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Website as a medium for intervention in teen smoking

Institution: University of California, San Diego
Investigator(s): Shu-Hong Zhu, Ph.D.
Award Cycle: 1998 (Cycle 7) Grant #: 7IT-0072 Award: $73,159
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Inno Dev & Exp Awards (IDEAS)
Abstracts

Initial Award Abstract
This study will use state-of-the-art Internet-based technology to communicate smoking prevention and cessation information to teens. Public health campaigns aimed at preventing teen smoking have been considerable. However, in most of these campaigns, the youths are the passive recipients of negative health information. There is little active participation required of the teens. In these campaigns, there is little information for teens who are already smokers and want to quit smoking. This proposal describes a plan to develop an interactive approach using a computer-based method to attract teens to participate in smoking prevention education programs and cessation services.

The specific aims are to: a) Develop a Website that uses state-of-the-art Internet technology to deliver educational information on smoking to teens; discover if the Web site works well to help prevent teens from starting to smoke and to quit smoking; b) Use the Web site to recruit teen smokers for an on-going statewide telephone counseling program to help those who want to quit; c) Find out whether this teen-specific Web site is effective in recruiting teens' participation.

We currently have a Web site name (http://NOBUTTS.UCSD.EDU) that capitalizes on the popularity of the toll-free number for the statewide California Smokers' Helpline (800-7-NO-BUTTS), a project which is also conducted by this research group.

A major feature of the Web site in this study is that it is interactive: the Web users answer a series of questions on-line and then receive a personal profile for feedback. Also, they will receive personalized suggestions for their individual needs. Web users can also post any questions they have, which will be answered by an experienced counselor from the California Smokers' Helpline. Teens can also post their own suggestions and compare them with those from other teens who have used this Web site.

The main hypothesis of the study is that a Web site which allows users active and interactive participation will attract teens to be active in the process that will help keep them from becoming regular smokers or help them quit smoking, if they are already smokers. This will be examined by:1) tracking the number of pages viewed on both interactive and non-interactive Web pages; 2) how many users are willing to enroll in another smoking project after viewing the Web pages; and 3) how many teens call the California Smokers' Helpline for personal counseling.

Final Report
This study uses state-of-the-art Internet-based technology to communicate smoking prevention and cessation information to adolescents. Traditional public health campaigns aimed at reducing smoking in youth tend to treat them as the passive receivers of information. Little interaction is involved. They also tend to focus on youth who are potential smokers, and offer little to those who are smokers already but want to quit. This study uses a computer-based method to attract teens to participate in an interactive smoking prevention and cessation program via the web. It also offers the web visitors the opportunity of calling a helpline to receive personal counseling for quitting smoking. The study is a IDEA project—a small-scale study testing the feasibility of a new approach. The study tests the feasibility of using the Internet as a means of reaching teens and the feasibility of a direct randomization procedure on the web. Visitors of the study website are asked to register, a process which will allow them to be randomly assigned to one of two websites: an interactive site designed to fully engage the user and a non-interactive site that posts useful information for them to read. Both sites provide motivational materials that discourage the uptake of smoking and encourage current smokers to quit. Both sites advertise the California Smokers’ Helpline toll free numbers so that they can call for personal counseling if they so choose. In the course of project (7/98-12/99), (1). We have created an engaging website for adolescents (http://www.nobutts.ucsd.edu). (2). From 6/20/99 (when the website was first available tothe public) to 12/30/99, a total of 5,091 visits and 34,541 page views were recorded. (3). Adults as well as teens have used the website, although the site was created primarily for the teens. (4). The randomization procedure was shown to be feasible. However, the procedure appears to have hindered utilization because users have to register before they can access the detailed contents of the web. (5). Visitors stay with the website for a significant amount of time once they register (mean = 6 minutes), indicating their interest. Some requested self-help quit kits to be sent to them, but few called for counseling. The results from this study indicate (1) A website is a good way to reach smokers or people who are at the risk of taking up smoking because it is relatively inexpensive to operate once the site is created. (2) Randomization is feasible directly on the web, but it may hinder participation. Future studies aimed at testing the effect of websites need to consider randomizing participants before they access the website. (3) The interest web visitors show in reading the content and their subsequent request for self-help materials suggest that an interactive website can be a good self-help venue for those who are thinking about quitting smoking. (4) Because of the potential “reach” of a website, an effective web intervention can have significant impact on smoking prevalence in California.