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Pilot Study of an Internet-Based, Simulated Teachable Moment for Smoking Cessation

Published online by Cambridge University Press:  28 September 2018

Robin May*
Affiliation:
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, St Leonards, Australia Department of Cardiology, Royal North Shore Hospital, University of Sydney, Saint Leonards, Australia
Frances Walker
Affiliation:
Department of Cardiology, Royal North Shore Hospital, University of Sydney, Saint Leonards, Australia
Simon de Burgh
Affiliation:
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, St Leonards, Australia
Roger Bartrop (dec.)
Affiliation:
Drug & Alcohol Services, Royal North Shore Hospital, University of Sydney, St Leonards, Australia Department of Cardiology, Royal North Shore Hospital, University of Sydney, Saint Leonards, Australia
Geoffrey H Tofler
Affiliation:
Department of Cardiology, Royal North Shore Hospital, University of Sydney, Saint Leonards, Australia
*
Address for correspondence: Robin J. May, Cardiology Department, Royal North Shore Hospital, St Leonards, NSW 2065, Australia. E-mail: robin.may@health.nsw.gov.au

Abstract

Introduction

The internet has the potential to overcome geographic limitations for smoking cessation interventions, but further telehealth-based studies of utility are required.

Aims

To investigate the efficacy of an internet-based version of a quit smoking approach using a personalised video to create a simulated teachable moment.

Methods

Smokers within Australia were recruited through a dedicated website. After consent, eligible subjects, aged ≥30 years with a non-smoking partner, uploaded pictures of themselves, their partner and family, to be inserted into a video depicting the subject having a heart attack due to smoking, with consequences to them and their family. Nicotine replacement therapy (NRT) began prior to the quit attempt. The video was shown during two videoconference counselling sessions, with follow-up phone calls and text messaging support. Smoking status at 6 months by self-report (primary endpoint) was verified by partner/proxy and salivary cotinine (NicAlert™).

Results/Findings

Seventy seven smokers were screened, of whom 50 were eligible, and 17 of these (34%) were enrolled; 11 men and 6 women, aged 41.5 ± 6.9 years, daily cigarette consumption 20.8 ± 8.9, Heaviness of Smoking Index score 3.7 ± 1.7. Participants reported feeling personally involved with the video (5.9 ± 1.1), which felt real (5.8 ± 1.1) and emotionally moving (5.6 ± 1.5) [7-point Likert Scale]. A similar video response was reported by the four participants (24%), who due to bandwidth limitations, watched the video after the counselling session instead of during it. Non-smoking rates at 6 months were 65% (11/17) by self-report with proxy confirmation, and 47% (8/17) by self-report with biologic confirmation. Three non-smokers by self-report could not provide a valid NicAlert™ result due to current NRT use. One participant who by self-report smoked once in the prior 14-days was assessed as a non-smoker by both proxy and NicAlert™.

Conclusions

This pilot study demonstrates efficacy for an internet-based version of a quit smoking program based on creating a simulated teachable moment. The findings provide support for further research into this technique, with the internet enabling greater reach than face-to-face.

Type
Original Articles
Copyright
Copyright © The Author(s) 2018 

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References

Ammerlaan, J., van Os-Medendorp, H., Scholtus, L., de Vos, A., Zwier, M., Bijlsma, H., & Kruize, A.A (2014). Feasibility of an online and a face-to-face version of a self-management program for young adults with a rheumatic disease: experiences of young adults and peer leaders. Pediatric Rheumatology, 12, 10.Google Scholar
Bala, M. M., Strzeszynski, L., & Topor-Madry, R. (2017). Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews 11, CD004704. doi:10.1002/14651858.CD004704.pub4Google Scholar
Bolliger, C. T., Issa, J. S., Posadas-Valay, R., Safwat, T., Abreu, P., Correia, E. A., & Chopra, P. (2011). Effects of varenicline in adult smokers: a multinational, 24-week, randomized, double-blind, placebo-controlled study. Clinical Therapeutics, 33(4), 465477.Google Scholar
Borland, R., Yong, H.-H., O'Connor, R. J., Hyland, A., & Thompson, M. E. (2010). The reliability and predictive validity of the Heaviness of Smoking Index and its two components: findings from the International Tobacco Control Four Country study. Nicotine & Tobacco Research, 12(Suppl), S4550. doi:10.1093/ntr/ntq038Google Scholar
Bridle, C., Riemsma, R. P., Pattenden, J., Sowden, A. J., Mather, L., Watt, I. S., et al. (2005). Systematic review of the effectiveness of health behavior intervention based on TTM. Psychology and Health, 20(3), 283301. doi:10.1080/08870440512331333997Google Scholar
Cantera, C. M., Puigdomènech, E., Díaz-Gete, L., Trujillo, J. M., Camarelles, F., & Lozano, J. (2014). New technologies as interventions for giving up smoking. In Zapirain, B. G. & Zorrilla, A. M. (Eds.), ICTs for Health and Wellbeing: Principles and Practice. 731 Gull Ave, Foster City. CA 94404, USA: OMICS Group eBooks. Retrieved from https://www.esciencecentral.org/ebooks/ebookdetail/icts-for-health-and-wellbeing-principles-and-practice.Google Scholar
Carlson, L. E., Lounsberry, J. J., Maciejewski, O., Wright, K., Collacutt, V., & Taenzer, P. (2012). Telehealth-delivered group smoking cessation for rural and urban participants: feasibility and cessation rates. Addictive Behaviors, 37(1), 108114. doi:10.1016/j.addbeh.2011.09.011Google Scholar
Cha, S., Ganz, O., Cohn, A. M., Ehlke, S. J., & Graham, A. L. (2017). Feasibility of biochemical verification in a web-based smoking cessation study. Addictive Behaviors, 73, 204208.Google Scholar
Chouinard, M. C., & Robichaud-Ekstrand, S. (2005). The effectiveness of a nursing inpatient smoking cessation program in individuals with cardiovascular disease. Nursing Research, 54(4), 243254.Google Scholar
Chow, C.K., Redfern, J., Hillis, G.S., Thakkar, J., Santo, K., Hackett, M. L. et al. (2015). Effect of lifestyle-focused text messaging on risk factor modification in patients with coronary heart disease: a randomized clinical trial. Journal of the American Medical Association, 314(12), 12551263.Google Scholar
Cooke, F., Bullen, C., Whittaker, R., McRobbie, H., Chen, M. H., &Walker, N. (2008). Diagnostic accuracy of NicAlert cotinine test strips in saliva for verifying smoking status. Nicotine & Tobacco Research, 10(4), 607612. doi:10.1080/14622200801978680Google Scholar
Davis, F. D. (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly, 13, 319340.Google Scholar
Dohnke, B., Ziemann, C., Will, K. E., Weiss-Gerlach, E. & Spies, C. D. (2012). Do hospital treatments represent a ‘teachable moment’ for quitting smoking? A study from a stage-theoretical perspective. Psychology & Health, 27, 1291–307.Google Scholar
Ekeland, A. G., Bowes, A., & Flottorp, S. (2010). Effectiveness of telemedicine: a systematic review of reviews. International Journal of Medical Informatics, 79(11), 736771. doi:10.1016/j.ijmedinf.2010.08.006Google Scholar
Gilpin, E. A., Pierce, J. P., Cavin, S. W., Berry, C. C., Evans, N. J., & Johnson, M., & Bal, D. G. (1994). Estimates of population smoking prevalence: self-vs proxy reports of smoking status. American Journal of Public Health, 84(10), 15761579.Google Scholar
Gjeilo, K. H., Stenseth, R., Klepstad, P., Lydersen, S., & Wahba, A. (2010). Patterns of smoking behaviour in patients following cardiac surgery. A prospective study. Scandinavian Cardiovascular Journal, 44(5), 295300.Google Scholar
Gorber, S. C., Schofield-Hurwitz, S, Hardt, J, Levasseur, G., &Tremblay, M. (2009). The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine & Tobacco Research, 11(1), 1224.Google Scholar
Graham, A. L., Cobb, N. K., Papandonatos, G. D., Moreno, J. L., Kang, H., Tinkelman, D. G. et al. (2011). A randomized trial of Internet and telephone treatment for smoking cessation. Archives of Internal Medicine, 171(1), 4653.Google Scholar
Hagensa, P., Pietersea, M., van der Valk, P., & van der Palenc, J. (2017). Effectiveness of intensive smoking reduction counselling plus combination nicotine replacement therapy in promoting long-term abstinence in patients with chronic obstructive pulmonary disease not ready to quit smoking: protocol of the REDUQ trial. Contemporary Clinical Trials Communications, 8, 248257.Google Scholar
Hartmann-Boyce, J., Stead, L. F., Cahill, K., & Lancaster, T. (2013). Efficacy of interventions to combat tobacco addiction: Cochrane update of 2012 reviews. Addiction, 108(10), 17111721. doi:10.1111/add.12291Google Scholar
Horowitz, M. J., Wilner, N. R., & Alvarez, W. (1979). Impact of event scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209218.Google Scholar
Lai, D. T., Cahill, K., Qin, Y., & Tang, J. L. (2010). Motivational interviewing for smoking cessation. Cochrane Database of Systematic Reviews, CD006936. doi:10.1002/14651858.CD006936.pub2Google Scholar
Larabie, L. C. (2005). To what extent do smokers plan quit attempts? Tobacco Control, 14(6), 425428. doi:10.1136/tc.2005.013615Google Scholar
Lustria, M. L., Cortese, J., Noar, S. M., & Glueckauf, R. L. (2009). Computer-tailored health interventions delivered over the Web: review and analysis of key components. Patient Education and Counseling, 74(2), 156173. doi:10.1016/j.pec.2008.08.023Google Scholar
Mak, Y. W., Loke, A. Y., Lam, T. H., & Abdullah, A. S. (2005). Validity of self-reports and reliability of spousal proxy reports on the smoking behavior of Chinese parents with young children. Addictive Behaviors, 30(4), 841845.Google Scholar
May, R., Tofler, G., Bartrop, R., Heinrich, P., Baird, J., Jozefiak, E., & de Burgh, S. (2010). Smoking cessation through a novel behavior modification technique. American Journal of Cardiology, 106(1), 4446. doi:10.1016/j.amjcard.2010.02.010Google Scholar
McBride, C., Emmons, K., & Lipkus, I. (2003). Understanding the potential of teachable moments: the case of smoking cessation. Patient Education and Counseling, 18, 156170.Google Scholar
Mejia, R. M., Braun, S., Pena, L., Gregorich, S. E., & Perez-Stable, E. J. (2017). Validation of non-smoking status by spouse following a cessation intervention. Journal of Smoking Cessation, 12(1), 3842. doi:10.1017/jsc.2015.11Google Scholar
Naslund, J. A., Kim, S. J., Aschbrenner, K. A., McCulloch, L. J., Brunette, M. F., Dallery, J. et al. (2017). Systematic review of social media interventions for smoking cessation. Addictive Behaviors, 73, 8193. doi:10.1016/j.addbeh.2017.05.002Google Scholar
Niaura, R. (2008). Nonpharmacologic therapy for smoking cessation: characteristics and efficacy of current approaches. American Journal of Medicine, 121(4 Suppl 1), S11S19. doi:10.1016/j.amjmed.2008.01.021Google Scholar
Prochaska, J., & DiClemente, C. (1983). Stages and processes of self-change of smoking: towards an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390395.Google Scholar
Riemsma, R. P., Pattenden, J., Bridle, C., Sowden, A. J., Mather, L., Watt, I. S., & Walker, A. (2003). Systematic review of the effectiveness of stage interventions based to promote smoking cessation. British Medical Journal, 326, 1175, 17.Google Scholar
Sampson, A., Bhochhibhoya, A., Digeralamo, D., & Branscum, P. (2013). The use of text messaging for smoking cessation and relapse prevention: a systematic review of evidence. Journal of Smoking Cessation, 10(1), 5058. doi:10.1017/jsc.2013.36Google Scholar
Smith, S., McCarthy, D., Japuntich, S., Christiansen, B., Piper, M., Jorenby, D., & Jackson, T. (2009). Comparative Effectiveness of 5 Smoking Cessation Pharmacotherapies in Primary Care Clinics. Archives of Internal Medicine, 169(22), 21482155.Google Scholar
Struik, L. L., & Baskerville, N. B. (2014). The role of Facebook in crush the crave, a mobile- and social media-based smoking cessation intervention: qualitative framework analysis of posts. Journal of Medical Internet Research, 16(7), e170. doi:10.2196/jmir.3189Google Scholar
Tofler, G. H., May, R., Bartrop, R., Kirkness, A., Glinatsis, H., & de Burgh, S. (2013). Acute coronary syndrome as a teachable moment for smoking cessation. Journal of Smoking Cessation, 10(1), 511. doi:10.1017/jsc.2013.35Google Scholar
Ubhi, H. K., Michie, S., Kotz, D., Wong, W. C., & West, R. (2015). A mobile app to aid smoking cessation: preliminary evaluation of SmokeFree28. Journal of Medical Internet Research, 17(1), e17. doi:10.2196/jmir.3479Google Scholar
West, R. (2005). Time for a change, putting the transtheoretical (stages of change) model to rest. Addiction 100, 10361039. doi:10.1111/j.1360-0443.2005.01139.xGoogle Scholar
West, R., & Sohal, T. (2006). “Catastrophic” pathways to smoking cessation: findings from national survey. British Medical Journal, 332(7539), 458460. doi:10.1136/bmj.38723.573866.AEGoogle Scholar
Whittaker, R., McRobbie, H., Bullen, C., Rodgers, A., & Gu, Y. (2016). Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews , 4, CD006611. doi: 10.1002/14651858.CD006611.pub4Google Scholar
Yu, C., Shi, Y., Kadimpati, S., Sheng, Y., Jing, J., Schroeder, D., et al. (2013). Perioperative smoking behavior of Chinese surgical patients. Anesthesia & Analgesia, 116(6), 12381246.Google Scholar