Providing Online Live Chat Services for Smokers Looking to Quit: Lessons Learned from the Integration of the National Cancer Institute's Livehelp into Smokefree.Gov

Background:  Despite advances in prevention and cessation efforts, smoking continues to have a detrimental impact on the economic and physical health of the nation. The national unassisted quit rates of Americans remains low, while smoking is the leading cause of preventable death and disease in the U.S, killing over 480,000 Americans annually. One of the more recent, cost-effective, and active means of reaching smokers with cessation support has been through digital outlets. 

Program background:  The National Cancer Institute’s (NCI) Smokefree initiative provides smoking cessation services across a number of digital platforms. While Smokefree provides on-demand support and information through its websites, and tailored cessation services via SmokefreeTXT text and mobile applications, there were not opportunities for users to interact in real-time with smoking cessation specialists. However, such services are available through NCI’s Cancer Information Service’s (CIS) LiveHelp online chat module. CIS provides up-to-date information on both cancer related topics and smoking cessation through a national telephone quitline and online live chat services (LiveHelp). Via LiveHelp, persons can chat online in real time with trained specialists. To further promote LiveHelp and provide Smokefree users with another, more personal smoking cessation service, this collaborative pilot project aimed to integrate LiveHelp into the Smokefree.gov website. Working directly with CIS, the Smokefree team was able to integrate LiveHelp into the Smokefree.gov website via a proactive pop-up chat box. This chat box is served to users after they have been on the site for 90 seconds, and inquires if they would like to chat with a smoking cessation information specialist. If they agree, they are routed directly into the LiveHelp chat queue. Integration of the chat feature was completed on February 19, 2015. 

Evaluation Methods and Results:  CIS tracks a number of LiveHelp data, including referring sites, overall chat usage, and interactions from each chat. Three months prior to the integration (November 2014-January 2015), CIS conducted 505 total smoking cessation chats, with an average of 168 chats per month. In February 2015, there were 566 total chats. That number rose to 1,318 chats in March 2015 (first full month of the integration into the Smokefree website). Comparing totals from January 2015 (last month without integration) to March 2015 (first full month with integration), there was a 590% increase in chats. In total, Smokefree.gov referred 2,126 chats to LiveHelp in March 2015 and was the #1 referrer to the service. 

Conclusions:  This collaborative pilot project provided a new avenue for LiveHelp expansion and an additional smoking cessation tool for Smokefree.gov users. Following the integration, LiveHelp smoking cessation chat numbers skyrocketed.  

Implications for research and/or practice:  Collaborative partnerships between complimentary services can provide added value for both parties, especially in a government climate where resources are limited. This partnership also shows that pop-up live chat services, which are widely utilized in commercial contexts, can be adapted and successfully implemented in health and government contexts. Additionally, innovative web-based smoking cessation tools, such as LiveHelp, hold promise for reaching smokers and helping them quit.