Text messaging program helps smokers fight the urge to light up

This image shows a smart phone with a sample Text2Quit message held by lead researcher Lorien Abroms at the George Washington University. Credit: William Atkins/George Washington University

More than 11 percent of smokers who used a text- messaging program to help them quit did so and remained smoke free at the end of a six- month study as compared to just 5 percent of controls, according to a new report by researchers at Milken Institute School of Public Health at the George Washington University (Milken Institute SPH.)

"Text messages seem to give smokers the constant reminders they need to stay focused on quitting," says Lorien C. Abroms, ScD, MA, an associate professor of prevention and community health at Milken Institute SPH and the lead author of the study. "However, additional studies must be done to confirm this result and to look at how these programs work when coupled with other established anti-smoking therapies."

A new Surgeon General's report on smoking concludes that cigarette smoking kills nearly half a million Americans every year. Smokers trying to quit can turn to the tried-and-true methods like phone counseling through a quit line and nicotine replacement therapies, but increasingly the evidence is building for using text messaging on mobile phones. Text-messaging programs, like Text2Quit, work by sending advice, reminders and tips that help smokers resist the craving for a cigarette and stick to a quit date. More than 75,000 people in the United States have enrolled in the Text2Quit program through quit lines and enrollment is on the rise.

Yet despite the widespread use of anti-smoking apps and texting programs, there had been no long-term studies of such programs in the United States. Most of the existing research on such programs were small in size, lacked a , and did not biochemically verify smoking status, Abroms said.

To help address such gaps, Abroms and her colleagues decided to carry out a large, randomized trial of a text-messaging program. They recruited 503 smokers on the internet and randomized them to receive either a text-messaging program called Text2Quit or self-help material aimed at getting smokers to quit.

The text messages in the Text2Quit program are interactive and give smokers advice but they also allow participants to ask for more help or to reset a quit date if they need more time. Smokers who have trouble fighting off an urge can text in and get a tip or a game that might help distract them until the craving goes away, Abroms said.

At the end of six months, the researchers sent out a survey to find out how many people in each group had stopped smoking. They found that people using the text-messaging program had a much higher likelihood of quitting compared to the control group, a finding that suggests that text-messaging programs can provide an important boost for people struggling with a tobacco habit.

However, self-reports of smokers can be misleading. To verify the positive results, the researchers collected a sample of saliva from who reported quitting and tested it to see if it showed any evidence of a nicotine byproduct called cotinine. The quit rates for people with biochemically confirmed abstinence at the six month mark were still two times higher than the control group, Abroms said.

This study adds to other evidence suggesting that stop-smoking text-messaging programs are a promising tool, Abroms says.

Still many questions remain to be answered. This study looked at only people who were already highly motivated to quit and those that were already searching for quit-smoking information on the Internet. Additional studies will have to be done to verify that text-messaging programs do in fact work in less digitally connected populations and in those with lower levels of motivation to quit. In addition, researchers will have to compare this text-messaging program with others now in use such as SmokefreeTXT, which was launched by the National Cancer Institute in 2011.

More information: The study, which was funded by the National Cancer Institute, appeared online June 6 in the American Journal of Preventive Medicine.

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