Internet Versus In-Person Counseling for Patients Taking Varenicline for Smoking Cessation

Introduction: Quit rates for smoking cessation attempts are maximized by using counseling with medication. Internet-based counseling might be a suitable replacement for in-person counseling. Methods: Patients in a military medical system in the active phase of quitting presented for study intake. They were randomized to in-person counseling (n = 44) or Internet counseling (n = 173). In-person counseling consisted of four 1.5 hour classes based on the American Cancer Society's Freshstart program. Internet counseling consisted of daily e-mails with recommended activities through Pfizer's Get Quit program. Both groups were concomitantly treated with standard dose varenicline. The primary outcome was the quit rate at 12 weeks, defined as abstinence and an exhaled carbon monoxide level <10 ppm at the 12-week visit. All those lost to follow-up were considered persistent smokers. Results: 217 smokers were randomized, of which 43% returned for the 12-week follow-up visit. Quit rates between the two groups were similar (Internet group: 21%, n = 36/173; in-person group: 18%, n = 8/44, p = 0.7). Conclusions: Internet-based counseling might be equivalent to in-person counseling for smoking cessation in patients taking varenicline. Additional studies with more complete and longer-term (>= 1 year) follow-up are needed to confirm these findings.