Smoking Cessation
Conditions
Keywords
relapse prevention, recurrence, mHealth, instant messaging, WhatsApp, chatbot, conversational agent, Chinese
Brief summary
Most smokers return to smoking (relapse) after making a quit attempt, but evidence of effective intervention to prevent relapse is scarce. Taking advantage of recent advances in mobile technologies, this study aims to evaluate the effectiveness of a mobile chat messaging-based relapse prevention intervention in promoting successful quitting in people who recently quit smoking (recent abstainers) using a randomised controlled trial design.
Detailed description
Most smokers who made quit attempts and achieved short-term abstinence return to smoking (relapse) over time, even when aided by effective smoking cessation treatment. Since relapse mostly occurred in the first 4 weeks of abstinence, relapse prevention in the early phase of abstinence could potentially boost long-term abstinence. Several behavioural interventions for smoking relapse prevention have been proposed and tested in RCTs. Yet, a 2019 Cochrane review did not find traditional approaches, including self-help materials, telephone counselling and group therapy, effective in increasing long-term abstinence at 6 months or longer. The widespread use of mobile devices has provided a highly accessible and scalable means for novel behavioural interventions for smoking cessation. A formative qualitative study in current smokers conducted by the investigators showed that mobile chat messaging is a feasible and acceptable platform for delivering smoking cessation support. A subsequent cluster randomised controlled trial on 1148 smokers found that mobile chat messaging combined with brief intervention was effective in increasing biochemically validated abstinence at 6 months. Nonetheless, whether mobile chat messaging could prevent relapse in recent abstainers has remained untested. The investigators did a pilot trial to confirm the feasibility and acceptability of mobile chat messaging for relapse prevention in recent abstainers. This study aims to evaluate the effectiveness of mobile chat messaging relapse prevention intervention in promoting abstinence in recent abstainers.
Interventions
BEHAVIORALStandard smoking cessation treatment
Standard smoking cessation treatment (behavioural and pharmacotherapy) provided by Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation
BEHAVIORALPersonalised chat messaging
Personalised chat messaging focusing on smoking relapse prevention for 3 months from randomisation. A trained counsellor will interact with a participant individually and provide relapse prevention advice via WhatsApp. The participant can also access a supportive chatbot in WhatsApp, which will provide on-demand smoking relapse prevention support when the counsellor is not available (e.g., during nighttime).
BEHAVIORALSMS text messaging
SMS text messaging on generic information about the harms of smoking and the benefits of quitting for 3 months from randomisation.
Sponsors
Health and Medical Research Fund
Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation
United Christian Nethersole Community Health Service Smoking Cessation Programme
The University of Hong Kong
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Hong Kong residents aged 18 years or above * Own a smartphone with WhatsApp installed * Enrolled in a smoking cessation program under Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation * Smoked daily before the present quit attempt * Abstained from smoking for 3 to 30 days
Exclusion criteria
* Diagnosed with a mental disease or on regular psychotropic drugs * Participating in other ongoing smoking cessation studies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Biochemically validated tobacco abstinence | 6 months after randomisation | Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Self-reported 6-month prolonged tobacco abstinence | 6 months after randomisation | Not more than five lapses permitted for 6 months after baseline |
| Self-reported 7-day point prevalent tobacco abstinence | 3 months after randomisation | Being completely smoke-free in the past 7 days |
| Self-reported relapse rate | 3 months after randomisation | Defined as use of tobacco products for 7 consecutive days or longer |
| Biochemically validated tobacco abstinence | 12 months after randomisation | Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test |
| Self-reported 12-month prolonged tobacco abstinence | 12 months after randomisation | Not more than five lapses permitted for 12 months after baseline |
Countries
Hong Kong
Outcome results
None listed