RESEARCH REPORT doi:10.1111/j.1360-0443.2006.01534.x
© 2006 The Authors. Journal compilation © 2006 Society for the Study of Addiction Addiction, 101, 1352–1361
Original Article
ATTEMPT: a cohort of smokers intending to quit
Robert West
et al.
Correspondence to: Robert West, University College London, Gower Street, London WC1E 6BT, UK. E-mail: robert.west@ucl.ac.uk
Submitted 26 October 2005; initial review completed 20 December 2005; final version accepted 30 March 2006
RESEARCH REPORT
The ATTEMPT cohort: a multi-national longitudinal
study of predictors, patterns and consequences of
smoking cessation; introduction and evaluation of
internet recruitment and data collection methods
Robert West
1
, Alicia Gilsenan
2
, Florence Coste
3
, Xiaolei Zhou
2
, Remi Brouard
3
,
James Nonnemaker
2
, Susan J. Curry
4
& Sean D. Sullivan
5
University College London, London, UK,
1
RTI Health Solutions, RTI, Research Triangle Park, NC, USA,
2
Sanofi-Aventis, Paris, France,
3
Institute for Health Research
and Policy, University of Illinois at Chicago, Chicago, IL, USA,
4
University of Washington, Seattle, USA
5
ABSTRACT
Aims The ATTEMPT study was designed to chart the natural history of smoking cessation and associated short-term
health outcomes and effects on medical resource utilization among a cohort recruited across multiple countries. This
paper describes the methods for recruitment and follow-up, the baseline population characteristics of the enrolled
population and 1-year response rates. Design ATTEMPT is a multi-national prospective cohort study that used
the internet for subject recruitment and online assessments every 3 months for 2.5 years. Setting Subjects were
recruited via e-mail from existing internet panels [Canada (n = 208), France (n = 201), the United Kingdom (n = 200)
and the United States (n = 1400]. Subjects Panel members who were aged 35–65 years, smoked at least five ciga-
rettes per day and at initiation stated an intention to quit smoking within the next 3 months were eligible for this study.
Measurements Measures included: attempts to quit, smoking status, smoking history, nicotine dependence and crav-
ing, methods used to quit smoking, reasons for quitting or failing to quit smoking, short-term health effects, health
resource utilization, wellbeing, concern over weight gain, confidence in preventing weight gain, body weight and
demographics. In addition, in-home assessments of weight were undertaken by field staff for a random sample of US
participants. Findings Country-specific recruitment was completed within 17 days. The recruitment method pro-
duced a sample with characteristics broadly similar to those found in national surveys of smokers except for higher
prevalence of obesity in the US and Canadian samples and higher educational level. At the end of 1 year the response
rate was 52%, and there was little evidence of differential loss to follow-up by key subject characteristics. Weight
reported in the survey was found to correlate highly with weight measured during in-home visits. Conclusion This
paper demonstrates the feasibility of enrolling and following a diverse cohort of smokers for self-reported health and
behaviour measures via the internet.
Keywords Economics, health effects, internet, longitudinal study, smoking cessation.
INTRODUCTION
The ATTEMPT cohort is a multi-national, observational
study that uses internet recruitment and follow-up to
accomplish the following primary research objectives: (1)
to describe the natural history and patterns of smoking
cessation success or failure, including possible predictors
such as weight gain and fear of weight gain; and (2) to
describe the short-term health outcomes and effects of
smoking cessation on medical resource utilization.
Understanding the dynamics of smoking cessation, as
well as the effects on health-related outcomes, resource
utilization and weight change, requires detailed follow-
up to observe successive cessation attempts. It is bec-
oming increasingly difficult to use traditional methods
(e.g. mail and telephone) for study recruitment and data
collection, as participation rates in studies using these
methods are declining. Another traditional method,
recruitment of subjects through physicians, can be
extremely costly and limits subjects to those who have