Development and preliminary evaluation of a structured and personalized self-help smoking cessation program: A prospective observational study.

Abstract

Introduction: We have developed the 'Two Weeks to Quit' (TWTQ) program, a self-help smoking cessation toolkit. Self-help programs represent a cost-effective and accessible option for successful smoking cessation. TWTQ includes a two-week preparation phase leading up to a quit-smoking date at the end of week two and a four-week period focused on maintaining a smoke-free status. The objective was to assess its effectiveness.

Methods: This prospective observational study, conducted without a control group, evaluated the TWTQ program among smokers aged 18-60 years in Paris, France, between February 2023 and April 2024. Participants were recruited via pharmacies, social media platforms, and through outreach to the general population. Program adherence was monitored weekly by email. The primary outcome was smoking cessation, assessed at the end of the program using the Fagerström test for nicotine dependence and a self-reported smoking status question, corresponding to one month after the theoretical quit date.

Results: Of the 97 participants enrolled, 47 completed the program. At six weeks, 57.4% reported smoking cessation, all on the scheduled quit date. At five months, 40.4% of these participants remained abstinent, with an intent-to-treat abstinence rate of 19.6%. The mean Fagerström score decreased significantly from 4 to 0.87 at six weeks (p<0.001), with sustained reductions at two and five months. Adherence to the step order, pacing, and older age significantly predicted short-term cessation. In contrast, no factor predicted abstinence at five months, and greater use of customizable tools was unexpectedly associated with higher relapse risk.

Conclusions: TWTQ demonstrates potential benefits as a structured self-help program for smoking cessation and tobacco consumption reduction, with sustained effects. Results underscore the need to evaluate both engagement and effectiveness in large-scale campaigns like 'Stoptober'.