The effect of mobile text messages on short and long term quitting in motivated smokers: a randomised controlled trial

Behavioural support—often delivered via static self help booklets—has become a mainstay of comprehensive cessation interventions and has been found to consistently, if modestly, promote cessation. A number of recent studies have found that behavioural support delivered via text messages can significantly improve outcomes. However, exactly how such programs work—and hence how they can be improved—is currently unknown. A complication is that such programs have so far been evaluated in samples co-using pharmacotherapy, and/or in the absence of a control group using a non-text message based behavioural support program. We aimed to explore the effectiveness of a text message-based behavioural support program in the absence of pharmacotherapy. Methods: 284 interested quitters were randomised to either a text message group or a control condition.

The text group received tailored text messages 4-5 times a day (plus additional messages on request); participates in the control group received a quit booklet only. All participants monitored their smoking, affect and activities in real-time using hand-held smartphones during their quit attempt. Abstinence (verified by CO) was assessed at weekly study visits. Results: 7-day point-prevalence abstinence did not differ between the groups at either 28-day or 6mth follow-up (p>.05). Discussion: The observed quit rates were on par with studies using brief advice in the absence of pharmacotherapy, but behavioural support offered by text messages in the absence of pharmacotherapy did not improve outcomes. Implications for future research will be discussed.

FUNDING: This study was support by a grant from the National Health & Medical Research Council awarded to the authors. Stuart Ferguson has consulted for GlaxoSmithKline Consumer Healthcare (GSKCH) on matters relating to smoking cessation and has received researcher-initiated project grant funding from Pfizer (through the GRAND initiative). Neither GSKCH nor Pfizer had any involvement in the current study.

JUSTIFICATION: The study has implications for the use of text messages to delivery behavioural support.