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Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial
Open accessAbstract
Background Smoking cessation programmes delivered via mobile phone text messaging show increases in self-reported quitting in the short term. We assessed the effect of an automated smoking cessation programme delivered via mobile phone text messaging on continuous abstinence, which was biochemically verified at 6 months. Methods In this single-blind, randomised trial, undertaken in the UK, smokers willing to make a quit attempt were randomly allocated, using an independent telephone randomisation system, to a mobile phone text messaging smoking cessation programme (txt2stop), comprising motivational messages and behavioural-change support, or to a control group that received text messages unrelated to quitting. The system automatically generated intervention or control group texts according to the allocation. Outcome assessors were masked to treatment allocation. The primary outcome was self-reported continuous smoking abstinence, biochemically verified at 6 months. All analyses were by intention to treat. This study is registered, number ISRCTN 80978588. Findings We assessed 11,914 participants for eligibility. 5800 participants were randomised, of whom 2915 smokers were allocated to the txt2stop intervention and 2885 were allocated to the control group; eight were excluded because they were randomised more than once. Primary outcome data were available for 5524 (95%) participants. Biochemically verified continuous abstinence at 6 months was significantly increased in the txt2stop group (10·7% txt2stop vs 4·9% control, relative risk [RR] 2·20, 95% CI 1·80-2·68; p<0·0001). Similar results were obtained when participants that were lost to follow-up were treated as smokers (268 [9%] of 2911 txt2stop vs 124 [4%] of 2881 control [RR 2·14, 95% CI 1·74-2·63; p<0·0001]), and when they were excluded (268 [10%] of 2735 txt2stop vs 124 [4%] of 2789 control [2·20, 1·79-2·71; p<0·0001]). No significant heterogeneity was shown in any of the prespecified subgroups. Interpretation The txt2stop smoking cessation programme significantly improved smoking cessation rates at 6 months and should be considered for inclusion in smoking cessation services. Funding UK Medical Research Council, Primary Care Research Networks.
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In the citing paper
“In Kenya, text messages to health workers significantly improved their adherence to guidelines for malaria treatment.”
From Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here? (2012) · cites this paper as [50]
Experimental — accuracy not yet measuredIn the citing paper
“Digital health interventions (DHI) can be used to promote healthy behaviours (e.g. smoking cessation, 1, 2 healthy eating, 3 physical activity, 4 safer sex 5 or alcohol consumption 6)”
From Evaluating Digital Health Interventions (2016) · cites this paper as [1]
In the citing paper
“Multi-faceted mHealth interventions have been shown to increase smoking cessation in a high-income setting and adherence to HIV medication in a low-income setting [19, 20].”
In the citing paper
“In a large randomized controlled trial, the adapted and modified SMS text messaging program (txt2stop) doubled biochemically verified continuous abstinence in 6 months compared with unassisted quit attempts, that is, 268/2911 (9%) versus 124/2911 (4%), respectively, (P<.001) [16].”
From Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study (2018) · cites this paper as [16]
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Metadata
- Authors
- Free, C., Knight, R., Robertson, S., Whittaker, R., Edwards, P., Zhou, W., Rodgers, A., Cairns, J., Kenward, M. G., & Roberts, I.
- Affiliations
- London School of Hygiene & Tropical Medicine (GB)
- University of Auckland (NZ)
- The University of Sydney (AU)
- Corresponding author
- Free, Caroline
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2011-07
- Volume
- 378
- Issue
- 9785
- Pages
- 49-55
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3143315
- OpenAlex
- W2102316523
- Cited by
- 728
- References
- 28
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 20 · 2023: 31 · 2022: 34 · 2021: 45 · 2020: 39 · 2019: 53 · 2018: 50 · 2017: 70 · 2016: 74 · 2015: 72 · 2014: 66 · 2013: 86 · 2012: 54
- FWCI
- 43.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- ResearchSpace (University of Auckland) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- smoking cessation, text messaging, automated intervention, continuous abstinence, motivational messages, quit attempts, digital health interventions, loss to follow-up, subgroup analysis, tobacco control, smoking cessation services, smoking cessation interventions
- MeSH terms
- Adolescent, Adult, Behavior Therapy, Educational Status, Employment, Female, Humans, Male, Motivation, Single-Blind Method, Smoking Cessation, Cell Phone, Young Adult
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