Improving Adherence to Smoking Cessation Treatment: Intervention Effects in a Web-Based Randomized Trial

Area of Science:

• Digital Health
• Behavioral Science
• Public Health

Background:

• Web-based smoking cessation interventions offer broad reach but often suffer from low adherence to evidence-based components.
• Improving adherence is crucial for maximizing the effectiveness of digital health tools in smoking cessation.

Purpose of the Study:

• To evaluate the impact of a social network (SN) intervention and free nicotine replacement therapy (NRT) on adherence to evidence-based smoking cessation treatment components within a web-based program.
• To compare the effectiveness of a web-based intervention alone versus combined with SN, NRT, or both.

Main Methods:

• Adult smokers (N=5290) were randomized into four groups: web-based intervention (WEB) alone, WEB+SN, WEB+NRT, or WEB+SN+NRT.
• Adherence was assessed at 3-month follow-up, measuring website utilization, skills training use, social support, and pharmacotherapy use.

Main Results:

• The combined WEB+SN+NRT group showed superior adherence across website utilization, practical tools, social support, and NRT use compared to other groups.
• Social network interventions improved online community engagement, while NRT arms demonstrated higher medication adherence.
• The integrated approach was the only one to significantly increase private messaging and community page views over the web-based intervention alone.

Conclusions:

• Integrated approaches combining medication provision (NRT) and social network engagement within web-based platforms enhance adherence to smoking cessation treatment components.
• Nicotine replacement therapy, when part of an integrated program, improves adherence to other elements and augments its own effects.
• Focusing on improving treatment adherence is key to optimizing the effectiveness of digital smoking cessation interventions.