selleck kinase inhibitor Because positive effects of the intervention could be undermined by high levels of emotional distress resulting from the biomedical risk assessment (Lerman et al., 1997; McClure, 2001), we also monitored the emotional impact of the intervention as a secondary outcome. All outcomes were assessed immediately following the counseling and at 1-month postintervention. Methods Setting and participants All activities were reviewed and approved by the Group Health Institutional Review Board. Study enrollment began in March 2005 and ended September 2007. Smokers were recruited throughout western Washington State using a variety of outreach strategies including health plan records, data from the Washington State Quitline, and a purchased mailing list of smokers (McClure, Richards, Westbrook, Pabiniak, & Ludman, 2007).

Likely smokers were mailed a study invitation letter and then called to be screened for interest and eligibility. Ads also were placed in local media, public clinics, and other local venues. Interested smokers were invited to call to learn more and be screened for eligibility. Individuals eligible based on the phone screening were scheduled for an in-person appointment. Smokers were eligible if at the baseline appointment they were 18 years or older, could read and write in English, were not currently receiving cessation treatment, had no significant physical or mental impairments that prevented use of a computer or phone or impaired their ability to comprehend the counseling, and reported no medical contraindications for spirometry assessment (e.g.

, recent heart attack or chest surgery). Participation also was limited to smokers with elevated expired CO levels consistent with current smoking (��10 p.p.m.; SRNT Subcommittee on Biochemical Verification, 2002) and who either smoked an average of 15 cigarettes/day for the past year or smoked at least 10 cigarettes/day but had smoked for 10 years or more. The latter criterion was added to accommodate lighter smokers who had a significant history of smoking. Eligible smokers completed a computer-based survey and were automatically randomized to treatment. All participants were offered a free personalized health risk assessment and advice on changes they could make to improve their health. The intervention was presented as a free health screening, not as a smoking cessation program, and recruitment Entinostat materials emphasized that people did not have to be interested in quitting smoking to participate.