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 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%) “Adorable” 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

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%) “Looks like a happy dance to me!” “Luv it, that’s gonna be me when I am smoke free ”

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 “Maybe if they put Justin Bieber on each pack of smokes then people will maybe quit smoking lol” “Pathetic if you need an app to help you quit smoking.”

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!