Cited by 734Smoking Behavior and CessationMobile Health and mHealth ApplicationsSubstance Abuse Treatment and Outcomes

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Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial

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Free, Caroline, Knight, Rosemary, Robertson, Steven, Whittaker, Robyn, Edwards, Phil, Zhou, Weiwei, Rodgers, Anthony, Cairns, John, Kenward, Michael G, Roberts, Ian·2011·The Lancet

DOI 10.1016/s0140-6736(11)60701-0PMC PMC3143315

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Abstract

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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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: Free, Caroline
Whittaker, Robyn
Edwards, Phil
Zhou, Weiwei
Rodgers, Anthony
Cairns, John
Kenward, Michael G
Roberts, Ian
Venue: The Lancet
Publisher: Elsevier BV
Published: 2011-07
Volume: 378
Issue: 9785
Pages: 49-55
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(11)60701-0
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: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
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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