Utilization of Services in a Randomized Trial Testing Phone- and Web-Based Interventions for Smoking Cessation

Abstract

Introduction: Phone counseling has become standard for behavioral smoking cessation treatment. Newer options include Web and integrated phone-Web treatment. No prior research, to our knowledge, has systematically compared the effectiveness of these three treatment modalities in a randomized trial. Understanding how utilization varies by mode, the impact of utilization on outcomes, and predictors of utilization across each mode could lead to improved treatments. Methods:One thousand two hundred and two participants were randomized to phone, Web, or combined phone-Web cessation treatment. Services varied by modality and were tracked using automated systems. All participants received 12 weeks of varenicline, printed guides, an orientation call, and access to a phone supportline. Self-report data were collected at baseline and 6-month follow-up.Results: Overall, participants utilized phone services more often than the Web-based services. Among treatment groups with Web access, a significant proportion logged in only once (37% phone-Web, 41% Web), and those in the phone-Web group logged in less often than those in the Web group (mean = 2.4 vs. 3.7, p = .0001). Use of the phone also was correlated with increased use of the Web. In multivariate analyses, greater use of the phone-or Web-based services was associated with higher cessation rates. Finally, older age and the belief that certain treatments could improve success were consistent predictors of greater utilization across groups. Other predictors varied by treatment group. Conclusions:Opportunities for enhancing treatment utilization exist, particularly for Web-based programs. Increasing utilization more broadly could result in better overall treatment effectiveness for all intervention modalities.

Randomized controlled trial of the combined effects of Web and Quitline interventions for smokeless tobacco cessation

“…Inconsistent with the results of Balmford, Borland, Benda, and Howard (2013) and Zbikowski et al (2011) – this website engagement did not differ in the two Web interventions (Web + Quitline= 90.4%; Web Only= 90.0%;). It is important to note further that the level of Web visits we observed was higher than in our previous Web-based smokeless tobacco cessation RCTs (Danaher et al, 2013; Danaher et al, 2015; Severson et al, 2008) as well as reported by Cobb and Graham (2014) for smokers who called a commercial Quitline (QuitNet.com) 25% of whom never logged into their assigned Web intervention.…”

Use of Non-Assigned Interventions in a Randomized Trial of Internet and Telephone Treatment for Smoking Cessation

“…Smokers that participate in web-based cessation studies are often highly motivated to quit smoking (Graham et al, 2011;Richardson et al, 2013;Saul et al, 2007;Zbikowski et al, 2011) and may seek out additional "non-assigned" cessation methods beyond the interventions assigned in the trial. Not unlike participants in other types of studies, those who join Internet cessation trials are free to avail themselves of other cessation interventions.…”

An analysis of randomised controlled trials that utilise internet based smoking reduction/cessation programs

“…Motivation to participate in face to face smoking reduction and cessation programs is typically high. Yet, it was shown that online users that are effectively engaged are as successful as those participating in more difficult to access and more expensive face to face programs (Christensen et al, 2004;Eysenbach, 2005;Farvolden et al, 2005;Zbikowski et al, 2011). But face to face programs are not as readily available worldwide as internet based interventions.…”