Reaching Spanish-speaking smokers online: a 10-year worldwide research program.

OBJECTIVE To describe a 10-year proof-of-concept smoking cessation research program evaluating the reach of online health interventions throughout the Americas. METHODS Recruitment occurred from 2002 - 2011, primarily using Google.com AdWords. Over 6 million smokers from the Americas entered keywords related to smoking cessation; 57 882 smokers (15 912 English speakers and 41 970 Spanish speakers) were recruited into online self-help automated intervention studies. To examine disparities in utilization of methods to quit smoking, cessation aids used by English speakers and Spanish speakers were compared. To determine whether online interventions reduce disparities, abstinence rates were also compared. Finally, the reach of the intervention was illustrated for three large Spanish-speaking countries of the Americas-Argentina, Mexico, and Peru-and the United States of America. RESULTS Few participants had utilized other methods to stop smoking before coming to the Internet site; most reported using no previous smoking cessation aids: 69.2% of Spanish speakers versus 51.8% of English speakers (P < 0.01). The most used method was nicotine gum, 13.9%. Nicotine dependence levels were similar to those reported for in-person smoking cessation trials. Overall observed quit rate for English speakers was 38.1% and for Spanish speakers, 37.0%; quit rates in which participants with missing data were considered to be smoking were 11.1% and 10.6%, respectively. Neither comparison was significantly different. CONCLUSIONS The systematic use of evidence-based Internet interventions for health problems could have a broad impact throughout the Americas, at little or no cost to individuals or to ministries of health.