Dropout, Response, and Abstinence Outcomes of a National Text-Messaging Smoking Cessation Interventi
Friday, August 14, 2020
Posted by: Natalia Gromov
Chan C, Kamke K, Assuah F,
El-Toukhy S.
Dropout, Response, and
Abstinence Outcomes of a National Text-Messaging Smoking Cessation Intervention
for Teens, SmokeFreeTeen.
[published online ahead of print, 2020 Jul 25]. Transl Behav Med. 2020;ibaa069.
doi:10.1093/tbm/ibaa069
Although text-messaging interventions are effective for smoking cessation, few
target teens in the USA and little is known about their effectiveness. The
purpose of this manuscript is to examine correlates of dropout, response to
smoking status prompts, and abstinence rates among subscribers of
SmokeFreeTeen, a free, publicly available text-messaging smoking cessation
intervention sponsored by the National Cancer Institute's SmokeFree.Gov
initiative, on quit day through 1 month follow-up. In a sample of teens (N =
2,685), aged 13-19, we examined demographics, smoking frequency, cigarettes
smoked per day, prequit intervention time (i.e., maximum of 14 days of prequit
day preparation), and number of quit attempts as correlates of response and
abstinence rates among program initiators (i.e., participants who reached quit
day but dropped out on or before intervention end) and completers (i.e.,
participants who reached quit day and completed the intervention). We also
conducted Cox regression analysis of time from quit day to dropout by daily and
nondaily smoking status. Two-thirds (n = 1,733, 64.54%) dropped out before the
intervention ended, with dropout rates peaking on quit day (n = 289, 13.10%).
Response rate to smoking status prompts remained below 30% throughout the
intervention. At intervention end and 1 month follow-up, abstinence was 2.63%
and 2.55% among program initiators, whereas abstinence was 6.09% and 6.01%
among program completers. Dropout, response, and abstinence rates did not
consistently differ by subscriber characteristics. Prequit time was associated
with decreased likelihood of dropping out (adjusted hazards ratio: 0.94,
confidence interval [CI]: 0.93-0.95), responding to smoking status prompts
(adjusted odds ratio [aOR]: 0.94, CI: 0.92-0.96), and being abstinent (aOR:
0.96, CI: 0.93-0.99) on quit day. Two or more quit attempts were associated
with increased response (aOR: 1.61, CI: 1.16-2.23) and abstinence (aOR: 1.91,
CI: 1.25-2.92) rates on Day 7. In a first assessment of SmokeFreeTeen outcomes,
we document high dropouts and low response and abstinence rates. SmokeFreeTeen
produced abstinence rates lower than comparable text-messaging interventions
targeting teens and young adults. Improving SmokeFreeTeen's reach, engagement,
and effectiveness is needed.
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