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Internet-based tobacco cessation interventions

Health Factors: Tobacco Use
Decision Makers: Employers & Businesses Local Government State Government Public Health Professionals & Advocates
Evidence Rating: Scientifically Supported
Population Reach: 10-19% of WI's population
Impact on Disparities: Likely to increase disparities

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Description

Internet-based tobacco cessation interventions typically provide information, strategies, or behavioral support to assist tobacco users who want to quit (CG-Tobacco use). Such interventions include websites, computer programs, or other electronic aids (Chen 2012). Interventions may rely solely on internet technology or include components such as in-person counseling, remote counseling, text messaging, or pharmacotherapy (e.g., nicotine replacement therapy (NRT)) (Cochrane-Civljak 2013). 

Expected Beneficial Outcomes

Increased quit rates

Evidence of Effectiveness

There is strong evidence that internet-based tobacco cessation interventions help tobacco users quit (Park 2015, Chen 2012, Danaher 2015, Brown 2014c). Interventions for individuals who are cessation-ready and those who have not yet decided to quit both appear effective (Chen 2012). Interventions are effective for adults (Cochrane-Civljak 2013, Hutton 2011) and college students (Cochrane-Civljak 2013, Gulliver 2015, Hutton 2011); additional research is needed to determine effects for teens (Hutton 2011, Cochrane-Civljak 2013).

Internet-based interventions that include text messages (Brown 2013a), e-mail messages (Hutton 2011), or a combination of the two (Danielsson 2014) have been shown to help adults quit smoking. Interventions that are interactive, tailored to participants’ circumstances, and include automated phone contacts can also help adults quit (Cochrane-Civljak 2013).

Internet-based interventions combined with pharmacotherapies such as nicotine replacement therapy (NRT) can increase the likelihood of successful quit attempts (Cochrane-Civljak 2013). Participants better adhere to internet-based cessation programs with NRT or an online supportive social network than programs without these features (Graham 2016). Additional research is needed to determine the effectiveness of cessation programs that use Twitter (Pechmann 2015), Facebook (Cobb 2016), and other forms of social media (Pechmann 2015).

Research suggests that effective internet-based smoking cessation programs for adolescents (Park 2015) and adults (Newman 2011) usually include combinations of multimedia and interactive features (e.g., videos or stories), content that is tailored to participants' demographic characteristics, or feedback that reflects participants' progress and goals (Park 2015, Newman 2011). Some studies suggest that websites that are interactive or tailored to participants’ demographic characteristics are more effective than sites that are static or more general; other studies suggest equal effects (Cochrane-Civljak 2013, Hutton 2011). Adding internet-based components to counseling may not improve counseling’s effects on quit rates (Cochrane-Civljak 2013, Hutton 2011).   

Internet-based interventions appear to be cost-effective (Chen 2012, Graham 2013). Additional evidence is needed to determine if internet-based interventions are more cost-effective than quitlines or in-person counseling (Cochrane-Civljak 2013).

Smokers who are highly educated appear more likely than smokers with less education to use internet-based programs to quit tobacco (Hill 2013a). 

Implementation

United States

The US Department of Health and Human Services provides several targeted internet-based smoking cessation interventions which include Smokefree Women, Smokefree Teen, Smokefree Vet, Smokefree Espanol, and Smokefree 60+ (Smokefree.gov). Many other websites offer online cessation programs to help individuals stop smoking. Examples of such sites include QuitNet and Stop Smoking Center (QuitNet, Stop Smoking Center).  

Wisconsin

The University of Wisconsin Center for Tobacco Research and Intervention includes references to self-help websites to quit using tobacco, including programs through Smokefree.gov (UW-CTRI, Smokefree.gov).

Implementation Resources

ALA-FFS Online - American Lung Association (ALA). Freedom from smoking online. Accessed on November 30, 2016
EX - EX. Become an Ex. A new way to think about quitting smoking. Accessed on November 30, 2016
QSC - Quit Smoking Community (QSC). Accessed on November 30, 2016
Smokefree.gov - US Department of Health and Human Services (US DHHS). Smokefree.gov. Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App. Accessed on March 2, 2017
WebMD-Smoking cessation - WebMD. Smoking cessation health center. Accessed on November 30, 2016

Citations - Description

CG-Tobacco use - The Guide to Community Preventive Services (The Community Guide). Tobacco. Accessed on April 3, 2017
Chen 2012 - Chen Y, Madan J, Welton N, et al. Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: A systematic review and network meta-analysis. Health Technology Assessment (Winchester, England). 2012;16(38):1–205, iii–v. Accessed on November 30, 2016
Cochrane-Civljak 2013* - Civljak M, Stead LF, Hartmann-Boyce J, Sheikh A, Car J. Internet-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2013;(7):CD007078. Accessed on November 30, 2016

Citations - Evidence

Brown 2013a* - Brown J. A review of the evidence on technology-based interventions for the treatment of tobacco dependence in college health. Worldviews on Evidence-Based Nursing. 2013;10(3):150–62. Accessed on November 30, 2016
Brown 2014c* - Brown J, Michie S, Geraghty AWA, et al. Internet-based intervention for smoking cessation (StopAdvisor) in people with low and high socioeconomic status: A randomised controlled trial. The Lancet Respiratory Medicine. 2014;2(12):997-1006. Accessed on December 19, 2016
Chen 2012 - Chen Y, Madan J, Welton N, et al. Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: A systematic review and network meta-analysis. Health Technology Assessment (Winchester, England). 2012;16(38):1–205, iii–v. Accessed on November 30, 2016
Cobb 2016* - Cobb NK, Jacobs MA, Wileyto P, Valente T, Graham AL. Diffusion of an evidence-based smoking cessation intervention through Facebook: A randomized controlled trial. American Journal of Public Health. 2016;106(6):1130-1135. Accessed on December 19, 2016
Cochrane-Civljak 2013* - Civljak M, Stead LF, Hartmann-Boyce J, Sheikh A, Car J. Internet-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2013;(7):CD007078. Accessed on November 30, 2016
Danaher 2015* - Danaher BG, Severson HH, Crowley R, et al. Randomized controlled trial examining the adjunctive use of nicotine lozenges with MyLastDip: An eHealth smokeless tobacco cessation intervention. Internet Interventions. 2015;2(1):69-76. Accessed on December 19, 2016
Danielsson 2014* - Danielsson AK, Eriksson AK, Allebeck P. Technology-based support via telephone or web: A systematic review of the effects on smoking, alcohol use and gambling. Addictive Behaviors. 2014;39(12):1846-1868. Accessed on December 19, 2016
Graham 2013* - Graham AL, Chang Y, Fang Y, et al. Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of The iQUITT Study. Tobacco Control. 2013;22(6):e11. Accessed on November 30, 2016
Graham 2016* - Graham AL, Papandonatos GD, Cha S, et al. Improving adherence to smoking cessation treatment: Intervention effects in a web-based randomized trial. Nicotine & Tobacco Research. 2016. Accessed on December 19, 2016
Gulliver 2015 - Gulliver A, Farrer L, Chan J, et al. Technology-based interventions for tobacco and other drug use in university and college students: A systematic review and meta-analysis. Addiction Science & Clinical Practice. 2015;10(1):5. Accessed on December 19, 2016
Hill 2013a - Hill S, Amos A, Clifford D, Platt S. Impact of tobacco control interventions on socioeconomic inequalities in smoking: Review of the evidence. Tobacco Control. 2013;0:1–9. Accessed on November 30, 2016
Hutton 2011* - Hutton HE, Wilson LM, Apelberg BJ, et al. A systematic review of randomized controlled trials: Web-based interventions for smoking cessation among adolescents, college students, and adults. Nicotine & Tobacco Research. 2011;13(4):227–38. Accessed on November 30, 2016
Newman 2011* - Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: Is human contact necessary for therapeutic efficacy? Clinical Psychology Review. 2011;31(1):178-186. Accessed on December 19, 2016
Park 2015* - Park E, Drake E. Systematic review: Internet-based program for youth smoking prevention and cessation. Journal of Nursing Scholarship. 2015;47(1):43-50. Accessed on December 19, 2016
Pechmann 2015 - Pechmann C, Pan L, Delucchi K, Lakon CM, Prochaska JJ. Development of a Twitter-based intervention for smoking cessation that encourages high-quality social media interactions via automessages. Journal of Medical Internet Research. 2015;17(2):e50. Accessed on December 19, 2016

Citations - Implementation

QuitNet - QuitNet. Don't quit alone. Accessed on December 16, 2016
Smokefree.gov - US Department of Health and Human Services (US DHHS). Smokefree.gov. Resources to quit smoking: Smokefree VET, Smokefree Women, Smokefree Teen, Smokefree Espanol, Smokefree 60+, SmokefreeTXT, QuitGuide app, and QuitSTART App. Accessed on March 2, 2017
Stop Smoking Center - Stop Smoking Center. Accessed on November 30, 2016
UW-CTRI - University of Wisconsin Center for Tobacco Research and Intervention (UW-CTRI). Self-help websites to quit tobacco. Accessed on December 19, 2016

Page Last Updated

December 20, 2016

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