Improving Adherence to Web-Based Cessation Programs: A Social Network Approach

This study will compare the efficacy of an interactive, evidence-based smoking cessation
website (WEB) alone and in conjunction with 1) a theory-driven, empirically-informed social
network (SN) protocol designed to integrate participants into the online community, and 2)
access to a 4-week supply of free NRT. Using a 2 (SN integration, no SN) x 2 (access to free
NRT, no access) randomized, controlled factorial design with repeated measures at baseline,
3, and 9 months, this study will recruit N=5,000 new members of a Web-based smoking
cessation program and randomize them to: 1) WEB, 2) WEB+SN, 3) WEB+NRT, or 4) WEB+SN+NRT.

Aim 1: To evaluate the comparative efficacy of WEB+SN, WEB+NRT, and WEB+SN+NRT versus WEB
alone with regard to self-reported 30-day point prevalence abstinence at the primary
endpoint of 9 months and at secondary endpoint of 3 months. Hypothesis 1a: All three
intervention conditions will outperform WEB. Hypothesis 1b: WEB+SN+NRT will outperform
WEB+SN and WEB+NRT.

Aim 2: To examine whether the impact of treatment condition on cessation is mediated by
greater adherence to problem solving/skills training tools, social support, and
pharmacotherapy. Hypothesis 2: WEB+SN+NRT will have the greatest impact on treatment
adherence, which will yield higher quit rates than the other treatments.

Exploratory Aim: To advance theory and identify the processes through which social network
integration and provision of free NRT influence treatment adherence. Specifically,
exploratory analyses will examine whether social support and social norms are active
elements in the pathway to adherence, along with other known mediators of abstinence such as
self-efficacy.

Inclusion Criteria:

- Age 18 years and older

- Current smoker

- Registered user on BecomeAnEX.org

Exclusion Criteria:

- Pregnant or breastfeeding

- Cardiovascular conditions

- Current use of any stop smoking medication