Text Messaging Program Increased Smoking Cessation Rates at 6 Months

A personalized smoking cessation text message intervention was more effective than a nonpersonalized intervention, according to results of a study published in JAMA Network Open.

This double-blind randomized clinical trial was conducted in 2021 in 5 cities in China. Adults (N=722) who were daily or weekly smokers were recruited via advertisements and randomly assigned to receive either a personalized (n=360) or nonpersonalized (n=362) text message intervention. The participants received approximately 1 text message every day for 3 months. The messages provided encouragement, practical advice about maintaining abstinence, and information about health effects. The personalized messages were based on the transtheoretical model and protection motivation theory. The primary outcome was continuous biochemical abstinence at 6 months.

The study population comprised 99.2% men, 54.8% were aged 18 to 44 years, 82.2% were daily smokers, 63.6% had low nicotine dependence, and 74.4% had a strong intention to quit. At baseline, the intervention and control cohorts were well balanced.

At 6 months, 6.9% of the personalized message group and 3.0% of the nonpersonalized message recipients had verified continuous biochemical abstinence (odds ratio [OR], 2.38; 95% CI, 1.15-4.92; P =.02).

Stratified by shorter time periods, the personalized message group had higher rates of continuous abstinence at 1 (OR, 1.86; P =.03) and 3 (OR, 2.44; P <.001) months and in the first 3 (OR, 2.15; P <.001) and last 3 (OR, 2.06; P <.001) months of the study compared with the nonpersonalized message group.

Similar trends in self-reported abstinence were observed.

Stratified by nicotine dependence levels, continuous biochemically verified abstinence was not significantly greater among the low dependence (OR, 1.96; 95% CI, 0.86-4.50; P =.11) or moderate and high dependence (OR, 3.73; 95% CI, 0.76-18.30; P =.11) subsets of personalized message recipients compared with the control group. Among the subset of individuals with a strong intention to quit, the primary outcome was achieved among more personalized message recipients than nonpersonalized message recipients (OR, 2.24; 95% CI, 1.07-4.66; P =.03).

These findings may have been biased, as the biochemical test for smoking cessation was not infallible.

Study authors concluded, “[A] behavior change theory–based intervention using personalized text messages increased biochemically verified smoking cessation at 6 months compared with an intervention using nonpersonalized text messages. This study provided new evidence supporting the utility of mobile health methods for smoking cessation.”