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Social Media as an Intervention: There's Plenty of Smoke, but Can It Help People Quit?


New social media studies come out daily. A conflicting report from UCSF researchers claims to show that Facebook can be a smoking intervention...maybe.

Social media is something of a Rorschach test in behavioral healthcare: It either helps or it hurts, depending on how it’s being used and who you ask. New studies pop up daily that “find” that the direct connectivity it provides can be used to either influence negative behaviors or positively intervene to assuage them. Plenty of (digital) ink has been spilled over whether or not it makes people more depressed; at the same time, researchers have found that it might be used to detect mental health conditions and alert healthcare providers when those situations take a turn.

That same ambiguous dichotomy pertains to social media and substance use. A day after University of Pennsylvania researchers announced a study that they say shows social media can encourage underage drinking, University of California San Francisco researchers have published a report that they believe shows Facebook might be useful in helping young people quit smoking—with caveats.

>>READ: Even Without PHI, Facebook Generates A Lot of Useful Health Data

"We found that we could reach a hard-to-reach population, have short-term abstinence, and also have excellent engagement," 1 of the UCSF authors, Danielle Ramo, PhD, said. "It suggests that the social media environment can be an engaging tobacco treatment tool, even for those not ready to quit.”

Her team conducted a randomized control trial to test the Tobacco Status Project (TSP)—a Facebook-based quit-smoking readiness protocol Ramo and others introduced a few years ago—against another online quit-smoking initiative. TSP uses hidden Facebook groups, daily posts, live question-and-answer sessions, and live counseling sessions with a doctoral-level cessation counselor. The control group was referred to the National Cancer Institute’s smokefree.gov site and its associated resources.

The study split 500 participants evenly (251 TSP, 249 control) between the 2 tracks. The populations were similar to the US smoking population: 45% male, 73% white, and 87% daily smokers with a mean age of 21. Abstinence was assessed by biochemically‐verified 7‐day abstinence from smoking at baseline, 3-, 6-, and 12-month intervals, and participants were not given nicotine replacement therapy (patches, gum) during the study—though they were guaranteed $20 for each assessment, which would allow them to earn up to $100 for the yearlong study.

They found that smokers in the TSP group were 2.5 times more likely (8.3% to 3.2%) to have quit than in the control group after 3 months. Ramo pointed to engagement as the key factor there.

“Digital interventions can sometimes suffer from low engagement," she said. "We saw high engagement overall, with more than three-fourths of those in the project commenting at least once during the intervention, and the average person commented 31 times.”

The differences, however, did not remain statistically significance after 3 months: At 6 months the quit rate was nearly identical (6.2% to 6.0%) by 12 months they had actually taken a turn in the opposite direction (5.9% to 10.0%).

The study’s accompanying announcement declares that a “novel UCSF project finds social media treatment can be effective even for those not ready to quit.”

The study’s actual conclusion, on the other hand, was that “Compared with referral to a smoking cessation website, a novel USA‐focused Facebook smoking cessation intervention did not improve abstinence from smoking over one year,” although it did increase abstinence at the end of treatment and was engaging to participants.

Still, Ramo described the findings as “exciting” based on those engagement levels and the intervention’s success at 3 months. But as with most research surrounding social media and healthcare—a new study seems to pop up almost every day—the results remain subject to interpretation.

Related Coverage:

Does Facebook Have Positive Mental Health Potential?

Facebook and the Intertwining of Mental Health, AI, and Social Media

Hospitals Are All Over Facebook, But What Are They Posting About?

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