikely to be effective for people in precontemplation or contemplation stages. Tailoring materials to an individual's readiness for change is believed to be more effective. More research is needed on the effectiveness of stage based self help materials in moving individuals through the stages of smoking cessation.

Although this review looked at a variety of self help resources (eg, written and video), research is needed to evaluate the effectiveness of self help programmes available on the internet, particularly stage based, self help programmes that provide personalised interventions for smokers. Based on the results of this review, nurses working with people who want to stop smoking might consider (1) tailoring materials for clients based on their smoking habits and motivations rather than on the perceived needs of a broadly defined group of smokers; and (2) increasing the intensity of an intervention by providing telephone counselling.