Smoking
Conditions
Keywords
twitter, quit smoking, smoking cessation, social media, peer support
Brief summary
We conducted a two-arm (test vs. control, N=160) randomized controlled trial of small, private, online support groups for quitting smoking with 20 people per group who were seeking to quit smoking. A novel feature was a bot (auto-messenger) that posted a daily cessation-related discussion topic in each group, timed to the group's quit date.
Detailed description
Smoking relapse rates remain high, innovative strategies are needed to lower them, and web-based social networking may help like Twitter. This developmental research examined whether providing virtual (web-based) social support to smokers, through Twitter-enabled interactive peer texting, could help smokers quit and avoid relapses. Twitter is a free social networking and micro-blogging service, one of the most advanced and novel technologies available today that can provide social support to smokers, and it provides free texting to groups. It is global and has many features that are associated with treatment success including interactive, multi-way, live messaging and mobile accessibility, because the messages go instantly to mobile phones and to the web. It can provide an innovative way to reach smokers who might otherwise not seek treatment, and it can be extended to other health domains. From June 2012 through 2014, we conducted a two-condition randomized controlled trial. All participants in this trial (N=160) received 8 weeks of free nicotine patches, referral to the NCI's online Smokefree.gov Quit Guide, and instruction to set a quit date within 1 week of study start. Participants were also randomly assigned at the individual level to one of two conditions: (1) a virtual or online quit-smoking group on Twitter where the group members were instructed to use interactive peer messaging to help them quit and stay quit, or (2) a control group condition where the group members were not given this instruction or a Twitter group. In total, there were 4 Twitter groups and 4 control groups with 20 smokers randomly assigned to each group (i.e., N=80 test, N=80 control). In the Twitter groups, a bot (auto-messenger) posted a daily cessation-related discussion topic in each group, timed to the group's quit date. The primary outcome was self-reported 7-day point prevalence abstinence that was sustained at 7, 30 and 60 days after the quit date. Participants' posts, their virtual and face-to-face social networks, and several other possible mediating and moderating variables were also analyzed.
Interventions
BEHAVIORALsmoking cessation aides
All participants will receive 8 weeks of free nicotine patches, referral to the NCI's online Smokefree.gov Quit Guide, and instruction to set a quit date within 8 days of study start.
BEHAVIORALTwitter
Twitter quit-smoking group
Sponsors
National Institute on Drug Abuse (NIDA)
University of California, Irvine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 59 Years
Healthy volunteers
Yes
Inclusion criteria
* must have smoked 100 cigarettes during their lifetime * must currently smoke 5 or more cigarettes a day * must be in the preparation stage of quitting smoking * ages 18-59 years * English speaking * have a mobile phone with an unlimited texting plan and internet access * use text messaging at least once a week * use Facebook daily * have an active email account * live in the continental USA
Exclusion criteria
* a medical condition that is contra-indicated for nicotine replacement therapy: * pregnant * breast feeding * a recent heart attack * an irregular heartbeat * high blood pressure not controlled with medication * skin allergies to adhesive tape or serious skin problems * taking a prescription medicine for depression or anxiety * use drugs or marijuana regularly * live in the same household with another participant
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported 7-day Point Prevalence Abstinence From Smoking That Was Sustained at 60 Days After the Quit Date | 60 days after quit date | self-reported 7-day point prevalence abstinence from smoking that was sustained at 60 days after the quit date, based on survey |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Level of Engagement Based on Tweet Volume | 100 days total | level of engagement based on tweet volume which is observed in support groups |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Twitter Experimental participants are assigned a 20-person twitter quit-smoking group to interact with, are instructed to use Twitter-enabled interactive peer messaging,and are sent daily messages to encourage interaction. The baseline intervention 'smoking cessation aides' is also provided.
smoking cessation aides: All participants will receive 8 weeks of free nicotine patches, referral to the NCI's online Smokefree.gov Quit Guide, and instruction to set a quit date within 8 days of study start.
Twitter: Twitter quit-smoking group | 80 |
| Control Control participants are not assigned to a twitter group. The baseline intervention 'smoking cessation aides' is also provided.
smoking cessation aides: All participants will receive 8 weeks of free nicotine patches, referral to the NCI's online Smokefree.gov Quit Guide, and instruction to set a quit date within 8 days of study start. | 80 |
| Total | 160 |
Baseline characteristics
| Characteristic | Control | Total | |
|---|---|---|---|
| Age, Continuous age | 35.35 years STANDARD_DEVIATION 10.55 | 36.00 years STANDARD_DEVIATION 9.16 | 35.68 years STANDARD_DEVIATION 9.85 |
| Sex: Female, Male Female | 55 Participants | 61 Participants | 116 Participants |
| Sex: Female, Male Male | 25 Participants | 19 Participants | 44 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 80 | 0 / 80 |
| other Total, other adverse events | 0 / 80 | 0 / 80 |
| serious Total, serious adverse events | 0 / 80 | 0 / 80 |
Outcome results
Primary
Self-reported 7-day Point Prevalence Abstinence From Smoking That Was Sustained at 60 Days After the Quit Date
self-reported 7-day point prevalence abstinence from smoking that was sustained at 60 days after the quit date, based on survey
Time frame: 60 days after quit date
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Self-reported 7-day Point Prevalence Abstinence From Smoking That Was Sustained at 60 Days After the Quit Date | 26 Participants | |
| Control | Self-reported 7-day Point Prevalence Abstinence From Smoking That Was Sustained at 60 Days After the Quit Date | 14 Participants |
Secondary
Level of Engagement Based on Tweet Volume
level of engagement based on tweet volume which is observed in support groups
Time frame: 100 days total
Population: all participants were observed to assess their tweeting (posting) behavior
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Level of Engagement Based on Tweet Volume | 58.86 social media posts | Standard Deviation 68.02 | |
| Control | Level of Engagement Based on Tweet Volume | 0 social media posts | Standard Deviation 0 |