Web sites that support smokers in their attempts to quit show promise as powerful smoking cessation tools, suggest the results of a Web site pilot study.

Such sites offer “the potential to reach into the homes of millions of smokers with a program they can use any time, night or day,” says study author Edward G. Feil, Ph.D., of the Oregon Research Institute in Eugene. “The challenges of making certain that effective programs are available must be met.” Numerous Web sites offer smoking cessation support, but no studies have measured the effectiveness of these sites. Feil and colleagues developed a smoking cessation Web site to test ways to recruit smokers and help them quit. They enrolled more than 600 smokers, 77 percent of whom smoked 16 or more cigarettes per day, by listing the Web site with major Web search engines, placing banner advertisements and posting to Internet discussion groups related to smoking cessation. They also placed a newspaper advertisement, distributed brochures at dental clinics and doctors’ offices, and received coverage of their Web site through a newspaper article and a radio program. The researchers also followed a smaller subgroup of Web site users for a three-month period, offering them small monetary incentives to complete brief surveys measuring changes in their smoking behaviors, and eliciting their opinions on various Web site components. The Web site included a guide to help participants develop a personalized quit plan, a chat room and ask-an-expert area to provide peer and professional support, and a library of pamphlets, motivations materials, and Web links. “The intention was to create a reasonably full-featured, extensive Web site based on theoretically grounded and empirically validated intervention approaches,” Feil notes. The most successful recruitment strategies for the Web site — which enjoyed an average of 108 logins per day during the six-month pilot study period — were search engines and postings to user groups. The newspaper recruitment strategies were also successful but only drew users for a short interval. The social support component was the most popular, while the library was the second most popular area among users, the majority of whom were women, the researchers found. “The social support module in particular was heavily used, and many positive comments about it were received,” Feil notes. “We believe that the popularity of the social support module was due in large part to the presence of the ex-smoker staff member assigned to moderate the bulletin board and chat room.” The study results are published in the current issue of the journal Nicotine & Tobacco Research. Of the several hundred Web site users who responded to the three-month follow-up survey, 32 percent percent reported quitting, which the researchers described as “encouraging.” When the researchers included non-responding users as current smokers, however, the quit rate for the whole group dropped to 18 percent. Study participants rated the ask-an-expert section most highly, and 63 percent said the Web site was easy or very easy to use. “These results provide reason for further evaluations of comprehensive Internet-based smoking cessation interventions,” Feil says. Feil and colleagues note several challenges of ascertaining a Web site’s effectiveness as a smoking cessation tool, one being that they could not determine if their Web site actually caused smokers to quit. “Determining the relative contribution of a specific Web site presents difficult challenges, given that typical Internet users appear to sample various sites,” Feil notes. The anonymity of the Internet and the instability of electronic identities such as e-mail addresses may also pose problems to researchers trying to validate their results. Keeping track of participants via telephone interviews might help reduce study fallout, the researchers suggest. This research was supported a grant from the National Cancer Institute.

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