Feasibility and Quit Rates of the Tobacco Status Project: A Facebook Smoking Cessation Intervention for Young Adults.
Feasibility and Quit Rates of the Tobacco Status Project: A Facebook Smoking Cessation Intervention for Young Adults.
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DOI：
10.2196/jmir.5209
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发表时间：
2015-12-31
影响因子：
7.4
通讯作者：
Prochaska JJ
中科院分区：
文献类型：
--
作者：
Ramo DE;Thrul J;Chavez K;Delucchi KL;Prochaska JJ
年轻的成年吸烟者是一个具有挑战性的群体，从事戒烟干预。由于用户的广泛接触和参与，Facebook为年轻人提供了参与社会支持社区戒烟和保持禁欲的机会。我们开发并测试了烟草状况项目的初步疗效、参与度和可接受性，这是一项在Facebook上为年轻人提供的戒烟干预措施。该干预措施基于美国公共卫生服务临床实践指南和跨理论模型，并将参与者招募到研究运行的为期3个月的秘密Facebook群组中，根据戒烟准备情况进行匹配。通过Facebook招募了18-25岁的吸烟者（N=79），他们大多数时间使用Facebook。所有参与者都接受了干预，并被随机分配到与参与度相关的三个货币激励组之一（分组评论）。在基线、3个月、6个月和12个月随访时完成评估。分析检查了12个月内的保留、吸烟结局（7天时点戒烟率、吸烟减少≥50%、戒烟尝试和使用的策略、戒烟准备）、参与度和对干预的满意度。6个月时的保留率为82%（65/79），12个月时为72%（57/79）。从基线到12个月随访，准备戒烟的比例显著增加（10/79，13%; 36/79，46%，P<0.001）。超过三分之一（28/79，35%）的人减少了50%或更多的吸烟量，66%（52/79）的人在研究期间至少有一次24小时的戒烟尝试。在意向治疗分析中，13%（10/79）的患者在12个月随访时自我报告了7天的禁欲（6/79，8%经生化验证）。在他们的戒烟尝试中，11%（9/79）使用了美国食品和药物管理局批准的尼古丁替代疗法，而18%（14/79）使用电子尼古丁输送系统戒烟（例如，电子烟）。大多数人（48/79，61%）评论了至少一个Facebook帖子，在3个月时经过生化验证的禁欲者（P=.036）和随机接受个人金钱奖励的人（P=.015）中评论更多。超过三分之一的参与者（28/79，35%）报告阅读了大部分或全部Facebook帖子。干预的最高可接受性评级是放松后（57/79，72%）和思考他们阅读的内容（52/79，66%）; 71%（56/79）向其他人推荐该计划。只有5名参与者参加了可选的认知行为咨询课程，尽管他们的出席率很高（总共6/7次），并且这些课程被评为易于理解，有用和有帮助（所有90-100%的人都同意）。Facebook的戒烟干预是有吸引力的，也是可行的，早期的疗效数据令人鼓舞。然而，电子烟的使用量是尼古丁替代产品的1.5倍，这一点令人担忧。
Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, P<.001). Over a third (28/79, 35%) reduced their cigarette consumption by 50% or greater, and 66% (52/79) made at least one 24-hour quit attempt during the study. In an intent-to-treat analysis, 13% (10/79) self-reported 7-day abstinence (6/79, 8% verified biochemically) at 12-months follow-up. In their quit attempts, 11% (9/79) used a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were for post ease (57/79, 72%) and thinking about what they read (52/79, 66%); 71% (56/79) recommended the program to others. Only 5 participants attended the optional cognitive-behavioral counseling sessions, though their attendance was high (6/7 sessions overall) and the sessions were rated as easy to understand, useful, and helpful (all 90-100% agreed). A Facebook quit smoking intervention is attractive and feasible to deliver, and early efficacy data are encouraging. However, the 1.5-fold greater use of electronic cigarettes over nicotine replacement products for quitting is concerning.