Addressing Tobacco Use Disparities through an Innovative Mobile Phone Intervention: The textto4gosmokelesstobacco

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 DESCRIPTION (provided by applicant): Rural Americans are a vulnerable group at high risk for tobacco-related illness. Smokeless tobacco use is high among rural Americans at 11% and has not decreased significantly in the past decade. Rural Americans who want to quit have access to few innovative interventions. This is a significant missed opportunity for tobacco control in this population. Scheduled Gradual Reduction (SGR) may be an effective intervention to help smokeless tobacco users quit and has been minimally studied. Delivering SGR interventions via Short Message Service (SMS) text messaging is an innovative way to increase reach of smokeless tobacco cessation interventions in rural populations. We propose a 3-year pilot randomized controlled trial to evaluate the feasibility, acceptability and preliminary efficay of a SGR intervention via SMS text messaging plus SMS Support Messages in decreasing smokeless tobacco use in a rural population. The SGR group (n=60) will receive a four week SGR program delivered via SMS text messages plus SMS support messages. The control group (n=30) will receive SMS support messages to aid in quitting. We will use a variety of recruitment methods to obtain our sample and will use 2:1 treatment allocation strategy to be sure we have an adequate sample in the intervention group to generate reliable effect sizes for future studies. Primary outcomes for each participant will be: 1) proportion of messages read (feasibility); 2) ratings of the usefulness of the intervention received (acceptability) and 3) smokeless tobacco cessation at 3 and 6 months (preliminary efficacy). This will be the first SMS texting intervention using SGR with smokeless tobacco users targeting rural smokeless tobacco users who lack access to innovative and effective interventions. If successful, this study can be easily disseminated to rural smokeless tobacco users to aid in cessation, thus helping to decrease tobacco related health disparities.