title: Exploring the Utility of Web-Based Social Media Advertising to Recruit Adult Heavy-Drinking Smokers for Treatment.
abstract: BACKGROUND
  Identifying novel ways to recruit smokers for treatment studies is important. In particular, certain subgroups of adult smokers, such as heavy-drinking smokers, are at increased risk for serious medical problems and are less likely to try quitting smoking, so drawing this hard-to-reach population into treatment is important for improving health outcomes.
  
  
  OBJECTIVE
  This study examined the utility of Facebook advertisements to recruit smokers and heavy-drinking smokers for treatment research and evaluated smoking and alcohol use and current treatment goals among those who responded to the Web-based survey.
  
  
  METHODS
  Using Facebook's advertising program, 3 separate advertisements ran for 2 months targeting smokers who were thinking about quitting. Advertisements were shown to adult (at least 18 years of age), English-speaking Facebook users in the greater New Haven, Connecticut, area. Participants were invited to complete a Web-based survey to determine initial eligibility for a smoking cessation research study.
  
  
  RESULTS
  Advertisements generated 1781 clicks and 272 valid, completed surveys in 2 months, with one advertisement generating the most interest. Facebook advertising was highly cost-effective, averaging $0.27 per click, $1.76 per completed survey, and $4.37 per participant meeting initial screening eligibility. On average, those who completed the Web-based survey were 36.8 (SD 10.4) years old, and 65.8% (179/272) were female. Advertisements were successful in reaching smokers; all respondents reported daily smoking (mean 16.2 [SD 7.0] cigarettes per day). The majority of smokers (254/272, 93.4%) were interested in changing their smoking behavior immediately. Many smokers (161/272, 59.2%) also reported heavy alcohol consumption at least once a month. Among smokers interested in reducing their alcohol use, more were heavy drinkers (45/56, 80.4%) compared to non-heavy drinkers (11/56, 19.6%; χ(2)[1,N=272]=13.0, P<.001). Of those who met initial screening eligibility from the Web-based survey, 12.7% (14/110) attended an in-person follow-up appointment.
  
  
  CONCLUSIONS
  Social media advertisements designed to target smokers were cost-effective and successful for reaching adult smokers interested in treatment. Additionally, recruiting for smokers reached those who also drink alcohol heavily, many of whom were interested in changing this behavior as well. However, additional social media strategies may be needed to engage individuals into treatment after completion of Web-based screening surveys.
authors.affiliation: Yale School of Medicine, Department of Psychiatry, New Haven, CT, United States. krysten.bold@yale.edu.
authors.forename: Krysten W
authors.identifier: http://orcid.org/0000-0002-8012-6118
authors.initials: KW
authors.lastname: Bold
authors.forename: Tess H
authors.identifier: http://orcid.org/0000-0001-9057-9092
authors.initials: TH
authors.lastname: Hanrahan
authors.forename: Stephanie S
authors.identifier: http://orcid.org/0000-0002-1976-2369
authors.initials: SS
authors.lastname: O'Malley
authors.forename: Lisa M
authors.identifier: http://orcid.org/0000-0001-9410-2830
authors.initials: LM
authors.lastname: Fucito
mesh_terms: D000328:Adult; D000329:Advertising / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D061108:Social Media / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: alcohol drinking; research subject recruitment; smoking; social media