The effect of mobile phone text messages for quitting smoking in motivated smokers: A randomised controlled trial

Despite strong public health measures and availability of pharmacotherapy, smokers continue to find it difficult to quit smoking. Behavioural support is a mainstay of comprehensive cessation interventions, traditionally offered via static help booklets. A few recent studies have supported using text messages to deliver support to smokers during a quit attempt. However, they have typically allowed the co-use of pharmacotherapy and included messages prompting the use of pharmacotherapy. We aimed to explore the effectiveness of a text message-based behavioural support program in the absence of pharmacotherapy. Methods: Between 2011-13 we recruited 284 smokers with high motivation to quit. Participants were randomised to receive text messages at 4-5 random times a day and on request (including general quitting tips, motivational enhancement, cognitive and behavioural coping advice) plus a quit booklet (n=145) or a quit booklet only (n=139). All participants monitored smoking, affect and activities in real-time using hand-held smartphones during a quit attempt. Self-reported smoking status was verified by expired air CO analysis at weekly study visits. Results: 7-day point-prevalence abstinence at 28-days was disappointing low in both groups; text 5%, control: 9%, (pg.05). Conclusions: The observed quit rates were on par with studies using brief advice in the absence of pharmacotherapy. Behavioural support offered by text messages in the absence of pharmacotherapy did not improve outcomes. It is possible that efficacy in earlier studies was partly driven by improved use of smoking cessation medications.