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

Abstract

Introduction: 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.

Results: There were no significant 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.

Figure 1.

CONSORT diagram for progression of participants through UCSF/SFGH Internet World Health Research Center Internet Stop Smoking Trial (2005–2007). UCSF = University of California, San Francisco; SFGH = San Francisco General Hospital; Guía = smoking cessation guide; ITEMs = Individually Timed Educational Messages (sent via E-mail with link to site); MM = mood management intervention (eight-lesson cognitive-behavioral course); and VG = virtual group (an asynchronous bulletin board that allowed participants to provide each other mutual support and information).