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Similar to predecessor technologies, such as bulletin boards and listservs, prolonged engagement is often poor; initial interest may be high but often wanes.2 11–13 Research has identified three main reasons for this.14–17 People do not see and/or respond to others’ posts promptly enough, causing dropouts.17 New members’ posts may be ignored because they lack social capital within the group.16 18 Even active members gradually lose interest and disengage, and thus most groups have a limited duration.14We developed a novel intervention for smoking cessation called Tweet2Quit that seeks to address these limitations.Tweet2Quit sends twice-daily automated communications (‘autocommunications’) to encourage frequent and concurrent check-in, forms small intimate groups that start immediately and are closed to new members, and is purposefully of limited duration.Our university IRBs approved the research and participants consented online.

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All participants received study-provided nicotine patches and referral to the smoking cessation website.

Tweet2Quit builds on promising past work in buddy interventions, in which smokers were assigned physically proximal quit buddies.19–21 With Tweet2Quit, smokers meet numerous potential quit buddies in a virtual online forum.

Research on Tweet2Quit can provide valuable insights about the utility of extratreatment (ie, peer-based) social support for smoking cessation, because studies on this topic have been limited, and results have been mixed.19 22Tweet2Quit also builds on promising research on health interventions that employ autocommunications, that is, text or email messages from health experts that are sent automatically to participants to encourage healthy behaviours.23–27 At least 13 randomised controlled trials of autocommunication-based interventions for smoking cessation have been conducted, and the results have been promising.23 25 The results also suggest that fixed message schedules perform better than decreasing or variable schedules,28 so Tweet2Quit uses a fixed schedule.

Participants were also encouraged to access, the National Cancer Institute's quit-smoking website.

Automated emails sent module links as follows: day 1: Prepare to Quit, Quit date 4 days: Quitting, day 8: help line/live chat, Quit date 13 days: Staying Quit, and day 22: help line/live chat. Unique to the intervention condition was enrolment in a Tweet2Quit 20-person, 100-day, virtual peer support group.

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