Abstract

BackgroundConsidering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of “the efficacy of mobile phone-based text message interventions (‘Happy Quit’) for smoking cessation in China”. The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions (‘Happy Quit’) will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that ‘Happy Quit’ will be an effective, feasible and affordable smoking cessation program in China.Methods/DesignIn this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19–34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to ‘Happy Quit’, comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day.Discussion/ImplicationsThe results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public health significance of other interventions, such as mental health interventions.Trial registrationNCT02693626 (Registration data April 11, 2016).

Highlights

  • Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of “the efficacy of mobile phone-based text message interventions (‘Happy Quit’) for smoking cessation in China”

  • The availability of smoking cessation programs in China is extremely limited, and the majority of cessation attempts end in relapse

  • Considering the extreme shortage of smoking cessation programs in China, and the efficacy of mobile phone text message-based program for smoking cessation reported in other countries, we propose to design such a populationbased widely accessible smoking cessation program in China

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Summary

Background

Tobacco use and cigarette smoking in China Tobacco use is the leading cause of avoidable morbidity and mortality in China (a country does not have a comprehensive tobacco control policy) [1, 2]. The rapid development of mobile health technology (mHealth) provides unprecedented opportunities to improve health services and to reach underserved populations, and the effectiveness of text message mobile phone programs to improve smoking cessation has been reported in other countries. This proposed study is designed to determine the effectiveness of mobile phone-based text message interventions (‘Happy Quit’) for smoking cessation in China, which will be assessed by self-reported smoking abstinence at 4, 8, 12, 16, 20 and 24 weeks post-intervention This proposed study has important implications in providing valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China.

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