Effectiveness of a Web-Assisted Quitline for Smokeless Tobacco Users

Many Americans engage in the habitual use of smokeless tobacco (ST), and many wish to quit
but lack resources. There is a need for innovative, validated, and easily delivered low-cost
interventions to facilitate ST cessation in this under-served population of tobacco users.
In our current ChewFree study, we have developed a user-friendly, interactive Web-based
intervention, and in a randomized trial we have shown this website to be more efficacious
than a rigorous control condition that offered Web-based basic textual information on ST
cessation. We now seek to extend this proven approach by marrying it with a quitline
telephone counseling service that has been used with noteworthy success for smoking
abstinence but has not yet been evaluated with ST users. Our 2 x 2 design and large sample
size allow us to test both main effects - Web program, phone counseling - as well as explore
planned comparisons to examine the value-added contribution of the Web-based intervention to
phone counseling, and vice-versa.

This project takes advantage of the opportunity to conduct a study of two tobacco cessation
interventions that are growing in use. The use of tobacco help lines is now almost
ubiquitous, with more than 30 state and national services now being offered. The use of the
Internet for health information and behavior change (including tobacco cessation) has been
growing in popularity as well. The proposed project would be an extension of both lines of
research, evaluating the relative efficacy of our Internet-based program, telephone
counseling, and the combination of both.

We will use a multifaceted promotional plan to recruit more than 2,000 ST users. The
recruitment plan builds on the collaborative marketing efforts of a state tobacco control
organization and organized promotion through media mailings, on-line advertising, and direct
mailing. Follow-up assessment data will be collected electronically via the Internet
supplemented by telephone follow-up. Additional data will be derived from phone counselor
notes and measures of website usage.