COMMIT: COMMUNITY INTERVENTION TRIAL FOR SMOKING CESSATION

The Community Intervention Trial for Smoking Cessation (COMMIT) was a random-ized trial designed to determine whether an organized community-level approach to smoking cessation could help smokers, especially heavy smokers, quit and remain smoke-free. The trial, which involved a broad range of smoking cessation strategies, was funded by the National Cancer Institute (NCI) of the National Institutes of Health and was carried out from 1988 to 1992.

COMMIT involved 11 research institutions, each of which worked with a matched pair of communities. One of each community pair was randomly assigned to implement 58 smoking cessation activities; the other community served as a control. Activities were implemented through four channels: (1) public education (including the media and community-wide events), (2) health care workers, (3) worksites and other organiza-tions, and (4) smoking cessation resources. Activities included training of physicians and dentists on effective counseling for smoking cessation, on-site consultations to promote smoke-free policies in worksites, and the development of a smoking cessation resource guide. These were directed primarily at adult smokers, but the overall community approach included some activities directed at the young.

Baseline (1988) and final (1993) telephone surveys were used to determine the preva-lence of smoking behavior. Results showed no differences in smoking prevalence among heavy smokers in treatment and control communities. However, a significant decrease in smoking prevalence was seen among light to moderate smokers in treat-ment communities. The treatment effect was greatest for those with low educational attainment. Process evaluations identified many successes in organizing various projects and in developing specific intervention methods.

Carrying out a nationally sponsored research trial in many communities is a logistical challenge. In addition, obvious effects of treatment are difficult to achieve, especially in a period when there is a national trend toward smoking cessation. Process evalua-tions showed that considerable attention should be given to adapting intervention protocols

Return to Home Page