title: Who participates in Web-assisted tobacco interventions? The QUIT-PRIMO and National Dental Practice-Based Research Network Hi-Quit studies.
abstract: BACKGROUND
  Smoking is the most preventable cause of death. Although effective, Web-assisted tobacco interventions are underutilized and recruitment is challenging. Understanding who participates in Web-assisted tobacco interventions may help in improving recruitment.
  
  
  OBJECTIVE
  To understand characteristics of smokers participating in a Web-assisted tobacco intervention (Decide2Quit.org).
  
  
  METHODS
  In addition to the typical Google advertisements, we expanded Decide2Quit.org recruitment to include referrals from medical and dental providers. We assessed how the expanded recruitment of smokers changed the users' characteristics, including comparison with a population-based sample of smokers from the national Behavioral Risk Factors Surveillance Survey (BRFSS). Using a negative binomial regression, we compared demographic and smoking characteristics by recruitment source, in particular readiness to quit and association with subsequent Decide2Quit.org use.
  
  
  RESULTS
  The Decide2Quit.org cohort included 605 smokers; the 2010 BRFSS dataset included 69,992. Compared to BRFSS smokers, a higher proportion of Decide2Quit.org smokers were female (65.2% vs 45.7%, P=.001), over age 35 (80.8% vs 67.0%, P=.001), and had some college or were college graduates (65.7% vs 45.9%, P=.001). Demographic and smoking characteristics varied by recruitment; for example, a lower proportion of medical- (22.1%) and dental-referred (18.9%) smokers had set a quit date or had already quit than Google smokers (40.1%, P<.001). Medical- and dental-referred smokers were less likely to use Decide2Quit.org functions; in adjusted analysis, Google smokers (predicted count 17.04, 95% CI 14.97-19.11) had higher predicted counts of Web page visits than medical-referred (predicted count 12.73, 95% CI 11.42-14.04) and dental-referred (predicted count 11.97, 95% CI 10.13-13.82) smokers, and were more likely to contact tobacco treatment specialists.
  
  
  CONCLUSIONS
  Recruitment from clinical practices complimented Google recruitment attracting smokers less motivated to quit and less experienced with Web-assisted tobacco interventions.
authors: Division of Health Informatics & Implementation Science, University of Massachusetts Medical School, Worcester, MA, USA. rajani.sadasivam@umassmed.edu
authors: Rajani Shankar
authors: RS
authors: Sadasivam
authors: Rebecca L
authors: RL
authors: Kinney
authors: Kathryn
authors: K
authors: Delaughter
authors: Sowmya R
authors: SR
authors: Rao
authors: Jessica Hillman
authors: JH
authors: Williams
authors: Heather L
authors: HL
authors: Coley
authors: Midge N
authors: MN
authors: Ray
authors: Gregg H
authors: GH
authors: Gilbert
authors: Jeroan J
authors: JJ
authors: Allison
authors: Daniel E
authors: DE
authors: Ford
authors: Thomas K
authors: TK
authors: Houston
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003752:Dental Health Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation; D055815:Young Adult; D014026:Nicotiana
keywords: Google advertisements; Web-assisted tobacco intervention; dental practice; medical practice; public health informatics; smoking cessation
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