Connectedness Based on Shared Engagement Predicts Remote Biochemically Verified Quit Status within Smoking Cessation Treatment Groups on Facebook

Introduction: Engagement with online content and online social network integration are associated with smoking behavior change, but less is known about social dynamics of shared engagement between participants in group-based social media interventions. Methods: Participants were 251 young adult smokers aged 18 to 25 assigned to one of 29 secret Facebook groups tailored to their readiness to quit smoking ("pre-contemplation,""contemplation,"and "preparation"). Groups varied in size and were randomly assigned to receive monetary incentives for engagement. All groups received daily posts for 90 days and were assessed for remote biochemically verified smoking abstinence at the end of the intervention. Across 29 groups, we examined associations between group features (group size, incentive condition, readiness to quit) with how connected members were within the group based on shared engagement with the same content (measured by density). At the individual level, we examined associations between 7-day biochemically verified smoking abstinence and how connected an individual was within the group (measured by degree centrality). Results: After adjusting for comment volume, being in a contemplation group (vs. pre-contemplation group) was associated with a decrease in comment-based density. Individual degree centrality was significantly associated with biochemically verified smoking abstinence for both comments and likes. Conclusions: Future group-based social media interventions for smoking cessation may want to focus on promoting connected engagement between participants, rather than simply quantity of engagement. Implications: Participants in a smoking cessation intervention delivered through Facebook groups were more likely to have biochemically verified smoking abstinence if they were more connected to the rest of the group via shared engagement. Promoting shared engagement between participants may be more likely to promote behavior change than volume of engagement alone.