TY  - JOUR
AU  - Kahler, Christopher W
AU  - Cohn, Amy M
AU  - Costantino, Catherine
AU  - Toll, Benjamin A
AU  - Spillane, Nichea S
AU  - Graham, Amanda L
PY  - 2020
DA  - 2020/6/8
TI  - A Digital Smoking Cessation Program for Heavy Drinkers: Pilot Randomized Controlled Trial
JO  - JMIR Form Res
SP  - e7570
VL  - 4
IS  - 6
KW  - smoking cessation
KW  - alcohol drinking
KW  - internet
KW  - text messaging
KW  - therapy
AB  - 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%; χ21=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 
SN  - 2561-326X
UR  - https://formative.jmir.org/2020/6/e7570
UR  - https://doi.org/10.2196/formative.7570
UR  - http://www.ncbi.nlm.nih.gov/pubmed/32348286
DO  - 10.2196/formative.7570
ID  - info:doi/10.2196/formative.7570
ER  -