The Put It Out Project (POP) Facebook Intervention for Young Sexual and Gender Minority Smokers: Outcomes of a Pilot Randomized Controlled Trial

INTRODUCTION: This trial investigated whether a Facebook smoking cessation intervention culturally tailored to young sexual and gender minority (SGM) smokers (versus non-tailored) would increase smoking abstinence. METHODS: Participants were 165 SGM young adult U.S. smokers (age 18-25) recruited from Facebook in April 2018 and randomized to an SGM-tailored (POP; N=84) or non-tailored (TSP-SGM; N=81) intervention. Interventions delivered weekly live counseling sessions and 90 daily Facebook posts to participants in Facebook groups. Primary analyses compared POP and TSP-SGM on biochemically verified smoking abstinence (yes/no; primary outcome), self-reported 7-day point prevalence abstinence (yes/no), reduction in cigarettes per week by 50+% from baseline (yes/no), making a quit attempt during treatment (yes/no), and stage of change (precontemplation/contemplation vs. preparation/action). Supplemental analyses compared POP to two historical control groups. RESULTS: POP participants were more likely than TSP-SGM participants to report smoking abstinence at 3 (23.8% vs. 12.3%; OR=2.50; p=.03) and 6 months (34.5% vs. 12.3%; OR=4.06; p<.001) and reduction in smoking at 3 months (52.4% vs. 39.5%; OR=2.11; p=.03). Biochemically verified smoking abstinence did not significantly differ between POP and TSP-SGM at 3 (OR=2.00; p=.33) or 6 months (OR=3.12; p=.08), potentially due to challenges with remote biochemical verification. In supplemental analyses, POP participants were more likely to report abstinence at 3 (OR=6.82, p=.01) and 6 (OR=2.75, p=.03) months and reduced smoking at 3 months (OR=2.72, p=.01) than participants who received a referral to Smokefree.gov. CONCLUSIONS: This pilot study provides preliminary support for the effectiveness of a Facebook smoking cessation intervention tailored to SGM young adults. IMPLICATIONS: Sexual and gender minority (SGM) individuals have disproportionately high smoking prevalence. It is unclear whether smoking cessation interventions culturally tailored to the SGM community are more effective than non-tailored interventions. This pilot trial found preliminary evidence that an SGM-tailored Facebook smoking cessation intervention increased reported abstinence from smoking, compared to a non-tailored intervention.