School of Nursing, The University of Hong Kong, Hong Kong SAR.
Integrated Centre on Smoking Cessation, Tung Wah Group of Hospitals, Hong Kong SAR.
Nicotine Tob Res. 2023 Jan 5;25(2):291-297. doi: 10.1093/ntr/ntac045.
The ongoing COVID-19 pandemic had reduced access to traditional, in-person smoking cessation treatment. We examined the feasibility, acceptability, and potential effectiveness of mobile chat messaging in preventing smoking relapse in smokers who have recently quit smoking.
In this assessor-blinded, pilot randomized controlled trial in five cessation clinics, we recruited adult daily smokers who had been receiving cessation treatments and abstained for 3 to 30 days. The intervention group received real-time, personalized chat messaging on relapse prevention via WhatsApp for 3 months. The control group received generic text messaging on the harms of smoking and benefits of quitting for 3 months. The primary outcome was carbon monoxide-validated abstinence at 6 months post-treatment initiation. The trial was registered with ClinicalTrials.gov (NCT04409496).
From June to July 2020, 108 of 130 (83%) eligible subjects were randomized to the intervention (N = 54) or control (N = 54) groups. The retention rate was 93% at 3 months (end of treatment) and 85% at 6 months. In the intervention group, 80% of participants responded to the chat messages at least once; 43% continuously engaged with the intervention over the 3-month intervention period. By intention-to-treat, validated abstinence at 6 months was higher in the intervention than control group (31% vs. 22%), with a relative risk of 1.72 (95% CI = 0.91% to 3.23%; p = .09) after adjusting for pre-quit nicotine dependence, duration of abstinence, and cessation treatment at baseline.
This pilot trial showed the feasibility and acceptability of mobile chat messaging for relapse prevention with preliminary evidence on its effectiveness in increasing validated abstinence.
Smoking relapse is the most likely outcome of smoking cessation attempts and an undertreated problem. This pilot trial showed the feasibility and acceptability of personalized chat messaging via WhatsApp for relapse prevention in recent abstainers amid the COVID-19 pandemic. The higher carbon monoxide-validated abstinence rate in participants who received chat messaging than controls showed preliminary evidence on the effectiveness of the intervention. Fully powered trials are warranted to test the intervention.
持续的 COVID-19 大流行使得传统的面对面戒烟治疗变得难以获得。我们研究了移动聊天信息在预防近期戒烟的吸烟者复吸方面的可行性、可接受性和潜在有效性。
在五个戒烟诊所中，我们进行了这项评估者设盲的、初步的随机对照试验，招募了正在接受戒烟治疗且已戒断 3 至 30 天的成年每日吸烟者。干预组通过 WhatsApp 接受为期 3 个月的实时、个性化的预防复吸聊天信息。对照组接受为期 3 个月的关于吸烟危害和戒烟益处的通用短信。主要结局是在治疗开始后 6 个月时经一氧化碳验证的戒烟。该试验已在 ClinicalTrials.gov（NCT04409496）注册。
2020 年 6 月至 7 月，130 名符合条件的受试者中有 108 名（83%）被随机分配至干预组（n = 54）或对照组（n = 54）。3 个月时（治疗结束时）的保留率为 93%，6 个月时为 85%。在干预组中，80%的参与者至少回复了一次聊天信息；43%的参与者在 3 个月的干预期间持续参与了干预。按照意向治疗分析，干预组在 6 个月时的经验证的戒烟率高于对照组（31%对 22%），在调整了戒烟前尼古丁依赖程度、戒烟持续时间和基线时的戒烟治疗后，相对风险为 1.72（95%CI = 0.91%至 3.23%；p =.09）。
这项初步试验表明，移动聊天信息在预防复吸方面是可行和可接受的，并且初步证明了其在增加经验证的戒烟率方面的有效性。
吸烟复吸是戒烟尝试最有可能的结果，也是一个治疗不足的问题。这项初步试验表明，在 COVID-19 大流行期间，对于最近戒烟的人，通过 WhatsApp 进行个性化聊天信息可以预防复吸，具有可行性和可接受性。与对照组相比，接受聊天信息的参与者的一氧化碳验证戒烟率更高，这初步证明了该干预措施的有效性。需要进行充分的试验来测试该干预措施。
