Effect of adding personalized instant messaging applications to brief smoking cessation model in community smokers: A pragmatic randomized clinical trial (Preprint)

Abstract

Text-messaging is effective for smoking cessation (SC).

We assess if more interactive and adaptive instant messaging (IM) apps on a smartphone that allows personalization and chatting with SC advisors could further increase SC.

700 adult Chinese daily cigarette users were proactively recruited in communities in Hong Kong from December 2018 to November 2019 and 1:1 randomized. All participants received face-to-face brief advice on SC, active referral (AR) to SC services at baseline. Intervention group received personalized regular messages and chatting through IM apps for 3 months, meanwhile control group received text messages on general health. The primary outcomes were smoking abstinence validated by carbon monoxide <4 parts per million at 6 and 12 months after intervention initiation. Trial Registry: ClinicalTrials.gov NCT03800719.

72.1% were male, 69.4% were aged 40 or above. At 6- and 12-month follow-up (retention rate: 65.1% and 63.7%), by intention to treat, validated quit rates were similar between the intervention (4.0% and 5.4%) and control (3.1% and 6.0%) groups. Self-reported 7-day point prevalence abstinence (9.1% vs 8.3%, 13.1% vs 14.3%) at both follow-ups were similar. Intervention group reported more SC service use at 12-month (35.1%) than control group (28.0%): adjusted risk ratio=1.26 (95% confidence interval 1.01-1.57).

An IM-based intervention providing support and assistance on top of brief SC advice and AR did not further increase quitting but promoted SC service use. Further studies can examine if increased SC service use result in better SC in a longer term.

Trial Registry: ClinicalTrials.gov NCT03800719. ULR:https://beta.clinicaltrials.gov/study/NCT03800719