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Rob Hicks, MD
June 30, 2011 -- Mobile phones could hold the key to people giving up smoking after a study involving sending motivational and supportive text messages to smokers doubled quit rates after six months.
The "txt2stop" study is the first to verify quit rates using biochemical testing. It shows that smokers are twice as likely to quit their habit when receiving motivational text messages compared with those receiving standard texts.
The study published in The Lancet is by Caroline Free, PhD, of the Clinical Trials Research Unit of the London School of Hygiene and Tropical Medicine, and colleagues. It was partly funded by the U.K. Medical Research Council.
In a news release, Free says, "Text messages are a very convenient way for smokers to receive support to quit. People described txt2stop as like having a 'friend' encouraging them or an 'angel on their shoulder.' It helped people resist the temptation to smoke."
Researchers randomly assigned 5,800 U.K. smokers who were willing to quit to either the txt2stop group (2,915 smokers) or to a comparison group receiving only non-motivational texts (2,885 smokers).
The txt2stop group received five text messages a day for the first five weeks and then three per week for the next 26 weeks, with a personalized system that also allowed people to receive instant messages at times of need by texting the word "crave" or "lapse."
Motivational texts included encouragement up to the actual quit day, advice on keeping weight off while quitting, and help dealing with cravings. For example, the craving text read: "Cravings last less than five minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over."
Participants who texted "lapse" would receive a text that read: "Don't feel bad or guilty if you've slipped. You've achieved a lot by stopping for a while. Slip-ups can be a normal part of the quitting process. Keep going, you can do it!"
Non-motivational texts simply thanked people for their participation, requested confirmation of contact details, or said a range of other things not connected to smoking itself. For example: "Being part of this will help others in the future. Thanks for your help!" or "Only four more weeks to go until completion of the study!"
Abstinence from smoking was confirmed by testing the levels of cotinine (a chemical in tobacco) found in participants' saliva.
Quitting smoking has huge implications for health, but although two out of three smokers would like to give up, they often fail. Participants in the txt2stop group were more than twice as likely to have quit after six months than those in the comparison group (10.7% vs. 4.9% respectively).
Professor Max Parmar, director of the Medical Research Council clinical trials unit in the U.K., says in a news release, "This research has shown that texting could be a powerful tool to help people to walk away from cigarettes for good."
Glyn Mcintosh, director of development and communications at the U.K. charity QUIT, which helped develop the text messages and find volunteers for the study, says in a news release, "We are delighted with the results and hope that text motivation will now become a standard part of the quitting process."
Fergus Joel, of Edinburgh, Scotland, says he successfully gave up his 20-a-day habit thanks to txt2stop and feels much healthier as a result.
The supermarket worker, who has two young children, says he likened the messages to a 24/7 friend providing encouragement and useful advice, which spurred him on during moments of weakness.
Joel, 36, who started smoking in 2000, used to light up three or four cigarettes before his morning coffee until he gave up during the txt2stop program in August 2009. He says in a news release, "The messages really helped me. I'd tried to give up before but it's tough to keep up the willpower.
"To get a text message at that time of day, even at weekends, it's like having a companion with you 24/7 encouraging you to stop. It does motivate you to stop. You're thinking, 'I shouldn't really smoke here, because this is somebody sending me messages here, on my own phone, in my own private space.' The wording of the messages was really good too, telling me things like 'the craving will pass,' 'hold on,' 'drink some water.'
"At the end of the day, I've got two children, and I don't want them to see their daddy as a smoker, this man who's stinking of stale smoke all the time. And the thing that motivated me most was the children but it was also for my health as well.
"I feel much fitter now -- I can run about with the children, I can taste my food much better, I can smell the air, it's just brilliant. It's been two years now and I'm very happy I've come this far."
SOURCES:News release, The Lancet.News release, London School of Hygiene and Tropical Medicine/Medical Research Council.
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