Web-based support as an adjunct to group-based smoking cessation for adolescents

Area of Science:

• Public Health
• Behavioral Science
• Digital Health Interventions

Background:

• Group-based programs are standard for adolescent smoking cessation but have limited efficacy and reach.
• Web-based adjuncts offer potential to enhance existing programs for greater impact.
• The American Lung Association's Not on Tobacco (NOT) program is a widely used group-based intervention.

Purpose of the Study:

• To evaluate the effectiveness of augmenting the Not on Tobacco (NOT) program with a web-based adjunct (NOT Plus).
• To assess the impact of NOT Plus on adolescent smoking cessation rates.
• To explore user engagement and satisfaction with the web-based component.

Main Methods:

• Randomized controlled trial in 29 high schools comparing NOT alone versus NOT Plus (NOT with web adjunct and proactive calls).
• Hierarchical linear modeling used to analyze self-reported smoking behavior at end-of-program and 3-month follow-up.
• Controlled for student demographics (gender, grade, race) and baseline smoking rate.

Main Results:

• The NOT Plus condition showed a significant improvement in smoking cessation at 3-month follow-up (p<.05) compared to NOT alone.
• Approximately 57% of adolescents accessed the web-based component, with usage associated with cessation at end-of-program (p<.05).
• Urban adolescents were more likely to access the web site; participants rated the site positively.

Conclusions:

• Enhancing group-based adolescent smoking cessation programs with web-based adjuncts can significantly improve quit rates.
• The NOT Plus intervention demonstrates potential for increasing the efficacy and reach of adolescent smoking cessation efforts.
• Web-based adjuncts are a valuable addition to traditional programs, though reasons for non-use require further investigation.