More than on-line: Combining coaching with a web-based smoking cessation program

Smoking cessation remains an important public health issue and interventionists need innovative, efficacious and cost-effective approaches to address the complex needs of would-be quitters. Personalized cessation strategies such as in-person counseling (e.g. phone support), and promoting social support are effective, but can be expensive and difficult to administer. Internet-based approaches show promise; program content can be widely distributed with fidelity for a very low cost, however, automated interventions can be perceived as impersonal. This project combined these validated cessation strategies and consists of an online video-based smoking cessation program that provided cognitive-behavioral support for stopping smoking, promoted pharmacological aids, a personalized quit plan, an online bulletin board messaging with other quitters and live support provided by a smoking cessation coach. The program was evaluated via the Internet in a randomized clinical trial of 500 smokers recruited through major worksites across the U.S. The primary outcome was a successful quit. Participants were assessed at pretest, 30 day, 120 day and 1 year follow ups. Using the conservative intent-to-treat analysis model, at 30 days, treatment subjects were three times as likely to have quit as those in the control group. At 120 days and one year follow ups, treatment smokers were twice as likely to have stopped smoking –statistically significant differences that strongly support this approach. In this presentation, the theoretical grounding of the intervention, implementation and evaluation will be discussed, and portions of the online program will be shown. Lessons learned and implications for future interventions and evaluations will be discussed.