Weekly enrollment and usage patterns in an Internet smoking cessation intervention

- Enrollment rates for an Internet smoking cessation intervention were highest on Mondays and Tuesdays.
- Participants tended to select quit dates that fell on Sunday-Tuesday, though Thursday quit dates were also common.
- Some website features were utilized at higher rates by users who enrolled early in the week compared to over the weekend.
- Patterns of enrollment and engagement may indicate general fluctuations in smokers' interest in and commitment to quitting.
- Internet interventions and public health campaigns could deliver strategic messaging when smokers may be more receptive.

BackgroundPrevious analyses of Google search queries identified circaseptan (weekly) rhythms in smoking cessation information seeking, with Google searches for “quit” and “smoking” peaking early in the week. Similar patterns were observed for smoking cessation treatment seeking, such as calls to quitlines. These findings suggest that smoking cessation behaviors may have a weekly rhythm that could be leveraged to improve smoking cessation efforts.AimsTo assess whether weekly enrollment and usage patterns exist for an Internet smoking cessation intervention.MethodsWe used process data from a large, longstanding Internet smoking cessation intervention (www.becomeanex.org). Pearson's chi-squared tests were performed to identify day-of-the week differences in enrollment, first visit to site community pages, and quit date. Differences were considered statistically significant at the 1% level if p < 0.00167 due to multiple comparisons. Regression analysis was used to examine differences in engagement activity based on the day of the week a user enrolled.ResultsWebsite users (n = 69,237) were more likely to enroll on the site at the beginning of the week (Mondays and Tuesdays) (p < 0.0001). Current smokers who selected quit dates (n = 5574) preferred quit dates that came early in the week (Sundays and Mondays) compared to other weekdays (p < 0.0001). Generally, there were no significant differences in overall website utilization metrics by day of enrollment, but there were some exceptions. Use of interactive features to select quit dates, track cigarette use, and record coping strategies was generally lower for Friday/Saturday enrollees.ConclusionsConsistent with prior research, the beginning of the week appears to be a time when individuals are more likely to enroll in an Internet smoking cessation intervention and engage with its core features. Emphasizing marketing and promotional efforts during the beginning of the week could result in greater reach of Internet smoking cessation interventions.