JMIR Res Protoc. 2016 Jun 14;5(2):e119. doi: 10.2196/resprot.5542.

A Preliminary Exploration of Former Smokers Enrolled in an Internet Smoking Cessation Program.

JMIR research protocols

Sarah Cha, Amy M Cohn, Hoda Elmasry, Amanda L Graham

PMID: 27302500 PMCID: PMC4925934 DOI: 10.2196/resprot.5542

Abstract

BACKGROUND: Internet interventions may have an important role to play in helping self-quitters maintain an initial period of abstinence. Little is known about the characteristics and utilization patterns of former smokers who use Internet cessation programs.

OBJECTIVE: The overarching aim of this preliminary study was to establish the feasibility of a subsequent randomized trial of the effectiveness of Internet interventions in preventing relapse. Specifically, this study sought to determine the number of former smokers that register on a smoking cessation website, the characteristics of former smokers and their website utilization patterns, and potential predictors of sustained abstinence.

METHODS: Participants were self-identified former smokers who registered on a free smoking cessation website. Recruitment occurred immediately following site registration. Participants completed Web-based baseline and 1-month follow-up assessments. Website utilization metrics were extracted at 1 month. Descriptive statistics were used to characterize the full sample. Baseline differences were examined between recent quitters (≤7 days of abstinence at enrollment) and more established quitters (8+ days of abstinence at enrollment) using chi-square tests and t tests. Univariate logistic regression examined demographic, smoking, psychosocial characteristics, and website utilization metrics as predictors of 1-month abstinence.

RESULTS: During the 10-month study period, 1141 former smokers were recruited to participate: 494 accepted the invitation, 395 were eligible, 377 provided informed consent, and 221 completed the baseline and fully enrolled (56% of those eligible). At 1 month, 55.7% (123/221) of participants completed the follow-up survey. Mean age was 44.25 years (SD 12.78) and the sample was primarily female (174/221, 78.7%), white (196/221, 88.7%), and had at least some college education (177/221, 80.1%). Slightly more than half of participants (123/221, 55.7%) reported quitting more than a week prior to website registration and 43.9% (97/221) had quit within 7 days of registration. The website features most likely to be used were an interactive Quit Date tool (166/221, 75.1%) and the Community (134/221, 60.6%). Univariate regression models showed that recent quitters, those with higher motivation to remain abstinent, and those who used cessation medication in the past year were more likely to use the Community. Older age, longer duration of abstinence at registration, better health status, and health care provider advice to quit were associated with 1-month abstinence. Website utilization metrics did not predict abstinence, though odds ratios suggested higher utilization was associated with greater odds of abstinence.

CONCLUSIONS: This exploratory study demonstrated the feasibility of recruiting former smokers to a research study and documented the uptake of an Internet cessation intervention among this group of self-quitters. Results also showed higher levels of website utilization and greater likelihood of community use among smokers early in their quit attempt compared to those with a longer period of abstinence at enrollment. Important areas for future research include identifying former smokers who may be more susceptible to relapse and determining which components of an Internet intervention are most helpful to prevent relapse in the early and later stages of a quit attempt.

Keywords: Internet; relapse prevention; smoking cessation

References

1. Nicotine Tob Res. 2006 Dec;8 Suppl 1:S13-9 - PubMed
2. Behav Res Ther. 2013 Nov;51(11):719-22 - PubMed
3. J Health Commun. 2011 Jan;16(1):90-107 - PubMed
4. J Med Internet Res. 2006 Sep 19;8(3):e17 - PubMed
5. MMWR Morb Mortal Wkly Rep. 2011 Nov 11;60(44):1513-9 - PubMed
6. J Consult Clin Psychol. 1985 Aug;53(4):455-60 - PubMed
7. J Med Internet Res. 2010 Aug 18;12(3):e34 - PubMed
8. J Pers Assess. 1996 Feb;66(1):20-40 - PubMed
9. Cochrane Database Syst Rev. 2013 Aug 20;(8):CD003999 - PubMed
10. Health Educ Behav. 2011 Feb;38(1):49-62 - PubMed
11. Addict Behav. 2009 Apr;34(4):365-73 - PubMed
12. J Med Internet Res. 2011 Jan 06;13(1):e2 - PubMed
13. J Am Med Inform Assoc. 2013 May 1;20(3):568-76 - PubMed
14. Med Care. 1992 Jun;30(6):473-83 - PubMed
15. J Med Internet Res. 2013 Jan 28;15(1):e14 - PubMed
16. Behav Res Ther. 2012 Mar;50(3):180-90 - PubMed
17. J Consult Clin Psychol. 1983 Jun;51(3):465-6 - PubMed
18. Nicotine Tob Res. 2010 Apr;12(4):432-7 - PubMed
19. BMC Public Health. 2011 Jul 27;11:592 - PubMed
20. J Med Internet Res. 2011 Aug 05;13(3):e52 - PubMed
21. J Med Internet Res. 2008 Dec 17;10(5):e54 - PubMed
22. Ann Behav Med. 2015 Oct;49(5):732-42 - PubMed
23. Addiction. 2012 Mar;107(3):673-82 - PubMed
24. J Consult Clin Psychol. 1990 Jun;58(3):304-9 - PubMed
25. J Consult Clin Psychol. 1986 Aug;54(4):447-53 - PubMed
26. J Med Internet Res. 2005 Mar 31;7(1):e11 - PubMed
27. Addiction. 2010 Aug;105(8):1362-80 - PubMed
28. Arch Intern Med. 1997 Feb 10;157(3):335-40 - PubMed
29. Addiction. 2002 Sep;97(9):1093-108 - PubMed
30. Annu Rev Clin Psychol. 2007;3:257-84 - PubMed
31. Addiction. 2012 Dec;107(12):2183-90 - PubMed
32. J Med Internet Res. 2012 Nov 14;14(6):e152 - PubMed
33. Nicotine Tob Res. 2006 Dec;8 Suppl 1:S43-8 - PubMed
34. J Med Internet Res. 2013 Mar 25;15(3):e69 - PubMed
35. Prev Med. 2012 Sep;55(3):233-6 - PubMed
36. J Consult Clin Psychol. 2004 Oct;72(5):797-808 - PubMed
37. Tob Control. 2013 Nov;22(6):e11 - PubMed
38. Addiction. 2004 Jan;99(1):29-38 - PubMed

Publication Types

• Journal Article

Grant support

• R01 CA155489/CA/NCI NIH HHS/United States
• R01 CA192345/CA/NCI NIH HHS/United States
• R03 CA175870/CA/NCI NIH HHS/United States