Balmford James, Borland Ron, Benda Peter
VicHealth Centre for Tobacco Control, 1 Rathdowne Street, Carlton, Victoria, 3053, Australia.
J Med Internet Res. 2008 Dec 17;10(5):e54. doi: 10.2196/jmir.1016.
The QuitCoach, an "expert system" program of tailored advice for smoking cessation developed in Australia, has been publicly available since July 2003, albeit with limited promotion. The program is designed to be used on multiple occasions, guiding the user through the process of smoking cessation in the manner of a "life coach". Email reminders are sent at scheduled intervals to prompt optimal and repeated use.
The aims of this study were to characterize QuitCoach users and to determine what characteristics of smokers affect their participation over time. Of particular interest was whether users tend to return following a relapse and, thus, use the program as a tool for relapse prevention or recovery. We also explored patterns of change associated with returns to the site, whether prompted by reminder emails or not prompted at all.
Between July 2003 and June 2007, 28,247 individuals completed an initial assessment on the QuitCoach, of whom 83.7% (n = 23,656) registered. Data were collected during a 10-minute online questionnaire that all users completed in order to obtain tailored cessation advice. This included questions concerning basic demographic information, quitting history, current smoking status and cigarette consumption, stage of change, and use of pharmacotherapy.
The median age of users was 34 years, and 62% were female. Most (96%) were current smokers. Overall, 91% were planning to quit in the next 30 days, and half (49.9%) had set a quit date. Those who had recently relapsed to smoking following a quit attempt made up 37%. Among registered users, 27% returned for a second visit, a median 9 days after their first. Overall, a third visit was completed by 11% and 2% returned within 2 days. Women, older smokers, those who had recently quit, and those using pharmacotherapy were more likely to return. From the second visit on, most people who completed an assessment had quit. Likelihood of responding to a prompt to return was largely unrelated to user characteristics or cessation outcome.
Internet-based programs have considerable potential to reach large numbers of smokers at low cost. The QuitCoach is attracting considerable use, with most using it to make a quit attempt and, for those who continue to use the QuitCoach, to help them stay quit. Nonetheless, most users only visited the site once, suggesting improved strategies are needed for encouraging repeated use.
“戒烟指导师”是澳大利亚开发的一个提供个性化戒烟建议的“专家系统”程序，自2003年7月起已公开提供，不过推广力度有限。该程序设计为可多次使用，以“生活教练”的方式指导用户完成戒烟过程。会按预定间隔发送电子邮件提醒，以促使最佳且重复地使用该程序。
本研究的目的是描述“戒烟指导师”用户的特征，并确定吸烟者的哪些特征会随时间影响他们的参与度。特别感兴趣的是，用户在复吸后是否倾向于再次使用该程序，从而将该程序用作预防复吸或恢复的工具。我们还探讨了与返回该网站相关的变化模式，无论是否由提醒电子邮件触发。
在2003年7月至2007年6月期间，28247人在“戒烟指导师”上完成了初始评估，其中83.7%（n = 23656）进行了注册。数据是在一个10分钟的在线问卷中收集的，所有用户都完成了该问卷以获得个性化的戒烟建议。这包括有关基本人口统计学信息、戒烟历史、当前吸烟状况和香烟消费量、改变阶段以及药物治疗使用情况的问题。
用户的年龄中位数为34岁，62%为女性。大多数（96%）是当前吸烟者。总体而言，91%计划在未来30天内戒烟，一半（49.9%）设定了戒烟日期。那些在尝试戒烟后最近复吸的人占37%。在注册用户中，27%返回进行第二次访问，中位数为首次访问后9天。总体而言，11%完成了第三次访问，2%在2天内返回。女性、年龄较大的吸烟者、最近戒烟的人以及使用药物治疗的人更有可能返回。从第二次访问开始，大多数完成评估的人已经戒烟。对返回提示做出响应的可能性在很大程度上与用户特征或戒烟结果无关。
基于互联网的程序有以低成本覆盖大量吸烟者的巨大潜力。“戒烟指导师”正被大量使用，大多数人用它来尝试戒烟，对于那些继续使用“戒烟指导师”的人来说，它帮助他们保持戒烟状态。尽管如此，大多数用户只访问了该网站一次，这表明需要改进策略以鼓励重复使用。
