Charles J. Bentz, MD, FACP
Does an automated, personalized, cellular phone text-messaging program increase continuous smoking abstinence at 6 months?
Randomized controlled trial. Current Controlled Trials ISRCTN 80978588.
Blinded (data collectors and outcome assessors).*
5800 persons ≥ 16 years of age (mean age 37 y, 55% men), who smoked, were willing to attempt to quit smoking in the next month, and owned a cellular phone.
A cellular phone text-messaging smoking cessation program (txt2stop) (n = 2911) or control (n = 2881). Participants in the txt2stop group set a quit date within 2 weeks of randomization. They received 5 text messages per day for 5 weeks, then 3 per week for 26 weeks. The 186 core messages were motivational or provided behavior change techniques. Additional personalized messages (selected from a database of 713 messages) were based on demographic and other baseline information or were triggered by participant texts. The control group received simple, short text messages every 2 weeks on the importance of trial participation. Pay-as-you-go phone plan users were provided with £20 (approximately US $32 based on exchange rates 10 Aug 2011) vouchers.
Primary outcome was self-reported continuous smoking abstinence (≤ 5 cigarettes since start of abstinence), biochemically verified at 6 months using a postal salivary-cotinine test (cutpoint 7 ng/mL) or in-person carbon monoxide test (cutpoint 6 ppm). Secondary outcomes included self-reported vehicle crashes, repetitive strain injury in the thumb, and use of other smoking cessation services during the trial.
95% completed follow-up (intention-to-treat analysis). Of 666 participants who self-reported continuous abstinence at 6 months, 542 (81%) completed biochemical assessment, 50 (7.5%) self-reported relapsing, and 74 (11%) had no follow-up.
The txt2stop program increased biochemically verified continuous smoking abstinence at 6 months compared with control (Table). Groups did not differ for involvement in vehicle crashes, thumb pain while texting, or use of other smoking cessation or support services (Table).
An automated, personalized, cellular phone text-messaging program for smoking cessation improved biochemically confirmed continuous smoking abstinence at 6 months.
†RBI = relative benefit increase; NS = not significant; other abbreviations defined in Glossary. RBI, RRI, NNT, and CI calculated from data in article.
‡Multiple imputation by chained equations (number of imputations = 100).
Bentz CJ. A personalized, cellular phone text-messaging program increased smoking cessation at 6 months. Ann Intern Med. ;155:JC4–4. doi: 10.7326/0003-4819-155-8-201110180-02004
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Published: Ann Intern Med. 2011;155(8):JC4-4.
Cardiology, Coronary Risk Factors, Smoking, Tobacco, Alcohol, and Other Substance Abuse.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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