Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Exploring consensus on how to measure smoking cessation. A Delphi study

Authors: Kei Long Cheung, Dennis de Ruijter, Mickaël Hiligsmann, Iman Elfeddali, Ciska Hoving, Silvia M. A. A. Evers, Hein de Vries

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Different criteria regarding outcome measures in smoking research are used, which can lead to confusion about study results. Consensus in outcome criteria may enhance the comparability of future studies. This study aims (1) to provide an overview of tobacco researchers’ considered preferences regarding outcome criteria in randomized controlled smoking cessation trials, and (2) to identify the extent to which researchers can reach consensus on the importance of these outcome criteria.

Methods

A three-round online Delphi study was conducted among smoking cessation experts. In the first round, the most important smoking cessation outcome measures were collected by means of open-ended questions, which were categorized around self-reported and biochemical validation measures. Experts (n = 17) were asked to name the outcome measures (as well as their assessment method and ideal follow-up period) that they thought were important when assessing smoking-related outcomes. In the second (n = 48) and third rounds (n = 37), a list of outcome measures—identified in the first round—was presented to experts. Asking them to rate the importance of each measure on a seven-point scale.

Results

Experts reached consensus on several items. For self-reports, experts agreed that prolonged abstinence (6 or/and 12 months), point prevalence abstinence (7 days), continuous abstinence (6 months), and the number of cigarettes smoked (7 days) are important outcome measures. Experts reached consensus that biochemical validation methods should not always be used. The preferred biochemical validation methods were carbon monoxide (expired air) and cotinine (saliva). Preferred follow-ups included 6 and/or 12 months, with or without intermediate measurements.

Conclusions

Findings suggest only partial compliance with the Russell standard and that more outcome measures may be important (including seven-day point-prevalence abstinence, number of cigarettes smoked, and cotinine when using biochemical validation). This study showed where there is and is not consensus, reflecting the need to develop a more comprehensive standard. For these purposes we provided suggestions for the Russell 2.0 standard.
Literature
1.
2.
3.
4.
DiClemente CC, Prochaska JO. Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addict Behav. 1982;7(2):133–42.CrossRefPubMed
5.
Smit ES, de Vries H, Hoving C. Effectiveness of a web-based multiple tailored smoking cessation program: a randomized controlled trial among Dutch adult smokers. J Med Internet Res. 2012;14(3):e82.CrossRefPubMedPubMedCentral
6.
Lemmens V, Oenema A, Knut IK, Brug J. Effectiveness of smoking cessation interventions among adults: a systematic review of reviews. Eur J Cancer Prev. 2008;17(6):535–44.CrossRefPubMed
7.
Velicer WF, Prochaska JO, Rossi JS, Snow MG. Assessing outcome in smoking cessation studies. Psychol Bull. 1992;111(1):23.CrossRefPubMed
8.
Velicer WF, Prochaska JO. A comparison of four self-report smoking cessation outcome measures. Addict Behav. 2004;29(1):51–60.CrossRefPubMed
9.
Society for Research on Nicotine and Tobacco Subcommittee on Biochemical Verification. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4(2):149–59.CrossRef
10.
Hurt RD, Sachs DP, Glover ED, Offord KP, Johnston JA, Dale LC, Khayrallah MA, Schroeder DR, Glover PN, Sullivan CR. A comparison of sustained-release bupropion and placebo for smoking cessation. N Engl J Med. 1997;337(17):1195–202.CrossRefPubMed
11.
West R, Hajek P, Stead L, Stapleton J. Outcome criteria in smoking cessation trials: proposal for a common standard. Addiction. 2005;100(3):299–303.CrossRefPubMed
12.
Viswesvaran C, Schmidt FL. A meta-analytic comparison of the effectiveness of smoking cessation methods. J Appl Psychol. 1992;77(4):554.CrossRefPubMed
13.
ACP. ACoP: methods for stopping cigarette smoking. Ann Intern Med. 1986;105(2):281–91.CrossRef
14.
15.
16.
Hughes JR, Keely JP, Niaura RS, Ossip-Klein DJ, Richmond RL, Swan GE. Measures of abstinence in clinical trials: issues and recommendations. Nicotine Tob Res. 2003;5(1):13–25.CrossRefPubMed
17.
Richmond RL. A comparison of measures used to assess effectiveness of the transdermal nicotine patch at 1 year. Addict Behav. 1997;22(6):753–7.CrossRefPubMed
18.
Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2012;11:11.
19.
Ruger JP, Weinstein MC, Hammond SK, Kearney MH, Emmons KM. Cost-effectiveness of motivational interviewing for smoking cessation and relapse prevention among low-income pregnant women: a randomized controlled trial. Value Health. 2008;11(2):191–8.CrossRefPubMed
20.
Cyphert FR, Gant WL. The Delphi technique: a case study. Phi Delta Kappan. 1971;52(5):272–3.
21.
Custer RL, Scarcella JA, Stewart BR. The modified Delphi technique-A rotational modification. J Career Tech Educ. 1999;15(2).
22.
Dalkey N, Helmer O. An experimental application of the Delphi method to the use of experts. Manag Sci. 1963;9(3):458–67.CrossRef
23.
Dalkey NC, Brown BB, Cochran S. The Delphi method: an experimental study of group opinion, vol. 3. Santa Monica: Rand Corporation; 1969.
24.
Linstone HA, Turoff M. The Delphi method: techniques and applications, vol. 29. MA: Addison-Wesley Reading; 1975.
25.
Young SJ, Jamieson LM. Delivery methodology of the Delphi: a comparison of two approaches. J Park Recreat Adm. 2001;19(1):42–58.
26.
Hsu C-C, Sandford BA. The Delphi technique: making sense of consensus. Pract Assess Res Eval. 2007;12(10):1–8.
27.
Ludwig BG. Internationalizing Extension: An exploration of the characteristics evident in a state university Extension system that achieves internationalization. Columbus: The Ohio State University; 1994.
28.
Delbecq AL, Van de Ven AH, Gustafson DH. Group techniques for program planning: a guide to nominal group and Delphi processes. Glenview: Scott Foresman; 1975.
29.
Ludwig B. Predicting the future: have you considered using the Delphi methodology. J Ext. 1997;35(5):1–4.
30.
31.
Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M. The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res. 2009;11(1):12–24.CrossRef
32.
Cohen S, Lichtenstein E, Prochaska JO, Rossi JS, Gritz ER, Carr CR, Orleans CT, Schoenbach VJ, Biener L, Abrams D. Debunking myths about self-quitting: evidence from 10 prospective studies of persons who attempt to quit smoking by themselves. Am Psychol. 1989;44(11):1355.CrossRefPubMed
33.
Stanczyk N, de Vries H, Candel M, Muris J, Bolman C. Effectiveness of video-versus text-based computer-tailored smoking cessation interventions among smokers after one year. Prev Med. 2016;82:42–50.CrossRefPubMed
34.
Cheung KL, Wijnen BF, Hollin IL, Janssen EM, Bridges JF, Evers SM, Hiligsmann M. Using best–worst scaling to investigate preferences in health care. PharmacoEconomics. 2016:1–15.
35.
Clark MD, Determann D, Petrou S, Moro D, de Bekker-Grob EW. Discrete choice experiments in health economics: a review of the literature. PharmacoEconomics. 2014;32(9):883–902.CrossRefPubMed
36.
Swanborn PG. Methoden van sociaal-wetenschappelijk onderzoek [Social science research methods]. 4th ed. Meppel: Boom; 1987.
37.
Blankers M, Smit ES, van der Pol P, de Vries H, Hoving C, van Laar M. The missing= smoking assumption: a fallacy in internet-based smoking cessation trials? Nicotine Tob Res. 2016;18(1):25–33.PubMed
Metadata
Title
Exploring consensus on how to measure smoking cessation. A Delphi study
Authors
Kei Long Cheung
Dennis de Ruijter
Mickaël Hiligsmann
Iman Elfeddali
Ciska Hoving
Silvia M. A. A. Evers
Hein de Vries
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4902-7

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

Longitudinal associations between built environment characteristics and changes in active commuting

Research article

Behavioral antecedents for handwashing in a low-income urban setting in Bangladesh: an exploratory study

Research article

Pathways linking car transport for young adults and the public health in Northern Ireland: a qualitative study to inform the evaluation of graduated driver licensing

Research article

Consistent condom use and its correlates among female sex workers at hair salons: a cross-sectional study in Zhejiang province, China

Research article

A systematic review including meta-analysis of work environment and burnout symptoms

Research article

Race and nativity are major determinants of tuberculosis in the U.S.: evidence of health disparities in tuberculosis incidence in Michigan, 2004–2012