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Randomized Controlled Trial
. 2019 Apr 8;19(1):387.
doi: 10.1186/s12889-019-6727-z.

WhatsApp embedded in routine service delivery for smoking cessation: effects on abstinence rates in a randomized controlled study

Seyfi Durmaz  1 , Isil Ergin  2 , Raika Durusoy  2 , Hur Hassoy  2 , Ayhan Caliskan  2 , Pinar Okyay  3
Affiliations
Randomized Controlled Trial

WhatsApp embedded in routine service delivery for smoking cessation: effects on abstinence rates in a randomized controlled study

Seyfi Durmaz et al. BMC Public Health. .

Abstract

Background: The demand for smoking cessation services has risen in Turkey, as smokers planning to quit reached 35% in 2012. Communication technologies are used globally to support quitters, yet their integration to health services is rare. This study aims to evaluate the effect of support messages through WhatsApp application added to the usual care of a university hospital cessation unit, as compared to usual care alone, on abstinence rates at first month.

Methods: A randomized controlled intervention study was conducted with 132 patients applying to Ege University Hospital's Department of Public Health Smoking Cessation Clinic, between March and July 2017. Intervention content was prepared and 60 WhatsApp messages about having a plan of action and preventing relapse were developed through expert panels. These messages lasted for 3 months and follow-ups continued for 6 months. The primary outcome was abstinence rate at 1st month post target quit day. As secondary outcomes; the continuous abstinence rates at 3rd and 6th months, number of follow-ups, change in weight and continuity of medication were evaluated. Intention-to-treat analysis was used.

Results: Abstinence rate at 1st month was 65.9% in the intervention group and 40.9% in the control group (p = 0.007); 50.0 and 30.7% at 3rd month and 40.9 and 22.7% at 6th month, consecutively (both p < 0.05). Being in the intervention group increased abstinence rate by 3.50 (OR, 95% CI = 1.30-9.44) times in the 1st month. When controlled for all other factors in the multivariate logistic regression, the intervention was the only variable significantly associated with abstinence. For secondary outcomes, the intervention increased abstinence rate by 2.50 (OR, 95% CI = 1.08-6.40) times in the 3rd and 2.31 (OR, 95% CI = 1.03-5.16) times in the 6th month. In the intervention group, the number of follow-ups and face-to-face follow-ups were higher at 1st and 3rd months and continuity of medication was longer at 3rd month.

Conclusions: WhatsApp support embedded in cessation service delivery increases the abstinence rate and has favorable effects on follow-up.

Trial registration: This trial is retrospectively registered online at ClinicalTrials.gov with the identifier NCT03714971 .

Keywords: Abstinence; Cessation service; Randomized controlled study; Smoking cessation; WhatsApp.

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Conflict of interest statement

Ethics approval and consent to participate

The study was submitted and approved by the Ethics Committee of Clinical Studies of Ege University, Faculty of Medicine (Ethical clearance number: 16–12.1/11) on January 6, 2017 and written informed consent was obtained from all participants before they participated in the study.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram of the RCT
Fig. 2
Fig. 2
Smoking cessation success rates among respondents, first, third and sixth month follow ups (intervention, control groups)
See this image and copyright information in PMC

References

    1. American Cancer Society, Vital Strategies. Tobacco Atlas. Turkey; 2019. tobaccoatlas.org/country/turkey accessed 10 Feb 2019
    1. Turkish Statistical Institute . The percentage of individuals' status of smoking tobacco products by sex and age group (2010-2016) 2016.
    1. Turkish Statistical Institute . Global adult tobacco survey. TSI Bulletin. 2012.
    1. Turkish Ministry of Health . Health Promotion General Directorate. Smoke-free Turkey. 2016.
    1. Turkish Ministry of Health . Tobacco control in Turkey. 2016.

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