Text to Quit China: An mHealth Smoking Cessation Trial

Abstract

Purpose To assess the feasibility, acceptability, and efficacy of a text message–based smoking cessation intervention in China. Design Randomized control trial with a 6-month follow-up assessment of smoking status. Setting Zhejiang, Heilongjiang, and Shaanxi provinces in China. Subjects 8,000 adult smokers in China who use Nokia Life Tools and participated in Phase II (smoking education via text message) of the study. Intervention High Frequency Text Contact (HFTC) group received one to three messages daily containing smoking cessation advice, encouragement, and health education information. Low Frequency Text Contact (LFTC) group received one weekly message with smoking health effects information. Measures Our primary outcome was smoking status 0, 1, 3, and 6 months post-intervention. Secondary outcomes include participant perceptions of the HFTC intervention, and factors associated with smoking cessation among HFTC participants. Analysis Descriptive and chi-square analyses were conducted to assess smoking status and acceptability. Factors associated with quitting were assessed using multiple logistic regression analyses. Results Quit rates were high in both HFTC and LFTC groups (HFTC: 0 month 27.9%, 1 month 30.5%, 3 months 26.7%, 6 months 27.7%; LFTC: 0 month 26.7%, 1 month 30.4%, 3 months 28.1%, 6 months 27.7), with no significant difference between the two groups in an intent-to-treat analysis. Attitudes towards the HFTC intervention were largely positive. Conclusion Our findings suggest that a text message–based smoking cessation intervention can be successfully delivered in China and is acceptable to Chinese smokers, but further research is needed to assess the potential impact of this type of intervention.

The efficacy of smoking cessation interventions in low‐ and middle‐income countries: a systematic review and meta‐analysis

“…The studies included a total of 13 141 participants from 11 countries. Seven studies (29%) were carried out in China [27,29,35,36,38,44,45], three (13%) each in India [39,42,46], Brazil [30,32,40] and Iran [22,26,33], two (8%) each in Malaysia [28,31] and South Africa [24,37] and one (4%) each in Pakistan [41], Syria [43], Thailand [23] and Turkey [34]. Four studies recruited participants from the community, one from a prison, and the remaining 19 recruited participants from medical clinics.…”

“…It investigated the efficacy of a high-versus low-frequency text message intervention for smoking cessation among 1500 self-identified smokers recruited through text messages via their service provider [27]. It investigated the efficacy of a high-versus low-frequency text message intervention for smoking cessation among 1500 self-identified smokers recruited through text messages via their service provider [27].…”

“…Three studies did not use a placebo control when evaluating pharmacological interventions [25,33,41]. Ten studies (42%) failed to indicate whether their outcome assessors were blinded to study condition [25,29,[32][33][34]36,[39][40][41]45], four studies (17%) reported that their assessors were not blinded to study condition [27,30,37,42] and the remaining 10 studies (42%) reported using blinded assessors [23,24,26,28,31,35,38,43,44,46]. Ten studies (42%) failed to indicate whether their outcome assessors were blinded to study condition [25,29,[32][33][34]36,[39][40][41]45], four studies (17%) reported that their assessors were not blinded to study condition [27,30,37,42] and the remaining 10 studies (42%) reported using blinded assessors [23,24,26,28,…”

“…Reported attrition rates ranged from 0% [33] to 37.7% [24] for in-person treatments; Augustson [27] had higher rates of attrition (57.2%) for a mobile phone intervention. In three studies, attrition rates were significantly different between study arms [25,30,35].…”

“…We identified only one RCT of a mobile phone intervention which met our review criteria. It investigated the efficacy of a high-versus low-frequency text message intervention for smoking cessation among 1500 self-identified smokers recruited through text messages via their service provider [27]. The intervention lasted for 6 weeks, with a followup duration of 6 months.…”