Amanda L. Graham, Ph.D.

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Online Interventions for Smoking Cessation

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

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Acknowledgements Disclosure

• Jackie Stoddard Smokefree.gov
• Jean-Francois Etter StopTabac.ch
• QuitNet State Partners
• Nathan Cobb QN Founder
• Pat Milner QN Product Manager

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Product / Service
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Product / Service

• STRENGTHS
• Reach x Efficacy Impact
• 68 adults online 147M
• 7 searched for cessation info in 2004
• 10 million US adults
• Conservative efficacy estimate 7
• Relapse prevention
• Social support
• Real-time tailoring

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Populations

• 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)

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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 isnt so bad.
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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

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Promotion Image ads

• Pricing model - Cost per thousand views of the ad
• Targeted
• By geographical location
• By area of the site/topic

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Promotion Text ads

• Pricing model - cost per click on the ad
• Targeted
• By Geography
• By Search term/Keyword
• Fully automated

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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

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Colorado Phase I Results
Advertiser QuitNet Regs QuitLine Refs Total Reg/Ref Spend 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
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Colorado Phase II Results
Advertiser QN Registrants Spend 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
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Colorado Phase II Results
Advertiser QN Registrants Spend 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
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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

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Policy

• If Stakeholders support it, they will come

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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