Using mobile phones for smoking cessation
Lorien Abroms, ScD.Milken Institute School of Public HealthPrevention & Community HealthGeorge Washington University Slide2
’ll coverCurrent Research Program
personalized text messages for quitting smokingSupporting website and emailsMessages are timed around quit dateProactive: Advice on quitting, peer ex-smoker messages, medication msgs, games, and relapse messages.On-Demand: need additional motivation, having a craving, relapse.2-3 messages/day following quitdateSlide4
On demand games & tips
Text2Quit. Tomorrow’s the big day! Throw out all your cigs & clean out ashtrays. Keep busy & avoid smokers. Text CRAVE to fight cravings.
Advice on QuittingSlide5
/No DateReasons for quitting
TriggersGenderUse of pharmacotherapy Stats on money saved and health benefits accruedPersonalizationPersonalized ReasonsText2Quit. Lorien’s
reasons to quit are: To improve my health, To save money, So that I can be there for my kids Lailah, David & MayaSlide6
Evidence: Cessation programs should follow 5A’s:
Ask for tobacco use status
Advise every user to quitAssess willingness to quitAssist with a quit planPractical counseling Intra-treatment social supportConnect to a quitlineArrange for follow-upSlide7
Advantages of mobile
1. Help anywhere and anytime2. Proactive messages interrupt you
3. Interactive help4. Personalized help5. Increase contact time6. Unobtrusive and confidential 7. (Goes with smoking) Source: Abroms, Padmanabhan, and Evans 2011Slide8
Participants (n = 503) were recruited on the Internet with
google ad wordsRandomized to receive Text2Quit or a self-help material (Smokefree.gov; Clearing the Air). Surveyed at baseline and at 1, 3, and 6 months post-enrollment to assess smoking status.
Saliva collected from self-reported quitters at 6 monthsAn intent to treat analysis was used, and those lost to follow up were categorized as smokers. Abroms LC, Boal AL, Simmens SJ, Mendel JA, Windsor RA. A Randomized Trial of Text2Quit: A Text Messaging Program for Smoking Cessation. American Journal of Preventive Medicine. 2014Randomized Trial of Text2QuitSlide9
Be Free Study (N=503)
in the Past 7 days30.5%14.5%33.2%19.9%31.7%
SJ, Mendel JA, Windsor RA. A Randomized Trial of Text2Quit:
Text Messaging Program for Smoking Cessation.
Journal of Preventive Medicine
27 States, 675 employers/health plans -Participants receive:
Phone counseling 2) Web Coach® 3) Text2QuitSM -Over 100,000 callers enrolled in Text2Quit+Slide11
Whittaker et al. Meta-Analysis.
Outreach Partners:Telecoms industry support:12
N=900,000+ subscribers since launch (2011)
CMS pays for Quit4baby as add on service in 4 states
300+ enrolled in Quit4babySlide13
1-month1-monthMeasure Abstained from smoking in past 7 daysa,b,c
Abstained from smoking in past 30
Number of continuous days
Banned smoking from their
Banned smoking from their
Smoking-Related Outcomes Slide16
Program Data: Days Enrolled
~30% unsubscribe in first weekN=480
Abroms LC, Leavitt LE, Schindler-Ruwisch JM, Augustson, EM. 2015Slide17
Does it work with hard to reach smokers (e.g. pregnant, HIV+)Does it work in a real world contextEnrollment
High unsubscribe ratesNext Frontier:Personalized MedicineOptimize with sensors, apps, social mediaIntegrate with human help (quitlines)Other health behaviors (asthma)Does it work in health systems as a outreach toolText Messaging Future QuestionsSlide18
Automated text messaging programs are easy to developSlide19
Thank-you ! Acknowledgements:
Baby & Me/
SmokefreeMOM Study Team: Co-I’s: Margaret Montgomery, Sean Cleary & Monique TurnerConsultant: Tom Brandon
Study Manager &Research Assistants: Leah Leavitt
, MPH, Laura
, Shawn Chiang
, Shelby Fallon, Indira Singh,
References & Selected Readings
Abroms LC, Ahuja M, Kodl, Y, Thaweethai L, Sims J, Winickoff J, Windsor RA. (2012a) Text2Quit:results from a pilot test of a personalized, interactive mobile health smoking cessation program. Journal of Health Communication (2012).
Abroms LC, Ahuja M, Windsor RA. (2012b). Text2Quit:results from a randomized trial of a personalized, interactive mobile health smoking cessation program. Presented at SRNT, 2013. Abroms LC, Padmanabhan N, Evans WD. (2011a). Mobile Phones for Health Communication to Promote Behavior Change. eHealth applications: Promising strategies for behavior change. Noar, S. M., & Harrington, N. G. (Eds.). New York: Routledge, (in-press). Abroms LC, Padmanabhan N, Thaweethai L, Phillips T. (2011b). A content analysis of iPhone apps for smoking cessation. American Journal of Preventive Medicine. 40(3):279-85. Brendryen H, Drozd F, Kraft P. A Digital Smoking Cessation Program Delivered Through Internet and Cell Phone Without Nicotine Replacement (Happy Ending): Randomized Controlled Trial. J Med Internet Res. 2008; 10(5):e51. Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiologic Rev. 2010; 32(1):56-69. Free C, Knight R, Robertson S, Whittaker R, Edwards P, Zhou W, Rodgers A, Cairns J, Kenward MG, Roberts I. (2011). Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind,
trial. Lancet. 378(9785):49-55.
Free et al. 2013.Review of
Guide to Community Preventive Services. (2011). Increasing tobacco use cessation: mobile phone-based interventions. Accessed on 2/22/12 at :
F, Prevost AT, Gilbert H, Sutton S. (2012). Randomized Controlled Trial Evaluation of a Tailored Leaflet and SMS Text Message Self-help Intervention for Pregnant Smokers (
Res. Feb 6.
Rodgers A, Corbett T,
D. Do U Smoke after TXT? Results of a randomized trial of smoking cessation using mobile phone text messaging. Tobacco Control. 2005;14(4): 255-261.
The Quit Group. Evaluation of the first year of the Txt2Quit Services (Online) July 31,
2009: [Cited: March 2011]Available at: http://www.quit.org.nz/file/research/FINAL%202008-09%20Txt2Quit%20evaluation%20report%2020090731.pdf Whittaker R, Borland R,
C, Lin RB,
H, Rodgers A. Mobile
phone-based interventions for smoking .The Cochrane Library, 2009;(4).
H. A Multimedia Mobile Phone-Based Youth Smoking Cessation Intervention Findings From Content Development and Piloting Studies, Journal of Medical Internet Research, 2008;10(5): e49.
Whittaker R. et al. The
Library, 2012. Slide22Slide23
25% of State Quitlines
(NAQC 2013)Text2Quit to over 100,000 callers since April 2012SmokefreeTXT (smokefree.gov)100,000+ users since Sept. 2012New Zealand; UK National Health Service; AustraliaWHO initiative to spread to lower income countries: Costa Rica, India, Tunisia…
Text Messaging Services Spreading
1. SMS Programs
3. Mobile Web2. Smartphone Apps4. Mobile Devices & Sensors
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Lorien Abroms ScD Milken Institute School of Public Health Prevention amp Community Health George Washington University Topics I ll cover Current Research Program Future opportunities ID: 736080 Download Presentation