Sequeira Miriam, Naughton Felix, Velleman Richard, Gaikwad Leena, Murthy Pratima, Pacheco Marimilha Grace, D'souza Joseline, Nair Ganga, Shah Rachit, Sambari Seema, Bhatia Urvita, Nadkarni Abhijit
Addictions and related-Research Group, Sangath, Porvorim, Goa, India.
Behavioural and Implementation Science Group, University of East Anglia, Norwich, UK.
Nicotine Tob Res. 2024 Dec 21. doi: 10.1093/ntr/ntae306.
Tobacco consumption is a leading cause of mortality globally. Eighty percent of these deaths occur in low- and middle-income countries (LMICs). Despite this, there is a large treatment gap due to both demand and supply-side barriers. Digital interventions are an innovative solution to bridge this gap. We describe the systematic development of ToQuit, a text-messaging intervention for tobacco cessation in India.
ToQuit was developed in sequential steps: a) Identifying Behaviour Change Techniques (BCTs) from evidence-based tobacco cessation interventions; b) Identifying additional BCTs through in-depth interviews (IDIs); c) Online expert survey to rate BCTs on feasibility, acceptability and perceived effectiveness when delivered via text messaging; and d) A consultation workshop with practitioners.
Thirty BCTs were identified from steps one and two. Three were excluded in step three. The final intervention included 27 BCTs delivered over three phases: phase one - orientation (information about antecedents and consequences of tobacco consumption, goal setting, reattribution, pros and cons of quitting); phase two - skill-building (self-monitoring, avoidance of cues for behaviour, behaviour substitution, distraction, stress-management, handling urges, restructuring physical and social environments, instructions on how to perform a behaviour, prompts and cues, problem-solving, social support and referrals among others); and phase three - relapse prevention (psychoeducation about lapse and relapse, review goals, action planning and feedback on behaviour). The intervention is delivered via text messages over eight weeks with 2-3 messages a day, 2-3 days a week.
ToQuit is a contextually relevant and potentially scalable text messaging intervention for tobacco cessation in resource-constrained settings.
This manuscript is an important piece in the development of contextually relevant digital interventions for cessation of both smoked and smokeless forms of tobacco. The detailed description of the steps followed in developing the ToQuit intervention will help others replicate these procedures while developing similar interventions responsive to their contexts; particularly in LMICs.
烟草消费是全球死亡的主要原因。其中80%的死亡发生在低收入和中等收入国家（LMICs）。尽管如此，由于需求和供应方面的障碍，存在很大的治疗差距。数字干预是缩小这一差距的创新解决方案。我们描述了ToQuit的系统开发过程，这是一种针对印度戒烟的短信干预措施。
ToQuit分阶段开发：a）从循证戒烟干预措施中识别行为改变技术（BCTs）；b）通过深入访谈（IDIs）识别其他BCTs；c）在线专家调查，以评估通过短信发送时BCTs在可行性、可接受性和感知有效性方面的情况；d）与从业者举办一次咨询研讨会。
从第一步和第二步中识别出30种BCTs。第三步排除了3种。最终干预措施包括在三个阶段实施的27种BCTs：第一阶段——定向（关于烟草消费的前因后果、目标设定、重新归因、戒烟利弊的信息）；第二阶段——技能培养（自我监测、避免行为线索、行为替代、分散注意力、压力管理、应对冲动、重构物理和社会环境、关于如何实施行为的指导、提示和线索、解决问题、社会支持和转介等）；第三阶段——预防复发（关于失误和复发的心理教育、回顾目标、行动计划和行为反馈）。干预措施通过短信在八周内实施，每天2 - 3条短信，每周2 - 3天。
ToQuit是一种在资源有限环境中与实际情况相关且可能具有可扩展性的戒烟短信干预措施。
本手稿是开发与实际情况相关的数字干预措施以戒除吸烟和无烟烟草形式的重要组成部分。ToQuit干预措施开发过程中所遵循步骤的详细描述将有助于其他人在开发类似的因地制宜的干预措施时复制这些程序；特别是在低收入和中等收入国家。
