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Tobacco Status Project


The Tobacco Status Project involves Facebook groups based on readiness to quit smoking that provide young adults with support from peers and a specialist.

Users of the Tobacco Status Project are sorted into one of three private Facebook groups (i.e. Not Ready to Quit, Thinking About Quitting, Getting Ready to Quit) where they can view and interact with posts made daily by specialists tailored to their readiness to quit smoking. Posts to Facebook groups were based on decisional balance or one of the ten processes of change described in the Transtheoretical Model of Change (TTM). Posts made to groups people in different stages of readiness to quit smoking were based on different processes of change. On a weekly basis, a specialist is available for members to ask any questions they have about smoking or quitting. Members also have the opportunity to receive group cognitive behavioral therapy (CBT) over Facebook chat.

Social Media

Theoretical Approach(es):
Stages of Change
Transtheoretical Model of Change
Cognitive Behavioral Therapy (CBT)

Target Substance:

Target Outcome(s):
Smoking Cessation

Young Adults (18-30)



Remote Access

Geographic Location(s):

United States


  • Feasibility and quit rates of the Tobacco Status Project: A Facebook smoking cessation intervention for young adults.

    Ramo DE, Thrul J, Chavez K, Delucchi KL, Prochaska JJ. Journal of Medical Internet Research. 2015. 17(12): e291. doi: 10.2196/jmir.5209

    Summary: This study was an initial evaluation of the feasibility and efficacy of the Tobacco Status Project. Researchers used Facebook advertisements to recruit 79 young adult smokers aged 18-25 years. Participants were invited to participate in a private Facebook group for 90 days. At baseline, participants completed an assessment of smoking characteristics and stage of change. Participants completed monthly assessments of stage of change; assessments of program use and acceptance at the end of the intervention; and an assessment of smoking outcomes at 3-, 6-, -and 12-months post-baseline. Participants who reported seven days of abstinence from smoking were asked to verify their abstinence with a saliva cotinine test. Rates of 7-day abstinence were 9% at three-months, 18% at 6-months, and 13% at 12-month follow-up. Abstinence was verified in about half of the participants who reported abstinence. Over the course of the study 66% of participants reported making a quit attempt of at least 24 hours and 35% reduced the number of cigarettes they smoked by at least half. About half of participants (51%) liked at least one post and 61% commented on at least one post. Most participants reported that they would recommend the intervention to others and participants who participated in the group CBT sessions rated 90% of the sessions as being helpful.

    Take Away: The Tobacco Status Project was shown to be feasible as a smoking cessation intervention for young adults and showed some efficacy for promoting quit attempts and cigarette reduction, but rates of seven-day abstinence were low.

  • Smoking cessation intervention on Facebook: Which content generates the best engagement?

    Thrul J, Klein AB, Ramo DE. Journal of Medical Internet Research. 2015. 17(11): e244. doi: 10.2196/jmir.4575

    Summary: Researchers used data from the feasibility study (Ramo et al., 2015) to evaluate participants’ engagement with Facebook posts based on different processes of change based on their readiness to quit smoking. Researchers used comments on TTM-based posts to measure engagement. Participants made 718 comments to intervention posts. Most participants (60.8%) of participants commented at least once and 53.2% of participants commented more than once. Participants commented about 15 times on average. Participants in the Pre-Contemplation and Contemplation groups commented more than average on decisional balance posts. Participants in Contemplation groups commented less than average on dramatic relief and self-liberation posts. Participants in the Preparation groups commented more than average on consciousness raising posts.

    Take Away: Posts tailored to readiness to quit smoking generated different levels of engagement among participants in private Facebook groups.

  • Cessation strategies young adult smokers use after participating in a Facebook intervention.

    Thrul J, Ramo DE. Substance Use and Misuse. 2017. 52(2): 259-264. doi: 10.1080/10826084.2016.1223690

    Summary: Researchers used data from the feasibility study to examine participants’ quit attempts and methods used during quit attempts. At the 3-, 6-, and 12-month follow-up, participants were asked about each quit attempt they made and whether they used e-cigarettes, nicotine replacement therapy (NRT), professional advice, or no additional assistance during each quit attempt. During the 12-month study period, 52 participants made 215 quit attempts. Participants who made at least one quit attempt, attempted to quit 4.13 times on average. Forty-five participants attempted to quit without additional assistance, 19 used e-cigarettes in a quit attempt, nine used NRT, and four used professional advice in a quit attempt. Of the 215 total quit attempts, 75.4% were made with no additional assistance, 17.7% were made with the assistance of e-cigarettes, 7.4% with NRT, and 3.7% with professional advice. Not smoking daily, smoking fewer cigarettes, and being in the Contemplation or Preparation stage of change at baseline was related to making a quit attempt. Participants were more likely to use e-cigarettes in a quit attempt if they had made at least one quit attempting the year prior to the baseline assessment.

    Take Away: Most participants made at least one quit attempt during the study and the majority of these used no additional assistance during their quit attempts. E-cigarettes were a more popular method than NRT in participants’ quit attempts.