Effectiveness of text messaging as an adjuvant to health advice in smoking cessation programmes in primary care. A randomized clinical trial
Mené en Espagne auprès de 320 fumeurs âgés de 18 ans ou plus, cet essai évalue, du point de vue du taux de participants ayant arrêté de fumer au bout de 6 mois, l'efficacité d'une intervention en médecine générale reposant sur des conseils de santé et l'envoi de SMS
Introduction : Smoking remains a major risk factor for chronic diseases. Health advice is considered one of the most cost-effective interventions; however, changes produced by counselling tend not to persist over time, it is necessary to implement enforcement mechanisms. Methods : Randomized clinical trial to evaluate the effectiveness of a combined program that includes health advice and text messaging to mobile phone (SMSalud®). Patients were randomized to one of two interventions: health advice (control group) or health advice and text messaging (intervention group). We included 320 smoker patients who met the inclusion criteria: being motivated, aged over 18 years, having a mobile phone, being able to read and send messages. Patients were excluded if they had a history of mental or behavioural disorders, or depression. The primary endpoint was the percentage of patients who had stopped smoking by 6 months and confirmed by CO breath test. Results : By 6 months after the start of the program, 24.4% (39/160) of patients in the intervention group and 11.9% (19/160) of controls had stopped smoking (OR: 2.3; 95% CI: 1.3 - 4.3, p=0.007). Patients with no dependence or mild dependence were more likely to stop (28.3%, 36/127 versus 11.4%, 22/193; OR: 3.0, 95% CI: 1.7-5.5, p<0.001). The rate of continuous abstinence at 12 months was 16.3% (26160) in intervention group patients and 5.6% (9/160) in controls (OR: 3.2; 95% CI: 1.3-5.9). Conclusions : The combined program is effective for smoking cessation. Patients with less tobacco dependence have a higher probability of success. IMPLICATIONS : Health advice is effective for promoting changes in lifestyle but these changes do not persist over time, so we have to use strengthening mechanisms, as e-health, and specifically, mobile phone based interventions. SMSalud® is an innovate program that includes text messaging and health advice, and it’s effective for smoking cessation. The only feature that seems to affect the probability of smoking cessation is the degree of tobacco dependence.