J. Med. Internet Res. - Efficacy of a text message-based smoking cessation intervention for young people: a cluster randomized controlled trial.

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Resumo

CKGROUND: Smoking prevalence remains high, particularly among adolescents and young adults with lower educational levels, posing a serious public health problem. There is limited evidence of effective smoking cessation interventions in this population.OBJECTIVE: To test the efficacy of an individually tailored, fully automated text messaging (short message service, SMS)-based intervention for smoking cessation in young people.METHODS: A 2-arm cluster randomized controlled trial, using school class as the randomization unit, was conducted to test the efficacy of the SMS text messaging intervention compared to an assessment-only control group. Students who smoked were proactively recruited via online screening in vocational school classes. Text messages, tailored to demographic and smoking-related variables, were sent to the participants of the intervention group at least 3 times per week over a period of 3 months. A follow-up assessment was performed 6 months after study inclusion. The primary outcome measure was 7-day smoking abstinence. Secondary outcomes were 4-week smoking abstinence, cigarette consumption, stage of change, and attempts to quit smoking. We used regression models controlling for baseline differences between the study groups to test the efficacy of the intervention. Both complete-case analyses (CCA) and intention-to-treat analyses (ITT) were performed. Subgroup analyses were conducted for occasional and daily smokers.RESULTS: A total of 2638 students in 178 vocational school classes in Switzerland participated in the online screening. Overall, 1012 persons met the inclusion criteria for study participation, and 755 persons (74.6%) participated in the study (intervention: n=372; control: n=383). Of the 372 program participants, 9 (2.4%) unsubscribed from the program during the intervention period. Six-month follow-up data were obtained for 559 study participants (74.0%). The 7-day smoking abstinence rate at follow-up was 12.5% in the intervention group and 9.6% in the control group (ITT: P=.92). No differences between the study groups were observed in 4-week point prevalence abstinence rates. The decrease in the mean number of cigarettes smoked per day from baseline to follow-up was higher in the intervention group than in the control group (ITT: P=.002). No differences between the groups were observed in stage of change (ITT: P=.82) and quit attempts (ITT: P=.38). The subgroup analyses revealed lower cigarette consumption in both occasional and daily smokers in the intervention group compared to the control group. Occasional smokers in the intervention group made more attempts to quit smoking than occasional smokers in the control group.CONCLUSIONS: This study demonstrated the potential of an SMS text message-based intervention to reach a high proportion of young smokers with low education levels. The intervention did not have statistically significant short-term effects on smoking cessation; however, it resulted in statistically significant lower cigarette consumption. Additionally, it resulted in statistically significant more attempts to quit smoking in occasional smokers.TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 19739792; http://www.controlled-trials.com/ISRCTN19739792 (Archived by WebCite at http://webcitation.org/6IGETTHmr).

Resumo Limpo

ckground smoke preval remain high particular among adolesc young adult lower educ level pose serious public health problem limit evid effect smoke cessat intervent populationobject test efficaci individu tailor fulli autom text messag short messag servic smsbase intervent smoke cessat young peoplemethod arm cluster random control trial use school class random unit conduct test efficaci sms text messag intervent compar assessmenton control group student smoke proactiv recruit via onlin screen vocat school class text messag tailor demograph smokingrel variabl sent particip intervent group least time per week period month followup assess perform month studi inclus primari outcom measur day smoke abstin secondari outcom week smoke abstin cigarett consumpt stage chang attempt quit smoke use regress model control baselin differ studi group test efficaci intervent completecas analys cca intentiontotreat analys itt perform subgroup analys conduct occasion daili smokersresult total student vocat school class switzerland particip onlin screen overal person met inclus criteria studi particip person particip studi intervent n control n program particip unsubscrib program intervent period sixmonth followup data obtain studi particip day smoke abstin rate followup intervent group control group itt p differ studi group observ week point preval abstin rate decreas mean number cigarett smoke per day baselin followup higher intervent group control group itt p differ group observ stage chang itt p quit attempt itt p subgroup analys reveal lower cigarett consumpt occasion daili smoker intervent group compar control group occasion smoker intervent group made attempt quit smoke occasion smoker control groupconclus studi demonstr potenti sms text messagebas intervent reach high proport young smoker low educ level intervent statist signific shortterm effect smoke cessat howev result statist signific lower cigarett consumpt addit result statist signific attempt quit smoke occasion smokerstri registr intern standard random control trial number isrctn httpwwwcontrolledtrialscomisrctn archiv webcit httpwebcitationorgigetthmr

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