Department of Public Health, Department of Psychology, Reference Center on Research, Intervention and Evaluation on Alcohol and Other Drugs (CREPEIA), Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS.
Nicotine Tob Res. 2019 Nov 19;21(12):1700-1705. doi: 10.1093/ntr/nty165.
Text messaging interventions are effective. Despite high utilization of smartphones, few studies evaluate text messaging for cessation in middle-/lower-income countries. Initiating tobacco treatment in hospitals is an effective but underutilized approach for reaching smokers. We evaluated a hybrid phone counseling/text messaging intervention for supporting cessation among hospitalized smokers in Brazil.
We used an experimental design to assess the feasibility and potential effect size of the intervention. Participants (N = 66) were recruited from a university hospital and randomized in a 2:1 ratio into TXT (one session of telephone counseling plus 2 weeks of text messaging; N = 44) or Standard Care control group (N = 22). Participants lost to follow-up were counted as smokers.
Counselors sent 1186 texts, of which 924 (77.9%) were received by study participants. Participants rated the TXT content as "helpful" (80.4%) and the phone counseling length to be "just right" (95.1%). Although the study was not powered to evaluate abstinence rates, we did observe a higher prevalence of abstinence in the TXT compared to control group at both 1-month follow-up (25.0% vs. 9.1%) and 3-month follow-up (31.8% vs. 9.1%). Carbon monoxide-verified abstinence at month 3 was also higher in TXT (20.5% vs. 4.5%).
This hybrid telephone/text intervention should progress to full-scale effectiveness testing as it achieved favorable outcomes, was acceptable to participants, and was readily implemented. This type of intervention has strong potential for expanding the reach of hospital-initiated tobacco treatment in middle-/lower-income countries.
This study extends research on hospital-initiated smoking cessation by establishing the feasibility of a novel text-messaging approach for post-discharge follow-up. Text messaging is a low-cost alternative to proactive telephone counseling that could help overcome resource barriers in middle- and lower-income countries. This hybrid texting/counseling intervention identified smokers in hospitals, established rapport through a single telephone follow-up, and expanded acceptability and reach of later support by using text-messaging, which is free of charge in this and other low-income countries. The favorable cessation outcomes achieved by the hybrid intervention provide support for a fully powered effectiveness trial.
短信干预措施是有效的。尽管智能手机的使用率很高，但很少有研究评估在中低收入国家使用短信进行戒烟。在医院启动烟草治疗是一种有效但未充分利用的方法，可以帮助吸烟者戒烟。我们评估了一种混合电话咨询/短信干预措施，以支持巴西住院吸烟者戒烟。
我们使用实验设计来评估该干预措施的可行性和潜在效果大小。参与者（N=66）从一所大学医院招募，并按照 2:1 的比例随机分为 TXT 组（一次电话咨询加 2 周短信；N=44）或标准护理对照组（N=22）。随访失访者被视为吸烟者。
咨询师发送了 1186 条短信，其中 924 条（77.9%）被研究参与者接收。参与者认为 TXT 内容“有帮助”（80.4%），电话咨询时长“恰到好处”（95.1%）。尽管该研究没有足够的能力评估戒烟率，但我们确实观察到 TXT 组在 1 个月随访（25.0%比 9.1%）和 3 个月随访（31.8%比 9.1%）时的戒烟率更高。3 个月时 TXT 组的一氧化碳验证戒烟率也更高（20.5%比 4.5%）。
由于该混合电话/短信干预措施取得了良好的效果，参与者可以接受，并且易于实施，因此应继续进行全面的有效性测试。这种干预措施在中低收入国家扩大医院启动的烟草治疗的范围具有很大的潜力。
本研究通过建立一种新的短信随访方法，为医院启动的戒烟研究提供了可行性，扩展了这方面的研究。短信是一种比主动电话咨询成本更低的选择，可以帮助克服中低收入国家的资源障碍。这种混合短信/咨询干预措施在医院识别吸烟者，通过一次电话随访建立关系，并通过免费的短信提供后续支持，从而扩大了接受度和覆盖面。混合干预措施取得的良好戒烟结果支持进行全面的有效性试验。
