Background: Online health behavior change interventions ? including
smoking cessation programs ? offer great promise, but little is known about
the components that may add to their effect.
Objectives: We propose a controlled test assessing tobacco abstinence
associated with an adjunctive lapse management system combined with a
best-practices online smoking cessation intervention. We hypothesize that
a program that includes the lapse management system will yield greater
efficacy than a program that does not include such a component.
Methods: We propose a 2-arm RCT with 1080 adult study participants
randomized to either a lapse management intervention or a standard practice
online intervention without the lapse management system. Because the
central question is whether the lapse management system improves efficacy,
both conditions use a very similar standard-practices core web-service that
embodies many of the features found in the interventions tested in our prior
online smoking cessation trials. The lapse management system will be
based on the day-to-day logging of target behavior and providing just-in-time
therapy to clients reporting a lapse.
Measures: The primary outcome is 7-day point prevalence tobacco
abstinence (i.e., not even a puff of smoke in the previous seven days,
as assessed at the 2-, 6- and 12-months follow-up). Potential predictors,
moderators, and mediators of abstinence will also be examined.
Benefits: To the best of our knowledge, this application describes the first
RCT that assesses the incremental efficacy of adding a lapse management
system to an online smoking cessation intervention. These interventions
constitute a cost-effective means to reach smokers who want to quit. By
seeking to identify beneficial adjunctive mechanisms, their efficacy may be
improved, which can make a substantial public health impact.