Text messaging-based intervention helps smokers to quit smoking
Happy Quit, a mobile-phone-based text messaging intervention, has led smokers in a China study to stop smoking with either high- (HFM) or low-frequency messaging (LFM). This intervention may be paired with other smoking cessation services for treatment-seeking smokers.
“Because Happy Quit has far greater reach and higher feasibility among smokers than in-person treatments and is not expected to have risks of adverse effects, it has the potential to improve population health and should be considered for inclusion in smoking cessation programmes, to be made widely available for people who are seeking services for smoking cessation in China,” researchers said.
A total of 1,369 participants (mean age 38.1 years; 94.6 men) who smoked an average of 20.1 cigarettes per day were included in this randomized controlled trial across 30 cities and provinces in China from 17 August 2016 to 27 May 2017. They received 12 weeks of Happy Quit (HFM: n=674; LFM: n=284) or control text messages (n=411) with continued follow-up for 12 weeks. The control group received text messages unrelated to quitting.
Biochemically verified continuous smoking abstinence at 24 weeks was the primary endpoint, while secondary endpoints included self-reported 7-day point prevalence of abstinence (ie, not even a puff of smoke for the last 7 days) at 1, 4, 8, 12, 16, 20 and 24 weeks; self-reported continuous abstinence at 4, 12 and 24 weeks; and self-reported average number of cigarettes smoked per day.
Baseline characteristics were similar across groups, and participants were included in an intention-to-treat analysis.
Biochemically verified continuous smoking abstinence at 24 weeks was reported by 44 participants in the HFM group (6.5 percent), 17 in the LFM group (6.0 percent) and eight in the control group (1.9 percent). [PLoS Med 2018;15:e1002713]
Participants in both the HFM (odds ratio [OR], 3.51; 95 percent CI, 1.64–7.55; p<0.001) and the LFM (OR, 3.21; 1.36–7.54; p=0.002) groups were more likely to quit compared to those in the control group. However, quit rate was not significantly different between the HFM and LFM interventions.
The 7-day point quit rate from week 1–24 ranged from about 10 percent to >26 percent with the intervention and from <4 percent to approximately 12 percent without the intervention. Furthermore, participants in the HFM who continued smoking smoked 1–3 fewer cigarettes per day compared to those in the LFM group over the 24 weeks of trial.
“The 7-day point quit rates from week 1–24 that we observed are roughly similar to those reported in other studies,” researchers said. “It is interesting to note that the 7-day point prevalence cessation rate increased up to around 16 weeks and then reduced slightly in this trial.” [Nicotine Tob Res 2017;19:901-907; Tob Control 2009;18:88-91; Tob Control 2005;14:255-261]
The present study had certain limitations. First, participants were able to use other smoking cessation services, but very few reported using them. Second, cotinine tests could only detect smoking status for a few days. Also, the proportion of quitters was small.