Authors: Laura L Struik , RN, MSN, PhD Student; Bruce Baskerville, MHA , PhD

1. “If I can do it, anyone can. YOU CAN!”: An exploratory analysis of the role of Crush the Crave in supporting smoking cessation. Authors: Laura L Struik, RN, MSN, PhD Student; Bruce Baskerville, MHA , PhD CPHA Conference – May 26-29, 2014

2. Background • 21% of smokers are young adults (Health Canada, 2013). • Young adults are extensive Facebook users (Duggan & Brenner, 2013). • Facebook included in smoking cessation interventions (Cobb et al., 2011). • Facebook is under-examined for health promotion.

3. Purpose Characterize content of the Crush the Crave (CTC) Facebook page.

4. CTC • An evidence-informed quit smoking app. • What works to get young adults to quit. • Principles of persuasive technology.

5. The CTC Facebook Page • Facebook Insights Data (at time of study) • 34,690 likes • 7, 282 reach • 56% men, 44% women • 60% aged 18 to 34 • 57% from Canada • User engagement = 70/post

6. Sample and Data Collection • 399 posts collected • October 10, 2012 – June 12, 2013 • QSR Nvivo 10 • 121 original posts • 278 reply posts

7. Data Analysis • Framework approach (Ritchie & Spencer, 1994; Ritchie & Lewis, 2003) • Familiarization (constant comparison methods) • Identifying a thematic framework • Indexing • Charting • Mapping and interpretation

8. Results Original Posts • Support smoking cessation (71%) • Market CTC (29%)

9. Results • Reply Posts • Support smoking cessation (77%) • Market CTC (23%)

10. Results Getting there, the more it gets cold out the less I smoke, plus I can spend the whole evening inside without smoking…plus made a deal with my grandson and wouldn’t want him to think I’m weak he is 5 years old and counting on it…lol “Adorable” Support Smoking Cessation Reply Posts • Engagement with images (39%) • Sharing smoking-related experiences (38%) • Discussing tobacco-control measures (5%) • Negative attitudes towards smoking (4%) • Tags (2%) • Sharing smoking-related facts (1%) • Encouraging others (1%) • Sarcasm (1%)

11. Results • Marketing CTC Reply Posts • Engagement with images (45%) • Sharing smoking-related experiences (17%) • Tagging (9%) • Sarcasm (9%) • Negative attitudes towards CTC (6%) • Gathering information on CTC (5%) • Encouraging others (1.5%) • Positive attitude towards CTC (1.5%) “Luv it, that’s gonna be me when I am smoke free ” “Looks like a happy dance to me!”

12. Results • More men joined the CTC Facebook page (56% vs 44%) • Women made 78% of the responses • Men made more sarcastic remarks • Men expressed negative attitudes towards CTC “Pathetic if you need an app to help you quit smoking.” • “Maybe if they put Justin Bieber on each pack of smokes then people will maybe quit smoking lol”

13. Discussion • The CTC Facebook page is supportive. • Moderators play a key role. • Facebook can engage young adults. • Men were more likely to express sarcasm.

14. Discussion • CTC Facebook page is used for self-reflection. • Various tobacco use experiences were shared. • Quit successes were commonly shared.

15. Conclusion • CTC Facebook page is supportive. • Facebook warrants inclusion in tobacco control efforts. • More research is needed. • Evaluation (e.g., pragmatic designs) • Gender-based research • Social support as moderator between social media use and cessation

16. Acknowledgements • Administration and development: • Stephanie Filsinger (Propel Centre for Population Health Impact) • Dr. David Hammond (School of Public Health and Health Systems, University of Waterloo) • IMP Canada • Funding • Health Canada, Federal Tobacco Control Strategy (Agreement #: 6549-15-2011/8300125) • Canadian Institutes of Health Research (CIHR) (Grant #: MOP-130303) • Canadian Cancer Society Research Institute (Grant #: 2011-701019)

17. Thank you!