“There are a number of proven strategies out there for quitting
smoking, and now we have growing evidence that text messaging is
another option for quitting,” said Lorien Abroms, a behavioral
scientist at George Washington University in Washington, D.C., who
led the study.
Just 11 percent of the people who used Abroms’ text2quit service
ended up smoke-free at the six-month mark, but that compared to 5
percent of those who got supportive literature.
That success rate among text users is in line with other types of
smoking-cessation support, like telephone quitlines, Abroms and her
colleagues point out in the American Journal of Preventive Medicine.
It’s also in keeping with results from other studies of text
messaging to help smokers quit (see Reuters Health story of November
14, 2012, here: http://reut.rs/SWlAWm).
Texts have been tried in recent years - with mixed results – to
deliver healthcare messages ranging from support in managing
diabetes to reminders to get a flu vaccination.
“I started with thinking about emails for helping people quit
smoking and then I just saw cell phones taking off as a big change
in communication tech and (saw) how we can use them to change health
behavior,” Abroms told Reuters Health.
Almost 70 percent of smokers say they want to stop smoking, but it
typically takes at least two attempts to give up tobacco, according
to the Centers for Disease Control and National Institutes of
“When I developed it there was no other (text-to-quit) program in
the U.S.,” Abroms, said.
To test the approach, she and her colleagues recruited participants
in 2011 and 2012 through an ad that appeared to people searching
Google for information on smoking-cessation. Thousands responded,
and 503 people ended up being included in the study.
They were randomly assigned to one of two groups that either got the
text2quit program or received National Cancer Institute booklet on
smoking cessation called “Clearing the Air.”
Text users received encouraging messages leading up to their quit
date, and after that they got multiple supportive messages each day
in their first week. These tapered to once-a-week messages after two
and a half months.
The text users could also send messages such as “CRAVE” and get back
a tailored response, like a tip or a trivia game. They could text
“STAT” to see their quitting statistics or the word “SMOKED” to
indicate that they had smoked and potentially needed to restart the
Abroms and her team surveyed all participants one month, three
months and six months after they began the program. Those who said
at the six-month follow-up that they hadn’t smoked in the past seven
days were asked to provide a saliva sample, which was tested for
cotinine, a byproduct of nicotine.
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Having chemical confirmation of abstinence for the portion of both
study groups who said they were not smoking at six months adds
strength to the results, the study team writes.
All participants were encouraged to use their assigned support
method in tandem with other cessation techniques like nicotine
patches, counseling and phone help lines. The goal of the program is
to help people quit smoking using any and all methods that work for
them, Abroms said.
“The (text) messages were a constant reminder that they were trying
to quit, and the program offers interactive tools so they could get
help every time they had a craving,” she said.
“They felt that someone actually cared that they quit, the messages
were like an electronic conscience, even though they knew it was
computer-generated it still gave them a sense of someone supporting
them,” Abroms added.
“The advantage of the text program is that a smoker can text for
help when they’re having a moment of weakness, and the program can
text them back with suggestions on how to cope,” said Dr. Joseph R.
DiFranza, a professor of family medicine & community health at the
University of Massachusetts Medical School in Worcester.
The National Cancer Institute offers a text-messaging support
service through its website smokefree.gov.
The text2quit service, which has been offered for several years
without charge through the national 1-800-QUITNOW phone support
line, is now also available online as a stand-alone product at
www.text2quit.com for a fee.
The program is currently only available in English, but there are
plans to roll out a Spanish version in 2015, according to Justin
Sims, CEO of Voxiva, the company that supports Text2Quit.
SOURCE: http://bit.ly/1ioRyGJ American Journal of Preventive
Medicine, online June 5, 2014.
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