Texting Therapy Doubles Success in Quitting Smoking

By Kaidi Wang, MD

Instead of reaching for that cigarette pack, smokers hoping to quit the habit may do well to reach for their cell phones.

Smokers who used a popular texting program to help them stop smoking were more than twice as likely to quit, according to a study published Friday in the American Journal of Preventive Medicine.

Called "Text2Quit," the program encourages smokers to quit by sending texts to their phone, telling them how much money they could save if they stubbed out their habit, or providing advice on adhering to smoking cessation drugs. Users can also text keywords at any point, such as "CRAVE" to receive a tip to keep their mind off smoking, or "SMOKED" to indicate they have relapsed, prompting the program to give tips on getting back on track.

The developer of the program, Lorien Abroms of the Milken Institute School of Public Health at the George Washington University, led the study. Her team looked at a group of more than 500 smokers who were trying to quit, giving roughly half of them access to the program. What they found at six months was that over 11 percent of smokers who were getting texts managed to quit, compared with only 5 percent of those who were not.

And unlike some past research, the participants submitted to saliva tests to see if they had snuck a cigarette, rather than relying upon their word alone.

"People are using mobile phones," Abroms said. "This is a tool that people are regularly using, in touch with, living their lives attached to.

"Given how widespread mobile phone use is, it's great we can take advantage of it to help people quit smoking."

According to the latest estimates by the U.S. Centers for Disease Control and Prevention, there are more than 42 million smokers in the United States - nearly one-fifth of American adults. Despite all of the progress made to curb smoking, it still remains the number one cause of preventable death, accounting for one in five deaths in the United States each year. So given that 81 percent of cellphone users send and receive text messages, according to the Pew Research Center, utilizing text messaging to help smokers quit is an intriguing prospect.

Dr. Michael Fiore, a smoking cessation expert from the University of Wisconsin-Madison who was not involved with the study, said a growing number of high-tech solutions to tobacco addiction - such as the online resources at the government-run Smokefree.gov - are putting solutions at smokers' fingertips.

"Text2Quit, in my view, now is added to the list of applications that show not just promise, but… evidence of effectiveness," Fiore said.

He said, however, that the program may not be a solution that works for everyone.

"There will not be a one-size-fits-all solution at helping more Americans quit," he said. "People are individuals first and foremost, and we need to come up with options that are science-based and fit the individual."

But, he said, one of the messaging program's strengths is its potentially broad reach. And Abroms noted that she believes the program may represent an important addition to other scientifically supported interventions, such as nicotine replacement methods and telephone quit-lines.

"We have another tool that we can offer in (the) bag of tools that we have," Abroms said.

Doctor's Take

As we have continued to see in the statistics, smoking is a tremendously powerful addiction - one that can be extraordinarily difficult to shake. There is a need for more evidence-based ways to help smokers quit. So the results of this study may be important in guiding future studies - as well as those who are addicted to smoking today.

Importantly, there are other similar programs available to aid in smoking, such as SmokefreeTXT, which was developed by the National Cancer Institute. Smokers can find it at smokefree.gov.

Not all of these other programs have been studied like Text2Quit has been, but smokers may find it comforting that we now have at least some science behind the idea of text messaging for smoking cessation. With time, we can only expect the emergence of even more creative, evidence-based technologies like this one to help smokers finally stub out their last cigarette.