Effects of Encouraging Rapid Implementation and/or Structured Planning of Quit Attempts on Smoking Cessation Outcomes: a Randomized Controlled Trial.

Background: Recent research has led to debate over the benefit of planning quit attempts, suggesting that attempts implemented spontaneously may be more effective. The roles of planning and spontaneity require prospective examination.

Purpose: The purpose of this study is to test the benefit of encouraging smokers using an online program to quit as soon as possible (Rapid Implementation arm) and of structured planning advice incorporating implementation intentions (Structured Planning arm).

Methods: Randomized controlled trial with 1601 cases in the Rapid Implementation arm and an additional 964 in the Structured Planning arm; 2565 in total.

Results: There was no effect of Rapid Implementation, but Structured Planning significantly increased 6-month sustained abstinence (14.6 vs 10.2%; p = 0.001). There was significantly less relapse after 1 week in the structured planning group (61.0 vs 71.2%, p = 0.001).

Conclusions: A structured planning intervention delivered online can reduce relapse to smoking. Smokers should be encouraged to form implementation intentions and do most of their planning for relapse prevention after they have quit.