Such
sites offer “the potential to reach into the homes of millions
of smokers with a program they can use any time, night or day,” says
study author Edward G. Feil, Ph.D., of the Oregon Research Institute in
Eugene. “The challenges of making certain that effective programs
are available must be met.”
Numerous Web sites offer smoking cessation support, but no studies have
measured the effectiveness of these sites.
Feil and colleagues developed a smoking cessation Web
site to test ways to recruit smokers and help them quit. They enrolled
more than 600 smokers,
77 percent of whom smoked 16 or more cigarettes per day, by listing the
Web site with major Web search engines, placing banner advertisements
and posting to Internet discussion groups related to smoking cessation.
They
also placed a newspaper advertisement, distributed brochures at dental
clinics and doctors’ offices, and received coverage of their Web
site through a newspaper article and a radio program.
The researchers also followed a smaller subgroup of Web site users for
a three-month period, offering them small monetary incentives to complete
brief surveys measuring changes in their smoking behaviors, and eliciting
their opinions on various Web site components.
The Web site included a guide to help participants develop a personalized
quit plan, a chat room and ask-an-expert area to provide peer and professional
support, and a library of pamphlets, motivations materials, and Web links.
“The intention was to create a reasonably full-featured, extensive
Web site based on theoretically grounded and empirically validated intervention
approaches,” Feil notes.
The most successful recruitment strategies for the Web
site — which
enjoyed an average of 108 logins per day during the six-month pilot study
period — were search engines and postings to user groups. The newspaper
recruitment strategies were also successful but only drew users for a
short interval.
The social support component was the most popular, while the library was
the second most popular area among users, the majority of whom were women,
the researchers found.
“The social support module in particular was heavily used, and many
positive comments about it were received,” Feil notes. “We
believe that the popularity of the social support module was due in large
part to the presence of the ex-smoker staff member assigned to moderate
the bulletin board and chat room.”
The study results are published in the current issue of
the journal Nicotine & Tobacco
Research.
Of the several hundred Web site users who responded to
the three-month follow-up survey, 32 percent percent reported quitting,
which the researchers
described as “encouraging.” When the researchers included
non-responding users as current smokers, however, the quit rate for the
whole group dropped
to 18 percent.
Study participants rated the ask-an-expert section most highly, and 63
percent said the Web site was easy or very easy to use.
“These results provide reason for further evaluations of comprehensive
Internet-based smoking cessation interventions,” Feil says.
Feil and colleagues note several challenges of ascertaining
a Web site’s
effectiveness as a smoking cessation tool, one being that they could not
determine if their Web site actually caused smokers to quit. “Determining
the relative contribution of a specific Web site presents difficult challenges,
given that typical Internet users appear to sample various sites,” Feil
notes.
The anonymity of the Internet and the instability of electronic identities
such as e-mail addresses may also pose problems to researchers trying to
validate their results. Keeping track of participants via telephone interviews
might help reduce study fallout, the researchers suggest.
This research was supported a grant from the National Cancer Institute.
