SMS Turkey: Harnessing the Power of Text Messaging to Promote Smoking Cessation

Study Overview
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Brief Summary
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The purpose of this study is to develop and test a text messaging-based smoking cessation program for adults who are currently smoking and want to quit, living in Turkey.

Detailed Description
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Smoking has long been recognized as a significant public health concern associated with great morbidity and mortality. Although smoking rates have decreased in high income countries, these trends have not been noted for tow and middle income countries. This is especially true in Turkey, which was ranked 6th in the world in smoking consumption. Between 51-63% of Turkish men and 24-26% of Turkish women 15 years of age and older are smokers. With lung cancer the leading cancer-related cause of death for both men and women, effective and accessible smoking cessation interventions are needed. Cell phone technology represents a unique opportunity to deliver evidenced-based smoking cessation behavioral treatments through a delivery mechanism already widely adopted by adults. An estimated 35 million Turks were using cell phones, making them 1.8 times more common than land lines. Cell phone interventions are a unique delivery method because of their 'always on' capability. The rapid uptake of cell phones allows us to potentially reach those who might otherwise not utilize smoking cessation services. We designed and evaluated SMS Turkey, an evidenced-based smoking intervention that takes advantage of technologies adopted by adult smokers in Turkey. The primary outcome measure is sustained abstinence 12 weeks after quit day, confirmed with a carbon monoxide (CO) reading of 8 ppm or less. Sustained abstinence was defined as 5 or fewer cigarettes smoked since the quit date, per West et al. Secondary outcome measures included: 7-day and 30-day point prevalence of smoking behavior at 3 months; CO-verified 7-day point prevalence at 4 weeks; and reduction in cigarettes per day for those who are smoking at 3 months.

Official Title
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SMS Turkey: Harnessing the Power of TXT Messaging to Promote Smoking Cessation

Conditions
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Smoking

Intervention / Treatment
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* Behavioral: SMS Turkey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age or older Currently smoking every day Owning a TXT-capable cell phone Sent or received TXT messages at least once in the past year Living in Ankara (to ease technology support if necessary) Agreement to set quit day in 15 days from enrollment date Agreement to verification of smoking cessation using a carbon monoxide breath monitor Exclusion Criteria: • No chronic disease.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: SMS Turkey<br>6-week smoking cessation program delivered via daily text messages | Behavioral: SMS Turkey<br>* 6-week smoking cessation program delivered via daily text messages SMS Turkey: 6-week smoking cessation program delivered via text messaging. SMS Turkey content is guided by the Cognitive Behavioral Therapy (CBT) theory. Content was tailored based on participant's stage in quitting (i.e., pre-quit, quit day, early-quit, late-quit, relapse). Based on the typical relapse trajectory, content paths were created for participants based on whether or not they were smoking 2 days after quit day; and again at 7 days after quit day. Depending on the participant's content path, the total number of messages received ranged from 91 (for those assigned to the encouragement arm) to 146 (for those who relapsed and then were assigned to the late quit messages).<br>* Other names: Cebiniz birakin diyor;|
| No Intervention: Brochure control<br>7-page brochure that provided general information and tips on how to quit smoking | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Carbon Monoxide-verified Continuous Abstinence at 12 Weeks | self-reported continuous abstinence since quit day (<=5 cigarettes) verified with carbon monoxide reading (<=8ppm) | 12-weeks post-quit day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CO-verified 7-day Point Prevalence Abstinence at 4 Weeks | self-reported continuous abstinence in the past 7 days at 4 weeks (<=5 cigarettes) verified with carbon monoxide reading (<=8ppm) | 4 weeks | 
| Self-reported 7-day Point Prevalence Abstinence at 12 Weeks | self-reported smoking abstinence in the past 7 days at 12 weeks (<=5 cigarettes) | 12 weeks | 
| Self-reported 30-day Point Prevalence Abstinence at 12 Weeks | self-reported smoking abstinence in the past 30 days at 12 weeks (<=5 cigarettes) | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Smoking Cessation, technology, developing countries