QuitSpit: An Internet-Based Smokeless Tobacco Cessation Program for Teens

描述(申请人提供)：许多美国青少年习惯于使用咀嚼或无烟烟草(ST)，并希望戒烟，但缺乏资源。该项目符合国家癌症研究所的目标，即向未得到充分服务的使用者群体提供戒烟服务，并重新重视对年轻人新的创新戒烟计划的评估。鉴于青少年是互联网的重度用户，而且有令人振奋的迹象表明，对其他健康行为进行基于网络的干预是有帮助的，我们建议开发并测试针对青少年的基于互联网的ST戒烟计划的有效性。这项拟议的双臂随机对照试验将比较有针对性、量身定做和高度互动的ST戒烟网站和提供中等技能互联网搜索用户可以找到的信息的对照网站的疗效。干预措施的核心特征包括：a)针对青少年ST用户；b)根据参与者与计划的持续互动定制内容；c)个性化、动态地展示ST戒烟工具、维护资源和信息；d)在网络论坛中监控在线点对点和专家对参与者的ST戒烟支持。在控制条件下的参与者将被暴露在一个包含ST戒烟内容的更静态的信息网站上，网站上有指向互联网上仅限信息的ST资源的注释链接。一项多方面的计划--针对与会者和可能推荐他们的人--将被用来招募1550名14-18岁的参与者。主要结果是在注册后6周和7.5个月戒烟，在定制的、有针对性的互动条件下，青少年的戒烟率预计会更高。我们还将调查基线受试者特征、项目参与度和过程变量作为戒烟结果的预测因素：成本分析将确定每次戒烟的成本和两种条件的相对成本效益。为青少年ST使用者提出的基于互联网的戒烟计划具有巨大的公共卫生潜力。相关性：针对这一未得到充分服务的无烟烟草使用者青少年受众，对网络提供的戒烟计划进行实证评估既有必要，也是及时的。鉴于绝大多数成年吸烟者在18岁之前就开始使用，青少年吸烟者几乎没有戒烟资源，利用互联网帮助年轻的ST吸烟者在成瘾过程中早期戒烟具有巨大的公共卫生潜力。

DESCRIPTION (provided by applicant): Many American teens engage in the habitual use of chewing or smokeless tobacco (ST) and wish to quit but lack resources. This project meets the goals of the National Cancer Institute for providing tobacco cessation services to underserved populations of users and the renewed focus on evaluation of new and innovative cessation programs for young people. Given that teens are heavy users of the Internet and there are promising signs that web-based interventions for other health behaviors have been helpful, we propose to develop and test the effectiveness of an Internet-based ST cessation program targeted to teens. This proposed two-arm randomized control trial will compare the efficacy of a targeted, tailored, and highly interactive ST cessation website to a control website that presents information that the moderately skillful Internet search user could locate. The core features of the intervention include: a) targeted to teen ST users; b) tailored content based on ongoing participant interaction with the program; c) personalized, dynamic presentation of ST cessation tools, maintenance resources, and information; and d) monitored online peer-to-peer and expert-to-participant ST cessation support in a web forum. Participants in the control condition will be exposed to a more static informational website containing ST cessation content, with annotated links to information-only ST resources on the Internet. A multifaceted plan-aimed both attendees and persons who could refer them-will be used to recruit 1,550 participants ages 14-18. The primary outcomes are tobacco cessation at 6 weeks and 7.5 months post-enrollment, with quit rates expected to be higher in teens enrolled in the tailored, targeted interactive condition. We will also investigate baseline subject characteristics, program engagement, and process variables as predictive of cessation outcomes: A cost analysis will determine the cost per quit and relative cost-effectiveness of the two conditions. The public health potential of the proposed Internet-based tobacco cessation program for teen ST users is great. Relevance: An empirical evaluation of an web delivered cessation program for this underserved teen audience of smokeless tobacco users is both warranted and timely. Given that a vast majority of adult tobacco users started their use before age 18, and there are few cessation resources available to teen tobacco users, there is great public health potential in using the Internet to assist young ST users in quitting early in their addiction process.