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VA study looks to Internet to help smokers quit

March 11, 2014

A VA study is testing whether the Internet can help smokers quit. (Photo: ©iStock/Mac99)

A VA study is testing whether the Internet can help smokers quit. (Photo: ©iStock/Mac99)

There isn't much the Internet can't help people do, from tracking finances, to finding a date, to fixing a leaky faucet. But can it help smokers to quit? That's the focus of a four-year study at the Durham VA Medical Center, where researchers are trying to determine if Veterans of operations Enduring Freedom and Iraqi Freedom will be more successful at quitting with the help of a website called QuitNet. More than 400 Veterans are taking part in the research, due to end early next year.

Veterans returning from Iraq and Afghanistan are smoking at rates much higher than those of the general population and are therefore at a higher risk for smoking-related illnesses.VA runs tobacco cessation clinics that have proved highly effective.

Up to half of patients who regularly attend such programs will successfully stop smoking at least for a while, research shows, while about a quarter will stay away from cigarettes long-term.

The main problem with clinic-based programs, though, is poor attendance, says lead investigator Patrick Calhoun, PhD, a psychologist with VA and Duke University. According to Calhoun, barriers to Veterans' participation include long distances to clinics—especially for those in rural areas—and the limited availability of specially trained counselors. These factors make it harder for patients to fit in clinic visits around their work schedules.

Calhoun believes Web-based methods are a potent alternative. Based on U.S. Public Health Service guidelines, QuitNet features chat rooms, advice from experts, medication tips, buddy match-ups, social media space, and other tools to support smokers in their quest to stop smoking. Launched on a wide scale 10 years ago with help from Boston University's School of Public Health, QuitNet boasts 60,000 users worldwide.

Half of the Veterans in the study have received premium membership to QuitNet. They have also been offered nicotine replacement therapy from VA. This entails a telephone assessment and shipments of supplies—usually skin patches or chewing gum—through the mail. These Veterans can opt for medication, too, if they want to commit to clinic visits along with their website usage.

The other study participants are getting standard care. This means referral to a clinic at the Durham VA geared to help returning Veterans quit smoking. The clinic uses a mix of methods, such as group behavioral counseling and telephone support, as well as nicotine replacement therapy and medication management. For those Veterans prescribed a drug, bupropion (sold as Zyban) is the most common choice.

"We think the approach has great promise for increasing access to smoking cessation care, especially among Veterans in rural areas," Calhoun says. "The Internet in combination with telehealth for nicotine replacement therapy may help to increase motivation and avoid barriers to access."

The study is just one part of VA's effort to help Veterans quit smoking. Other approaches include a quitline (1-855-QUIT VET), a smoking cessation texting program called SmokefreeVet, and a downloadable mobile app.

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