Santé publique France, the National Public Health Agency, Saint Maurice Cedex, France.
Sylia-Stat, Bourg la Reine, France.
Nicotine Tob Res. 2019 Jan 4;21(2):163-172. doi: 10.1093/ntr/nty016.
The Internet offers an interesting alternative to face-to-face and telephone-based support for smoking cessation. This study was designed to assess the effectiveness of a personalized and automated Internet-based program.
French current adult smokers willing to quit within 2 weeks were recruited for a randomized controlled trial. The intervention consisted of an automated program of 45 e-mails ("e-coaching") sent over a 3-month period. The control group received a PDF version of a booklet on smoking cessation. Self-reported 7-day point prevalence smoking abstinence was measured at 6 months (primary outcome), at 3 and 12 months of follow-up (secondary outcomes).
2478 smokers were randomized (1242 for e-coaching, 1236 for the booklet). Cessation rate in the intention-to-treat population was not significantly different between the two groups at 6 and 12 months, but was higher in the e-coaching group at 3 months than in the control group (27.5% vs. 23.5%, p = .02, odds ratio [OR] = 1.24, confidence interval [CI] = [1.03-1.49]). After adjustment for baseline conditions, the effect of the intervention in the per-protocol (PP) sample was significant at 3 months (adjusted odds ratio [aOR] = 1.72 [1.31-2.28], p < .001, N = 1042) and at 6 months (aOR = 1.27 [1.00-1.60], p = .05, N = 1082). GLM repeated measure analyses showed significant group by time interaction in the intent-to-treat and a significant group effect in the PP population.
Analyzed intention-to-treat, e-coaching was superior to a booklet at 3 months (end of intervention) but no more superior at 6 and 12 months follow-up. Among those who actually followed the program, the effectiveness is also observed 3 months after the intervention is stopped.
Analyzed intention-to-treat, our French tailored and personalized Internet-based cessation program was superior to a smoking cessation booklet at 3 months (end of intervention) but no more superior at 6 months follow-up. Among those who actually followed the program (PP population), the effectiveness is observed in the short-term but also 3 months after the intervention is stopped.
互联网为戒烟提供了一种有吸引力的面对面和电话支持的替代方式。本研究旨在评估个性化和自动化基于互联网的程序的有效性。
招募愿意在 2 周内戒烟的法国成年吸烟者进行随机对照试验。干预措施包括在 3 个月期间发送 45 封电子邮件的自动程序（“电子指导”）。对照组收到了一本关于戒烟的 PDF 小册子。6 个月（主要结局）、3 个月和 12 个月随访（次要结局）时测量自我报告的 7 天点流行率吸烟戒断率。
2478 名吸烟者被随机分配（1242 名接受电子指导，1236 名接受小册子）。意向治疗人群在 6 个月和 12 个月时两组的戒烟率没有显著差异，但在 3 个月时电子指导组高于对照组（27.5%对 23.5%，p=0.02，优势比[OR]=1.24，95%置信区间[CI]=[1.03-1.49]）。在调整基线条件后，在方案人群（PP）中，干预措施在 3 个月时的效果显著（调整后的优势比[aOR]=1.72[1.31-2.28]，p<0.001，N=1042）和 6 个月时（aOR=1.27[1.00-1.60]，p=0.05，N=1082）。GLM 重复测量分析显示，意向治疗和 PP 人群的组间时间交互作用有统计学意义。
分析意向治疗，电子指导在 3 个月（干预结束时）优于小册子，但在 6 个月和 12 个月随访时没有更高的优势。在实际遵循该计划的人群中，在干预停止后 3 个月也观察到了效果。
分析意向治疗，我们的法国定制和个性化基于互联网的戒烟计划在 3 个月（干预结束时）优于戒烟小册子，但在 6 个月随访时没有更高的优势。在实际遵循该计划的人群（PP 人群）中，短期效果明显，干预停止后 3 个月也能观察到效果。
