Using mobile phones for smoking cessation - PowerPoint Presentation

Slide1

Using mobile phones for smoking cessation

Lorien Abroms, ScD.Milken Institute School of Public HealthPrevention & Community HealthGeorge Washington University Slide2

Topics I

’ll coverCurrent Research Program

Future opportunitiesSlide3

Text2Quit

Automated, interactive,

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

Medication msg

Peer ex-smoker

msg

On demand games & tips

Check-ins

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

QuitDate

/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)

No Smoking

in the Past 7 days30.5%14.5%33.2%19.9%31.7%

20.7%

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

. 2014Slide10

-Covers

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.

Cochrane. 2012Slide12

Text4Baby

Core Partners:

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

Quit4BabySlide14
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InterventionControl

 1-month1-monthMeasure  Abstained from smoking in past 7 daysa,b,c

24%

21%

Abstained from smoking in past 30

days

a,b,c

12%

0%

Number of continuous days

quit

b

13.0

9.4

Banned smoking from their

home

b

66%

58%

Banned smoking from their

car

b,c

63%

35%

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

,

Jennifer Schindler-

Ruwisch

, MPH, Laura

Macherelli

, Shawn Chiang

,

Nisha

Radhakrishnan

, Whitney

McInvale

, Shelby Fallon, Indira Singh,

Dasha

AfanasevaSlide20
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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,

randomised

trial. Lancet. 378(9785):49-55.

Free et al. 2013.Review of

mHealth

.

Plos

One.

Guide to Community Preventive Services. (2011). Increasing tobacco use cessation: mobile phone-based interventions. Accessed on 2/22/12 at :

http://www.thecommunityguide.org/tobacco/cessation/mobilephone.html

Naughton

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 (

MiQuit

). Nicotine

Tob

Res. Feb 6.

Rodgers A, Corbett T,

Bramley

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,

Bullen

C, Lin RB,

McRobbie

H, Rodgers A. Mobile

phone-based interventions for smoking .The Cochrane Library, 2009;(4).

Whittaker R,

Maddison

R,

McRobbie

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

Cochrance

Library, 2012. Slide22
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U.S.

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…

mCessation

Text Messaging Services Spreading

+Slide24

mCessation Services

1. SMS Programs

3. Mobile Web2. Smartphone Apps4. Mobile Devices & Sensors