Smoking continues to be the leading preventable cause of death. Digital interventions for smoking cessation (DISCs) are health communication programs accessible via the internet and smartphones and allow for greater reach and effectiveness of tobacco cessation programs. DISCs, including ours, called Decide2Quit (D2Q; www.decide2quit.org), have led to high 6-month cessation rates and also reach vulnerable populations. Despite this, the impact of DISCs has been limited, and new ways to increase access and effectiveness are needed. A widely used and proven behavioral intervention tool is computer-tailored health communication (CTHC). We will test 2 different ways of implementing CTHC: standard CTHC, which selects quit email messages based on participants’ readiness to quit smoking measured by a single self-report question; and the recommender CTHC, which uses a machine learning algorithm that incorporates user ratings to select quit email messages. We also used a peer-recruitment tool on the D2Q website. Our pilot data showed that the recommender CTHC can potentially be more engaging and effective than is standard CTHC. Peer recruitment engages users to recruit their friends and family to the intervention. Our pilot study showed that providing smokers with access to peer recruitment increased their motivation to quit smoking, quadrupled the sample size, and increased the proportion of African American smokers in the sample.
