DESCRIPTION (provided by applicant): The Internet has several structural and process characteristics that may improve the delivery of cancer prevention programs, such as smoking cessation counseling. Tobacco use is the leading cause of preventable death in the United States. Tobacco use, particularly smoking, continues to be prevalent among young adults, with many progressing into regular use and heavy nicotine dependency during these ages. In this project, investigators aim to produce an Internet smoking cessation program and evaluate it for effectiveness against a minimal treatment control group, with smokers aged 18-30 years. Smokers will be identified from student populations at 36 community (n=12) and four-year (n=24) colleges in the United States by having students complete an On-line Health Risk Appraisal. Letters of invitation for the smoking cessation services will be sent to smokers either by email or regular mail to test whether interactive features of Internet technology improves enrollment. The primary outcomes will be the proportion of identified smokers who enroll for cessation services. The Internet smoking cessation program will be compared to a minimally-tailored print-based self-help program on effectiveness measures as continuous smoking abstinence. It also will be compared to a telephone quit line on cost-effectiveness per smoker who uses the program, completes it and quits smoking. The main trial will consist of a stratified group-randomized three group (Internet, telephone, minimal print) pretest-posttest controlled design. Pretest data will be obtained from the Online Health Risk Appraisal. Posttests will be conducted by telephone at 12-weeks and 52-weeks post enrollment for cessation services. The primary outcome will be the proportion of enrolled smokers who remain abstinent from smoking at each follow-up. Additional analyses will test the moderating effects of modalities by measuring characteristics of the Internet like interactivity and privacy and the mediating effects of use, self-efficacy and benefits related to smoking. Cost-effectiveness analyses will be performed at follow-up.
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