Mobile Chat Messaging for Preventing Smoking Relapse Amid the COVID-19 Pandemic: A Pilot Randomized
Thursday, January 19, 2023
Posted by: Natalia Gromov
Luk
TT, Cheung YTD, Chan HC, Fok PW, Ho KS, Sze CD, Lam TH, Wang MP.
Mobile Chat Messaging for
Preventing Smoking Relapse Amid the COVID-19 Pandemic: A Pilot Randomized
Controlled Trial.
Nicotine Tob Res. 2023 Jan 5;25(2):291-297. doi: 10.1093/ntr/ntac045. PMID:
35166327; PMCID: PMC9383464.
Introduction. 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.
Methods. 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).
Results. 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.
Conclusions. 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.
Implications. 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.
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