Reach and Uptake of Internet- and Telephone-Based Smoking Cessation Interventions: Results from a Cohort Study and Randomised Controlled Trial
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Abstract
Background: The public health impact of smoking cessation interventions is highly dependent on their reach and the degree to which they are used. A better understanding of the reach smoking cessation interventions and who become active users of internet-based smoking cessation programs and telephone counselling will be of value in designing effective interventions.
Objective: To investigate patterns of reach of smoking cessation interventions and how uptake of an internet-based smoking cessation program and telephone counselling varies according to demographic and smoking-related characteristics.
Methods: The study uses data from a randomised smoking cessation trial where participants were recruited among 9,924 smokers who previously participated in two large national health surveys conducted in 2007-2008 and 2010. The invitation was sent by e-mail or letter. 1809 consented and were eligible for the trial. Trial participation was studied as an indicator of reach using data from the two cohort studies. The trial itself included four interventions: 1) a tailored smoking cessation program delivered through internet and mobile phone text-messages 2) Five proactive telephone counselling sessions 3) Standard reactive quit line counselling 4) A self-help booklet. Information about intervention uptake was self-reported at one month follow-up. Participants were encouraged but not obliged to use the interventions. Uptake was studied in relation a range of demographic and smoking related characteristics.
Results: Reach was highest among those aged 40-59, women, heavy smokers, and those with at least 15 years of education. Among participants in the RCT, we saw large differences in intervention uptake between the four groups. 69 % of those randomized to the internet-based intervention signed up for the program. 74 % accepted the offer of proactive counselling, whereas only 9 % called the quit line in the group randomized to reactive telephone counselling. In multivariate analysis, young age was associated with uptake of the internet-based intervention and short education was positively associated with accepting the offer of proactive telephone counselling.
Conclusions: The communication channel and degree of proactivity greatly affect intervention uptake. Internet-based interventions and telephone counselling appear to attract different age groups and different socio-economic groups.
Objective: To investigate patterns of reach of smoking cessation interventions and how uptake of an internet-based smoking cessation program and telephone counselling varies according to demographic and smoking-related characteristics.
Methods: The study uses data from a randomised smoking cessation trial where participants were recruited among 9,924 smokers who previously participated in two large national health surveys conducted in 2007-2008 and 2010. The invitation was sent by e-mail or letter. 1809 consented and were eligible for the trial. Trial participation was studied as an indicator of reach using data from the two cohort studies. The trial itself included four interventions: 1) a tailored smoking cessation program delivered through internet and mobile phone text-messages 2) Five proactive telephone counselling sessions 3) Standard reactive quit line counselling 4) A self-help booklet. Information about intervention uptake was self-reported at one month follow-up. Participants were encouraged but not obliged to use the interventions. Uptake was studied in relation a range of demographic and smoking related characteristics.
Results: Reach was highest among those aged 40-59, women, heavy smokers, and those with at least 15 years of education. Among participants in the RCT, we saw large differences in intervention uptake between the four groups. 69 % of those randomized to the internet-based intervention signed up for the program. 74 % accepted the offer of proactive counselling, whereas only 9 % called the quit line in the group randomized to reactive telephone counselling. In multivariate analysis, young age was associated with uptake of the internet-based intervention and short education was positively associated with accepting the offer of proactive telephone counselling.
Conclusions: The communication channel and degree of proactivity greatly affect intervention uptake. Internet-based interventions and telephone counselling appear to attract different age groups and different socio-economic groups.
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