Zbikowski Susan M, Hapgood Jenny, Smucker Barnwell Sara, McAfee Tim
Free & Clear, Inc, 999 Third Avenue, Suite 2100, Seattle, WA 98104, USA.
J Med Internet Res. 2008 Nov 14;10(5):e41. doi: 10.2196/jmir.999.
Phone-based tobacco cessation programs have been proven effective and widely adopted. Web-based solutions exist; however, the evidence base is not yet well established. Many cessation treatments are commercially available, but few integrate the phone and Web for delivery and no published studies exist for integrated programs.
This paper describes a comprehensive integrated phone/Web tobacco cessation program and the characteristics, experience, and outcomes of smokers enrolled in this program from a real-world evaluation.
We tracked program utilization (calls completed, Web log-ins), quit status, satisfaction, and demographics of 11,143 participants who enrolled in the Free & Clear Quit For Life Program between May 2006 and October 2007. All participants received up to five proactive phone counseling sessions with Quit Coaches, unlimited access to an interactive website, up to 20 tailored emails, printed Quit Guides, and cessation medication information. The program was designed to encourage use of all program components rather than asking participants to choose which components they wanted to use while quitting.
We found that participants tended to use phone services more than Web services. On average, participants completed 2-2.5 counseling calls and logged in to the online program 1-2 times. Women were more adherent to the overall program; women utilized Web and phone services significantly (P = .003) more than men. Older smokers (> 26 years) and moderate smokers (15-20 cigarettes/day) utilized services more (P < .001) than younger (< 26 years) and light or heavy smokers. Satisfaction with services was high (92% to 95%) and varied somewhat with Web utilization. Thirty-day quit rates at the 6-month follow-up were 41% using responder analysis and 21% using intent-to-treat analysis. Web utilization was significantly associated with increased call completion and tobacco abstinence rates at the 6-month follow-up evaluation.
This paper expands our understanding of a real-world treatment program combining two mediums, phone and Web. Greater adherence to the program, as defined by using both the phone and Web components, is associated with higher quit rates. This study has implications for reaching and treating tobacco users with an integrated phone/Web program and offers evidence regarding the effectiveness of integrated cessation programs.
基于电话的戒烟项目已被证明有效且得到广泛采用。基于网络的解决方案也存在；然而，其证据基础尚未充分确立。许多戒烟治疗方法在市场上都有，但很少有将电话和网络结合起来进行服务提供的，且尚无关于综合项目的已发表研究。
本文描述了一个全面的电话/网络综合戒烟项目，以及从实际评估中纳入该项目的吸烟者的特征、体验和结果。
我们跟踪了2006年5月至2007年10月期间参加“终身免费戒烟”项目的11143名参与者的项目使用情况（完成的通话次数、网络登录次数）、戒烟状态、满意度和人口统计学特征。所有参与者均可获得多达五次由戒烟教练提供的主动电话咨询服务、无限次访问互动网站、多达20封量身定制的电子邮件、印刷版的戒烟指南以及戒烟药物信息。该项目旨在鼓励参与者使用所有项目组件，而不是让他们在戒烟时选择想要使用的组件。
我们发现参与者使用电话服务的频率高于网络服务。平均而言，参与者完成2至2.5次咨询电话，并登录在线项目1至2次。女性对整个项目的依从性更高；女性使用网络和电话服务的频率显著高于男性（P = 0.003）。年龄较大的吸烟者（>26岁）和中度吸烟者（每天吸15至20支烟）使用服务的频率高于年龄较小的吸烟者（<26岁）以及轻度或重度吸烟者（P < 0.001）。对服务的满意度较高（92%至95%），且随网络使用情况略有变化。在6个月随访时，采用应答者分析的30天戒烟率为41%，采用意向性分析的为21%。在6个月随访评估中，网络使用与增加的通话完成率和戒烟率显著相关。
本文扩展了我们对结合电话和网络两种媒介的实际治疗项目的理解。如通过同时使用电话和网络组件所定义的，对该项目更高的依从性与更高的戒烟率相关。这项研究对于通过电话/网络综合项目接触和治疗烟草使用者具有启示意义，并为综合戒烟项目的有效性提供了证据。
