A RANDOMIZED TRIAL OF INTERNET AND TELEPHONE TREATMENT FOR SMOKING CESSATION

Title: A Randomized Trial of Internet and Telephone Treatment for Smoking Cessation
Date Posted: January 10, 2011
Authors: Graham AL, Cobb NK, Papandonatos GD, et al.
Citation: Arch Intern Med 2011;171:46-53.

Study Question:
Does Internet and telephone treatment for smoking cessation increase quit rates?

Methods:
The Quit Using Internet and Telephone Treatment (iQUITT) study was a randomized controlled trial, which compared basic Internet, enhanced Internet, and enhanced Internet with proactive telephone counseling. QuitNet provided advice to quit, assistance in setting a quit date, assessment of motivation, smoking history, and nicotine dependence, individually tailored information on quitting, problem solving and skills training, assistance with using pharmacologic therapies for quitting, and online social support. The trial was conducted from March 8, 2005, through November 30, 2008. Current adult smokers in the United States who smoked five or more cigarettes per day were eligible. The primary outcome of interest was 30-day abstinence measured at 3, 6, 12, and 18 months after randomization using intent-to-treat analysis.

Results:
A total of 2,005 smokers were enrolled. Mean age of the cohort was 35.9 years, 51.1% were women, and 86.5% were white. The follow-up assessment rate at 18 months was 68.2%. At 18 months, the 30-day multiple point prevalence abstinence rate across all follow-up intervals was 3.5% for the basic Internet group, 4.5% for the enhanced Internet group, and 7.7% for the enhanced Internet with proactive telephone counseling. At 18 months, 30-day single point prevalence abstinence rates were 19.0% for the basic Internet group, 17.4% for the enhanced Internet group, and 19.6% for the enhanced Internet with proactive telephone counseling group, with no significant difference between the groups.

Conclusions:
The investigators concluded that a combined Internet and telephone treatment outperforms static and dynamic Internet interventions for smoking cessation.

Perspective:
The study is a well-designed trial exemplifying the novel aspects of Internet-based interventions for behavioral change. Although the quit rates were modest, the investigators used the Internet to reach a broad group of smokers; thus, the impact of this intervention has potential to be far greater than the traditional multicenter or single-center trial.

POSTED BY STEVEN ALMANY, MD