@Article{info:doi/10.2196/formative.7570,
author="Kahler, Christopher W
and Cohn, Amy M
and Costantino, Catherine
and Toll, Benjamin A
and Spillane, Nichea S
and Graham, Amanda L",
title="A Digital Smoking Cessation Program for Heavy Drinkers: Pilot Randomized Controlled Trial",
journal="JMIR Form Res",
year="2020",
month="Jun",
day="8",
volume="4",
number="6",
pages="e7570",
keywords="smoking cessation; alcohol drinking; internet; text messaging; therapy",
abstract="Background: Heavy drinking (HD) is far more common among smokers compared with nonsmokers and interferes with successful smoking cessation. Alcohol-focused smoking cessation interventions delivered by counselors have shown promise, but digital versions of these interventions---which could have far greater population reach---have not yet been tested. Objective: This pilot randomized controlled trial aimed to examine the feasibility, acceptability, and effect sizes of an automated digital smoking cessation program that specifically addresses HD using an interactive web-based intervention with an optional text messaging component. Methods: Participants (83/119, 69.7{\%} female; 98/119, 82.4{\%} white; mean age 38.0 years) were daily smokers recruited on the web from a free automated digital smoking cessation program (BecomeAnEX.org, EX) who met the criteria for HD: women drinking 8+ drinks/week or 4+ drinks on any day and men drinking 15+ drinks/week or 5+ drinks on any day. Participants were randomized to receive EX with standard content (EX-S) or an EX with additional content specific to HD (EX-HD). Outcomes were assessed by web-based surveys at 1 and 6 months. Results: Participants reported high satisfaction with the website and the optional text messaging component. Total engagement with both EX-S and EX-HD was modest, with participants visiting the website a median of 2 times, and 52.9{\%} of the participants enrolled to receive text messages. Participants in both the conditions showed substantial, significant reductions in drinking across 6 months of follow-up, with no condition effects observed. Although smoking outcomes tended to favor EX-HD, the condition effects were small and nonsignificant. A significantly smaller proportion of participants in EX-HD reported having a lapse back to smoking when drinking alcohol (7/58, 16{\%}) compared with those in EX-S (18/61, 41{\%}; $\chi$21=6.2; P=.01). Conclusions: This is the first trial to examine a digital smoking cessation program tailored to HD smokers. The results provide some initial evidence that delivering such a program is feasible and may reduce the risk of alcohol-involved smoking lapses. However, increasing engagement in this and other web-based interventions is a crucial challenge to address in future work. Trial Registration: ClinicalTrials.gov NCT03068611; https://clinicaltrials.gov/ct2/show/NCT03068611 ",
issn="2561-326X",
doi="10.2196/formative.7570",
url="https://formative.jmir.org/2020/6/e7570",
url="https://doi.org/10.2196/formative.7570",
url="http://www.ncbi.nlm.nih.gov/pubmed/32348286"
}