Tailoring online advice to a smoker’s particular patterns and beliefs about smoking was no more effective than standardized feedback in a new study comparing how many smokers successfully quit with each approach.

Research has shown that one-on-one counseling can help smokers break the habit and remain abstinent. But counseling isn’t affordable or convenient for everyone. Generalized quitting advice, especially delivered online, is cheaper and easier for many.

So researchers are trying to find a good middle ground: individualized advice that can be easily disseminated.

For the new study, reported in the journal Addiction, UK researchers tested their own version of tailored, online quit advice.

They randomly assigned 1,758 smokers to get either one-size-fits-all advice from a non-profit UK website called QUIT, or an individualized version based on a participant’s answers to a questionnaire about age, habits, lifestyle, motivations and other details.

For example, the standard-advice group was told how much money the typical smoker spends on the habit. People in the tailored group were told how much they themselves likely spent each week.

After six months, nine percent of smokers in each group said they had been smoke-free for the past three months.

The findings are somewhat surprising, according to lead researcher Dr. Dan Mason, of Cambridge University.

On the other hand, he said in an email, the general-advice group got much the same information as the tailored-advice group - albeit in a “more generic” way.

Smokers who got tailored advice were also invited to return to the website four weeks later to get a progress report. The problem, Mason’s team found, was that few of them did - less than one-quarter of the group.

Because the nine percent of each group who succeeded in remaining abstinent for three months were not compared to a group of smokers receiving no advice, “It’s a pretty tough test,” Mason said, “as we are really only testing the tailoring and not so much the content of the advice.”

The findings don’t mean that tailored quit help is of no use, according to the researchers.

Mason noted that researchers are still working on how to best individualize smoking-cessation help.

“Studies of tailored interventions show them to be effective in some cases and not in others,” Mason said.

“Our study,” he added, “adds information to this emerging picture.”

It’s possible that the approach in this test just wasn’t “interactive” enough, the researchers say.

“The issue is how to maintain engagement with smokers so that you can take advantage of the capability of a website environment to provide ongoing feedback and encouragement,” Mason said.

Sending people regular emails or text messages, offering online sessions with counselors, or setting up chat rooms for smokers to give each “social support” might all help keep website users engaged, according to Mason.

Whether that would translate into a higher rate of successful quit attempts is a whole other question, he noted.

Kicking the smoking habit is notoriously difficult.

Some smokers are able to quit “cold turkey,” but experts say that most people need a combination of therapies and multiple attempts.

One large review found that success rates for quit attempts with some kind of counseling or social support ranged from about four percent to six percent, while attempts that included nicotine replacement therapy or another medication were successful between seven percent and 16 percent of the time.

According to the American Lung Association (ALA), it takes the average smoker five or six serious tries to finally quit. In general, the group says the best bet is to try some type of behavioral counseling along with nicotine replacement therapy or medication.

The ALA has its own online program, called “Freedom From Smoking” (http://www.ffsonline.org).

SOURCE: Addiction, online June 12, 2012.

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