Mobile Phone Text Intervention for Smoking Cessation

Study Questions:

Does a mobile health (mHealth) text messaging intervention improve smoking cessation among young adults?

Methods:

This was a single-blind, two-arm randomized controlled trial conducted between October 2014 and April 2015. The trial, entitled Nicotine Exit [NEXit], enrolled participants who were willing to set a quit date within 1 month of enrollment. All college and university students throughout Sweden were contacted by email about the study. The intervention included a 1- to 4-week motivational phase during which the participants set their quit date. The interventional arm also received 157 text messages based on components of effective smoking cessations. Messages were sent over 12 weeks. The control group received one text every 2 weeks thanking them for participating in the study, with delayed access to the intervention. The primary outcomes of interest were self-reported abstinence from smoking defined as ≤5 cigarettes over the past 8 weeks and a 4-week point prevalence of complete smoking cessation (approximately 4 months after the quit date).

Results:

A total of 1,590 participants were randomized, most of which were between the ages of 21 and 30 years. A total of 827 (69.3% women) received the intervention and 763 (68.4% women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. There were no significant differences in sociodemographic factors or smoking characteristics between groups. At baseline, participants were smoking a median of 63 cigarettes per week in the intervention group and 70 cigarettes per week in the control group. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group. Complete cessation for 4 weeks was reported by 161 (20.6%) participants in the intervention group and 102 (14.2%) participants in the control group, a mean (standard deviation) of 3.9 (0.37) months after the quit date. The adjusted odds ratios for these findings were 2.05 (95% confidence interval [CI], 1.57-2.67) and 1.56 (95% CI, 1.19-2.05), respectively.

Conclusions:

The investigators concluded that the effects observed in this trial are comparable with those for traditional smoking cessation interventions. Also, the simple NEXit intervention has the potential to improve the uptake of effective smoking cessation interventions.

Perspective:

This trial supports the use of mHealth interventions such as text messaging for smoking cessation. Combining such interventions with other interventions may be synergistic for smoking cessation.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Prevention, CHD & Pediatrics and Arrhythmias, CHD & Pediatrics and Prevention, CHD & Pediatrics and Quality Improvement, Smoking

Keywords: Health Promotion, Nicotine, Primary Prevention, Self Report, Smoking, Smoking Cessation, Telemedicine, Text Messaging, Tobacco Use, Young Adult


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