Comparing the efficacy of two Internet-based, computer-tailored smoking cessation programs: a randomized trial - PubMed (original) (raw)

Randomized Controlled Trial

Comparing the efficacy of two Internet-based, computer-tailored smoking cessation programs: a randomized trial

Jean-François Etter. J Med Internet Res. 2005.

Abstract

Background: Online computer-tailored smoking cessation programs have not yet been compared directly.

Objective: To compare the efficacy of two Internet-based, computer-tailored smoking cessation programs.

Methods: Randomized controlled trial conducted in 2003-2004. Visitors to a smoking cessation website were randomly assigned to either an original online, interactive smoking cessation program or to a modified program. Both programs consisted of tailored, personalized counseling letters based on participants' characteristics, followed by monthly email reminders. The original program was based on psychological and addiction theory, and on preliminary research conducted in the same population. The modified program was shorter and contained more information on nicotine replacement therapy and nicotine dependence, and less information on health risks and coping strategies. In both programs, 1 month and 2 months after entering the study, participants were invited by email to answer the same tailoring questionnaire again in order to receive a second counseling letter. Participants in both programs obtained, on average, 1.2 feedback counseling letters over 2.5 months, and 84% received only 1 feedback letter. The outcome was self-reported smoking abstinence (no puff of tobacco in the previous 7 days), assessed 2.5 months after entry in the program. We report results from intention-to-treat (ITT) analyses, where all non-respondents at follow-up were counted as smokers.

Results: The baseline questionnaire was answered by a total of 11969 current (74%) and former (26%) smokers, and the follow-up survey by 4237 people (35%). In an ITT analysis, abstinence rates in baseline current smokers were respectively 10.9% and 8.9% (odds ratio [OR]=1.24, 95% confidence interval [CI]1.08-1.43, P=.003) in the original and modified programs, and 25.2% and 15.7% (OR=1.81, CI 1.51-2.16, P<.001) in baseline former smokers. While we found statistically significant differences in quit rates in smokers in the contemplation stage favoring the original program (OR=1.54, CI 1.18-2.02, P=.002), no between-group differences in quit rates were observed in smokers in the precontemplation (OR=1.07, CI 0.36-3.14, P=.91) and preparation (OR=1.15, CI 0.97-1.37, P=.10) stages of change.

Conclusions: In smokers in the contemplation stage of change and in former smokers, the original program produced higher smoking abstinence rates than the modified program.

PubMed Disclaimer

Conflict of interest statement

The author developed the two programs presented in this study as part of his work at the University of Geneva, Switzerland. Both programs are available at no charge to smokers. The author has no financial or commercial interest in these programs. The Institute of Social and Preventive Medicine, University of Geneva, Switzerland, receives support from the sponsors mentioned above to run these programs.

Figures

Figure 1

Figure 1

Screenshot of the tailoring questionnaire for the original program

Figure 2

Figure 2

Personal counseling letter of the original program

Figure 3

Figure 3

Screenshot of the tailoring questionnaire for the modified program

Figure 4

Figure 4

Personal counseling letter of the modified program

Figure 5

Figure 5

Flow chart of participants in the randomized controlled trial

References

    1. Lancaster T, Stead LF. Self-help interventions for smoking cessation. Cochrane Database Syst Rev. 2002;(3):CD001118. - PubMed
    1. Etter Jean-François. Using new information technology to treat tobacco dependence. Respiration. 2002;69(2):111–4. doi: 10.1159/000056311.res69111 - DOI - PubMed
    1. Brug J, Steenhuis I, Van Assema P, De Vries H. The impact of a computer-tailored nutrition intervention. Prev Med. 1996;25(3):236–42. doi: 10.1006/pmed.1996.0052.S0091743596900523 - DOI - PubMed
    1. Dijkstra A, De Vries H, Roijackers J, Van Breukelen G. Tailoring information to enhance quitting in smokers with low motivation to quit: three basic efficacy questions. Health Psychol. 1998 Nov;17(6):513–9. doi: 10.1037//0278-6133.17.6.513. - DOI - PubMed
    1. Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library. BMJ. 2000 Aug 5;321(7257):355–8. doi: 10.1136/bmj.321.7257.355. http://bmj.bmjjournals.com/cgi/content/full/321/7257/355. - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources