Preventing smoking relapse using text messages: analysis of data from the txt2stop trial

Nicotine Tob Res. 2013 Jan;15(1):77-82. doi: 10.1093/ntr/nts086. Epub 2012 Apr 19.


Introduction: Interactive text message-based technologies which operate in real time have the potential to be especially effective for delivery of relapse prevention interventions. We examined predictors of use of a text message system for providing support for lapses and cravings, describe the natural history of requests for support, and predictors of time to requests for support.

Methods: Data were collected prospectively from participants in the intervention arm of txt2stop, a large randomized controlled trial of an automated, text message-based smoking cessation intervention. Txt2stop included 2,915 men and women aged 16-78, recruited from London, United Kingdom from 2009 to 2010. Participants could text "crave" or "lapse" when they experienced either; an automated system registered the time of the text message to the nearest second.

Results: One thousand one hundred and twenty one (38.5%) participants sent a lapse or crave message to request support. Women were more likely to lapse at some point during the trial. Of those who lapsed, being female, younger age, and setting a Saturday quit date were predictors of sending a lapse text requesting support. Half of all crave texts arrived within 106 hr of quitting. Half of all lapse texts arrived between 4 and 17 days after the quit date. Sending a crave text, being female, younger, and setting a quit date on a Saturday were associated with shorter time to sending a first lapse text.

Conclusions: Text-based lapse support should be developed and evaluated, especially for women. Smokers may benefit from additional support to prevent lapses on days 4-17 postquit attempt.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • London
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Prospective Studies
  • Secondary Prevention*
  • Smoking Cessation / psychology*
  • Smoking Prevention
  • Text Messaging / statistics & numerical data*
  • Time Factors
  • Young Adult