Motivational text messages doubled the rate of smoking cessation, according to data from a randomized trial of 5,800 smokers published online June 30 in the Lancet.
"Because of the widespread ownership of mobile phones, fully automated smoking cessation support can be delivered to large numbers of people at low cost," said Caroline Free, Ph.D., of the London School of Hygiene and Tropical Medicine, and her colleagues.
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A recent study showed that smokers who received motivational text messages were more likely to self-report nearly a month of not smoking, compared with a placebo group.
After 6 months of an intervention text message or a placebo text message, 10.7% of the intervention group showed biochemically verified smoking abstinence, compared with 4.9% of the placebo group.
The researchers randomized 2,915 smokers to receive the "txt2stop" intervention messages and 2,885 to receive a placebo message.
The study participants were aged 16 years and older, and the demographics were similar between the two groups (Lancet 2011 June 30 [doi: 10.1016/S0140-6736(11)60701-0]).
In addition, participants in the intervention group were significantly more likely than those in the placebo group to self-report 28 straight days of not smoking (20% vs. 14%, respectively) and not smoking in the past 7 days (24% vs. 18%) after 6 months.
The study participants received five text messages daily for the first 5 weeks of the program, followed by three messages per week for the next 26 weeks. Participants in both groups were encouraged to use any additional smoking cessation services they wanted.
The intervention text messages focused on several topics. A sample text for a specific concern such as weight gain read: "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." In addition, participants were able to request targeted messages when they texted CRAVE or LAPSE. For example: "Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over."
The findings were limited in part by a lack of information about the mechanism by which the text messages helped people stop smoking and by occasional flaws in the biochemical tests for smoking cessation, the researchers noted. The results suggest, however, that "the txt2stop intervention should be considered as an addition to existing smoking cessation services," Dr. Free and her colleagues wrote.
In an accompanying editorial, Derrick A. Bennett, Ph.D., and Dr. Jonathan R. Emberson of the University of Oxford (England) noted that, although the cessation rates in the intervention group were twice those of the control group, the overall rate of 10.7% was low.
Dr. Jonathan R. Emberson
The smoking cessation rate in the text-messaging intervention group was similar to that seen in other intervention programs, and the text-messaging method might be especially helpful when targeting smokers in low- and middle-income countries, where death rates from smoking-related diseases are high and mobile phones are common, they said (Lancet 2011 June 30 [doi: 10.1016/S0140-6736(11)60882-9]).
"The lessons learned from the txt2stop trial could therefore not only provide a new approach to smoking cessation in high-income and middle-income countries, but could also provide a useful starting point for implementing behavioural change in resource-poor settings," Dr. Bennett and Dr. Emberson wrote.
The researchers and the editorial authors stated that they had no financial conflicts to disclose.