A randomized controlled trial evaluating efficacy of an intervention which enhances social support and positive affect through online social networking in smoking cessations

Introduction and Project Objectives: Online smoking cessation is effective. Peer support, positive affect, and immediate situational cue to action are new directions for smoking cessation; delivery of combinations of such interventions through on line social networking has not been evaluated by randomized controlled trials (RCT). A 2-arm RCT was conducted evaluating the relative efficacy in smoking cessation. The control group (n=203) was sent weekly online messages based on the Health Belief Model to create cognitive changes. The multi-domain intervention group (n=205) included three additional novel and theory-based components: i) a peer support group, ii) positive psychology Intervention (Three Good Things), and iii) immediate online interactions among peer group members to resist situational temptations.
Methods: The 2-arm non-blinded RCT design was used. The 2-month activities were conducted via WeChat. Participants included adult (>=18 years) current smokers who can communicate in Chinese. Exclusion criteria applied. Evaluation was conducted through phone interviews at baseline, 3 months and 6 months post-intervention. The primary outcome was self-reported 7-day point prevalence (pp) quit rate. At Month 6, self-reported quitting was validated by positive results of either exhale carbon monoxide test or saliva cotinine test. Secondary outcomes included reduction of cigarette consumption and other psychosocial variables.
Results: At Month 6, the self-reported quit rates were 29.0% and 27.3% in the intervention and active control groups, respectively (RR = 1.06; 95% Cl: 0.74-1.53); the validated quit rates among all participants were 18.6% and 12.7% respectively. The average number of cigarettes consumed by the non-quitters decreased from 9.1 to 6.1, and 10.6 to 6.4 In the two groups (p.05). Conclusions: Both groups resulted In similarly large self-reported and validated quit rates. Non-significant between-group differences may be explained by the same active messaging component in the two groups, and that the intervention group showed very poor compliance to the three novel active components.
Conclusion: The effective active control group can be recruited and intervened at low cost and is sustainable, and may not require additional interactive social networking components; Implementation of such components needs to consider compliance. Copyright © 2019 Health Research Symposium.