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Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial.
J Med Internet Res 2013; 15(8):e171JM

Abstract

BACKGROUND

Smoking prevalence remains high, particularly among adolescents and young adults with lower educational levels, posing a serious public health problem. There is limited evidence of effective smoking cessation interventions in this population.

OBJECTIVE

To test the efficacy of an individually tailored, fully automated text messaging (short message service, SMS)-based intervention for smoking cessation in young people.

METHODS

A 2-arm cluster randomized controlled trial, using school class as the randomization unit, was conducted to test the efficacy of the SMS text messaging intervention compared to an assessment-only control group. Students who smoked were proactively recruited via online screening in vocational school classes. Text messages, tailored to demographic and smoking-related variables, were sent to the participants of the intervention group at least 3 times per week over a period of 3 months. A follow-up assessment was performed 6 months after study inclusion. The primary outcome measure was 7-day smoking abstinence. Secondary outcomes were 4-week smoking abstinence, cigarette consumption, stage of change, and attempts to quit smoking. We used regression models controlling for baseline differences between the study groups to test the efficacy of the intervention. Both complete-case analyses (CCA) and intention-to-treat analyses (ITT) were performed. Subgroup analyses were conducted for occasional and daily smokers.

RESULTS

A total of 2638 students in 178 vocational school classes in Switzerland participated in the online screening. Overall, 1012 persons met the inclusion criteria for study participation, and 755 persons (74.6%) participated in the study (intervention: n=372; control: n=383). Of the 372 program participants, 9 (2.4%) unsubscribed from the program during the intervention period. Six-month follow-up data were obtained for 559 study participants (74.0%). The 7-day smoking abstinence rate at follow-up was 12.5% in the intervention group and 9.6% in the control group (ITT: P=.92). No differences between the study groups were observed in 4-week point prevalence abstinence rates. The decrease in the mean number of cigarettes smoked per day from baseline to follow-up was higher in the intervention group than in the control group (ITT: P=.002). No differences between the groups were observed in stage of change (ITT: P=.82) and quit attempts (ITT: P=.38). The subgroup analyses revealed lower cigarette consumption in both occasional and daily smokers in the intervention group compared to the control group. Occasional smokers in the intervention group made more attempts to quit smoking than occasional smokers in the control group.

CONCLUSIONS

This study demonstrated the potential of an SMS text message-based intervention to reach a high proportion of young smokers with low education levels. The intervention did not have statistically significant short-term effects on smoking cessation; however, it resulted in statistically significant lower cigarette consumption. Additionally, it resulted in statistically significant more attempts to quit smoking in occasional smokers.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number (ISRCTN): 19739792; http://www.controlled-trials.com/ISRCTN19739792 (Archived by WebCite at http://webcitation.org/6IGETTHmr).

Authors+Show Affiliations

Swiss Research Institute for Public Health and Addiction, an associated Institute of the University of Zurich, Zurich, Switzerland. severin.haug@isgf.uzh.chNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23956024

Citation

Haug, Severin, et al. "Efficacy of a Text Message-based Smoking Cessation Intervention for Young People: a Cluster Randomized Controlled Trial." Journal of Medical Internet Research, vol. 15, no. 8, 2013, pp. e171.
Haug S, Schaub MP, Venzin V, et al. Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial. J Med Internet Res. 2013;15(8):e171.
Haug, S., Schaub, M. P., Venzin, V., Meyer, C., & John, U. (2013). Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial. Journal of Medical Internet Research, 15(8), pp. e171. doi:10.2196/jmir.2636.
Haug S, et al. Efficacy of a Text Message-based Smoking Cessation Intervention for Young People: a Cluster Randomized Controlled Trial. J Med Internet Res. 2013 Aug 16;15(8):e171. PubMed PMID: 23956024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial. AU - Haug,Severin, AU - Schaub,Michael P, AU - Venzin,Vigeli, AU - Meyer,Christian, AU - John,Ulrich, Y1 - 2013/08/16/ PY - 2013/03/27/received PY - 2013/06/11/accepted PY - 2013/04/25/revised PY - 2013/8/20/entrez PY - 2013/8/21/pubmed PY - 2014/3/8/medline KW - school KW - smoking cessation KW - students KW - text messaging (SMS) KW - young people SP - e171 EP - e171 JF - Journal of medical Internet research JO - J. Med. Internet Res. VL - 15 IS - 8 N2 - BACKGROUND: Smoking prevalence remains high, particularly among adolescents and young adults with lower educational levels, posing a serious public health problem. There is limited evidence of effective smoking cessation interventions in this population. OBJECTIVE: To test the efficacy of an individually tailored, fully automated text messaging (short message service, SMS)-based intervention for smoking cessation in young people. METHODS: A 2-arm cluster randomized controlled trial, using school class as the randomization unit, was conducted to test the efficacy of the SMS text messaging intervention compared to an assessment-only control group. Students who smoked were proactively recruited via online screening in vocational school classes. Text messages, tailored to demographic and smoking-related variables, were sent to the participants of the intervention group at least 3 times per week over a period of 3 months. A follow-up assessment was performed 6 months after study inclusion. The primary outcome measure was 7-day smoking abstinence. Secondary outcomes were 4-week smoking abstinence, cigarette consumption, stage of change, and attempts to quit smoking. We used regression models controlling for baseline differences between the study groups to test the efficacy of the intervention. Both complete-case analyses (CCA) and intention-to-treat analyses (ITT) were performed. Subgroup analyses were conducted for occasional and daily smokers. RESULTS: A total of 2638 students in 178 vocational school classes in Switzerland participated in the online screening. Overall, 1012 persons met the inclusion criteria for study participation, and 755 persons (74.6%) participated in the study (intervention: n=372; control: n=383). Of the 372 program participants, 9 (2.4%) unsubscribed from the program during the intervention period. Six-month follow-up data were obtained for 559 study participants (74.0%). The 7-day smoking abstinence rate at follow-up was 12.5% in the intervention group and 9.6% in the control group (ITT: P=.92). No differences between the study groups were observed in 4-week point prevalence abstinence rates. The decrease in the mean number of cigarettes smoked per day from baseline to follow-up was higher in the intervention group than in the control group (ITT: P=.002). No differences between the groups were observed in stage of change (ITT: P=.82) and quit attempts (ITT: P=.38). The subgroup analyses revealed lower cigarette consumption in both occasional and daily smokers in the intervention group compared to the control group. Occasional smokers in the intervention group made more attempts to quit smoking than occasional smokers in the control group. CONCLUSIONS: This study demonstrated the potential of an SMS text message-based intervention to reach a high proportion of young smokers with low education levels. The intervention did not have statistically significant short-term effects on smoking cessation; however, it resulted in statistically significant lower cigarette consumption. Additionally, it resulted in statistically significant more attempts to quit smoking in occasional smokers. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 19739792; http://www.controlled-trials.com/ISRCTN19739792 (Archived by WebCite at http://webcitation.org/6IGETTHmr). SN - 1438-8871 UR - https://www.unboundmedicine.com/medline/citation/23956024/Efficacy_of_a_text_message_based_smoking_cessation_intervention_for_young_people:_a_cluster_randomized_controlled_trial_ L2 - https://www.jmir.org/2013/8/e171/ DB - PRIME DP - Unbound Medicine ER -