Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial
Summary: Background: Mobile instant messaging apps offer a modern way to deliver personalised smoking cessation support through real-time, interactive messaging (chat). In this trial, we aimed to assess the effect of chat-based instant messaging support integrated with brief interventions on smokin...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-08-01
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| Series: | The Lancet: Digital Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589750019300822 |
| _version_ | 1819069896930099200 |
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| author | Man Ping Wang, PhD Tzu Tsun Luk, BNurs Yongda Wu, BSc William H Li, PhD Derek Y Cheung, PhD Antonio C Kwong, LLB Vienna Lai, MPH Sophia S Chan, ProfPhD Tai Hing Lam, ProfMD |
| author_facet | Man Ping Wang, PhD Tzu Tsun Luk, BNurs Yongda Wu, BSc William H Li, PhD Derek Y Cheung, PhD Antonio C Kwong, LLB Vienna Lai, MPH Sophia S Chan, ProfPhD Tai Hing Lam, ProfMD |
| author_sort | Man Ping Wang, PhD |
| collection | DOAJ |
| description | Summary: Background: Mobile instant messaging apps offer a modern way to deliver personalised smoking cessation support through real-time, interactive messaging (chat). In this trial, we aimed to assess the effect of chat-based instant messaging support integrated with brief interventions on smoking cessation in a cohort of smokers proactively recruited from the community. Methods: In this two-arm, pragmatic, cluster-randomised controlled trial, we recruited participants aged 18 years or older who smoked at least one cigarette per day from 68 community sites in Hong Kong, China. Community sites were computer randomised (1:1) to the intervention group, in which participants received chat-based instant messaging support for 3 months, offers of referral to external smoking cessation services, and brief advice, or to the control group, in which participants received brief advice alone. The chat-based intervention included personalised behavioural support and promoted use of smoking cessation services. Masking of participants and the research team was not possible, but outcome assessors were masked to group assignment. The primary outcome was smoking abstinence validated by exhaled carbon monoxide concentrations lower than 4 parts per million and salivary cotinine concentrations lower than 10 ng/mL at 6 months after treatment initiation (3 months after the end of treatment). The primary analysis was by intention to treat and accounted for potential clustering effect by use of generalised estimating equation models. This trial is registered with ClinicalTrials.gov, number NCT03182790. Findings: Between June 18 and Sept 30, 2017, 1185 participants were randomly assigned to either the intervention (n=591) or control (n=594) groups. At the 6-month follow-up (77% of participants retained), the proportion of validated abstinence was significantly higher in the intervention group than in the control group (48 [8%] of 591 in intervention vs 30 [5%] of 594 in control group, unadjusted odds ratio 1·68, 95% CI 1·03–2·74; p=0·040). Engagement in the chat-based support in the intervention group was low (17%), but strongly predicted abstinence with or without use of external smoking cessation services. Interpretation: Chat-based instant messaging support integrated with brief cessation interventions increased smoking abstinence and could complement existing smoking cessation services. Funding: Hong Kong Council on Smoking and Health. |
| first_indexed | 2024-12-21T16:57:20Z |
| format | Article |
| id | doaj.art-99ae59a9587f4d0da56a78a260f60a3f |
| institution | Directory Open Access Journal |
| issn | 2589-7500 |
| language | English |
| last_indexed | 2024-12-21T16:57:20Z |
| publishDate | 2019-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet: Digital Health |
| spelling | doaj.art-99ae59a9587f4d0da56a78a260f60a3f2022-12-21T18:56:44ZengElsevierThe Lancet: Digital Health2589-75002019-08-0114e183e192Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trialMan Ping Wang, PhD0Tzu Tsun Luk, BNurs1Yongda Wu, BSc2William H Li, PhD3Derek Y Cheung, PhD4Antonio C Kwong, LLB5Vienna Lai, MPH6Sophia S Chan, ProfPhD7Tai Hing Lam, ProfMD8School of Nursing, University of Hong Kong, Hong Kong SAR, China; Correspondence to: Dr Man Ping Wang, School of Nursing, University of Hong Kong, Pokfulam, Hong Kong SAR, ChinaSchool of Nursing, University of Hong Kong, Hong Kong SAR, ChinaSchool of Nursing, University of Hong Kong, Hong Kong SAR, ChinaSchool of Nursing, University of Hong Kong, Hong Kong SAR, ChinaSchool of Nursing, University of Hong Kong, Hong Kong SAR, ChinaHong Kong Council of Smoking and Health, Hong Kong SAR, ChinaHong Kong Council of Smoking and Health, Hong Kong SAR, ChinaSchool of Nursing, University of Hong Kong, Hong Kong SAR, ChinaSchool of Public Health, University of Hong Kong, Hong Kong SAR, ChinaSummary: Background: Mobile instant messaging apps offer a modern way to deliver personalised smoking cessation support through real-time, interactive messaging (chat). In this trial, we aimed to assess the effect of chat-based instant messaging support integrated with brief interventions on smoking cessation in a cohort of smokers proactively recruited from the community. Methods: In this two-arm, pragmatic, cluster-randomised controlled trial, we recruited participants aged 18 years or older who smoked at least one cigarette per day from 68 community sites in Hong Kong, China. Community sites were computer randomised (1:1) to the intervention group, in which participants received chat-based instant messaging support for 3 months, offers of referral to external smoking cessation services, and brief advice, or to the control group, in which participants received brief advice alone. The chat-based intervention included personalised behavioural support and promoted use of smoking cessation services. Masking of participants and the research team was not possible, but outcome assessors were masked to group assignment. The primary outcome was smoking abstinence validated by exhaled carbon monoxide concentrations lower than 4 parts per million and salivary cotinine concentrations lower than 10 ng/mL at 6 months after treatment initiation (3 months after the end of treatment). The primary analysis was by intention to treat and accounted for potential clustering effect by use of generalised estimating equation models. This trial is registered with ClinicalTrials.gov, number NCT03182790. Findings: Between June 18 and Sept 30, 2017, 1185 participants were randomly assigned to either the intervention (n=591) or control (n=594) groups. At the 6-month follow-up (77% of participants retained), the proportion of validated abstinence was significantly higher in the intervention group than in the control group (48 [8%] of 591 in intervention vs 30 [5%] of 594 in control group, unadjusted odds ratio 1·68, 95% CI 1·03–2·74; p=0·040). Engagement in the chat-based support in the intervention group was low (17%), but strongly predicted abstinence with or without use of external smoking cessation services. Interpretation: Chat-based instant messaging support integrated with brief cessation interventions increased smoking abstinence and could complement existing smoking cessation services. Funding: Hong Kong Council on Smoking and Health.http://www.sciencedirect.com/science/article/pii/S2589750019300822 |
| spellingShingle | Man Ping Wang, PhD Tzu Tsun Luk, BNurs Yongda Wu, BSc William H Li, PhD Derek Y Cheung, PhD Antonio C Kwong, LLB Vienna Lai, MPH Sophia S Chan, ProfPhD Tai Hing Lam, ProfMD Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial The Lancet: Digital Health |
| title | Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial |
| title_full | Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial |
| title_fullStr | Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial |
| title_full_unstemmed | Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial |
| title_short | Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial |
| title_sort | chat based instant messaging support integrated with brief interventions for smoking cessation a community based pragmatic cluster randomised controlled trial |
| url | http://www.sciencedirect.com/science/article/pii/S2589750019300822 |
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