ChewFree.com: evaluation of a Web-based cessation program for smokeless tobacco users.
The sizeable percentage of adults who use smokeless tobacco (ST) represents an important public health target since the majority of ST users have a strong desire to quit, but many lack resources. We tested the impact of an interactive, tailored Web-based intervention (Enhanced Condition) versus a more linear, text-based website (Basic Condition) in a randomized trial with 2523 adult ST users. As is common in Internet-based research, there was considerable attrition: follow-up rates at 3 months, 6 months, and for both 3 and 6 months were 48%, 45% and 34%, respectively. Results using repeated point prevalence of all tobacco use at 3 and 6 months showed that participants in the Enhanced Condition quit at significantly higher rates than those in the Basic Condition. Using a Complete Case analysis, abstinence was 40.6% in the Enhanced Condition vs. 21.2% in the Basic Condition (p< .001). Using intent-to-treat analysis, quit rates were 12.6% vs. 7.9%, respectively (p< .001). Similar results were obtained for only ST use. Unobtrusive measures of program exposure indicated that program use was significantly related to outcome as well as to attrition. We conclude that a tailored, interactive Web-assisted cessation program can be an efficacious method for assisting adult ST users to quit.
Severson
Herbert H
HH
Oregon Research Institute, Eugene, Oregon 97405, USA. herb@ori.org
Gordon
Judith S
JS
Danaher
Brian G
BG
Akers
Laura
L
D000328:Adult; D003376:Counseling / Q000379:methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data*; D015397:Program Evaluation; D020377:Self Efficacy; D012657:Self-Help Groups; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data*; D012944:Social Support; D013813:Therapy, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless