Automated Motivational Text Messages Help Stop Smoking

A new UK study has found that smokers who participated in an smoking cessation program called “text2stop” which was delivered by automated mobile phone text messages achieved continuous abstinence at 6 months at twice the rate of a control group.

The study was conducted by Caroline Free PhD, of the London School of Hygiene and Tropical Medicine, and her colleagues, and was published in the July 2, 2011 issue of The Lancet.

Study Methodology

In the study, 5,800 people, aged 16 or older, who were trying to quit smoking and who volunteered to participate, were randomly assigned to a txt2stop intervention group (2,915 participants) or a control group (2,885 participants).

Those in the intervention group received both standard and personalized text messages encouraging them to abstain from smoking. The “personalized” messages were automatically selected among messages focused toward particular interests and concerns checked off by participants in an opening questionnaire, as well as by demographics. Those in the control group received neutral text messages that did not directly encourage them to quit smoking.

All participants received five text messages per day for the first 5 weeks, and then three texts per week for the next 26 weeks.

Examples of the Text Messages

Participants in the txt2stop intervention group received standardized messages such as the following during the days before their self-selected quit date:

“To make things easier for yourself, try having some distractions ready for cravings and think up some personal strategies to help in stressful situations”; “why not write an action list of your reasons why you want to quit. Use it as your inspiration.”

During the program, participants who in their opening questionnaire had indicated particular concern with gaining weight, might receive a standard “customized” message, such as:

“TXT2STOP: Think you’ll put on weight when you quit? We’re here to help – We’ll TXT weight control and exercise tips, recipes, and motivation tips.”

And, after quit day, all participants received standardized messages such as:

“TXT2STOP: Quick result! Carbon monoxide has now left your body!”; “Day4=Big day – cravings still strong? Don’t worry tomorrow will be easier! Keep your mind & hands busy. Save this txt so u can txt CRAVE to us at any time during the programme.”

If participants felt a craving, they could text “crave” and receive responsive texts to support and distract them, such as, for example:

“Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over.”

Or, if they gave up and smoked, participants could text “lapse” and receive responsive texts reminding them of their progress up to that point and encouraging them to keep going. For example:

“Don’t feel bad or guilty if you’ve slipped. You’ve achieved a lot by stopping for a while. Slip-ups can be a normal part of the quitting process. Keep going, you can do it!”

The control group, on the other hand simply received text messages such as:

“Thanks for taking part. Remember, if you have changed contact details please let us know. We will need to contact you at the end of the study.”

Both groups were encouraged to participate in other smoking cessation support programs, including especially smoking cessation helplines provided by the British National Health Service. Approximately 50% of each group did so.

Findings

After six months, the researchers biochemically verified continuous abstinence by administering tested saliva samples for cotinine, a byproduct of nicotine, to measure which participants had really quit smoking.

They found that 10.7% of the participants in the motivational text intervention group and 4.9% of those in the control group had quit smoking continuously at the 6 month point. Thus, more than twice as many had quit in the txt2stop intervention group as in the control group.

“Smoking cessation support delivered via mobile phone text messaging doubles quit rates at 6 months,” the authors wrote.

While the percentages of each group who quit appear quite low in both groups, the study report points out that such results are similar to results achieved from other direct one-on-one behavioral interventions.

Conclusion

In conclusion, the study authors stated:

“On the basis of these results the txt2stop intervention should be considered as an addition to existing smoking cessation services. In this trial the intervention was effective on its own and when used alongside other smoking cessation interventions. To scale up the txt2stop intervention for delivery at a national or international level would be technically easy. The intervention might require some adaptation, translation into other languages, and local evaluation before delivery to other populations. The intervention is low cost and likely to be highly cost-effective. A cost-effectiveness analysis of txt2stop will be reported separately.

Our finding that the txt2stop intervention increased biochemically verified smoking cessation at 6 months raises the possibility that mobile-technology-based interventions might be effective in changing other behavioural risk factors for diseases.”

More Information

A full copy of the study report is available in the July 2, 2011 issue of The Lancet.

See also an editorial on the study published in the July 2, 2011 issue of The Lancet.

See generally, our resource pages on Wellness/ Healthy Living for Seniors and Caregivers

And Specifically, our page on: Sleep, Hygiene, Quit Smoking & Other Healthy Practices: Physical Wellness

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Copyright © 2011 Care-Help LLC

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1 comment to Automated Motivational Text Messages Help Stop Smoking

  • quitjuice

    Text messages to quit smoking makes sense. Unfortunately the txt2stop is not based in USA and our gov is making a lot of cuts right now to funding for services like smoking cessation. In fact Washington state just lost funding for a quitline to non medicaid persons. We’ve been working on a product that does sms, voice, and email messages and think it could be a great resource for American’s trying to quit. quitjuice.com is not free but I think it is coming at a good time as all of this research is supporting the method.

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