Effect of mobile interventions with nicotine replacement therapy sampling on long-term smoking cessation in community smokers: A pragmatic randomized clinical trial

TY - JOUR

T1 - Effect of mobile interventions with nicotine replacement therapy sampling on long-term smoking cessation in community smokers

T2 - A pragmatic randomized clinical trial

AU - Guo, Ningyuan

AU - Luk, Tzu Tsun

AU - Wu, Yongda Socrates

AU - Guo, Ziqiu

AU - Chu, Jessica Chi Lok

AU - Cheung, Yee Tak Derek

AU - Chan, Ching Han Helen

AU - Kwok, Tyrone Tai On

AU - Wong, Victor Yiu Lun

AU - Wong, Carlos King Ho

AU - Lee, Jung Jae

AU - Kwok, Yu Kwong

AU - Viswanath, Kasisomayajula

AU - Lam, Tai Hing

AU - Wang, Man Ping

N1 - Publisher Copyright: © 2023 Guo N. et al.

PY - 2023/3

Y1 - 2023/3

N2 - INTRODUCTION Mobile interventions enable personalized behavioral support that could improve smoking cessation (SC) in smokers ready to quit. Scalable interventions, including unmotivated smokers, are needed. We evaluated the effect of personalized behavioral support through mobile interventions plus nicotine replacement therapy sampling (NRT-S) on SC in Hong Kong community smokers. METHODS A total of 664 adult daily cigarette smokers (74.4% male, 51.7% not ready to quit in 30 days) were proactively recruited from smoking hotspots and individually randomized (1:1) to the intervention and control groups (each, n=332). Both groups received brief advice and active referral to SC services. The intervention group received 1-week NRT-S at baseline and 12-week personalized behavioral support through SC advisor-delivered Instant Messaging (IM) and a fully automated chatbot. The control group received regular text messages regarding general health at a similar frequency. Primary outcomes were carbon monoxide-validated smoking abstinence at 6 and 12 months post-treatment initiation. Secondary outcomes included self-reported 7-day point-prevalence and 24-week continuous abstinence, quit attempts, smoking reduction, and SC service use at 6 and 12 months. RESULTS By intention-to-treat, the intervention group did not significantly increase validated abstinence at 6 months (3.9% vs 3.0%, OR=1.31; 95% CI: 0.57–3.04) and 12 months (5.4% vs 4.5%, OR=1.21; 95% CI: 0.60–2.45), as were self-reported 7-day point-prevalence abstinence, smoking reduction, and SC service use at 6 and 12 months. More participants in the intervention than control group made a quit attempt by 6 months (47.0% vs 38.0%, OR=1.45; 95% CI: 1.06–1.97). Intervention engagement rates were low, but engagement in IM alone or combined with chatbot showed higher abstinence at 6 months (adjusted odds ratios, AORs=4.71 and 8.95, both p<0.05). CONCLUSIONS Personalized behavioral support through mobile interventions plus NRT-S did not significantly improve abstinence in community smokers compared to text only messaging. The suboptimal intervention engagement needs to be addressed in future studies.

AB - INTRODUCTION Mobile interventions enable personalized behavioral support that could improve smoking cessation (SC) in smokers ready to quit. Scalable interventions, including unmotivated smokers, are needed. We evaluated the effect of personalized behavioral support through mobile interventions plus nicotine replacement therapy sampling (NRT-S) on SC in Hong Kong community smokers. METHODS A total of 664 adult daily cigarette smokers (74.4% male, 51.7% not ready to quit in 30 days) were proactively recruited from smoking hotspots and individually randomized (1:1) to the intervention and control groups (each, n=332). Both groups received brief advice and active referral to SC services. The intervention group received 1-week NRT-S at baseline and 12-week personalized behavioral support through SC advisor-delivered Instant Messaging (IM) and a fully automated chatbot. The control group received regular text messages regarding general health at a similar frequency. Primary outcomes were carbon monoxide-validated smoking abstinence at 6 and 12 months post-treatment initiation. Secondary outcomes included self-reported 7-day point-prevalence and 24-week continuous abstinence, quit attempts, smoking reduction, and SC service use at 6 and 12 months. RESULTS By intention-to-treat, the intervention group did not significantly increase validated abstinence at 6 months (3.9% vs 3.0%, OR=1.31; 95% CI: 0.57–3.04) and 12 months (5.4% vs 4.5%, OR=1.21; 95% CI: 0.60–2.45), as were self-reported 7-day point-prevalence abstinence, smoking reduction, and SC service use at 6 and 12 months. More participants in the intervention than control group made a quit attempt by 6 months (47.0% vs 38.0%, OR=1.45; 95% CI: 1.06–1.97). Intervention engagement rates were low, but engagement in IM alone or combined with chatbot showed higher abstinence at 6 months (adjusted odds ratios, AORs=4.71 and 8.95, both p<0.05). CONCLUSIONS Personalized behavioral support through mobile interventions plus NRT-S did not significantly improve abstinence in community smokers compared to text only messaging. The suboptimal intervention engagement needs to be addressed in future studies.

KW - community smoker

KW - messaging

KW - mHealth

KW - randomized controlled trial

KW - smoking cessation

UR - http://www.scopus.com/inward/record.url?scp=85153607143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85153607143&partnerID=8YFLogxK

U2 - 10.18332/tid/160168

DO - 10.18332/tid/160168

M3 - Article

AN - SCOPUS:85153607143

SN - 1617-9625

VL - 21

JO - Tobacco Induced Diseases

JF - Tobacco Induced Diseases

IS - March

M1 - 44

ER -