Program Reviews

NEXit

Program Overview

NEXit delivers text messages encouraging smoking cessation up to 4 weeks before a selected quit date and in the 12 weeks following the quit date.

NEXit is a text-messaging intervention to facilitate smoking cessation. Participants are asked to set a quit date 1-4 weeks after intervention initiation and receive daily text messages for a motivation period between intervention initiation and their quit date and for 12 weeks following their quit date. Text message content and frequency varies over time. During the motivation period, users receive 2 text messages per day with relevant information about what to expect with quitting and how to cope with challenges when quitting. In the 3 days before and after quitting, users receive 5 messages per day with information about benefits of quitting and tips for quitting and staying quit. Users receive a decreasing amount of text messages per day for the rest of the cessation period, with users receiving 4 messages per day for the rest of week 1, 2 messages per day in weeks 2-4, 3 messages every 2 days in weeks 5-7, and 1 message per day in weeks 8-12. Messages during the cessation period include motivational content, tips for dealing with challenges (e.g., weight gain, craving, triggers). Users can request additional issue-specific messages to cope with cravings, relapse, or weight gain.

Delivery:
Text-messaging

Theoretical Approach:
None specified

Target Substance:
Tobacco

Target Outcome:
Smoking cessation

Ages:
Young Adults (18-30)
Adults (30+)

Genders:
Male
Female

Races/Ethnicities:
Unspecified

Setting:
Universities

Geographic Location:
Unspecified

Country:
Sweden

Language:
Swedish

Evaluations

  • Müssener U, Bendtsen M, Karlsson N, White IR, McCambridge J, Bendtsen P. JAMA Internal Medicine. 2016. 176(3): 321-328. doi: 10.1001/jamainternmed.2015.8260

    Summary: Researchers recruited 1,590 university students who smoked from 25 university student health centers in Sweden. Participants were eligible if they smoked at least weekly and were willing to set a quit date in the 4 weeks following enrollment. Participants were randomized to receive NEXit immediately or to a waitlist control group that received NEXit after 4 months. Both groups received text messages every two weeks thanking them for participating. Researchers assessed prolonged abstinence since quit date (fewer than 5 cigarettes in the past 8 weeks), 4-week point prevalence abstinence (no cigarettes in the past 4 weeks), 7-day point prevalence abstinence (no cigarettes in the past week), number of quit attempts during the study, use of smoking cessation services, and weekly cigarette consumption about 4 months after each participant’s quit date. Participants in the intervention group were significantly more likely than control group participants to report prolonged abstinence, 4-week point prevalence abstinence, and 7-day point-prevalence abstinence. Participants in the intervention group also used significantly more smoking cessation resources on average than the control group. Among participants who were still smoking post-intervention, participants in the intervention group made more quit attempts during the study period and smoked fewer cigarettes per week.

    Take Away: NEXit may promote smoking cessation, use of smoking cessation resources, reductions in smoking, and quit attempts in university students who are motivated to quit smoking.

  • Müssener U, Bendtsen M, McCambridge J, Bendtsen P. BMC Public Health. 2016. 16(1179). doi: 10.1186/s12889-016-3848-5

    Summary: Researchers sent participants from the intervention group a 14-question survey assessing perceptions of the structure and content of the NEXit intervention after the post-intervention assessment. Of the 289 respondents, about half (55%) felt the motivational phase provided good support before the quit date; 40% of respondents indicated that they did not think the motivational phase was supportive. Eighty-four respondents had quit smoking. Of respondents who had quit smoking, about two-thirds (67%) felt the motivational phase was supportive than the sample as a whole. Most respondents appreciated the mix of motivational content, facts, and advice in the intervention messages (78%). Most respondents found the content of the motivational (65%) and intervention (69%) messages to be good, though only 34% felt that all or nearly all of the messages were valuable. Respondents favored short messages and felt that the longer messages were often repetitive. Some respondents reported the quit date procedure was too restrictive (40%), many wanted to quit immediately. Almost half of respondents (47%) felt that there were too many messages in the 3 days before the quit date. Most respondents reported reading all or nearly all of the messages (68%) and that they would recommend NEXit to a peer (84%).

    Take Away: Participants generally found the content and structure of NEXit to be acceptable, but feedback highlighted potential improvements to the content, frequency, and quantity of program messages as well as to the process surrounding setting a quit date in NEXit.

  • SMS-based smoking cessation intervention among university students: Study protocol for a randomised controlled trial (NEXit trial). Müssener U, Bendtsen M, Karlsson N, White IR, McCambridge J, Bendtsen P. Trials. 2015. 16(140). doi: 10.1186/s13063-015-0640-2

    mHealth smoking cessation intervention among high-school pupils (NEXit Junior): Study protocol for a randomized controlled trial. Thomas K, Bendtsen M, Linderoth C, Müssener U. Trials. 2018. 19(648). doi: 10.1186/s13063-018-3028-2

    Exploring the experiences of individuals allocated to a control setting: Findings from a mobile health smoking cessation trial. Müssener U, Linderoth C, Bendtsen M. JMIR Human Factors. 2019. 6(2): e12139. doi: 10.2196/12139