International Spanish/English Internet smoking cessation trial yields 20% abstinence rates at 1 year

Abstract

Results: There were no signifi cant differences among the four conditions. The overall 12-month 7-day abstinence rates were 20.2% for Spanish speakers and 21.0% for English speakers when those with missing data were assumed to be smoking. Discussion:Internet smoking cessation interventions with such abstinence rates provided globally in additional languages could contribute substantially to tobacco control efforts. IntroductionThere are 1.1 billion smokers worldwide ( World Bank, 1999 ), and there were 5.4 million tobacco attributable deaths in 2005 ( Mathers & Loncar, 2006 ). International approaches to smoking cessation are needed to help those with less access to traditional smoking cessation methods. The Internet provides one means of providing such interventions. Traditional smoking cessation methods, such as nicotine replacement therapy or smoking cessation groups, yield abstinence rates in the range of 14% -27% at 6 months ( Fiore, Smith, Jorenby, & Baker, 1994 ;Lando, McGovern, Barrios, & Etringer, 1990 ;Schroeder, 2005 ). Newer medications, such as varenicline ( Gonzales et al., 2006 ) and long-term combination approaches ( Hall, Humfl eet, Reus, Muñoz, & Cullen, 2004 ), can increase and maintain abstinence rates to 30% or higher levels. AbstractIntroduction: There are 1.1 billion smokers worldwide. Traditional smoking cessation methods, such as nicotine replacement therapy and smoking cessation groups, yield between 14% and 27% abstinence rates at 6 months. Evidence-based Internet interventions with comparable abstinence rates could be a powerful global tool to reduce tobacco-related morbidity and mortality. Methods:We report a randomized control trial in which 500 Spanish-speaking and 500 English-speaking adult Internet users, smoking at least 5 cigarettes/day and intending to quit in the next month, were recruited online from 68 countries. Consenting participants who completed baseline measures, logged cigarettes smoked on 3 days within a week, and set a quit date were randomized to four conditions. Each condition added new elements: Condition 1 was the " Guía Para Dejar de Fumar, " a static National Cancer Institute evidence-based stop smoking guide; Condition 2 consisted of Condition 1 plus E-mail reminders to return to the site; Condition 3 consisted of Condition 2 plus mood management lessons; and Condition 4 consisted of Condition 3 plus a " virtual group " (an asynchronous bulletin board). Main outcome measures were 7-day point prevalence abstinence at 1, 3, 6, and 12 months after initial quit date.

Internet and Telephone Treatment for Smoking Cessation: Mediators and Moderators of Short-Term Abstinence

“…Self-reported smoking status is a commonly accepted outcome measure in Internet cessation trials, 12,[22][23][24][25][26][27] where biochemical verification of abstinence is not feasible and misreporting of abstinence is expected to be minimal given low demand characteristics.…”

Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.

“…Egger's test for all the three outcome measures does not suggest significant funnel plot asymmetry, although the possibility of some missing studies with negative outcomes cannot be ruled out by inspection of the funnel plots for point prevalence abstinence and prolonged abstinence at longest follow-up. This section summarises two studies 100,123 that evaluated interventions with single or multiple generic components; both were aid to cessation studies. The characteristics of these studies and their participants are presented in Table 5 and are briefly described below.…”

“…Al-Chalabi et al 100 conducted a pilot RCT in smokers attending NHS stop-smoking clinics to evaluate the feasibility of delivering, by e-mail, instructions for performing activities (isometric exercises and body scan) that might help reduce the urges to smoke. Muñoz et al 123 compared a static, online cessation guide with three interventions with incremental features added to this guide, including automated e-mails with links to sections of the guide, an eight-lesson cognitive-behavioural mood management course and an asynchronous bulletin board for mutual support between smokers. The static online guide, the additional automated e-mails, and mood management course were considered generic components and thus the three interventions including these components (incrementally) are described in this section.…”

“…Al-Chalabi et al 100 reported continuous abstinence during a 4-week follow-up period and Muñoz et al 123 reported 7-day point prevalence abstinence at various points during the follow-up of 1 year. Prolonged abstinence was not reported.…”

Global tobacco inequalities: a new frontier

“…At the same time, the intervention described here offers an important means of actively halting the tobacco epidemic. There is also potential to reach many smokers through Internetbased interventions to promote behavioral change [32]. Cleary, reducing the tobacco burden calls for a comprehensive approach using many strategies, including policy, mass media, and taxation to reduce the rising burden associated with tobacco use.…”