This project is a 3-group prospective randomized controlled trial to determine the efficacy and cost-effectiveness of providing access to free nicotine patches, with or without a required linkage to proactive telephone counseling, as adjuncts to a tailored, web-based smoking cessation program.

1. Determine the efficacy of providing access to free nicotine patches as an addition to online smoking cessation services.
2. Determine the efficacy of providing access to free nicotine patches linked with proactive telephone counseling as an addition to online smoking cessation services.
3. Determine the cost-effectiveness of providing access to free nicotine patches, with or without linkage to proactive phone counseling, as an addition to online cessation services.
4. Examine potential mediators and moderators of intervention effects.
   

Smokers who search online for help quitting (n=2,475) are recruited and randomized to one of three study arms:

1. online smoking cessation services (web)
2. online cessation services plus access to free nicotine patches (web+patch)
3. online cessation services with access to free patches contingent upon participation in proactive telephone counseling (web+patch+phone)
   

All participants receive a web-based tailored guide to help them quit smoking. Email messages are sent to participants regarding various aspects of the program, including the availability of new web guide materials.

The 6 components for each web guide include:

• Source Letter (available immediately after baseline survey)
• Action Plan (available 7 days before Quit date)
• Efficacy x 2 (available 1 day before and 7 days after Quit date)
• Outcomes (available 14 days after Quit date)
• Testimonial (available 21 days after Quit date)

Participants randomized into the web+patch arm receive free nicotine replacement therapy patches before their self-selected quit date along with their online program.

Participants randomized to the web+patch+phone arm receive free nicotine replacement therapy contingent upon their use of the phone counselors. Counselors are able to review participants' use of site for phone counseling sessions. Participants are informed that they need to complete a phone coaching session prior to delivery of the patches.

The primary outcome measure is self-reported 6-month prolonged abstinence measured at the 9-month evaluation.

Study in progress.

Study in progress.