The Effectiveness of An Online Cessation Website to Promote Quit Behavior

Theoretical Background and research questions/hypothesis: To harness the ability of the internet to deliver evidence-based cessation information to consumers, Legacy created BecomeAnEX.org, a free branded smoking cessation website designed to engage smokers through videos, interactive content, a personalized quit plan, and an online community of smokers. With over 500,000 registered users, we sought to evaluate the website’s effect on quit behavior.

Methods: An online study system recruited 1033 new registrants to the BecomeAnEX.org (bex.org) website beginning in January 2011. Quit behavior was assessed through surveys at 1, 3, and 6 months follow-up. Logistic regression was used to determine the association between increased online activity and quit behavior. The sample consisted primarily of daily smokers (93.1%) who smoked an average of 16.4 cigarettes per day.

Results: This was a highly motivated group of individuals; at baseline, 72.3% endorsed having made at least one quit attempt in the past 12 months, 82.2% said they’ve been thinking recently about the changes they will have to make to quit smoking, and 71.5% intended to quit in the following 30 days. Users visited the website an average of 6.56 times over the course of the study and 90.5% said that they got help or advice about quitting from bex.org. At the 6-month follow-up, 82.7% of the respondents endorsed making at least one quit attempt, and there was a 7-day abstinence rate of 20.7%% and a 30-day abstinence rate of 18.4%. Adjusted regression analyses show that there is a statistically significant association between visits to the website during the study period and abstinence at 6-months; each additional visit to the website was associated with an approximate 67% increase 7-day (p<0.001) and 75.5% increase in 30-day (p<0.001) and abstinence. There was a similar relationship between increased distinct website pages viewed and both 7- and 30-day abstinence.

Conclusions: These results suggest that there is a dose-response relationship between exposure to bex.org and abstinence.

Implications for research and/or practice: Further understanding how the website engages the user and prompts quit behavior is essential in order to optimize the user-experience and maximize quit rates.