Background A key factor in successfully reducing and quitting smoking, as well as preventing smoking relapse is access to and engagement with social support. Recent technological advances have made it possible for smokers to access social support via online community forums. While community forums associated with smoking cessation interventions are now common practice, there is a gap in understanding how and when the different types of social support identified by Cutrona and Suhr (1992) (emotional, esteem, informational, tangible, and network) are exchanged on such forums. Community forums that entail “superusers” (a key marker of a successful forum), like QuitNow, are ripe for exploring and leveraging promising social support exchanges on these platforms. Objective The purpose of this study was to characterize the posts made on the QuitNow community forum at different stages in the quit journey, and determine when and how the social support constructs are present within the posts. Methods A total of 506 posts (including original and response posts) were collected. Using conventional content analysis, the original posts were coded inductively to generate categories and subcategories, and the responses were coded deductively according to the 5 types of social support. Data were analyzed using Microsoft Excel software. Results Overall, individuals were most heavily engaged on the forum during the first month of quitting, which then tapered off in the subsequent months. In relation to the original posts, the majority of them fit into the categories of sharing quit successes, quit struggles, updates, quit strategies, and desires to quit. Asking for advice and describing smoke-free benefits were the least represented categories. In relation to the responses, encouragement (emotional), compliment (esteem), and suggestion/advice (informational) consistently remained the most prominent types of support throughout all quit stages. Companionship (network) maintained a steady downward trajectory over time. Conclusions The findings of this study highlight the complexity of how and when different types of social support are exchanged on the QuitNow community forum. These findings provide directions for how social support can be more strategically employed and leveraged in these online contexts to support smoking cessation.

BACKGROUND Tobacco use has shifted in recent years, especially with the introduction of e-cigarettes. Despite the now variable and intersecting tobacco product use among tobacco users, most want to quit, which necessitates cessation programming to adapt to these variable trends (versus focusing on combustible cigarettes alone). The use of online modalities for cessation support has become quite popular in recent years, and has been compounded by the Covid-19 pandemic. Therefore, understanding the current strengths and weaknesses of existing programming to meet the needs of today’s various tobacco users is critical to ensuring the saliency of such programming moving forward. OBJECTIVE The purpose of this study was to understand the strengths and limitations of online cessation support offered through QuitNow to better understand the needs of a variety of end-users who smoke, dual-use, or vape. METHODS Semi-structured interviews were conducted with 80 tobacco users in British Columbia. Using conventional content analysis methods, we inductively derived descriptive categories and themes related to the strengths and weaknesses of QuitNow. We analyzed the data with the support of Nvivo 12 and Excel. RESULTS Participants described several strengths and limitations of QuitNow, as well as suggestions for improvement, which fell under two broad categories: Look and Feel, and Content and Features. Strengths included the government backing, welcoming vibe, and social and professional support available. Limitations included too much text, the need to create an account, and the lack of tailored behavioral support and user-driven content. In relation to suggestions for improvement, participants stated that the site needed more interaction, intuitive organization, improved interface aesthetics, a complementary smartphone app, forum discussion tags, more information for different tobacco user profiles, and user testimonials. Participants also provided ideas on how to raise awareness of QuitNow, which included social media, print-based materials, outreach, and product-based marketing. CONCLUSIONS The findings of this study provide directions for enhancing the saliency of online cessation programming for a variety of tobacco use behaviors that hallmark today’s tobacco use.

BACKGROUND A key factor in successfully reducing and quitting smoking, as well as preventing smoking relapse is access to and engagement with social support. Recent technological advances have made it possible for smokers to access social support via online community forums. While community forums associated with smoking cessation interventions are now common practice, there is a gap in understanding how and when the different types of social support (emotional, esteem, informational, tangible, and network) are exchanged on such forums. Community forums that entail “superusers” (a key marker of a successful forum), like QuitNow, are ripe for exploring and leveraging promising social support exchanges on these platforms. OBJECTIVE The purpose of this study was to characterize the posts made on the QuitNow community forum at different stages in the quit journey, and determine when and how the social support constructs are present within the posts. METHODS A total of 506 posts (including original and response posts) were collected. Using conventional content analysis, the original posts were coded inductively to generate categories and sub-categories, and the responses were coded deductively according to the five types of social support. Data were analyzed using Microsoft Excel software. RESULTS Overall, individuals were most heavily engaged on the forum during the first month of quitting, which then tapered off in the subsequent months. In relation to the original posts, the majority of them fit into the categories of sharing quit successes, quit struggles, updates, quit strategies, and desires to quit. Asking for advice and describing smoke-free benefits were the least represented categories. In relation to the responses, encouragement (emotional), compliment (esteem), and suggestion/advice (informational) consistently remained the most prominent types of support throughout all quit stages. Companionship (network) maintained a steady downward trajectory over time. CONCLUSIONS The findings of this study highlight the complexity of how and when different types of social support are exchanged on the QuitNow community forum. These findings provide directions for how social support can be more strategically employed and leveraged in these online contexts to support smoking cessation. CLINICALTRIAL