Twitter helps smokers kick the habit

Cornelia Pechmann, professor of marketing at UCI's Paul Merage School of Business, and Judith J. Prochaska, associate professor of medicine at Stanford, found that overall engagement in two consecutive Tweet2Quit groups was high, with 78 percent of members tweeting their fellow study subjects at least once during the 100-day study.

The average number of tweets per person was 72, and 60 percent tweeted past the 30-day mark. Group No. 1 had a smoking cessation rate of 42 percent. Using lessons gleaned from that trial, researchers tweaked the automessaging process, and Group No. 2 had a success rate of 75 percent.

The findings were published recently in the Journal of Medical Internet Research.

"Our results indicate that incorporating social media-delivered automessages from trained counselors was effective in promoting smoking cessation," Pechmann said. "The twice-daily messages encouraged people to tweet their group members, which made them more accountable for quitting."

Members of the Tweet2Quit's two closed, 20-person groups communicated online via Twitter for 100 days. Participants each received a free supply of nicotine patches, along with daily automated text messages. They were encouraged to use a Web-based guide to develop a cessation plan and were asked to tweet their group at least once a day about their progress.

There were no expert facilitators in the groups; the smokers themselves supported one another. However, the daily automessages encouraged and directed peer-to-peer discussions, and distinct tweeting spikes occurred when the messages were sent, at 9 a.m. and 5 p.m.

"The Twitter environment created a sort of party dynamic," Pechmann said. "That's especially important for social smokers. In addition, group leaders naturally emerged, facilitating the online conversations. These leaders played a critical role in keeping people engaged."

Several types of tweets related positively to smoking abstinence. The more people shared about setting a quit date, using nicotine patches, countering roadblocks, utilizing self-rewards, believing in themselves and feeling pride, the more likely they were to remain smoke-free.

Support, accountability, advice and bragging rights are a few of the benefits that make social media a promising platform for self-help groups, Pechmann noted. However, while health-related online forums, blogs and websites can be informative, they lack the instantaneous interaction of Twitter.

Tweet2Quit's hybrid approach combines automated messages with the social media element. The prompts are based on clinical guidelines for smoking cessation and employ positive, open-ended questions that encourage online discussion, such as "What will you do when you feel the urge to smoke?" On average, about 23 percent of tweets were in response to these automated texts, while 77 percent were spontaneous.

Pechmann and her team are currently working on a follow-up study involving Latino smokers.