Quit4hlth: Enhancing Tobacco and Cancer Control Through Framed Text Messages

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 DESCRIPTION (provided by applicant): The overall goal of the proposed research is to address tobacco and cancer control by increasing smoking cessation rates through the use of framed text messages among smokers who enroll in quitline treatment. We will compare quit rates for smokers who receive 30 weeks of tailored, gain-framed text messages with smokers who receive 30 weeks of tailored, standard care (unframed) text messages, both combined with standard quitline treatment, to develop an effect size estimate for 7-day point prevalence abstinence smoking cessation at 30 weeks after intake. Smoking cessation support provided via text message is effective and is emerging as a standard service provided by quitlines. A recent large efficacy trial found a that the smoking cessation rate at 6 months for participants who received text-based motivational messages and behavior change support was 5.8% higher than participants who received control messages unrelated to quitting. Moreover, we have shown that in accordance with prospect theory, gain-framed quitline counseling and print messages are effective for enhancing smoking cessation, and gain-framed messages are more effective than loss-framed messages for increasing intentions to quit and quit attempts. Therefore, we plan to test a strategy to enhance the known benefits of text messaging interventions for smoking cessation by delivering gain-framed text messages. We theorize that the gain-framed text message intervention will increase cessation rates at 30 weeks as compared to unframed text messages. We chose this approach based on the population-level impact of quitlines, which involves both reach and effect. This innovative approach gives us the potential to translate our findings to all quitlines, which are state-wide treatment settings that reach millions of smokers every year. Thus, this intervention has the potential to make a substantial impact on tobacco and cancer control.