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Texting program doubled smoking cessation
Free C. Lancet. 2011;378:49-55.
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A smoking cessation program that used motivational text messages, “txt2stop,” significantly improved the rates of smoking cessation at 6 months, according to a single blind, randomized trial.
The study included any smoker older than 16 years who was willing to make an attempt to quit smoking within a month of trial enrollment. The trial enrolled 2,915 smokers to the txt2stop arm and 2,885 smokers to the control group. All smokers were allowed to participate in other smoking cessation studies besides the trial.
The control group received text messages unrelated to quitting; however, the txt2stop group received messages that motivated participants to quit smoking and provided behavioral change support. The txt2stop group received five text messages a day for the first 5 weeks and three a week thereafter.
At 6 months, 28% of those participants who self-reported smoking abstinence had biochemically confirmed results showing that they were still smoking. In the txt2stop group, 10.7% of participants had stopped smoking vs. 4.9% of the control group (P<.0001). Results remained almost double for the txt2stop group, even when those participants lost to follow-up were treated as smokers and when they were excluded entirely from the data.
In addition, the researchers found that the text intervention was effective across multiple socioeconomic and age groups.
One limitation listed by researchers was a lack of insight into why the text messaging intervention may have increased smoking cessation.
A study in the July 2, 2011 Lancet by Free et al demonstrates the effectiveness of a smoking cessation support program delivered by mobile phone text messaging. Among the 5,800 participants, this "txt2stop" program resulted in a significant increase in the biochemically-confirmed, 6-month abstinence rates (9% vs. 4%; RR 2.14) compared with smokers receiving "control" text messages. Although the mechanism of this benefit is not entirely clear as approximately half of the participants also used other treatment resources, this type of intervention could serve to maintain motivation throughout the day, provide support and helpful "tips," and could act as a "rescue" during high-risk craving and near-lapse situations. Regardless, it appears that text messaging can be an effective way to deliver cessation support to a large number of smokers, thus giving tobacco users and treatment providers another tool to help reduce the devastating impact of the leading cause of preventable death and disease.
– Michael B. Steinberg, MD, MPH, FACP
UMDNJ-Robert Wood Johnson Medical School
Tobacco Dependence Program, New Brunswick
Disclosure: Dr. Steinberg reports no relevant financial disclosures.
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