A text messaging-based smoking cessation program for adult smokers: randomized controlled trial.
A text messaging-based smoking cessation program for adult smokers: randomized controlled trial.
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DOI：
10.2196/jmir.2231
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发表时间：
2012-12-27
影响因子：
7.4
通讯作者：
Emri S
中科院分区：
文献类型：
--
作者：
Ybarra M;Bağci Bosi AT;Korchmaros J;Emri S
尽管西方国家的数据很有希望，但在其他环境中，包括吸烟率较高的中东地区，缺乏对基于短信的戒烟计划的有效性的研究。本文报告了在SMS Turkey中观察到的戒烟率，SMS Turkey是土耳其安卡拉成年吸烟者基于短信的戒烟计划。本研究是一项在土耳其安卡拉进行的小规模、平行组随机对照试验（RCT）。参与者是成年的每日吸烟者，他们正在认真考虑在未来15天内戒烟，并居住在土耳其安卡拉。短信干预，SMS土耳其，提供6周的每日信息，旨在为参与者提供帮助他们戒烟的技能。消息以自动方式发送，除了初始退出日后2天和7天。在第2天和第7天，研究助理根据参与者是否仍然不吸烟或是否复吸，手动将他们分配到内容“路径”。对照组收到一本提供类似戒烟信息的小册子。主要结果测量是自我报告的3个月持续禁欲，通过一氧化碳（CO）读数验证。参与者和研究人员都不知道手臂分配。151名参与者被随机分配到两组中的一组：76名为SMS土耳其干预组，75名为小册子对照组。使用意向治疗，所有151名参与者都被纳入分析。三个月的戒烟趋势在干预组中并不显著更高：11%的干预组与5%的对照组戒烟（χ 2 1 = 1.4，P = 0.24; R2 = 2.0，95%CI 0.62 - 6.3）。当样本按性别分层时，女性干预参与者（14%，n = 5）在3个月时戒烟的可能性显著高于女性对照参与者（0%，n = 0; χ 2 1 = 3.7，P = 0.05）。在轻度吸烟者（即每天吸烟少于20支的人）中，干预参与者（17%，n = 5）与对照参与者（0%，n = 0; χ 2 1 = 5.3，P = 0.02）相比也更有可能戒烟。我们注意到男性或重度吸烟者的戒烟率没有差异。参与者在研究过程中遇到了重大的技术问题。一些参与者在试验期间至少收到一次重复的短信;其他人没有收到一些程序消息。收到重复消息（χ 2 1 = 0.12，P = 0.73）或丢失5条或更多程序消息（χ 2 1 = 0.75，P = 0.39）都不会对戒烟率产生负面影响。虽然这项研究没有把握检测统计学上的显著差异，因为主要目的是提供效应量的估计值，可用于更好地为更大规模的试验提供把握度分析，但研究结果提供了乐观的看法，即SMS Turkey可能能够影响吸烟率高的环境中的戒烟率，如土耳其安卡拉。SMS Turkey软件程序不像2年前那样工作。该系统将需要更新，以保持软件与不断发展的技术的兼容性。Clinicaltrials.gov
Despite promising data in Western countries, there is a dearth of research into the efficacy of text messaging-based smoking cessation programs in other settings, including the Middle East, where smoking prevalence rates are higher. This paper reports cessation rates observed in SMS Turkey, a text messaging-based smoking cessation program for adult smokers in Ankara, Turkey. This study was a small-scale, parallel-group randomized controlled trial (RCT) conducted in Ankara, Turkey. Participants were adult daily smokers who were seriously thinking about quitting in the next 15 days and living in Ankara, Turkey. The text messaging intervention, SMS Turkey, provided 6 weeks of daily messages aimed at giving participants skills to help them quit smoking. Messages were sent in an automated fashion, except 2 days and 7 days after the initial quit day. On days 2 and 7, the research assistant manually assigned participants to content “paths” based on whether they were still not smoking or had relapsed. The control arm received a brochure that provided similar information about smoking cessation. The main outcome measure was self-reported 3-month sustained abstinence, verified by carbon monoxide (CO) readings. Neither participants nor researchers were blinded to arm assignment. The 151 participants were randomly assigned to 1 of 2 groups: 76 to the SMS Turkey intervention group and 75 to the brochure control group. Using intention to treat, all 151 participants were included in analyses. Three-month cessation trends were not significantly higher in the intervention group: 11% intervention vs 5% control had quit (χ2 1=1.4, P=.24; R2=2.0, 95% CI 0.62-6.3). When the sample was stratified by sex, female intervention participants (14%, n=5) were significantly more likely to have quit at 3 months than female control participants (0%, n=0; χ2 1=3.7, P=.05). Among light smokers (ie, those smoking less than 20 cigarettes per day), intervention participants (17%, n=5) also were significantly more likely to have quit compared to control participants (0%, n=0; χ2 1=5.3, P=.02). We noted no difference in cessation rates for males or heavy smokers. Participants experienced significant technology problems during the study. Some participants received duplicate text messages at least once during the trial; others failed to receive some program messages. Neither receiving duplicate messages (χ2 1=0.12, P=.73), or missing 5 or more program messages (χ2 1=0.75, P=.39) negatively affected quitting rates. Although the study was not powered to detect statistically significant differences, as the primary aim was to provide estimates of effect size that could be used to better inform a power analysis for a larger trial, findings provide optimism that SMS Turkey may be able to affect quitting rates in environments with high smoking prevalence, such as Ankara, Turkey. The SMS Turkey software program did not work as well as it did 2 years previous. The system will need to be updated to maintain software compatibility with ongoing technology evolution. Clinicaltrials.gov NCT00912795 http://clinicaltrials.gov/ct2/show/NCT00912795 (Archived by WebCite at http://www.webcitation.org/6Ch1cIA8l).
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