All ETDs from UAB

Advisory Committee Chair

Connie L Kohler

Advisory Committee Members

Ellen M Funkhouser

Kathleen F Harrington

Peter S Hendricks

Lori W Turner

Document Type

Dissertation

Date of Award

2014

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

MIDGE N. RAY HEALTH PROMOTION AND EDUCATION ABSTRACT Nicotine addiction is a chronic and relapsing disease that has serious health consequences. Tobacco continues to be the leading preventable cause of morbidity and mortality in the United States. In 2010, approximately 58.3 million Americans were identified as cigarette smokers. This study was part of the Hygienists' Internet Tobacco Cessation Study (Hi Quit), a randomized controlled trial that employed a web-assisted tobacco intervention (WATI) called Decide2Quit to assist smokers in quitting. Smokers (N=258) were enrolled in the study by dental practices (N=100) that referred patients who smoke to the website. The control group had access to the Decide2Quit (D2Q) website tools including resources pertaining to health risks, nicotine replacement therapy, how to talk with the provider, and additional web resources. In addition to having access to the same D2Q tools, the intervention group could asynchronously interact with an online tobacco treatment specialist (TTS). The overall purpose of this current investigation was to (1) evaluate the effectiveness of the intervention group compared to the control group of Decide2Quit and (2) identify factors associated with quitting. Variables that demonstrated independent association with 30-day point prevalence smoking abstinence were examined using logistic regression models. The independent variables of interest included demographic factors, facilitators of quitting, and perceived receipt of tobacco cessation assistance from the dental practice. Using intent to treat analysis, we found no significant difference between the intervention and control groups in the 30-day point prevalence tobacco abstinence at six months follow up. A higher proportion of male than female smokers quit (18% vs. 8%; p = 0.02). The 30-day point prevalence tobacco abstinence did not differ significantly by age, education, race, facilitators to quitting, nor receipt of tobacco cessation services. Only male sex was significantly associated with quitting in three of the four models. Additionally, smoking less than 10 cigarettes per day was associated with quitting in two of the models. Additional investigations should be conducted to measure the components of the WATI that are effective in assisting smokers with quitting. Further, we should explore better methods to encourage smokers to actively utilize the online smoking cessation tools, such as interacting with the TTS.

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