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Learn How to Quit Smoking

By: 
Renee Despres

WebQuit, an online study to help people stop smoking, is looking for people who want to quit the cigarette habit. People who sign up for the program will recieve free online help, including tips and advice about how to quit smoking and the benefits of quitting smoking.

On June 25, we spoke with WebQuit study director Jonathon Bricker, Ph.D., a faculty member in the Cancer Prevention Program in the Hutchinson Center’s Public Health Sciences Division, about WebQuit. Bricker, a clinical psychologist who specializes in smoking-cessation research, talked about WebQuit, the limits of current online smoking cessation programs, how to sign up for the free program, and what you should expect if you sign up.

You’re potentially eligible to participate in the study if you are:

  • 18 or older
  • A United States resident, or at least reside in the United States for three months of the study period
  • Hoping to quit smoking in the next thirty days
  • Willing to be randomly assigned (like a coin toss) to one of two self-paced web programs for quitting smoking
  • Willing to complete a three-month follow-up survey

You can enroll in the WebQuit study at https://webquit.org. The deadline for enrollment is August 31, 2011. And while you're clicking, don’t forget to check out YourMedicalSource’s resources on how to quit smoking – especially if you’re pregnant.

 

YourMedicalSource. Why do we need online, as opposed to face-to-face, smoking cessation options?

JB: We need all of them. There are people who respond well to online interventions because they’re so convenient and inexpensive. They have tremendous reach. We can reach people who would not otherwise participate in phone or in person programs. They may not find it as comfortable meeting in a group or to talk on the phone. So we’re reaching different populations by offering another option. The thing about online programs is that they’re available 24 hours a day, 7 days a week, and very, very inexpensive for them. As a matter of fact, our program is free to users.

 

YourMedicalSource: Is the program also inexpensive for you? Who is funding it?

JB: We are funded by grant from the National Cancer Institute (NCI), the largest arm of the National Institutes of Health (NIH). The NIH is the federal government’s agency for supporting health research in the United States. It was very expensive to program the website, design the intervention, and it will be expensive to maintain and to analyze the data.

Participants don’t have to worry about expense. All they need to do is learn how to quit and stay quit. As a matter of fact, we will pay $10 to all participants who complete a follow-up survey.

Editor’s note:  Findings published in 2005 by a group of Danish researchers suggests that the expense of tobacco-cessation programs is well worth the investment. The Danish research team compared the estimated health-care costs of smokers (light, moderate, and heavy), ex-smokers, and people who never smoked. They then estimated the savings over a lifetime of a moderate smoker who quit at age 35. The numbers? Men would save 24 800 € (about $35,150) and women 34,100 € (nearly $48,300) in health-care costs alone.

YourMedicalSource: What is the goal of the WebQuit program?

JB: Our longterm goal is to be able to determine which of two programs is most effective in helping people quit smoking. We already know that both are helpful and will be useful to people. But we’re conducting a scientific study to learn which is most helpful. Once we know which one is most helpful to most people, we’ll be able to broadly distribute it.

So our goal is to make sure these treatments work and get them out there. The current online interventions have only modest success rates. We’re aiming to help millions of people every day. We want to give people something we know works and that they can use.

We want to make effective treatment available to as many people as possible. That is the goal. But we can’t do that if we don’t learn what’s most effective. It’s very important that we provide  a controlled, randomized study. To ensure that the study is randomized, a computerized “coin toss” will be used to assign participants to one of two groups.

 

YourMedicalSource:  By default, the study will be limited to people with regular access to the internet, some facility with online environments, and a desire to participate in this type of environment. How will that limit study results? 

JB: The limits are probably less than they appear. Rates of internet use are pretty high in our country. Currently, 80 percent of us adults use the internet, according to data from the last Pew Internet and American Life Center. It’s likely that percentage is going to go up over time as internet access becomes more inexpensive and more widely available. By the time our program is tested and available for dissemination, we expect an even greater percentage of people and a broader demographic to be using the internet.

 

YourMedicalSource: How will cultural and socioeconomic factors be addressed and evaluated, including demographics, language barriers, and culturally-specific perceptions of cigarette smoking?

JB: The current program is limited in that it is only currently available in English. We plan to expand that. In the future, the program will be delivered in other languages. Spanish would be the first.

 

YourMedicalSource: Can people participate in this study if they don’t have a computer and regular internet access at home? 

JB: People need to be able to access the internet for at least one hour per week. However, they can download the materials and print them if, for instance, their only internet access is at the local public library. The program does not require participants to be online constantly.

 

YourMedicalSource:  What should people who sign up for the study expect? How much time will they need to spend online and in program-related activities, and how much and what type of support should they expect?

JB: The time commitment is completely up to the user. Participants can make as little or as much as they want of the study. The program will be available to them 24/7 as soon as they are assigned to a group. That said, people who log into the websites they’re assigned to more often have a higher likelihood of quitting. When they log on, users will have a chance to practice the program and read tips, motivational statements, and messages. So it depends how much time the user is willing to commit; if they commit more time, they’re more likely to succeed at quitting and staying quit.

In terms of content, both programs will focus on helping people stay motivated to quit. I can’t provide specifics, as that would harm the integrity of the study. But I can say both programs provide motivational messages and other components to help people stay focused on the goal. For instance, they’ll learn useful strategies to deal with urges and cravings, which are part of the normal process of quitting. They’ll learn how to set a quit date and stay focused. Participants will also receive weekly e-mail reminders to log into their assigned websites. They can also contact the intervention they’re assigned to when they need resources or support. They’ll have access to expert advice to deal with urges and stay motivated.

 

YourMedicalSource: How will participants’ confidentiality be secured?

JB: We have the latest level of encryption available set by our computer programmers. All of the data for our study is housed internally here at the cancer center. There are number of firewalls we use to protect the data, as well as a high level of encryption. Once you log in, a password will be randomly assigned. If you don’t want to share your information, simply don’t share your password.

We are using the latest security technology. Once the person has completed the screening survey, which is  anonymous, if they are eligible for the study, they will be randomly assigned a password. Once the participant enters password that password, she or he will be asked to fill out a baseline survey and consent form. All data will be confidential. Only a few people on our staff will be allowed to see the data. We limit that to people who have a need to know. The study meets all requirements of federal privacy rules (HIPAA) and is approved by our Institutional Review Board (IRB).

 

YourMedicalSource: How will you verify the accuracy of your data?

JB: We will rely on what people tell us about their success in quitting. This is called self-reported data. For lower intensity interventions such as internet or telephone studies, there’s  a very tiny discrepancy between self-reported and biologically confirmed verification of whether you’ve quit. Biological confirmation – for instance, a blood test – is not necessary and could harm our outcome data collection rate. People could become annoyed if they’re asked to provide a biological sample.

In point of fact, a number of studies to test the level of confirmation have shown consistency between self-reported and confirmed data. It would be different if we were doing an in-person study. In those studies, people might now want to let their your clinicians down and might lie about whether they’ve quit or not. But in an internet study, the motivation to be deceptive isn’t there.

 

YourMedicalSource: Will participants be able to get any more support after the three-month study period is ended?  

JB: We can send anyone who requests additional support a link to resources for continued help. That has come up in past studies, so we’ve compiled a host of other resources to help people on their journey to quitting smoking if haven’t quit by the end of our program and still want help.

 

References

Bricker, J. (2011, June 25). Telephone Interview.

Rasmussen, S.R., Prescott, E., Sørensen, T.I.A., & Søgaard, J. (2005). The total lifetime health cost savings of smoking cessation to society, Eur J Public Health 15(6): pp. 601-606 first published online July 13, 2005 doi:10.1093/eurpub/cki024.