Internet-based smoking cessation initiatives - Availability, varieties, and likely effects on outcomes

Tobacco use remains widespread in every nation in the world. Worldwide, > 1.3 billion people use tobacco products. Many smokers who attempt to quit need cessation assistance such as education, motivation, counseling, and pharmacologic treatments, but many lack access to these resources because of geographic isolation, economic constraints, and cultural barriers. As global Internet use continues to grow, Internet-based smoking cessation programs are a promising strategy for reaching smokers worldwide. The purpose of this article is to examine Internet-based initiatives to assist smokers to quit. The advantages and disadvantages of this type of forum, the likely effectiveness in achieving smoking cessation, and the impact on clinical and cost outcomes are discussed. The primary advantage of Intemet-based smoking cessation initiatives is their potential public health reach. Disadvantages include the potential for privacy and security breaches, concerns about inferior quality of information, and failure of websites to utilize online technologies. Intemet-based smoking cessation programs can extend the clinical encounter, in essence allowing the provider to offer 'virtual' support to the patient who is attempting to quit smoking. The potential of Internet technology to reach large numbers of smokers and provide reliable information for quitting is only beginning to be realized. Few studies have rigorously examined the question of efficacy, and many questions remain unanswered. To illustrate the important features of Internet-based smoking cessation initiatives, this review evaluated existing online programs. A smoking cessation program was defined as a structured, multi-component treatment plan specifically designed to aid in quitting. Twelve websites were identified from an Internet search (using an Internet search engine) that met our criteria. The interactive capabilities of Internet applications show great promise for customizing a smoking cessation plan 'on-the-fly' for individuals seeking support in quitting, but few websites offer programs that incorporate tailored approaches. Thus, patients should look to healthcare providers to help them understand the benefits and limitations of Internet-based information resources for smoking cessation.