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Phone and web-based tobacco cessation treatment: real-world utilization patterns and outcomes for 11,000 tobacco users.

Zbikowski SM, Hapgood J, Smucker Barnwell S, McAfee T - J. Med. Internet Res. (2008)

Bottom Line: Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation.Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates.This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Free & Clear, Inc, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA. susan.zbikowski@freeclear.com

ABSTRACT

Background: Phone-based tobacco cessation programs have been proven effective and widely adopted. Web-based solutions exist; however, the evidence base is not yet well established. Many cessation treatments are commercially available, but few integrate the phone and Web for delivery and no published studies exist for integrated programs.

Objective: This paper describes a comprehensive integrated phone/Web tobacco cessation program and the characteristics, experience, and outcomes of smokers enrolled in this program from a real-world evaluation.

Methods: We tracked program utilization (calls completed, Web log-ins), quit status, satisfaction, and demographics of 11,143 participants who enrolled in the Free & Clear Quit For Life Program between May 2006 and October 2007. All participants received up to five proactive phone counseling sessions with Quit Coaches, unlimited access to an interactive website, up to 20 tailored emails, printed Quit Guides, and cessation medication information. The program was designed to encourage use of all program components rather than asking participants to choose which components they wanted to use while quitting.

Results: We found that participants tended to use phone services more than Web services. On average, participants completed 2-2.5 counseling calls and logged in to the online program 1-2 times. Women were more adherent to the overall program; women utilized Web and phone services significantly (P = .003) more than men. Older smokers (> 26 years) and moderate smokers (15-20 cigarettes/day) utilized services more (P < .001) than younger (< 26 years) and light or heavy smokers. Satisfaction with services was high (92% to 95%) and varied somewhat with Web utilization. Thirty-day quit rates at the 6-month follow-up were 41% using responder analysis and 21% using intent-to-treat analysis. Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation.

Conclusions: This paper expands our understanding of a real-world treatment program combining two mediums, phone and Web. Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates. This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs.

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Related in: MedlinePlus

Quit calendar
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figure4: Quit calendar

Mentions: The online component of the program (Web Coach) contains interactive tools and tailored content based on participants’ readiness to quit. As described in Table 1, key features of Web Coach include an interactive quit plan (Figure 2), educational content in an online library (Figure 3), quit calendar (Figure 4), cost calculator and progress tracker (Figure 5), tool to email friends, family, and other participants for support (Figure 6), and active discussion forums to interact with other members and the Quit Coaches (Figure 7). Participants can use the Web tools to gain greater awareness of their tobacco triggers, learn from past quit attempts, and develop their plan to cope with cravings, stress, and triggers. Participants build social networks with other smokers and ex-smokers enrolled in the program through the discussion forums and messaging functions available on the website. Quit Coaches moderate the forums and provide feedback to participants on a daily basis. Once a participant reports quitting tobacco, the website changes in its look, feel, and content to reflect that the participant has now quit and is actively working to prevent relapse (see Figure 8). This “Staying Quit” phase includes exercises and educational content for relapse prevention. When participants achieve quitting milestones (having quit for 1 month, 6 months, and 12 months), they are sent e-certificates recognizing their achievement.


Phone and web-based tobacco cessation treatment: real-world utilization patterns and outcomes for 11,000 tobacco users.

Zbikowski SM, Hapgood J, Smucker Barnwell S, McAfee T - J. Med. Internet Res. (2008)

Quit calendar
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2630835&req=5

figure4: Quit calendar
Mentions: The online component of the program (Web Coach) contains interactive tools and tailored content based on participants’ readiness to quit. As described in Table 1, key features of Web Coach include an interactive quit plan (Figure 2), educational content in an online library (Figure 3), quit calendar (Figure 4), cost calculator and progress tracker (Figure 5), tool to email friends, family, and other participants for support (Figure 6), and active discussion forums to interact with other members and the Quit Coaches (Figure 7). Participants can use the Web tools to gain greater awareness of their tobacco triggers, learn from past quit attempts, and develop their plan to cope with cravings, stress, and triggers. Participants build social networks with other smokers and ex-smokers enrolled in the program through the discussion forums and messaging functions available on the website. Quit Coaches moderate the forums and provide feedback to participants on a daily basis. Once a participant reports quitting tobacco, the website changes in its look, feel, and content to reflect that the participant has now quit and is actively working to prevent relapse (see Figure 8). This “Staying Quit” phase includes exercises and educational content for relapse prevention. When participants achieve quitting milestones (having quit for 1 month, 6 months, and 12 months), they are sent e-certificates recognizing their achievement.

Bottom Line: Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation.Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates.This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs.

View Article: PubMed Central - HTML - PubMed

Affiliation: Free & Clear, Inc, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA. susan.zbikowski@freeclear.com

ABSTRACT

Background: Phone-based tobacco cessation programs have been proven effective and widely adopted. Web-based solutions exist; however, the evidence base is not yet well established. Many cessation treatments are commercially available, but few integrate the phone and Web for delivery and no published studies exist for integrated programs.

Objective: This paper describes a comprehensive integrated phone/Web tobacco cessation program and the characteristics, experience, and outcomes of smokers enrolled in this program from a real-world evaluation.

Methods: We tracked program utilization (calls completed, Web log-ins), quit status, satisfaction, and demographics of 11,143 participants who enrolled in the Free & Clear Quit For Life Program between May 2006 and October 2007. All participants received up to five proactive phone counseling sessions with Quit Coaches, unlimited access to an interactive website, up to 20 tailored emails, printed Quit Guides, and cessation medication information. The program was designed to encourage use of all program components rather than asking participants to choose which components they wanted to use while quitting.

Results: We found that participants tended to use phone services more than Web services. On average, participants completed 2-2.5 counseling calls and logged in to the online program 1-2 times. Women were more adherent to the overall program; women utilized Web and phone services significantly (P = .003) more than men. Older smokers (> 26 years) and moderate smokers (15-20 cigarettes/day) utilized services more (P < .001) than younger (< 26 years) and light or heavy smokers. Satisfaction with services was high (92% to 95%) and varied somewhat with Web utilization. Thirty-day quit rates at the 6-month follow-up were 41% using responder analysis and 21% using intent-to-treat analysis. Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation.

Conclusions: This paper expands our understanding of a real-world treatment program combining two mediums, phone and Web. Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates. This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs.

Show MeSH
Related in: MedlinePlus