Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial

Abstract

SummaryBackgroundSmoking cessation programmes delivered via mobile phone text messaging show increases in self-reported quitting in the short term. We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence, which was biochemically verified at 6 months.MethodsIn this single-blind, randomised trial, undertaken in the UK, smokers willing to make a quit attempt were randomly allocated, using an independent telephone randomisation system, to a mobile phone text messaging smoking cessation programme (txt2stop), comprising motivational messages and behavioural-change support, or to a control group that received text messages unrelated to quitting. The system automatically generated intervention or control group texts according to the allocation. Outcome assessors were masked to treatment allocation. The primary outcome was self-reported continuous smoking abstinence, biochemically verified at 6 months. All analyses were by intention to treat. This study is registered, number ISRCTN 80978588.FindingsWe assessed 11 914 participants for eligibility. 5800 participants were randomised, of whom 2915 smokers were allocated to the txt2stop intervention and 2885 were allocated to the control group; eight were excluded because they were randomised more than once. Primary outcome data were available for 5524 (95%) participants. Biochemically verified continuous abstinence at 6 months was significantly increased in the txt2stop group (10·7% txt2stop vs 4·9% control, relative risk [RR] 2·20, 95% CI 1·80–2·68; p<0·0001). Similar results were obtained when participants that were lost to follow-up were treated as smokers (268 [9%] of 2911 txt2stop vs 124 [4%] of 2881 control [RR 2·14, 95% CI 1·74–2·63; p<0·0001]), and when they were excluded (268 [10%] of 2735 txt2stop vs 124 [4%] of 2789 control [2·20, 1·79–2·71; p<0·0001]). No significant heterogeneity was shown in any of the prespecified subgroups.InterpretationThe txt2stop smoking cessation programme significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services.FundingUK Medical Research Council, Primary Care Research Networks.

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit)

“…However, it is the best estimate yet produced for the probable efficacy of text messaging used for smoking cessation in pregnancy. It is also of a similar magnitude to efficacy estimates derived from ‘definitive’ trials of similar interventions used by non‐pregnant smokers 36, 37 and to that from a smaller MiQuit trial 18. Additionally, our estimate for the probable cost‐effectiveness of the intervention is encouraging; compared with other cessation interventions, a cost‐per‐quitter of £134 is low.…”

Mobile technology: a synopsis and comment on “mobile phone-based interventions for smoking cessation”

“…Three interventions included text messages only [3][4][5]. One intervention included text messages and a web-based quit coach [6], while the last used text messages with links to internet videos [7].…”

“…Free et al adapted the intervention developed by Rodgers and colleagues (2009) to be delivered in the UK as a pilot study (2009) [4] and then as a full trial (2011) [5]. The findings from the small pilot study by Free et al [4] did not have significant results; however, the results from the full trial [5] demonstrated improvements in abstinence rates at the 6-month time point. Rodgers et al [3] found the same results in New Zealand.…”

“…However, the authors noted that the lack of effect may have been due to the smaller sample size (N=226). The trials by Rodgers [3], Free [5], and Borland [6] which produced significant results had sample sizes greater than 1,000.…”

Characterising the ‘Txt2Stop’ Smoking Cessation Text Messaging Intervention in Terms of Behaviour Change Techniques

“…The majority of people in high and lowmiddle income countries have mobile phones and in many of these countries text messaging services are free or nearly free to the user (OFCOM, 2009). A large UK-based trial of an intervention called 'Txt2Stop' , based on one that had previously been evaluated in New Zealand (STOMP) (Rodgers et al, 2005) has found a doubling of quit rates at six months (Free et al, 2011). The trial compared Txt2Stop with an intervention containing text messages unrelated to quitting in 5,800 smokers and analysed their effect on cessation by intention to treat.…”