Peer Mentoring and Automated Text Messages for Smoking Cessation: A Randomized Pilot Trial

Abstract

Introduction: Text-messaging programs for smoking cessation, while efficacious, have high drop-out rates. To address this problem, we developed and tested the feasibility and early efficacy of a peermentoring intervention for smoking cessation provided by former smokers.Methods: Adult U.S. smokers were recruited nationally into a randomized pilot trial (N=200), comparing 6-8 weeks of automated text-messaging support (SmokefreeTXT) and automated text support plus personalized texts from a peer mentor who formerly smoked. The primary outcome was biochemically verified 7-day point-prevalence abstinence at 3 months post-quite date, assessed on an intent-to-treat basis (missing = smoking). Self-reported abstinence, program acceptability, user engagement, and user perceptions were also assessed. Results:Biochemically verified abstinence at 3 months was 7.9% (8/101) in the intervention group and 3.0% (3/99) in the control group (adjusted difference 6.5, 95% CI 0.7-12.3; p=0.03). Self-reported abstinence at 3 months was 23.8% (24/101) in the intervention group versus 13.1% (13/99) in the control group (adjusted difference 12.7, 95% CI 1.2-24.1; p=0.03). The intervention had a positive but insignificant effect on overall satisfaction (78.3% vs. 72.9% control group, p=0.55). Having a mentor did not significantly alter duration of interaction with the program, nor the proportion unsubscribing, although the intervention group reset their quit date with greater frequency (p<0.01) and sent more messages (p<0.01).Conclusions: Peer mentoring combined with automated text messages was feasible and acceptable and increased smoking abstinence compared with automated messages alone. The results highlight the promise of this intervention approach and the need for a full-scale evaluation.Implications: Providing quitting assistance by automated text messaging has been shown to increase smoking abstinence. Yet, dropout rates in text-messaging programs are high. No studies have tested the effectiveness of peer mentors who are former smokers as part of a text-messaging intervention, although

Effectiveness of community health workers involvement in smoking cessation programme: A systematic review

“…One hundred full text articles were screened, of which 95 articles were excluded for following reasons: interventions were not given by CHWs (73 studies), study designs were non controlled trials (17 studies) and outcomes were not smoking cessation (5 studies). Finally, five studies were included in this review [28][29][30][31][32].…”

“…The studies were conducted between the year of 2011 and 2018. Two studies were conducted in United States of America (USA) [28,29] while the other studies were conducted in Hong Kong [30], Australia [32] and Vietnam [31]. The duration of the studies conducted ranged from 6 weeks to 30 months.…”

“…The usual care intervention given to both intervention groups and control group were mainly brief advice, and some of the studies provided self-help material. Four studies used brief advice; one study used AWARD model (Ask, Warn, Advise, Refer and Do-it-again) [30], one study used 4A's model (Ask for tobacco use, Advise to quit, Assess readiness to quit, and Assist) [31], one study used automated Smokefree TXT [29] and one study used on-screen advice [32]. Self-help materials in the form of leaflet or brochure were provided to the participants in three studies [28,30,31].…”

“…by CHWs [30]. One study used personalized text messages [29] as a mediator for smoking cessation intervention. Table 2 shows the details of the interventions.…”

“…The outcomes of the smoking abstinence rate were measured by either self-reporting or chemically verified using CO level. Two studies provided abstinence rate after 3 months [28,29] and the remaining three studies after 6 months [30][31][32]. The pooled OR were estimated using random effects models as the studies included were heterogenous with respect to interventions and populations.…”