Steven Meredith, PhD, was one of the presenters at the March 8, 2013 Clinical Trials Network’s Symposium entitled “Brave New World: Using Technology to Enhance Behavioral Health”. In his talk, “Information and Communication Technology to Promote Smoking Cessation” he discusses how Web and computer based interventions may increase the effectiveness of efforts to quit smoking. There were not many experiments done about smoking cessation prior to Meredith’s. The problems he wanted to address concerned disability, transportation, and access that kept people from being able to use standard medical care for this problem. The model he used, with the help of Jesse Dallery, PhD, was one of contingency, or the giving or withholding of monetary rewards in order to encourage behavioral change.
In the first experiment, each participant was offered a carbon monoxide (CO) monitoring device, CO being the main byproduct of smoking cigarettes, to test the participants’ smoking habits. Every test had to be filmed online and sent to the researchers. With every negative result, they were rewarded. To aid in not smoking, there were discussion boards where the different groups’ members could talk to and affirm one another. Initially, there was only one negative result. During the treatment period of the first experiment, however, the researchers used a mixed contingency method where people earned incentives for their own negative result and for all their team-members collectively getting negative results, thus increasing the number of negative results overall. This showed that there could be an effective, and relatively inexpensive, integration of incentive-based models into Web and computer formats.
Meredith was interested in comparing the effectiveness of no-incentive (only social support), interdependent contingency (getting money when all group members had negative results), and independent contingency (money based on individual results) models, using five-day trials for each model that differed sequentially per group. Each group had to experience each type. No group started with the no-incentive segment, indicating that the negative results that occurred were more sustainable after the incentive segments were offered but not prior to them. Having no incentives can help sustain, but may not start, smoking cessation practices. The interdependent trials were less monetarily sustainable than the other trials, despite its relatively positive results. This experiment provided clear evidence that group dynamics offer social support to people trying to quit smoking, only hinted at prior to these experiments.
All these experiments supported the idea of using Web and computer-based models, as well as the social benefits of the interpersonal dynamics of the discussion boards to aid in smoking cessation. A few different aids including a mobile CO monitoring device that is not on the market as well as devices that have worked for other things like quitting alcohol are highlighted. Websites like stickk.com and mobile applications like NCI QuitPal are positioned as possibly helpful in quitting smoking as well as quit hotlines and other low-tech options. Finally he emphasizes the need for research into the use of technology in any attempts to quit smoking or any other drug as society goes into the future and the need for standard medical care alongside these Web and computer-based interventions.
For Further Reading:
Escoffery, C., McCormick, L., & Bateman, K. (January 1, 2004). Development and process evaluation of a web-based smoking cessation program for college smokers: innovative tool for education. Patient Education and Counseling, 53, 2, 217-25.
Perryman, C. (2003). Information behaviors in an online smoking cessation forum. Libri, 53(3), 149-159.
Meredith, S. E., & Dallery, J. (April 01, 2013). Investigating group contingencies to promote brief abstinence from cigarette smoking. Experimental and Clinical Psychopharmacology, 21, 2, 144-154.
Simone Montague is a mental health blogger and graduate of DePaul University.