Web-based support as an adjunct to group-based smoking cessation for adolescents

Abstract

Although group-based programs remain the most common treatment approach for adolescent smoking cessation, success rates for these programs have been relatively modest, and their reach may be limited. Web-based adjuncts may be one way to boost the efficacy and reach of group-based approaches. The purpose of this study was to evaluate the effectiveness of enhancing the American Lung Association's Not on Tobacco program (NOT) with a Web-based adjunct (NOT Plus). Twentynine high schools were randomly assigned to either the NOT program alone or to the NOT Plus condition, which included access to a specially designed Web site for teens, along with proactive phone calls from the group facilitator to the participant. Self-reported smoking behavior was obtained at end-of-program and at a 3-month follow-up. Using hierarchical linear modeling, accounting for the clustering of students in schools, and controlling for student gender, grade, race, and baseline smoking rate, there was a marginally significant (p = .06) condition effect at end-of-treatment and a significant effect at 3-month follow-up (p < .05) favoring the NOT Plus condition. Approximately 57% of adolescents reported visiting the Web site, and among the NOT Plus condition, use of the Web site was associated with cessation significantly at end-of-program (p < .05), but not at 3 months. Adolescents in urban schools were more likely to access the Web site than those in rural schools. Participants who visited the Web site rated it positively on several dimensions. Reasons for not using the Web site will be discussed, as well as its value as an adjunct.

A systematic review of Internet-based therapy for the treatment of addictions

“…Five studies were randomized trials that compared two interventions, one of which was intended to act as an active control (Abroms, Windsor, & Simons-Morton, 2008;Brendryen, Drozd, & Kraft, 2008;Japuntich et al, 2006;King et al, 2009;Mermelstein & Turner, 2006). Two studies included treatment users who selfselected to participate in a research evaluation with no comparison or control group (Hotta et al, 2007;Zbikowski, Hapgood, Smucker Barnwell, & McAfee, 2008).…”

“…The majority of the studies evaluated programs specifically for tobacco cessation (Abroms et al, 2008;Brendryen et al, 2008;Japuntich et al, 2006;Hotta et al, 2007;Mermelstein & Turner, 2006;Woodruff et al, 2007;Zbikowski et al, 2008), with one study examining Internet treatment for problem and pathological gamblers (Carlbring & Smit, 2008) and one for substance abuse (King et al, 2009). The target population was primarily treatment-seeking adults, although three papers evaluated programs developed specifically for adolescents or young adults (Abroms et al, 2008;Mermelstein & Turner, 2006;Woodruff et al, 2007) and one targeted university employees (Hotta et al, 2007).…”

“…The target population was primarily treatment-seeking adults, although three papers evaluated programs developed specifically for adolescents or young adults (Abroms et al, 2008;Mermelstein & Turner, 2006;Woodruff et al, 2007) and one targeted university employees (Hotta et al, 2007).…”

“…CBT was the most commonly reported interventions with four programs claiming its use (Abroms et al, 2008;Brendryen et al, 2008;Carlbring & Smit, 2008;Japuntich et al, 2006). Four programs provided direct contact with therapists for support and encouragement via telephone (Brendryen et al, 2008;Carlbring & Smit, 2008;Mermelstein & Turner, 2006) or email (Abroms et al, 2008) exchange. Five interventions facilitated peer-based social support by enabling contact between treatment participants through discussion forums (Japuntich et al, 2006;Zbikowski et al, 2008), emails (Hotta et al, 2007) or group therapy sessions (King et al, 2009;Woodruff et al, 2007).…”

“…Five interventions facilitated peer-based social support by enabling contact between treatment participants through discussion forums (Japuntich et al, 2006;Zbikowski et al, 2008), emails (Hotta et al, 2007) or group therapy sessions (King et al, 2009;Woodruff et al, 2007). Information to assist in quitting was provided by the majority of programs on websites (Brendryen et al, 2008;Carlbring & Smit, 2008;Japuntich et al, 2006;Hotta et al, 2007;Mermelstein & Turner, 2006;Zbikowski et al, 2008), some of which included interactive tools and exercises for education and practical strategies (Carlbring & Smit, 2008;Japuntich et al, 2006;Zbikowski et al, 2008). Programs also reported incorporating motivational interviewing (MI) strategies (Hotta et al, 2007;Mermelstein & Turner, 2006Woodruff et al, 2007 and behavioural approaches (Woodruff et al, 2007) in their programs.…”