Amanda L. Graham, Ph.D.Brown Medical School

Online Interventions for Smoking Cessation

Acknowledgements & Disclosure

• Jackie Stoddard – Smokefree.gov

• Jean-Francois Etter – StopTabac.ch

• QuitNet & State Partners

– Nathan Cobb – QN Founder

– Pat Milner – QN Product Manager

Product / Service

STRENGTHS:

1. Reach x Efficacy = Impact– 68% adults online = 147M– 7% searched for cessation info in 2004– 10 million US adults– Conservative efficacy estimate = 7%

2. Relapse prevention

3. Social support

4. Real-time tailoring

Product / Service

• Typical cessation program users (QN data):

– Caucasian (88%)

– Female (64%)

– Under age 44 (70%)

– Some college (75%)

– Pregnant (~75,000 women each year)

– Planning to quit (75%) and recent quitters (20%)

Populations

Place

• Referred by search engines

• During business hours

• Higher percentage with broadband access compared to general Internet users

• Benefits:

– Available 24/7– Sustained usage– Engaging graphics, interactivity– Tracking & reporting capabilities

“I just type and click… and type and

click… and soon my

craving isn’t so bad.”

Price

• Development costs:– Highly scalable– Capacity virtually limitless

• Consumer costs:– Content mostly free– Subscription fee to unlock advanced features

• No analysis of cost per quit yet, only of cost per registrant– 30% response rate

Promotion – Image ads

• Pricing model - Cost per thousand views of the ad• Targeted:

– By geographical location– By area of the site/topic

Promotion – Text ads

• Pricing model - cost per click on the ad• Targeted

– By Geography– By Search term/Keyword

• Fully automated

Online vs. Offline Ads

• Targeting– Offline: No control over who sees the ad

– Online: Targeted by geography, age, topic

• Tracking– Offline: No tracking of ad performance with

billboards

– Online: Tracked by location, creative type

• Flexibility – Offline: No option to switch out a billboard

– Online: Switched out easily if ad underperforming

Colorado – Phase I Results

AdvertiserQuitNet

RegsQuitLine

RefsTotal

Reg/RefSpend

Cost per Reg/Ref

Google 282 95 377 $1,150 $3

CBS News4 97 0 97 $2,500 $26

Yahoo 382 44 426 $15,000 $35

Denver Post 114 4 118 $8,000 $68

AOL and CNN 63 0 63 $5,008 $79

MSN (Hotmail) 41 11 52 $8,000 $154

TOTAL 979 154 1,133 $40,000 $40

AdvertiserQN

RegistrantsSpend

Cost per Registrant

Google 94 $545 $6

Yahoo 31 $3,683 $33

AOL 24 $1,463 $61

iVillage 31 $4,659 $150

Denver Citysearch 11 $1,124 $102

WebMD 11 $3,005 $273

TOTAL 283 $13,913 $51

Colorado – Phase II Results

AdvertiserQN

RegistrantsSpend

Cost per Registrant

Google 94 $545 $6

Yahoo 31 $3,683 $33

AOL 24 $1,463 $61

iVillage 31 $4,659 $150

Denver Citysearch 11 $1,124 $102

WebMD 11 $3,005 $273

TOTAL 283 $13,913 $51

Colorado – Phase II Results

Reaching a Broader Audience

• Earlier in cessation process: – 16% of non-ad registrants already quit– 6% of ad-registrants already quit

• More men:– 62% of non-ad registrants are female (typical)– 49% ad-registrants female

• More minorities: – 9% non-ad registrants minorities– 11% ad-registrants minorities

Policy

If Stakeholders support it, they will come

Key Opportunities for Innovations

1. Integrate online cessation interventions with other treatment modalities

2. Relapse prevention

3. Create partnerships between online cessation providers and large stakeholders

4. Use online marketing approaches