Innovative Web-Based Intervention for Smoking Cessation Among College Students
Condition: Tobacco Use Cessation; Cigarette Smoking
Study type: Interventional
Phase: Phase 1

Summary: 
      Tobacco use is the leading cause of cancer death in the U.S. Because smokers who quit by age
      30 have cancer death risk similar to non-smokers, promoting cessation early in life is
      critical. U.S. colleges/universities, enrolling >14 million students/year (40% of those aged
      18 to 24), are an important venue to reach young adult smokers. While daily tobacco use in
      the U.S. has declined to 18.1%, nondaily smoking (smoking on some days but not every day) is
      increasing, particularly among young adults and African Americans. Moreover, young smokers
      and nondaily smokers (half of young adult smokers), respectively, are less likely to seek
      help in quitting; thus, innovative strategies are needed to assist cessation early in life,
      particularly among those who may not be motivated to quit or seek help. Unfortunately, no
      research has focused on developing a cessation intervention that addresses a broad range of
      smoking patterns (nondaily to daily smoking) or diverse campus settings among ethnically
      diverse student populations. Web-based interventions offer promise in helping college
      students to quit, given high rates of Internet use and web capacity to provide tailored
      cessation messages. A novel approach to delivering cessation information via the web might be
      to address broader lifestyle issues and apply market research strategies to identify market
      segments of smokers (groups of people with similar interests, goals, values) in order to
      target and engage these groups more effectively. Applying this strategy to an online
      cessation intervention should enhance both intervention use and processing of intervention
      messages, leading to greater abstinence rates. The investigators aim to: (1) develop and
      refine a tailored web-based intervention for smoking cessation targeting college students
      with a range of smoking levels; (2) test the usability, acceptability, and feasibility of the
      intervention among college student smokers; and (3) determine the potential effect of the
      intervention on smoking cessation, smoking level, quit attempts, and contextual factors.
    

Detailed description: 
      Tobacco use is the leading cause of cancer death. Because smokers who quit by 30 have cancer
      death risk similar to non-smokers, promoting cessation early in life is critical. U.S.
      colleges/universities, enrolling >14 million students/year (40% of those aged 18 to 24), are
      an important venue to reach young adult smokers. While daily tobacco use in the U.S. has
      declined to 18.1%, nondaily smoking (smoking on some days but not every day) is increasing,
      particularly among young adults and African Americans. Moreover, young smokers and nondaily
      smokers (half of young adult smokers9), respectively, are less likely to seek help in
      quitting; thus, innovative strategies are needed to assist cessation early in life,
      particularly among those who may not be motivated to quit or seek help. Unfortunately, no
      research has focused on developing a cessation intervention that addresses a broad range of
      smoking patterns (nondaily to daily smoking) or diverse campus settings among ethnically
      diverse student populations. Web-based interventions offer promise in helping college
      students to quit, given high rates of Internet use and web capacity to provide tailored
      cessation messages. A novel approach to delivering cessation information might be to address
      broader lifestyle issues and apply market research strategies such as those used by the
      tobacco industry to identify market segments of smokers (groups of people with similar
      interests, goals, values) in order to target and engage these groups more effectively.
      Applying this strategy to an online cessation intervention should enhance both intervention
      use and processing of intervention messages, leading to greater abstinence rates.

      Our specific aims are:

        -  Aim 1: To develop and refine a tailored web-based intervention for smoking cessation
           targeting young adults representing a range of sociodemographic backgrounds,
           particularly including those from low SES and African American backgrounds, and a range
           of smoking levels (i.e., nondaily, low-level smokers to daily, heavy smokers) attending
           college.

        -  Aim 2: To test the usability, acceptability, and feasibility of the intervention among a
           sample of college student smokers.

        -  Aim 3: To determine the potential effect of the intervention on smoking cessation,
           smoking level, quit attempts, and contextual factors (e.g., mood, alcohol use, social
           factors) among a sample of college student smokers from various backgrounds and smoking
           patterns.

      This research will be addressed through three phases. Phase 1 will involve the development of
      the web-site infrastructure, securing incentives, developing website content (dramas,
      stories), and developing the tailored feedback infrastructure. Phase 2 will involve expert
      feedback, which will be integrated into the next program version. Phase 3 involves a 6-week
      trial among a small sample of young adults at two college campuses (university;
      community/technical college) in Georgia (N = 200). At end-of-intervention, we will assess
      usability, acceptability, and feasibility of the program; smoking status and level; and
      psychosocial factors related to smoking (e.g. alcohol use, mood). Assessments of smoking
      status/level and psychosocial factors will also be conducted at 6 weeks post-intervention.
      The primary outcomes in the trial are usability, acceptability, and feasibility
      (self-reported and observed website utilization [check-in, activity]). Secondary outcomes
      include: (1) message processing (self-reported attention to messages, perceived relevance,
      and other message use items);19 (2) 7-day and 30-day point prevalence abstinence at
      end-of-treatment (6 weeks) and at 6-week follow-up (12 weeks) in order to appropriately
      examine cessation among daily and nondaily smokers; (3) smoking level at 6 and 12 weeks; (4)
      number of quit attempts since baseline; and (5) change in other contextual factors (mood,
      alcohol use, social aspects).
    

Intervention name(s): Online intervention arm; Online control arm
Intervention type(s): Behavioral; Behavioral
Intervention description(s): See online intervention arm; See online control arm
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Tobacco use cessation; Cigarette smoking