Program Overview
Text2Quit sends tailored, supportive texts to users based on self-selected smoking quit date. A website provides specific information about tobacco use.
Text2Quit is a text messaging intervention that is available to consumers through health insurance programs, quit lines, and the program website. Users complete an initial assessment that includes gender, planned quit date, reasons for quitting, estimated monetary costs of their smoking habit and savings from quitting smoking, social support, triggers, and use of cessation medications. Users’ responses are used to tailor text messages sent by the system before, during, and after a user’s selected quit date. Texts contain prompts for users to respond to and users can send keywords to prompt the system to provide them with specific information. The program also includes automatic emails and a web portal.
Link to commercial site here.
Delivery:
Text Messaging
Web-Based
Theoretical Approach:
Social Cognitive Theory
Target Substance:
Tobacco
Ages:
Young Adults (18-30)
Adults (30+)
Genders:
Male
Female
Target outcome:
Abstinence
Races/Ethnicities:
Unspecified
Setting:
Remote Access
Geographic Location:
Unspecified
Country:
USA
Language:
English
Evaluations
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Summary: Researchers used fliers, listservs, and promotions on campus to recruit undergraduate students for a pilot of Text2Quit. Participants had to be daily smokers that planned on quitting and not be pregnant. Participants also had to have a personal email address, cellphone, and unlimited texting plan. At baseline, 23 eligible participants completed the baseline assessment and assessments of smoking characteristics and nicotine dependence. At 2 and 4 weeks post-baseline, participants completed assessments of texting behavior, smoking in the past seven days, number of consecutive days of quit attempt, and use and opinions of Text2Quit. Records of website usage and text messaging were reviewed. More than 80% of participants liked the program and more than 75% of participants reported reading all or most of the text messages from the program. The most popular feature was ability to compare cigarettes smoked the previous day to a user-set goal. Usage of program email and website functions were lower than text messaging. A majority (91.3%) responded to the program at least once over four weeks. On average, participants responded to text prompts 11.8 times over 21.7 days. Men responded to texts more frequently than women. Almost half of participants stopped using the system after their quit date.
Take Away: Text2Quit is a feasible and acceptable intervention for undergraduate smokers. Issues with program engagement after the quit date suggest the program needs to better engage smokers after their quit date.
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Summary: Researchers used Google ads to recruit 503 participants that were then randomized into an intervention group (n=262) that received Text2Quit or a control group (n=241) that received information about smoking cessation. Participants had to be daily smokers who were not pregnant, and planned on quitting. Participants were compensated for completing the surveys at 1, 3, and 6 months and providing a saliva sample at 6 months. At baseline, participants completed assessments of smoking characteristics and nicotine dependence. Number of text messages sent and received prior to the study was assessed at 1 month. Follow-up surveys at 1, 3, and 6 months assessed abstinence in the past seven and 30 days, use of cessation aids, and engagement with Text2Quit (Treatment group). Participants who reported not smoking in the past seven days at 6-months were sent a saliva collection kit to biologically verify their abstinence. Biochemically confirmed repeated point abstinence was defined as self-reported abstinence for the past 30 days at 3- and 6-month follow-ups and a saliva sample confirming abstinence at 6-months. Retention was 76% at 6-months. Biochemically confirmed repeated point abstinence was more likely to occur in the treatment group (11.1%) than in the control group (5.0%). Self-reported abstinence at 6-months was higher in the treatment group than the control group, but there was no difference between groups in biochemical confirmation of self-reports of abstinence at six-months. Biochemically confirmed repeated point prevalence abstainers in the treatment group sent keywords to the program more than non-abstainers.
Take Away: Text2Quit engaged participants to interact with the program through text messaging and was more effective at encouraging abstinence than information about cessation alone.
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Summary: This study examined the acceptability of integrated quitline and Text2Quit counselling for smokers in New Mexico who were attempting to quit. Researchers administered the baseline survey by phone to 35 quitline callers after their initial quitline call. Participants received a version of Text2Quit that did not include the email component, used the quitline service’s native web component, and slightly modified the text messages to fit with the quitline service. Participants completed assessments the number of texts they received and read, their perceived helpfulness of the program, their smoking behaviors, and their cell phone use. At the time of the survey, 32 participants had passed their quit date and more than half (59.4%) of these participants reported that they had quit. Of participants who had quit, 84.2% had not smoked in at least seven days. The majority of participants (91.4%) of participants reported reading at least half of the Text2Quit messages, 65.7% reported reading all the messages, and 5.7% reported unsubscribing from Text2Quit. Most participants reported that they would highly recommend Text2Quit (75.8%), phone counselling (78.8%), and integrated Text2Quit and phone counselling (93.9%) to a friend. Participants generally liked the texts, but some participants (6%) reported that receiving the texts would remind them of smoking. Recommendations to the texting and phone services generally related to tailoring the programs, especially the timing of texts and calls to fit individual needs.
Take Away: Text2Quit, phone counselling, and the integrated services were acceptable to participants and may have helped participants quit smoking.
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Summary: Researchers examined usage metrics and survey responses and the contents of outgoing texts of the intervention group. Retention in the intervention group was 73% at 6-months. About 30% of participants withdrew their enrollment in the program. Participants spent an average of 144.18 days enrolled in the program, sent an average of 24.2 texts while they were enrolled, and received an average of 210.5 texts. Most participants (85.1%) interacted with the program at least once. Participants logged into the intervention website an average of 1.9 times and received 23.8 emails. Most texts sent by participants were sent after their quit date. At the six-month follow-up survey, 31.7% reported abstaining from smoking. There were no statistically significant relationships between engagement or length of enrollment and abstinence. Abstainers were less likely than non-abstainers to send a text to withdraw enrollment and more likely than non-abstainers to interact with the program after their quit date. Sending a text to pledge to live smoke free or responding to a survey assessing their smoking status seven days after their quit date was positively related to smoking cessation. Sending texts indicating that they had smoked or to withdraw their enrollment were negatively related to cessation. Women had higher engagement with Text2Quit than men.
Take Away: High participant engagement with Text2Quit indicates that the program was acceptable to participants and associated with cessation. Text2Quit promoted recovery support to users after their quit date.
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Hoeppner BB, Hoeppner SS, Abroms LC. Addiction. 2016. PMID: 27943511
Summary: Researchers assessed the relationships between self-efficacy, motivation, social support, expertise, and use of cessation aids at the one-month follow-up and seven-day point prevalence abstinence at six months. Participants who received Text2Quit reported higher endorsement of the four psychosocial indicators. Higher levels of self-efficacy, expertise, and social support were related to higher abstinence rates in the Text2Quit group. The psychosocial indicators accounted for 35% of the total effect of the intervention. Text2Quit was also related to higher uptake of cessation medication. Self-efficacy was positively associated with 7-day point prevalence abstinence at 6 months. Use of recommended cessation aids (i.e. medication, quitline) were not related to abstinence. Use of online cessation communities was positively related to abstinence and use of self-help materials was negatively related to abstinence. Participants who did not use cessation medications reported higher rates of abstinence in the Text2Quit group than in the control group. Participants who did use medication reported no differences in abstinence between groups.
Take Away: Text2Quit’s effects on abstinence can be partially explained by psychosocial factors, but more research is needed to evaluate other factors that explain the effects of Text2Quit. Additionally, Text2Quit is related to abstinence in users that do not use cessation medication, but did not influence abstinence over and above use of medication.
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Summary: Researchers analyzed data from quitline callers in areas where Text2Quit was available and areas where it was not. Researchers selected 4,363 callers who agreed to receive Text2Quit for the intervention group and 4,363 callers in areas where Text2Quit was unavailable for the control group. Participants who were pregnant or were already quitting were ineligible to participate. Researchers analyzed assessments administered during the initial quitline call of participants’ smoking history, smoking characteristics, stage of change, and intention to use nicotine replacement therapy. A six-month follow-up call assessed participants’ abstinence and program satisfaction. Researchers examined usage metrics to measure engagement. Participants in the intervention and control group were matched on based on baseline characteristics. Rates of follow up were 41.4% for the intervention group and 42.9% for the control group. At follow-up, 61.2% of the intervention group and 59.3% of participants reported abstinence in the past seven days. There were no significant differences between rates of abstinence between groups and receiving the integrated services did not predict abstinence. Number of counselling calls completed by participants was positively associated with past 7-day abstinence, but keyword texts to Text2Quit were negatively related to 7-day abstinence. Participant satisfaction ratings were slightly higher in the intervention group.
Take Away: Integrating Text2Quit with phone counselling may not increase chances of quitting beyond phone counselling alone, but may leave users more satisfied.