Background: Helping young smokers to quit early in life substantially reduces the risk of later morbidity and mortality due to tobacco use. The RealU study demonstrated the efficacy of a smoking-cessation website for college students that incorporated both individually tailored feedback and peer e-mail support. The relationship between peer e-mail support and cessation outcomes among intervention participants is examined here. Methods: This study was conducted at the University of Minnesota Twin Cities from Fall 2004 through Spring 2005. During the intervention period, peer-support students (E-pals) wrote weekly e-mails to intervention group participants (n=257) encouraging healthy behaviors including smoking abstinence. Ten survey items assessed perceived E-pal supportiveness. The number of e-mails replies sent by the participants to their E-pal was tracked as a measure of e-mail engagement. The primary outcome was self-reported 30-day abstinence at the end of the intervention period. Results: Over the course of the intervention, participants sent an average of 4.6 (SD=3.6) e-mails to their E-pals. Perceived E-pal support was significantly correlated with e-mail engagement (p<0.001). At Week 30, 40.5% of individuals in the RealU intervention group (104/257) reported not smoking any cigarettes in the prior 30 days. Bivariate analyses indicated that 30-day abstinence was related to both perceived support from the E-pal (p<0.001) and e-mail engagement (p<0.001). Multivariate analyses indicated that after controlling for age and baseline-level smoking, e-mail engagement remained a significant predictor of 30-day abstinence (p<0.001). Conclusions: Greater peer engagement via e-mail was associated with increased smoking abstinence and reduced frequency of smoking. These findings suggest that online peer support may be an important strategy when delivering Internet-assisted cessation programs to young adults.
Bibliographical noteFunding Information:
This research was funded by ClearWay Minnesota SM research program grant RC 2002–0025. The contents of this manuscript are solely the responsibility of the authors and do not necessarily reflect the official views of ClearWay Minnesota. Additional support for supplies was provided by the University of Minnesota Transdisciplinary Tobacco Research Center NIH P50 013333.