Sending motivational mobile phone texts to people who were trying to give up smoking was found to double their chances of still being non-smokers six months later, compared to others who received placebo texts, researchers from the London school of Hygiene and Tropical Medicine, UK, revealed in the medical journal The Lancet.

Dr Caroline Free and team randomly selected 5,800 volunteer smokers who wanted to quit into two groups:

  • txt2stop intervention group – these people were sent motivational texts before their giving up smoking day, plus regular texts after they gave up, which also included tips on dealing with cravings and maintaining a healthy body weight. They were given pay-as-you-go cell phones, plus a £20 ($32) top-up voucher to make sure they had enough credit to participate in the intervention.
  • The control (placebo) group – they also received texts which thanked them for taking part, asked for contact details, and included other messages unrelated to smoking or giving up.

An example of a text sent to the txt2stop intervention group, included:

“Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over.”

Participants sent saliva samples by post to the researchers, who tested them for abstinence from smoking. The scientists also gathered data on participants’ self-reports on whether they had stayed off the cigarettes. Any participant whose saliva sample showed they had been smoking were counted as smokers, regardless of what their self-report said.

After six months the researchers found that:

  • 10.7% of those in the txt2stop intervention group were still non-smokers
  • 4.9% of those in the control (placebo) group were still non-smokers

The scientists concluded:

“On the basis of these results the txt2stop intervention should be considered as an addition to existing smoking cessation services. In this trial the intervention was effective on its own and when used alongside other smoking cessation interventions. To scale up the txt2stop intervention for delivery at a national or international level would be technically easy.

The intervention might require some adaptation, translation into other languages, and local evaluation before delivery to other populations. The intervention is low cost and likely to be highly cost-effective. A cost-effectiveness analysis of txt2stop will be reported separately.”

Dr Free said (direct quote, not in the journal article):

“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.”

In the same journal in a linked comment, Dr Derrick A Bennett and Dr Jonathan R Emberson, from Oxford University, wrote:

“The lessons learned from the txt2stop trial could therefore not only provide a new approach to smoking cessation in high-income and middle-income countries, but could also provide a useful starting point for implementing behavioural change in resource-poor settings.”

“Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial”
Dr Caroline Free PhD, Rosemary Knight RGN, Steven Robertson BA, Robyn Whittaker MPH, Phil Edwards PhD, Weiwei Zhou MSc, Prof Anthony Rodgers PhD, Prof John Cairns PhD, Prof Michael G Kenward PhD, Prof Ian Roberts PhD
The Lancet, Volume 378, Issue 9785, Pages 49 – 55, 2 July 2011

Written by Christian Nordqvist