Related Issues

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Health Canada Smoking Cessation Study (December 2004)

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Related Issues

This section presents findings of a more general nature regarding the use and perceived effectiveness of the set of online tools and information,

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Site Viewed as Technically Sound & Easy to Navigate

None of the participants had any technical problems accessing the information online or downloading and printing the worksheets. While a few participants said they had problems of a technical nature, these had nothing to do with the site itself (i.e. it involved their own computer). A couple of participants added nonetheless that they would have liked to have the worksheets available in MS Word so as to have been able to type directly into the worksheets.

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In addition there was a near consensus that the site was easy to navigate. Only three participants said they had trouble or got lost navigating. However, all three noted that they were eventually able to find their way. They either got disoriented in sections that included different levels of information, such as section B (Controlling Cravings) or became confused by the numerous links in certain sections.

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Participants W ould Be More Selective in Use of Site if Visited on Their Own

Most participants suggested that if they came to this site on their own, they would use it more selectively (compared to what they did during this research), more suited to their own style or specifie needs. Approximately half said they would scan the site or browse through it to see what might be of interest or relevance to them. Sorne said they would book mark the site and return to it later or at different times to look through it at their own pace. Most indicated that they would neither read all the material nor complete all the worksheets, but would pick and choose among sections and worksheets. A few participants said they would have read as many sections as possible, but were unsure about the number of worksheets they would complete. Finally, a couple of participants said that it would really depend on how they felt when they came across the site.

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Website Useful For Helping Clarify or Confirm Personal Obstacles

While most said that the website helped them understand their personal obstacles to quitting, the extent to which this was the case varied. While sorne indicated that their experience with the website was revelatory (i.e. the website helped them understand things about themselves they did not know before), most suggested that it helped to a lesser extent by confirming or clarifying what they knew or suspected already. Former smokers were more likely than smokers to emphasize confirmation as opposed to discovery/revelation.

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A few said that the site was not particularly useful to them in this regard, but added that this was not a shortcoming of the site. They said they already had a good understanding of their personal obstacles. One participant said that the site was more useful to him in helping him understand the financial consequences of smoking.

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Health Canada Smoking Cessation Study (December 2004)

Tools/Inforrnation Seen as at Least Moderately Effective IF Backed by Motivation Most participants described this set of online tools and information as at least somewhat effective in terms of helping them quit smoking and remain quit. The main reasons given included clarification of triggers, pro vi ding strategies to deal with problems, and the ability to quantify and organize risks and risk factors. A few smokers felt that the tools and . information are effective because they have eut back on their smoking during the study

itself.

Conversely, sorne participants felt that the tools are not very effective. These were more likely to be non-smokers (but not only) who said that they now have few or no cravings.

As weIl, the effectiveness of the site was undermined for sorne participants because of the lack of new information and ideas on it. A few added that the site could still be effective for smokers and non-smokers who have not mastered their cravings or triggers. A number of participants added that in order to be effective, the tools and information have to be backed up by a strong desire or motivation to quit or remain quit, and that this cannot be provided by the tools and information themselves.

Asked how they could be improved to make them more effective, most participants could not think of anything, while a few said they could not be improved. Sorne referred back to suggestions they had previously made for improving the worksheets or other aspects of the site. In addition, individual participants suggested the following ways to make the information and tools more effective:

• Add a site map or table of contents to the site: This would have the effect of providing a good overview of the tools and information and allow people to access sections with more confidence since they would have sorne idea of what they would find there. As well, people would be less likely to miss important information, which can happen when someone is simply browsing or exploring a site (which many said they would do ifthey came to it on their own).

• Provide ail the materials in one place: Place all of the information in one place, perhaps in one well-organized PDF file. In this way, someone who wants an of it do es not have to click on all the links, print an the parts individuaIly, and worry about missing sorne sections. The worksheets could be grouped together into one location/POf file as weIl. A related suggestion is having it be like an e-book, where the contents of the site could be downloaded onto a computer. As with the previous suggestion, this would help ensure that nothing important might be missed.

• Pro vide overviews of worksheets: Provide an additionallink to each worksheet that gives sorne short overview or explanation of it, like an abstract.

• Make the site more inviting: In addition to providing tools and information, add videos and video clips to actually encourage people to enter the site. Currently the site looks too bureaucratie and governmental. Use language such as "Are you ready to quit smoking? If so, come on in".

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Health Canada Smoking Cessation Study (December 2004)

• Emphasize importance of lifestyle changes: In order for someone to effectively and permanently quit smoking, something has to take the place that smoking occupied.

More emphasis should be devoted to the importance of a change in lifestyle. It is not sufficient to focus on short-term strategies.

• Emphasize the consequences of smoking: Devote more attention to the negative effects of smoking, particularly the effects on one's health and the health of others (i.e. second-hand smoke).

• Reinforce the possibility of relapses: Make it very clear that when you quit smoking you may experience a relapse and that this is quite normal. Otherwise people who experience a relapse may become depressed and more likely to give up trying altogether.

• Pro vide 'testimonials: In time, try to include testimonials from people who have actually quit smoking or remained smoke-free as a result ofthis site.

No Other 'Challenges' Identified for Inclusion, Except for Weight Gain Issue

Most participants were unable to identify any other challenges that could be addressed through this set of online tools and information. A few participants re-iterated the importance of including information on weight gain. They felt this could be addressed from a variety of perspectives, which might include addressing it as a "gender-specific issue' (i.e. problem more likely to be experienced by women than men), a reason why sorne people are afraid to stop smoking, or a reason why sorne people begin smoking. It was also suggested that recornrnendations be given for dealing with food cravings (i.e.

what foods to keep around and what foods to get rid of in anticipation of this, how to deal with cravings, etc.). One participant did not remember seeing anything on loss of appetite, which was described as a cornrnon occurrence.

Many Would Return to Site, Sorne on "As Needed" Basis

When asked if they would retum to the site and use it again, slightly over half the participants said they would. Reasons given included the presence of helpful information and strategies, the fact that the information and tools encourage reflection, curiosity, a desire to re-read certain sections or print off more copies of the worksheets, and the fact that their smoking behaviour has already been affected through participation in the study . . Sorne participants gave a qualified 'yes' saying they would retum to the site if they needed

to. These were mostly non-smokers who said they would retum if they experienced a relapse (i.e. began to smoke again), had an upsurge in cravings, or began to experience things they did not expect.

Most participants who said they would probably not retum to the site felt there was no need. This included sorne former smokers who said they no longer felt cravings, as well as current smokers who said they leamed as much as they could from the site and did not need to go back. A few participants said they would not revisit the site because it was not

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Health Canada Smoking Cessation Study (December 2004)

useful to them either because there was nothing there they did not know about, or because they felt they needed something beyond self-help to help them stop smoking.

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^{Most W} ould Recommend Site to Others, Sorne Already Have

Though sorne participants might not themselves retum to the site, there was near unanimity in saying that they would recommend the site to others. Moreover, sorne said they had already done this. In explaining why, most said that the site could be helpful to others.

Sorne stated more specifically that the site contained good strategies for dealing with cravings and triggers, while a few described it as well organized and easy to understand. A few added that they would only recommend it to people who were serious about quitting smoking. Only one participant would not recommendthe site saying that there was nothing new there. Another said she would suggest it, but not recommend it.

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On-Line Delivery - Effective Way to Access Information

Participants were unanimous in the view that having this set of tools on-line is the most effective way for them to access it. Sorne added explanations why, which included:

• You can access the information when you want.

• You have links to other sites.

• It's the only way to complete the interactive worksheets.

• You can forward a link to the site to others you think it might help.

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One participant reemphasized something mentioned earlier by repeating that many smokers come from lower-income groups and may be less likely to have home computers.

Therefore, part of the target audience for these tools and information probably would not be able to access them.

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Most Smokers, Sorne Former Smokers Say Site Will Help Them QuitlRemain Quit Most of the smokers felt that when they did try to quit, this information and these worksheets will be helpful to them. The main reason - it is a good starting point for addressing the issues and problems they will have to face. Former smokers were less likely to say that the information and tools would help them remain smoke-free, but most of those who said this noted that they had overcome or begun to overcome their cravings.

Sorne ofthem added that it was good to know that the site is there as a resource ifneeded.

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One Smoker 'Quits' Using Tools During Research, Sorne Cut Down

One smoker claimed to have quit smoking during this research and with the help of the online tools and information. Sorne others tried to and said that while they did not quit completely, they had eut down, in one instance tremendously. One smoker claimed to have eut back from 35 to 6 cigarettes a day during the study. Those who eut back said that this provided them with encouragement that they will ultimately be able to quit altogether.

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Health Canada Smoking Cessation Study (December 2004)

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Review of Participant Tracking Sheets

Phoenix researchers reviewed the Participant Tracking Sheets that research participants were asked to fill out. In reviewing the tracking sheets, it seems c1ear that participants took seriously the exercise in which they were taking part. This is evident in the level of detail and precision generaIly provided in the tracking sheets. This inc1udes precision regarding the activities worked on, the time spent on them, as weIl as the tendency to include comments. Regarding the latter, an participants inc1uded comments in their tracking sheets and most provided specifie, often detailed comments and impressions. Very few inc1uded comments such as "easy", "OK", or "no comment" regarding the activities they completed.

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The overall time participants spent on the activities related to the study (based on the times provided in their tracking sheets) ranged from a minimum of five hours to a maximum of 20 hours. Note that activities such as re-reading sections and reviewing worksheets sometimes increased the total amount of time. Not surprisingly, the largest chunks of time tended to be devoted to reading sections, as opposed to completing worksheets. As far as can be told from the tracking sheets, participants tended to complete activities aIl at once (i.e. if they started an activity they completed it during the same time period rather than dropping it and retuming to it later).

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The timeframe during which participants completed activities ranged from a minimum of eight days to a maximum of 23. According to their tracking sheets, most participants completed at least one activity every day or every few days. The largest gap between activities registered in any tracking sheet was six days.

As far as can be told from the tracking sheets, seven participants completed more activities than they were required to do (aIl read additional information sections). The number may be higher due to a lack of precision in sorne worksheets regarding the actual activity completed (e.g. "read another section") and the difficulty reading certain entries in the worksheets.

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Health Canada Smoking Cessation Study (December 2004)

Appendix

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Health Canada Smoking Cessation

Study

(POR-04-06) Recruitment Screener

Profile characteristics:

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- 30 participants recruited from Halifax, Quebec City (French), Montreal (French), Toronto, Calgary, and Vancouver (and perhaps other urban centres).

- Canadian residents who are 18 years of age or oIder, who are CUITent or former smokers.

o 'Current' smokers will have made at least one attempt to quit smoking and will be seriously considering quitting within the next six months (with a mix of participants by amount smoked and number, length/success of previous quit attempts.)

o 'Former' smokers will have quit smoking within the past year. This is a significantly harder group to recruit so that these recruits will be included regardless ofprevious participation in public opinion research. No firm quota for this group - 'best efforts' to recruit up to 15 participants ( 12).

- One-third (10 participants) to be native French speaking from Quebec.

- AlI participants must have access to and use the Internet, and have a computer and printer at home.

- Mix of participants by age, gender, and level of education (with the expectation that the demographies of smokers will result in more participants with lower levels of education).

- Participants to be paid $200 (only to be revealed at end of the recruitment process).

- Sponsorship of study to be revealed (i.e. Health Canada).

- If respondent does not qualify, discontinue screener after completing 2-3 more questions.

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Health Canada Smoking Cessation Study (POR-04-06)

Dans le document Health Canada Smoking Cessation Study: (Page 36-44)