Although a free on-line quitting program is achieving six-month rates 543% higher than those relying exclusively upon costly over-the-counter nicotine patch and gum products, the program's directors assert it's an apples to oranges comparison.
A meta-analysis published in the March edition of Tobacco Control averaged the results of seven over-the-counter (OTC) nicotine patch and gum studies and determined that just 7% of users were still not smoking at six-months. In contrast, a free on-line program at WhyQuit.com is reporting a six-month abrupt cessation rate of 39%.
WhyQuit.com is a motivation, education and group support forum devoted exclusively to the art of abrupt nicotine cessation. In two consecutive quarterly studies of new members posting to the group at least once, 38.3% of June 2002 admissions (18 of 47) and 38.8% who joined the group during September 2002 (19 of 49) reported remaining 100% nicotine free for six full months.
The program is built around the teachings of Joel Spitzer, a 30 year developer and presenter of smoking prevention and cessation programs in the Chicago area. A former smoking programs coordinator for the Chicago Unit of the American Cancer Society and former coordinator of the Good Health Program Stop Smoking Clinic of the Rush North Shore Medical Center, Spitzer currently provides prevention and cessation programs for the Evanston and the Skokie Illinois Health Departments.
Membership to WhyQuit's on-line support group is limited to recent quitters (less than 30 days) who have remained 100% nicotine free for 72 hours. New arrivals devote the first 72 hours to outlined reading assignments, cessation philosophy skills development, and nicotine purging. Once nicotine clean they are admitted to the group. Any subsequent nicotine relapse - even one puff - permanently revokes group posting privileges.
According to John R. Polito, a South Carolina cessation educator and WhyQuit's 1999 founder, "our admissions policy, relapse policy, and program format do not allow for direct comparisons between our 37% midyear abrupt cessation rate and the 7% rate reported for those relying upon the OTC nicotine patch and gum. Clearly, we've dressed for success in creating a nicotine-free forum and we know it."
Other factors limit comparisons. Almost all patch and gum studies measured smoking cessation with little regard for whether participants were actually able to stop using all sources of nicotine (most notably the gum, lozenge, inhaler, chew, snuff or snus). "Their studies measure successful transfer from one nicotine delivery vehicle to another while we measure nicotine cessation," says Polito. "They define quitting in terms of smoking while we define it in terms of getting those addicted to nicotine off of all nicotine."
On-line programs rely upon visible participation and e-mail verification to determine group performance rates. Active member status at WhyQuit is easily determined as members wear achievement color codes behind their names. After one month of abstinence members join the group's green club, at three months bronze, at six months silver and at one year gold.
Using a "one day at a time" philosophy that encourages abandonment of the "quitting forever" yardstick as a measurement of success, the forum presents an iceberg view of cessation where a true chemical addiction has fathered numerous ingrained psychological nicotine feeding patterns and cues that lessons help members meet, embrace and recondition.
WhyQuit's education centerpiece is known as "Joel's Library," a collection of almost one hundred original reinforcement articles written by Spitzer. Topics range from youth prevention to cessation weight gain, with the bulk focusing on why smokers smoke, how to quit, and how to stay quit.
With members from every English-speaking nation on earth - and some that don't - the forum has developed an international flavor. More than 160,000 member posts are indexed on twenty-two different subject matter message boards. In the eyes of Spitzer, "millions and millions of words and they all boil down to one central premise - Never Take Another Puff!"
3. Hughes, et al. A meta-analysis of the efficacy of over-the-counter nicotine replacement. Tobacco Control, March 2003;12:21-27.
4. WhyQuit's 160,000 archived message board posts. New member participation data cited in this release is verifiable via archived member posts, as is midyear cessation status for all but a few members who were communicated with via their member profile e-mail address. All members failing to respond via e-mail were counted as having relapsed.
5. About WhyQuit.com