J. Med. Internet Res. - Quit now? Quit soon? Quit when you're ready? Insights about target quit dates for smoking cessation from an online quit date tool.


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CKGROUND: Setting a target quit date (TQD) is often an important component in smoking cessation treatment, but ambiguity remains concerning the optimal timing (ie, quitting spontaneously versus delaying to prepare).OBJECTIVE: We examined four questions about the timing of TQDs and smoking outcomes in secondary analyses of The iQUITT Study, a randomized trial of Internet and telephone treatment for cessation: (1) What are the characteristics of TQDs set using an online interactive quit date tool?, (2) What are the characteristics of individuals who use a quit date tool and do they differ from those who do not?, (3) Are there differences in smoker characteristics, treatment utilization, and cessation outcomes based TQD timing?, and (4) Is maintenance of an initial TQD predictive of abstinence or do changes to TQDs lead to cessation?METHODS: A total of 825 adult current cigarette smokers were randomized to enhanced Internet or enhanced Internet plus telephone counseling. Latency to TQD in days was calculated as the date difference between the initial TQD and enhanced Internet registration; prospective TQD setters were stratified into four latency groups (0, 1-14, 15-28, 29+ days). Baseline variables, website utilization, and 3-month cessation outcomes were examined between prospective TQD groups. Desire and confidence to quit, number of TQDs, and website logins were tested as predictors of 30-day point prevalence abstinence (ppa) at 3 months (responder-only analyses). Classification and regression tree (CART) analysis explored interactions among baseline variables, website utilization, and latency to TQD as predictors of 30-day ppa.RESULTS: There were few baseline differences between individuals who used the quit date tool and those who did not. Prospective TQDs were set as follows: registration day was 17.1% (73/427), 1-14 days was 37.7% (161/427), 15-28 days was 18.5% (79/427), and 29+ days was 26.7% (114/427). Participants with a TQD within 2 weeks had higher baseline self-efficacy scores but did not differ on smoking variables. Individuals whose TQD was the same day as registration had the highest logins, page views, number of TQDs set using the tool, and messages sent to other members. Logistic regression revealed a significant interaction between number of TQDs and website logins for 30-day ppa (P=.005). Among those with high logins, 41.8% (33/79) with 1 TQD were abstinent versus 25.9% (35/135) with 2+TQDs. Logins and self-efficacy predicted 30-day ppa in the CART model.CONCLUSIONS: TQD timing did not predict cessation outcomes in standard or exploratory analyses. Self-efficacy and an apparent commitment to an initial TQD were the components most highly related to abstinence but only via interactions with website utilization. Findings highlight the importance of feeling efficacious about handling specific smoking situations and engaging with treatment. Additional research focused on increasing engagement in Web-based cessation studies is needed.TRIAL REGISTRATION: ClinicalTrials.gov: NCT00282009; http://clinicaltrials.gov/show/NCT00282009 (Archived by WebCite at http://www.webcitation.org/6Kt7NrXDl).

Resumo Limpo

ckground set target quit date tqd often import compon smoke cessat treatment ambigu remain concern optim time ie quit spontan versus delay prepareobject examin four question time tqds smoke outcom secondari analys iquitt studi random trial internet telephon treatment cessat characterist tqds set use onlin interact quit date tool characterist individu use quit date tool differ differ smoker characterist treatment util cessat outcom base tqd time mainten initi tqd predict abstin chang tqds lead cessationmethod total adult current cigarett smoker random enhanc internet enhanc internet plus telephon counsel latenc tqd day calcul date differ initi tqd enhanc internet registr prospect tqd setter stratifi four latenc group day baselin variabl websit util month cessat outcom examin prospect tqd group desir confid quit number tqds websit login test predictor day point preval abstin ppa month responderon analys classif regress tree cart analysi explor interact among baselin variabl websit util latenc tqd predictor day pparesult baselin differ individu use quit date tool prospect tqds set follow registr day day day day particip tqd within week higher baselin selfefficaci score differ smoke variabl individu whose tqd day registr highest login page view number tqds set use tool messag sent member logist regress reveal signific interact number tqds websit login day ppa p among high login tqd abstin versus tqds login selfefficaci predict day ppa cart modelconclus tqd time predict cessat outcom standard exploratori analys selfefficaci appar commit initi tqd compon high relat abstin via interact websit util find highlight import feel efficaci handl specif smoke situat engag treatment addit research focus increas engag webbas cessat studi neededtri registr clinicaltrialsgov nct httpclinicaltrialsgovshownct archiv webcit httpwwwwebcitationorgktnrxdl

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