Müssener Ulrika, Bendtsen Marcus, Karlsson Nadine, White Ian R, McCambridge Jim, Bendtsen Preben
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Department of Computer and Information Science, Linköping University, Linköping, Sweden.
JAMA Intern Med. 2016 Mar;176(3):321-8. doi: 10.1001/jamainternmed.2015.8260.
Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people.
To determine the effectiveness of a text-based smoking cessation intervention among young people.
DESIGN, SETTING, AND PARTICIPANTS: A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate.
The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention.
The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date).
A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively, a mean (SD) of 3.9 (0.37) months after the quit date. The adjusted odds ratios (95% CIs) for these findings were 2.05 (1.57-2.67) and 1.56 (1.19-2.05), respectively.
With the limitation of assessing only the short-term effect of the intervention, the effects observed in this trial are comparable with those for traditional smoking cessation interventions. The simple NEXit intervention has the potential to improve the uptake of effective smoking cessation interventions.
isrctn.org Identifier: ISRCTN75766527.
在全球范围内，吸烟是最重要的可预防的健康不良和死亡原因。移动电话干预措施，尤其是短信服务（SMS）文本信息，有可能克服传统医疗服务的获取障碍，尤其是在年轻人中。
确定基于文本的戒烟干预措施对年轻人的有效性。
设计、设置和参与者：2014年10月23日至2015年4月17日进行了一项单盲、双臂随机临床试验（尼古丁退出[NEXit]）；数据分析于2014年4月23日至2015年5月22日进行。参与者包括愿意在入组后1个月内设定戒烟日期的每日或每周吸烟者。该研究通过电子邮件邀请瑞典所有大学生参与。
NEXit核心计划始于为期1至4周的动机激发阶段，在此期间参与者可以选择设定戒烟日期。然后，干预组在12周内收到基于有效戒烟干预措施组成部分的157条文本信息。对照组每2周收到1条感谢他们参与研究的信息，并延迟获得干预措施。
主要结局是自我报告的长期戒烟（过去8周内吸烟不超过5支）以及干预结束后不久（大约在戒烟日期后4个月）4周时点的完全戒烟患病率。
共有1590名参与者，主要年龄在21至30岁之间，被随机纳入研究；827名（573名[69.3%]为女性）被分配到干预组，763名（522名[68.4%]为女性）被纳入对照组。干预组783名（94.7%）和对照组719名（94.2%）有主要结局数据。基线时，参与者每周吸烟的中位数（范围）分别为63支（1 - 238支）和70支（2 - 280支）。干预组203名（25.9%）参与者报告8周长期戒烟，对照组105名（14.6%）；分别有161名（20.6%）和102名（14.2%）参与者报告4周时点完全戒烟，平均（标准差）在戒烟日期后3.9（0.37）个月。这些结果的调整后比值比（95%置信区间）分别为2.05（1.57 - 2.67）和1.56（1.19 - 2.05）。
鉴于仅评估了干预措施的短期效果这一局限性，本试验中观察到的效果与传统戒烟干预措施的效果相当。简单的NEXit干预措施有可能提高有效戒烟干预措施的接受度。
isrctn.org标识符：ISRCTN75766527。
