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Randomized Controlled Trial
. 2016 Jul;23(7):803-8.
doi: 10.1111/acem.12990. Epub 2016 Jul 1.

A Multicomponent Intervention Including Texting to Promote Tobacco Abstinence in Emergency Department Smokers: A Pilot Study

Steven L Bernstein  1   2   3 , June Rosner  1 , Benjamin Toll  4   2   5
Affiliations
Randomized Controlled Trial

A Multicomponent Intervention Including Texting to Promote Tobacco Abstinence in Emergency Department Smokers: A Pilot Study

Steven L Bernstein et al. Acad Emerg Med. 2016 Jul.

Abstract

Background: Emergency department (ED) patients commonly smoke. Current treatment approaches use motivational interviewing, which is effective, but resource-intensive. Mobile health approaches may be more feasible and generalizable.

Objective: The objective was to assess the feasibility of an ED-initiated program of tobacco dependence treatment that employs text messaging.

Methods: Smokers age 18 or older were randomized to intervention or control arms. Control subjects received a brochure describing the state smokers' quitline. Intervention subjects received the brochure, 4 weeks of nicotine patches and gum (with the initial dose administered in the ED), a referral to the quitline, and enrollment in SmokefreeTXT, a free SMS-messaging service. SmokefreeTXT delivered 28 days of messages, two to five messages/day. Some messages ask subjects to provide data on mood or craving. Follow-up was conducted by phone call.

Results: Sixty subjects were enrolled in May 2014. Of all subjects, 33 (55%) were nonwhite; 78% were insured by Medicaid. All intervention subjects used the texting program, with 24/30 (80%) using the program for all 28 days. At 1 month, 14/30 subjects (47%) in the intervention arm reported abstinence versus 3/30 (10%) in the control arm (p = 0.003). At 3 months, the abstinence rates in the intervention and control arms were, respectively, 9/30 (30%) and 4/30 (13%; p = 0.21). Subjects responding to more assessments of mood or craving were more likely to report abstinence at 1 month.

Conclusion: A texting program, combined with pharmacotherapy and a quitline referral, is feasible and may promote tobacco abstinence in ED smokers. A larger trial is planned to assess these results.

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Figures

Figure 1
Figure 1
Flow of subjects through the study.
Figure 2
Figure 2
Mood and craving in intervention subjects.
See this image and copyright information in PMC

References

    1. Stead LF, Koilpillai P, Lancaster T. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database of Systematic Reviews. 2015 - PubMed
    1. Fiore MC, Jaén CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: US Department of Health and Human Services; 2008.
    1. Benson FE, Stronks K, Willemsen MC, Bogaerts NM, Nierkens V. Wanting to attend isn’t just wanting to quit: why some disadvantaged smokers regularly attend smoking cessation behavioural therapy while others do not: a qualitative study. BMC Public Health. 2014;14:1–12. - PMC - PubMed
    1. Whittaker R, McRobbie H, Bullen C, Borland R, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. Cochrane Database of Systematic Reviews. 2012 doi: 10.1002/14651858.CD006611.pub3. - DOI - PubMed
    1. Bernstein SL, D’Onofrio G, Rosner J, et al. Successful Tobacco Dependence Treatment Achieved via Pharmacotherapy and Motivational Interviewing in Low-Income Emergency Department Patients. Ann Emerg Med. 2015;66:140–7. doi: 10.1016/j.annemergmed.2015.03.030. - DOI - PMC - PubMed

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