Nicotine & Tobacco Research Advance Access originally published online on July 29, 2009
Nicotine & Tobacco Research 2009 11(9):1025-1034; doi:10.1093/ntr/ntp090
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International Spanish/English Internet smoking cessation trial yields 20% abstinence rates at 1 year
Ricardo F. Muñoz, Ph.D., Department of Psychiatry at San Francisco General Hospital, Latino Mental Health Research Program, and Internet World Health Research Center, University of California, San Francisco, San Francisco, CA
Alinne Z. Barrera, Ph.D., Department of Psychiatry at San Francisco General Hospital, Latino Mental Health Research Program, and Internet World Health Research Center, University of California, San Francisco, San Francisco, CA
Kevin Delucchi, Ph.D., Department of Psychiatry at University of California, San Francisco, San Francisco, CA
Carlos Penilla, M.S., Department of Psychiatry at San Francisco General Hospital, Latino Mental Health Research Program, and Internet World Health Research Center, University of California, San Francisco, San Francisco, CA
Leandro D. Torres, Ph.D., Department of Psychiatry at San Francisco General Hospital, Latino Mental Health Research Program, and Internet World Health Research Center, University of California, San Francisco, San Francisco, CA
Eliseo J. Pérez-Stable, M.D., Division of General Internal Medicine, Medical Effectiveness Research Center for Diverse Populations, Department of Medicine and the Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
Corresponding Author: Ricardo F. Muñoz, Ph.D., Department of Psychiatry at San Francisco General Hospital, Latino Mental Health Research Program, and Internet World Health Research Center, University of California, San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Suite 7M, San Francisco, CA 94110, USA. Telephone: 415-206-5214; Fax: 415-206-8942; E-mail: ricardo.munoz{at}ucsf.edu
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Abstract |
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Introduction: There are 1.1 billion smokers worldwide. Traditional smoking cessation methods, such as nicotine replacement therapy and smoking cessation groups, yield between 14% and 27% abstinence rates at 6 months. Evidence-based Internet interventions with comparable abstinence rates could be a powerful global tool to reduce tobacco-related morbidity and mortality.
Methods: We report a randomized control trial in which 500 Spanish-speaking and 500 English-speaking adult Internet users, smoking at least 5 cigarettes/day and intending to quit in the next month, were recruited online from 68 countries. Consenting participants who completed baseline measures, logged cigarettes smoked on 3 days within a week, and set a quit date were randomized to four conditions. Each condition added new elements: Condition 1 was the "Guía Para Dejar de Fumar," a static National Cancer Institute evidence-based stop smoking guide; Condition 2 consisted of Condition 1 plus E-mail reminders to return to the site; Condition 3 consisted of Condition 2 plus mood management lessons; and Condition 4 consisted of Condition 3 plus a "virtual group" (an asynchronous bulletin board). Main outcome measures were 7-day point prevalence abstinence at 1, 3, 6, and 12 months after initial quit date.
Results: There were no significant differences among the four conditions. The overall 12-month 7-day abstinence rates were 20.2% for Spanish speakers and 21.0% for English speakers when those with missing data were assumed to be smoking.
Discussion: Internet smoking cessation interventions with such abstinence rates provided globally in additional languages could contribute substantially to tobacco control efforts.
Received: August 2, 2008; Accepted: January 28, 2009
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