#tweeting to quit

September 30, 2014 • By Connie Clark

Like many smokers, Karen (not her real name) tried to quit smoking with methods like stopping “cold turkey” and chewing nicotine gum, but she always relapsed. Then she tried something a little less traditional to kick the habit. She started tweeting.

Today is day 1 for me. When I woke up I actually lit a cig then realized what I was doing. I put it out & put on a patch. #proudofmyself.

Taking part in a promising new study examining how social media can help smokers quit and avoid relapses, Karen was one of 40 smokers who received a free, two-month supply of nicotine patches, along with daily automated texts. Members were encouraged to use a web-based guide to develop a quit plan. And they were asked to tweet at least once a day about their progress.

The study, known as Tweet2Quit, is spearheaded by Professor Connie Pechmann of UC Irvine’s Paul Merage School of Business, and combines expert-based messaging with a peer-to-peer social support network.

Pechmann had a hunch that combining auto text messages with social media could be a game-changer. “We expected that the expert-based and social media-delivered automessages would prove useful, but that traditional peer-to-peer social support would yield additional important psychosocial benefits,” she says.

It proved to be a very good guess. At the critical 60-day mark after their quit dates, 75 percent of participants in one of the groups self-reported that they had remained smoke free. By comparison, Pechmann says that traditional quit-smoking programs have a 20 percent quit rate.  

While Pechmann cautions that further research needs to be done, she’s encouraged by the results, and suggests that social media services like Twitter could play an active role in smoking cessation programs.    

Offering 24/7 free access and the ability to send 140-character messages instantly to groups, Twitter’s inherent social nature taps into an important need for smokers in particular. “Imagine being able to say, ‘I’m smoke free’ to your peers in real time,” says Pechmann. “It’s very self-affirming.”

With more than 230 million active users and 400 million tweets daily, Twitter’s numbers are still only a fraction of Facebook’s, yet it was selected over the social media titan because it offers more privacy for closed groups like Tweet2Quit.

The Twitter environment also created a sort of party dynamic, Pechmann says, and that’s especially important for social smokers. She notes that the groups developed individual patterns and rhythms, and that subgroups of two or three people with common interests or roles struck up conversations, as if mingling at a party. In addition, she says group leaders naturally emerged who acted as hosts “Just as if they were at a party; these hosts would find ways to draw people into conversations, or start new topics to get people talking.”

These hosts play a critical role in keeping people engaged, Pechmann says, especially because “the total volume of tweets related positively to the tweeter’s abstinence as measured across assessment points.” In other words, the more people tweeted, the more likely they were to stay smoke-free.

Credibility was another important factor in getting people to open up. “This was a group of experts,” she says. “Many had been smoking for a long time. They had all tried quitting before, so everyone had some expertise to share.”

The ability to communicate 24/7 across different time zones has its advantages over traditional face-to-face support groups, especially when the inevitable slip up occurs:

Im not going to lie I smoked 1 cig last night and today im sorry everyone im still quitting:/ I threw everything away.

A chorus of support responds quickly:
Don’t beat yourself up. It was only one, no biggie. We are here for you. I know you can do this!!!

You’ll be okay. Just change the order you do things. You can do this!

Support, accountability, advice, and bragging rights are a few of the benefits that make social media a promising platform for self-help groups, according to Pechmann. However, separately, online forums, blogs, and websites can have their drawbacks. For instance, a website such as WebMD can be a source of information, but it lacks the instantaneous interaction of Twitter. And people using only a blogging service (Twitter is considered a microblog) don’t always have the clinical expertise to dispense completely accurate health data.

In contrast, Tweet2Quit’s hybrid approach combines automated text messages with the social media element. The texts are based on clinical guidelines for health care professionals to discuss with smokers, and are phrased in positive, open-ended questions that encourage online discussion.

Pechmann and her team are working on a follow-up study in which they will refine the group dynamics. But until then, she’s encouraged by texts like these:

That’s why we r in this together. This is a great support group they put me with!