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Jan 11, 2011

Quitting Smoking: Study Shows How to Dial and Click Your Way to Success

Internet and telephone support helps smokers quit, for good.

Quitting smoking is tough. But the chances of success are much greater if you have interactive Internet tools at your fingertips and a trained health coach just a phone call away.

According to a new study, smokers are significantly more likely to quit if they receive telephone counseling and personal advice from a health coach, plus 24-hour-a-day access to a stop-smoking web site offering individually tailored information and a social support network. In the study, people who didn’t get telephone support—or worse, who received only basic Internet information without any interactive tools or social networking—were much less successful, especially at the beginning when quitting is most difficult.

The iQUITT study, as it is known, was published in the January 10, 2011, issue of the Archives of Internal Medicine.

The study recruited 2,005 participants by using Internet search engines such as Google and Yahoo! to identify people who were already searching for help in quitting smoking. Participants were randomly assigned to one of three treatment groups.

The first group, called the “enhanced Internet” group was given free access to a full version of for six months. Among other things, this web site provides advice on quitting smoking, tailors information to each user, helps users set goals and develop problem-solving skills, offers assistance with stop-smoking medications, and includes membership in a large online social network.

The second group, the “enhanced Internet plus phone” group, received full access to for six months plus five phone calls with a trained health counselor during the first 30 days of quitting, when support is needed most.

The third group, the “basic Internet” group, was given only limited access to, with general information on quitting smoking and anti-smoking medications, a list of frequently asked questions and a list of quit-smoking programs.

Three, 6, 12 and 18 months after first quitting, study participants answered questionnaires about their smoking habits. At 3 months, 19 percent of people who received both enhanced Internet and phone support reported they had successfully avoided smoking for the past 30 days, as compared to 10 percent in the enhanced-Internet group and 9 percent in the basic-Internet group.

The advantage of combined Internet and telephone treatment continued at 6 and 12 months and was highly significant, according to a statistical analysis. By 18 months, however, a similar number of people in the three groups reported not smoking during the previous month. Success rates ranged from 17.4 percent to 19.6 percent.

Researchers then looked at which study participants consistently reported being smoke-free throughout the study. They found that those who received both enhanced Internet and phone support did significantly better at each time point, including the 18-month follow-up. They concluded that combined Internet and phone support was the most effective way to help smokers quit initially and stay away from cigarettes over the long term.

Questions for You to Consider

  • Why is it so hard to quit smoking?

  • According to, smokers face both a physical addiction and a psychological addiction. The physical addiction comes from the way nicotine acts on the brain cells to create a feeling of pleasure and alertness. Unfortunately, your body clears away the nicotine in about 30 minutes, leaving you tired, jittery—and craving another cigarette.

    The psychological addiction comes from both habits that are hard to break and the positive feelings some people associate with smoking. For example, if you smoke a cigarette every morning when you first wake up, your brain comes to associate waking up with smoking, and you will automatically crave a cigarette first thing in the morning. This habit is made even stronger by the physical pleasure you feel when nicotine hits your brain. The other part of psychological addiction is the way smoking makes some people feel about themselves: cool, hip, relaxed. Getting through certain social situations without a cigarette can be difficult.
  • How should I prepare for "quit day?"

  • Getting ready to quit smoking is just as important as the actual "quit day." Here are some steps you can take:

    • Talk to your doctor not only about stop-smoking medications, but also about how quitting smoking may affect other medications you’re taking.
    • Arrange for a support system to help you at home, at work and in your social life.
    • Keep a record of when you smoke and why. This will help you identify triggers to smoking. Once you know your triggers, you can plan how to cope with them without smoking.

    Make quit day a big deal by starting fresh in lots of ways:

    • Throw away all of your cigarettes. Check all of your hiding places to make sure you get rid of every last one.
    • Get rid of your ashtrays.
    • Clean your house and wash your clothes to remove the cigarette smell.
    • Cut down on your caffeine intake starting several days before quit day. Nicotine makes your body metabolize caffeine more quickly. Once you stop smoking, you’ll feel jittery and nervous if you keep drinking the same amount of caffeine.
    • Drink lots of water.
    • Get some exercise. You’ll feel better and it will keep your mind off smoking.


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