Evaluating Outcomes of a Social Media-Based Peer and Clinician-Supported Smoking Cessation Program in Preventing Smoking Relapse: Mixed Methods Case Study.
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ABSTRACT: Background
Smoking relapse prevention after completion of a smoking cessation program is highly germane to reducing smoking rates.Objective
The purpose of this study was to evaluate the 1-year outcomes of a social media-based and peer and clinician-supported smoking cessation program on Facebook and examine communication patterns that could support smoking cessation and identify risk of relapse.Methods
We used a mixed methods case study evaluation approach featuring a single-case holistic design. We recruited volunteers who signed up after successful completion of a 12-week clinical smoking cessation program in a general medicine department in Japan. Participants contemporaneously accessed a closed Facebook page, and we analyzed their posts including text and emoticons. We used joint display analysis, which involved iterative structuring and restructuring construct-specific tables with both types of data to find the most effective approach for integrating the quantitative results with the qualitative results of content analysis.Results
One successful participant and 2 relapsed participants were analyzed to explore the specific patterns of postings prior to relapse. Decisive comments about quitting smoking were common among participants, but encouraging messages for peers were more common from the successful participant. Comments seeking social support and reassurance were warning signs of relapse. Conflicted comments also may be a warning sign of relapse risk.Conclusions
These findings based on a mixed methods case study of a social media platform supporting smoking cessation could be used to guide messaging in other online social networking service communities after a smoking cessation program to help reduce smoking relapse.Trial registration
UMIN Clinical Trials Registry UMIN000031172; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000035595.
SUBMITTER: Isse N
PROVIDER: S-EPMC8491124 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Smokers attempting to quit often attribute smoking relapse to negative affect, craving, and other nicotine withdrawal symptoms. In addition, there is evidence that smoking relapse can increase these symptoms, particularly negative affect. To address this issue, we analyzed data from an 11-week smoking cessation clinical trial in which smokers (n = 1,246) were randomized to receive either nicotine replacement therapy (NRT), varenicline, or placebo, combined with behavioral counseling. Using cross-lagged analyses, we examined the temporal bidirectional relationships between self-reported measures of affect, craving, and composite withdrawal symptoms and biochemically verified smoking abstinence. The relative strength of these temporal relationships was examined by comparing the explained variances of the models. The results showed that higher negative affect, craving, and composite withdrawal symptoms increased the likelihood of subsequent smoking relapse, and that smoking relapse led to subsequent increases in these same symptoms. A comparison of the explained variances found symptom predicting subsequent relapse models to be stronger than those where relapse predicted subsequent symptoms. Although the explained variance findings generally support a negative reinforcement conceptualization of nicotine dependence, the bidirectional relationship between symptoms and smoking relapse suggests that struggling with quitting smoking leads to significant negative affect, craving, and other withdrawal symptoms that do not quickly resolve. These findings highlight the importance of addressing specific symptoms within the context of smoking cessation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Project description:IntroductionPain and cigarette smoking are highly prevalent and frequently co-occurring conditions that interact in the manner of a positive feedback loop. Despite initial evidence that smokers with co-occurring pain may experience greater difficulty quitting, we are unaware of previous research that has tested prospective associations between pain status and the attainment of smoking cessation milestones.Aims and methodsThis study examined past 2-week pain status as a predictor of cessation milestones among current smokers who were motivated to quit (Sample 1; N = 301) and smokers who recently initiated a cessation attempt (Sample 2; N = 242). Cessation milestones included initiation of a quit attempt and 7-day point prevalence abstinence (PPA; Sample 1), lapse/relapse (Sample 2), and 7-day PPA at 2-month follow-up (both samples). Indirect associations between pain status and cessation milestones via confidence in quitting and nicotine withdrawal were also examined.ResultsSmokers with pain (vs. no pain) were as follows: less likely to initiate a quit attempt and achieve 7-day PPA; more likely to lapse and/or relapse; and less likely to report 7-day PPA at follow-up. Pain status was indirectly associated with latency cessation milestones via confidence in quitting and with latency to lapse via withdrawal severity.ConclusionsThis study demonstrated that pain status can predict smoking cessation outcomes. Clinical implications include the need to assess pain in the context of quitting and that smokers with co-occurring pain may benefit from tailored/integrated cessation interventions.ImplicationsA growing empirical literature indicates that the presence of co-occurring pain probably contributes to the maintenance of cigarette dependence. The current results provide novel evidence that smokers with co-occurring past 2-week pain are less likely to initiate a quit attempt and maintain smoking abstinence than smokers without co-occurring pain. These findings suggest that smokers with pain face unique barriers to quitting and underscore the utility of assessing and addressing pain among all smokers who are planning a smoking cessation attempt.
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