Contrary to popular belief many smokers, young and old, want to quit smoking. Yet, while taking the big step is challenging, staying abstinent is a greater struggle. Over the last decade, researchers have been designing and testing non-medical treatments to help smokers quit successfully. Some examples include mindfulness, counselling, and self-help interventions. Interestingly, many people start smoking in social settings with their family members, classmates, or colleagues. Then, what if we used social settings to help them quit smoking instead? 

You’ve probably heard of support groups such as Alcoholics/Nicotine/Narcotics Anonymous, where people with substance use problems who want to quit come together to create a space for sharing and support. More recently, internet interventions have also been designed on this principle. They encourage peer support, i.e. connecting with other smokers trying to quit. Such resources are even more relevant with the pandemic forcing most in-person events to be done virtually. Moreover, they are low-cost, ensure anonymity, and are easily accessible on anyone’s phone. One such online peer-support intervention for smokers with promising effects is Tweet2Quit. 

CORE
In Tweet2Quit, each participant was assigned to a 20-people cohort. They were given a Twitter account where they could interact with the 19 other heavy smokers who were also motivated to quit smoking. Over 100 days, they received automated tweets with discussion points related to the quit attempt over which they could engage with their cohort. Moreover, they could use the closed group space to interact with each other limitlessly. Finally, they received daily feedback on their (lack of) participation on Twitter. Researchers found that participants who experienced Tweet2Quit were twice as likely to be smoke-free 2 months after the quit date than those who didn’t experience the intervention. Moreover, participants who tweeted more were more likely to successfully quit as well. 

The success of Tweet2Quit tells us that there is promise in implementing small-scale online self-help groups as an add-on element during a quit attempt. Engaging with others who are in the same position can provide social and emotional support during this challenging period. Naturally, social media use has changed since 2017 when this study was conducted. Yet, features such as “tweeting” are still widely used, and more up-to-date, user-friendly, and accessible versions of the intervention are worth testing. 

RESEARCH METHODS
What?
The researchers tested whether participating in Tweet2Quit led to increased abstinence measured at 7 days, 1 month and 2 months after the quit date, as compared to the control group. At each of these points, participants were asked if they had been abstinent in the last 7 days to determine successful abstinence. 

Who? 
160 adults, mostly female (74%), White (89%), and aged 36 years on average (SD = 9.9). They were heavy smokers (smoked 18 cigarettes daily on averages who had been smoking for an average of 16.8 years) who were motivated to quit smoking. 

How?
Each time 40 new participants enrolled in a cohort, they were randomly divided into the Tweet2Quit or control group. Participants in both groups received nicotine patches to help with cravings, and frequent emails with links to the US government’s website for smoking cessation (smokefree.gov). In addition, only participants in the Tweet2Quit group got the Twitter peer support intervention as an add-on to see if it had benefits over and above typical cessation aid. 

FINDINGS

• In the Tweet2Quit group, 40% of participants abstained from smoking 2 months after they quit. However, in the control group 20% of participants were still abstinent. This suggests that Tweet2Quit had significant positive effects on their quit attempt. 
• Participants who tweeted more often and tweeted actively for a longer period were more successful with quitting. For example, for every 10 new tweets, the likelihood of abstinence increased by 20%. 

DETAILS
Pechmann, C., Delucchi, K., Lakon, C. M., & Prochaska, J. J. (2017). Randomised controlled trial evaluation of Tweet2Quit: a social network quit-smoking intervention. Tobacco Control, 26(2), 188-194.

This sci-fly was written by Suhaavi Kochhar (Radboud University) for RAD-blog, the blog about smoking, alcohol, drugs and diet.