Do smoking cessation online communities actually help people quit?

For smokers, quitting is hard. Online communities can help.

Smoking is a preventable cause of illness and death in the United States, but as anyone who’s tried to quit can tell you, it’s not easy to leave cigarettes behind. Ideally, online communities allow smokers and ex-smokers to share quit advice from the trenches: what works, what doesn’t, why quitters should stick it out, why they shouldn’t feel alone.

We wanted to learn about smokers who connect to online communities.

In our December 2016 article in Translational Behavioral Medicine, “Online Tobacco Websites and Online Communities—Who Uses Them and do Users Quit Smoking?”, we describe smokers who, after registering with our smoking cessation website (Decide2Quit.org), are curious about connecting through our site to an online community of people helping others quit.

BecomeAnEX.org is an online community…and more.

In our study, smokers interested in connecting to an online community from our site clicked on a link that led them to BecomeAnEX.org, a website run by the Schroeder Institute at Truth Initiative. By clicking on this link, they were able to view blogs written by other smokers and, importantly, ex-smokers. Writers support each other by discussing their quit strategies, challenges, and success stories.

In addition to its online community, BecomAnEX.org provides interactive tools, practical counseling, medication information, and other cessation support services. For our study, we just focused on the online community.

BecomeAnEx had many lurkers but few registrants.

We found that, while more than one in four study smokers visited BecomeAnEX (after registering on our cessation website), less than one in 10 went on to register for participation in the BecomeAnEX online forum. Those that visited but did not register were what we called “lurkers.” Lurking, which is common on online social networks and other social media platforms, means a person reads posts but does not write them.

Remember—the smokers in our study had already registered on our Decide2Quit website, which has some similar features to BecomeAnEX. It’s possible the need to register twice negatively affected registration rates for the BecomeAnEX online community. It’s also possible that for some smokers, lurking has value in itself. Smokers may benefit from reading posts without feeling the need to contribute to the online conversation.

BecomeAnEx visitors included more women and more people who had tried to quit in the past.

Overall, visitors to the BecomeAnEX community from our site were more likely to be aged 55 years or older, more likely to be women, more likely to have been on a smoking cessation website in the past, and more likely to say they had tried to quit smoking in the past year. Compared to those who didn’t visit, visitors were more likely to try other online cessation options on our website in addition to visiting the online community.

Smokers who registered with BecomeAnEX were similar to lurkers with respect to age and sex, but were more likely to have visited cessation websites before and less likely to have homes where smoking was allowed. Use of most online cessation options on our Decide2Quit.org website was comparable between lurkers and registrants.

Our study asked whether visiting BecomeAnEX (lurking or registering) was associated with quit rates 6 months after registration with our website. Visiting BecomeAnEX from our website was not associated with quitting in our study, but this finding should be interpreted cautiously. Not every smoker who began the study responded at the end (386 of the original 759 smokers reported on whether they had quit after 6 months) and nonvisitors were the group least likely to respond at 6 months.

Our analysis took this response rate into account, however it’s possible we might have seen a different outcome if quit status had been available for every smoker. Lack of improvement in quit rates may also have been due to low rates of engagement with the online community.

Online communities could better appeal to first-time quitters.

Online communities have the potential to influence smokers’ motivation to quit, provide support in the face of cessation-related stress, and help smokers improve coping skills. Our study indicated that those who visited an online community after registering with a tobacco cessation website were also more likely to be engaged in other web offerings and more likely to have a past quit attempt.

Cessation websites should consider presenting online communities in ways that appeal to smokers who are new to quitting or new to cessation websites. Ongoing work is also needed to study the effectiveness of engaging in an online community promoting tobacco cessation.

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