Impatient

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Can social media help you quit smoking?

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You use Facebook to stay in touch with old friends from high school. You use Instagram to share pictures of your breakfast.

But can you use Twitter to quit smoking?

Researchers from several California universities developed a Twitter-based smoking cessation program called Tweet2Quit and then tested it. They found that people who participated in the Twitter program were twice as likely to have abstained from smoking two months after quitting, compared with people who just used nicotine patches and visited the federal government's website designed to help people quit smoking.

The findings prove that social media "has potential" to be used to spur and reinforce other healthy behaviors, like exercise, weight loss, and quitting other drugs, says UC Irvine marketing professor Connie Pechmann, lead author of the study, which is published online in the journal Tobacco Control. But she cautions that research on how to successfully use social media is still developing.

Sean Young, who directs the UCLA Center for Digital Behavior and the University of California Institute for Prediction Technology, agrees. He says social media by itself isn't a cure-all; its effectiveness in changing health behaviors depends on how it's used.

"Technologies are just tools," he says. "If they're used correctly, it can improve people's health, but if it's not used correctly, it can hurt people's health, like any other tool."

Engaging participants

Much of the past research on using social media to influence health behaviors was "very discouraging," Pechmann says. She notes that previous studies on social media-based health interventions found the programs had "no effect" when compared with control groups.

A big reason, she explains, was that people didn't interact with the online tools frequently or consistently.

"In general, when people have set up these groups in the past, about two-thirds of people tweet or post one time – that's it - and then the rest of the group falls apart within a few weeks to a month," Pechmann says. She adds that people need to participate in the programs longer for them to have a lasting effect on habits and behaviors.

Several factors separate Tweet2Quit from other social media-based health interventions, she says. For one, the 20 participants in the study were interacting with a closed group: They opened Twitter accounts solely for this research project, and they only followed, and were followed by, other participants. 

Pechmann says two other elements of Tweet2Quit were key:

  • Every night, the participants received messages with questions, developed by the research team, that were intended to spur discussions among the participants.
  • Every morning, they received individualized messages, which praised people for tweeting and encouraged others to join the discussions.

This sort of structured engagement was also critical to a program that UCLA's Young developed. Called Harnessing Online Peer Education, or HOPE, it uses Facebook and other social media platforms to change people's health behaviors, including encouraging men who have sex with men to get tested for HIV.

Latino and African American men taking part in the program are trained to be peer role models, says Young. They learn to "talk to other strangers and ultimately build a bond with those strangers so they trust you, and get those strangers to decide to get an HIV test when they wouldn’t otherwise do it," he says.

Young credits these peer leaders' ability to engage others online for an extended period of time for much of the program's success: Those who participate in Harnessing Online Peer Education are two to three times as likely to get an HIV test, compared to those who don't join the group, he says.

"Help me out!"

Some of the draws of social media – its convenience and its ability to spark connection and communication – make Tweet2Quit successful, Pechmann says.

She recalls that when participants craved a cigarette, they would tweet the group and say, "I want to smoke. Help me out!" She says someone would quickly jump in and say, "don't do it!"

"I think it worked because it fit their lifestyles," she says.

And because participants connected online, Pechmann says they often forged bonds – and gained moral support – from people they might not have befriended in person.

"We had 21-year-olds and we had 55-year-olds and people were befriending each other, and I'm not sure that would have happened in real life," she says. "The differences demographically might have kept those people apart."

"In general, they were just relating to each other as smokers with a common goal of quitting, and feeling discriminated against and misunderstood by a lot of other people," she says.

Another benefit of doing health interventions through social media, Young says, is that it can bring a level of anonymity to something that is stigmatized in some communities – like getting tested for HIV.

"If people don't want to talk about something, they want to avoid face-to-face contact," Young says, adding that "technologies like social media can make it much easier for them to seek help." 

A "completely new" field

Trying to influence and change health behaviors through social media is a "completely new" field, Pechmann says.

"People have to have patience with the research in social media," she says. "It's going to be a trial and error situation, where we try out different approaches and then find parts of them that work and then piece together those parts into a strong intervention."

 Have you used social media to change a habit or behavior? Tell us about it in the comments section below or e-mail us at Impatient@scpr.org.

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