ChewFree.com: Evaluation of a Web-based cessation program for smokeless tobacco users
Abstract
The sizeable percentage of adults who use smokeless tobacco (ST) represents an important public health target since the majority of ST users have a strong desire to quit, but many lack resources. We tested the impact of an interactive, tailored Web-based intervention (Enhanced Condition) versus a more linear, text-based website (Basic Condition) in a randomized trial with 2523 adult ST users. As is common in Internet-based research, there was considerable attrition: follow-up rates at 3 months, 6 months, and for both 3 and 6 months were 48%, 45% and 34%, respectively. Results using repeated point prevalence of all tobacco use at 3 and 6 months showed that participants in the Enhanced Condition quit at significantly higher rates than those in the Basic Condition. Using a Complete Case analysis, abstinence was 40.6% in the Enhanced Condition vs. 21.2% in the Basic Condition (p< .001). Using intent-to-treat analysis, quit rates were 12.6% vs. 7.9%, respectively (p< .001). Similar results were obtained for only ST use. Unobtrusive measures of program exposure indicated that program use was significantly related to outcome as well as to attrition. We conclude that a tailored, interactive Web-assisted cessation program can be an efficacious method for assisting adult ST users to quit.
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Website exposure and program usage was positively correlated with outcomes in interventions targeting smokeless tobacco, depression, and physical activity.
“Website exposure and program usage was positively correlated with outcomes in interventions targeting smokeless tobacco [64], depression [65], and physical activity [66].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [64]
Social support by peers and professionals may enhance an extended stay on the website and may encourage a revisit to an intervention website.
“social support by peers and professionals may enhance an extended stay on the website and may encourage a revisit to an intervention website [26-28,31].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [31]
Interactive behavior change strategies, such as individualized computer-tailored feedback and goal setting, may enhance engagement in intervention content and completion of the program.
“Interactive behavior change strategies, such as the provision of individualized computer-tailored feedback and goal setting, may enhance engagement in the intervention content and completion of the program [26-28,31].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [31]
The possibility to monitor progress toward behavior change, the provision of regular new content, and periodic prompts and reminders may improve revisits.
“the possibility to monitor progress toward behavior change, the provision of regular new content, and periodic prompts and reminders may improve revisits [26-31].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [31]
A more interactive intervention resulted in a longer visit to the intervention and in more log-ins on the intervention website.
“A more interactive intervention resulted, for example, in a longer visit to the intervention [31,77] and in more log-ins on the intervention website [28,31,62].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [31]
We did not find an indication of better exposure to the intervention for the other categories of potential exposure-enhancing intervention characteristics.
“We did not find an indication of better exposure to the intervention for the other categories of potential exposure-enhancing intervention characteristics, even if these have been indicated as such in previous studies [26-31].”
From Which Intervention Characteristics are Related to More Exposure to Internet-Delivered Healthy Lifestyle Promotion Interventions? A Systematic Review (2011) · cites this paper as [31]
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- Authors
- Severson, H., Gordon, J., Danaher, B., & Akers, L.
- Affiliations
- Oregon Research Institute (US)
- Corresponding author
- Severson, Herbert
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-02
- Volume
- 10
- Issue
- 2
- Pages
- 381-391
- ISSN
- 1462-2203 (ISSN-L)
- OpenAlex
- W2057560781
- Cited by
- 81
- References
- 0
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 1 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 6 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 5 · 2012: 5
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01 CA 84225, R01CA084225)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- smokeless tobacco, tobacco cessation, online intervention, personalized interventions, interactive website, quit rates, abstinence, attrition
- MeSH terms
- Adult, Counseling, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Education as Topic, Self-Help Groups, Social Support, Therapy, Computer-Assisted, Tobacco, Smokeless, Program Evaluation, Smoking Cessation, Self Efficacy, Internet
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