Use of Non-Assigned Interventions in a Randomized Trial of Internet and Telephone Treatment for Smoking Cessation

Cobb, Caroline O.; Graham, Amanda L.

doi:10.1093/ntr/ntu066

Cited by 13 publications

(12 citation statements)

References 33 publications

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“…Inconsistent with the results of Balmford, Borland, Benda, and Howard (2013) and Zbikowski et al (2011) – this website engagement did not differ in the two Web interventions (Web + Quitline= 90.4%; Web Only= 90.0%;). It is important to note further that the level of Web visits we observed was higher than in our previous Web-based smokeless tobacco cessation RCTs (Danaher et al, 2013; Danaher et al, 2015; Severson et al, 2008) as well as reported by Cobb and Graham (2014) for smokers who called a commercial Quitline (QuitNet.com) 25% of whom never logged into their assigned Web intervention.…”

Section: Discussioncontrasting

confidence: 51%

“…Similarly, they were asked about their use of smoking cessation medications Zyban® (Wellbutrin; Bupropion) and Chantix® (Verenicline). To determine the extent to which participants used non-assigned programs as recommended by Danaher et al (Danaher, Lichtenstein, McKay, & Seeley, 2009) and Cobb et al (Cobb & Graham, 2014), we also asked participants whether they received advice on how to quit from a health professional (physician, pharmacist, dentist/dental hygienist, and/or nurse), individual counseling (in person), group cessation program, other websites, hypnotherapy, or acupuncture.…”

Section: Methodsmentioning

confidence: 99%

“…Abstinence results at 3 months favored the combined web and phone counseling condition although between-group differences did not emerge at 6 months follow-up. Moreover, in a study having relevance to the current research, Graham et al (Cobb & Graham, 2014; Cobb, Niaura, Donaldson, & Graham, 2014; Graham et al, 2013; Graham et al, 2011; Graham et al, 2014) have described results for the iQUITT study, a large smoking cessation RCT, that found a combination of Enhanced Web (interactive plus large social network) and Quitline outperformed both a Basic Web (static text webpages) and the Enhanced Web intervention.…”

Section: Introductionmentioning

confidence: 99%

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Randomized controlled trial of the combined effects of Web and Quitline interventions for smokeless tobacco cessation

Danaher

Severson

Zhu

et al. 2015

Internet Interventions

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Background Use of smokeless tobacco (moist snuff and chewing tobacco) is a significant public health problem but smokeless tobacco users have few resources to help them quit. Web programs and telephone-based programs (Quitlines) have been shown to be effective for smoking cessation. We evaluate the effectiveness of a Web program, a Quitline, and the combination of the two for smokeless users recruited via the Web. Objectives To test whether offering both a Web and Quitline intervention for smokeless tobacco users results in significantly better long-term tobacco abstinence outcomes than offering either intervention alone; to test whether the offer of Web or Quitline results in better outcome than a self-help manual only Control condition; and to report the usage and satisfaction of the interventions when offered alone or combined. Methods Smokeless tobacco users (N= 1,683) wanting to quit were recruited online and randomly offered one of four treatment conditions in a 2×2 design: Web Only, Quitline Only, Web + Quitline, and Control (printed self-help guide). Point-prevalence all tobacco abstinence was assessed at 3- and 6-months post enrollment. Results 69% of participants completed both the 3- and 6-month assessments. There was no significant additive or synergistic effect of combining the two interventions for Complete Case or the more rigorous Intent To Treat (ITT) analyses. Significant simple effects were detected, individually the interventions were more efficacious than the control in achieving repeated 7-day point prevalence all tobacco abstinence: Web (ITT, OR = 1.41, 95% CI = 1.03, 1.94, p = .033) and Quitline (ITT: OR = 1.54, 95% CI = 1.13, 2.11, p = .007). Participants were more likely to complete a Quitline call when offered only the Quitline intervention (OR = 0.71, 95% CI = .054, .093, p = .013), the number of website visits and duration did not differ when offered alone or in combination with Quitline. Rates of program helpfulness (p <.05) and satisfaction (p <.05) were higher for those offered both interventions versus offered only quitline. Conclusion Combining Web and Quitline interventions did not result in additive or synergistic effects, as have been found for smoking. Both interventions were more effective than a self-help control condition in helping motivated smokeless tobacco users quit tobacco. Intervention usage and satisfaction were related to the amount intervention content offered. Usage of the Quitline intervention decreased when offered in combination, though rates of helpfulness and recommendations were higher when offered in combination. Trial Registration Clinicaltrials.gov NCT00820495; http://clinicaltrials.gov/ct2/show/NCT00820495

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Section: Discussioncontrasting

confidence: 51%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Randomized controlled trial of the combined effects of Web and Quitline interventions for smokeless tobacco cessation

Danaher

Severson

Zhu

et al. 2015

Internet Interventions

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“…Treatment utilization metrics were extracted at 3 months post-randomization, given that this is the period when website use is typically highest (4, 34). Self-report data were gathered via mixed-mode follow-up (online surveys, telephone for online non-responders).…”

Section: Methodsmentioning

confidence: 99%

Improving Adherence to Smoking Cessation Treatment: Smoking Outcomes in a Web-based Randomized Trial

Graham

Papandonatos

Cha

et al. 2018

Annals of Behavioral Medicine

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Background Partial adherence in Internet smoking cessation interventions presents treatment and evaluation challenges. Increasing adherence may improve outcomes. Purpose To present smoking outcomes from an Internet randomized trial of two strategies to encourage adherence to tobacco dependence treatment components (i.e., skills training, social support, medication): 1) a social network (SN) strategy to integrate smokers into an online community, and 2) free nicotine replacement therapy (NRT). In addition to intent-to-treat analyses, we used novel statistical methods to distinguish the impact of treatment assignment from treatment utilization. Methods N=5,290 current smokers on a cessation website (WEB) were randomized to WEB, WEB+SN, WEB+NRT, or WEB+SN+NRT. The main outcome was 30-day point prevalence abstinence at 3 and 9 months post-randomization. Adherence measures included website metrics of skills training and community use, and self-reported medication use. Inverse Probability of Retention Weighting and Inverse Probability of Treatment Weighting jointly addressed dropout and treatment selection. Propensity weights were used to calculate Average Treatment effects on the Treated. Results Treatment assignment analyses showed no effects on abstinence for either adherence strategy. Treatment utilization analyses revealed that joint community and medication use yielded large percentage point increases in 3-month abstinence rates over skills training alone across arms: WEB=20.6 (95% CI=10.8, 30.4), WEB+SN=19.2 (95% CI=11.1, 27.3), WEB+NRT=13.1 (95% CI=4.1, 22.0), and WEB+SN+NRT=20.0 (95% CI=12.2, 27.7). Abstinence rates among participants that used all treatment components were 25.7%-32.2%. Conclusions Novel propensity weighting approaches can serve as a model for establishing efficacy of Internet interventions and yield important insights about mechanisms. Clinical Trials.gov NCT01544153

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“…Participants were asked which methods they had used to quit in the past 3 months and were presented a list of common quit methods. 25 Participants were considered e-cigarette users if they selected "e-cigarettes" in response to this question or if they entered terms like "vapors," "vaping," "vape," or "ecigs" in the "other quit methods" open-ended response option.…”

Section: Methodsmentioning

confidence: 99%

E-Cigarettes and Smoking Cessation: Insights and Cautions From a Secondary Analysis of Data From a Study of Online Treatment-Seeking Smokers

Pearson¹,

Stanton²,

Cha³

et al. 2014

NICTOB

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Background: Evidence from observational studies regarding the association between electronic cigarette (e-cigarette) use and cessation is mixed and difficult to interpret. Utilizing 2 analytic methods, this study illustrates challenges common in analyses of observational data, highlights measurement challenges, and reports associations between e-cigarette use and smoking cessation. Methods: Data were drawn from an ongoing web-based smoking cessation trial. The sample was comprised of 2,123 participants with complete 3-month follow-up data. Logistic regression models with and without entropy balancing to control for confounds were conducted to evaluate the association between e-cigarette use and 30-day cigarette smoking abstinence. Results: At follow-up, 31.7% of participants reported using e-cigarettes to quit in the past 3 months. E-cigarette users differed from nonusers on baseline characteristics including cigarettes per day, Fagerström score, quit attempt in the past year, and previous use of e-cigarettes to quit. At followup, e-cigarette users made more quit attempts and employed more cessation aids than smokers who did not use e-cigarettes to quit. E-cigarette use was negatively associated with abstinence after adjustment for baseline characteristics; however, the association was not significant after additional adjustment for use of other cessation aids at 3 months. Conclusions: The magnitude and significance of the estimated association between e-cigarette use and cessation in this study were dependent upon the analytical approach. Observational studies should employ multiple analytic approaches to address threats to validity. Future research should employ better measures of patterns of and reasons for e-cigarette use, frequency of e-cigarette use, and concurrent use of cessation aids.

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Use of Non-Assigned Interventions in a Randomized Trial of Internet and Telephone Treatment for Smoking Cessation

Cited by 13 publications

References 33 publications

Randomized controlled trial of the combined effects of Web and Quitline interventions for smokeless tobacco cessation

Randomized controlled trial of the combined effects of Web and Quitline interventions for smokeless tobacco cessation

Improving Adherence to Smoking Cessation Treatment: Smoking Outcomes in a Web-based Randomized Trial

E-Cigarettes and Smoking Cessation: Insights and Cautions From a Secondary Analysis of Data From a Study of Online Treatment-Seeking Smokers

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