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Original Investigation
January 10, 2011

A Randomized Trial of Internet and Telephone Treatment for Smoking Cessation

Author Affiliations

Author Affiliations: Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation (Drs Graham, Cobb, Niaura, and Abrams and Mr Moreno), and Georgetown University Medical Center/Lombardi Comprehensive Cancer Center (Drs Graham and Cobb), Washington, DC; Center for Statistical Sciences, Brown University (Dr Papandonatos and Mr Kang), and Centers for Behavioral and Preventive Medicine, Brown University/The Miriam Hospital (Dr Bock), Providence, Rhode Island; National Jewish Health, Denver, Colorado (Dr Tinkelman); and Department of Health, Behavior, and Society, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Niaura and Abrams).

Arch Intern Med. 2011;171(1):46-53. doi:10.1001/archinternmed.2010.451

Background  This study aimed to determine the relative effect of Internet and Internet plus telephone treatment for smoking cessation on smoking abstinence among US adults. A priori hypotheses were that Internet enhanced with tailored content and social support would outperform basic Internet (BI) and that enhanced Internet (EI) plus proactive telephone counseling would outperform the other conditions.

Methods  The Quit Using Internet and Telephone Treatment (iQUITT) study used a 3-group randomized controlled design comparing BI, EI, and EI and telephone combined (EI+P). The trial was conducted from March 8, 2005, through November 30, 2008. Current adult smokers in the United States who smoked 5 or more cigarettes per day were recruited via search engines. Characteristics of the 2005 participants include mean (SD) age of 35.9 (10.8) years, 51.1% women, and 86.5% white. The follow-up assessment rate at 18 months was 68.2%. The main outcome measure was 30-day point prevalence abstinence measured at 3, 6, 12, and 18 months after randomization using intent-to-treat analysis.

Results  At 18 months, the 30-day multiple point prevalence abstinence rate across all follow-up intervals was 3.5% (BI), 4.5% (EI), and 7.7% (EI+P), with EI+P significantly outperforming BI and EI. At 18 months, 30-day single point prevalence abstinence rates were 19.0% (BI), 17.4% (EI), and 19.6% (EI+P) and did not differ among the groups.

Conclusions  Combined Internet and telephone treatment outperforms static and dynamic Internet interventions.

Trial Registration  clinicaltrials.gov Identifier: NCT00282009