A pilot randomized controlled trial of automated and counselor-delivered text messages for e-cigarette cessation

Nandita Krishnan; Carla J Berg; Daisy Le; Jasjit Ahluwalia; Amanda L Graham; Lorien C Abroms

doi:10.18332/tpc/157598

A pilot randomized controlled trial of automated and counselor-delivered text messages for e-cigarette cessation

Tob Prev Cessat. 2023 Feb 14:9:04. doi: 10.18332/tpc/157598. eCollection 2023.

Authors

Nandita Krishnan¹, Carla J Berg^{1

2}, Daisy Le^{1

3}, Jasjit Ahluwalia⁴, Amanda L Graham^{5

6}, Lorien C Abroms^{1

2}

Affiliations

¹ Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States.
² George Washington Cancer Center, George Washington University, Washington, United States.
³ Department of Policy, Populations and Systems, George Washington University School of Nursing, Washington, United States.
⁴ Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Rhode Island, United States.
⁵ Innovations Center, Truth Initiative, Washington, United States.
⁶ Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, United States.

Abstract

Introduction: Automated text messaging programs show promise for e-cigarette cessation. Adding live text counseling could make them more engaging. We developed Quit the Vape (QTV), an automated e-cigarette cessation text messaging program, designed to be delivered as stand-alone or with counselor-delivered messages (QTV-C), and evaluated the acceptability and preliminary efficacy of QTV and QTV-C.

Methods: Between May and August 2021, we recruited 58 e-cigarette users, aged 20-43 years, 53.5% male, 63.8% non-Hispanic White, from an ongoing cohort study in the United States. Inclusion criteria were: using nicotine-containing e-cigarettes on ≥4 days per month; smartphone ownership; and not receiving tobacco cessation treatment. Motivation to quit did not impact eligibility. Participants were randomized to QTV (n=20), QTV-C (n=19), or control (link to e-cigarette cessation website, n=19). At end-of-treatment, we assessed program engagement and satisfaction, and self-reported quitting behaviors (e.g. point prevalence abstinence, PPA).

Results: At baseline, average past-month e-cigarette use was 26.8 days (SD=6.2). At follow-up at 4 weeks, among QTV and QTV-C participants, ≥85% replied to ≥1 message, ≥35% set a quit date, and ≤15% opted out. More QTV and QTV-C participants (55.6%) versus control (17.7%) reported program satisfaction (p=0.034). QTV-C participants (vs QTV and control) trended more favorably on 7-day e-cigarette PPA [27.8% (95% CI: 11.5-53.3) vs 11.1% (95% CI: 2.6-37.0) and 5.9% (95% CI: 0.7-34.5)] and quit attempts [66.7% (95% CI: 41.6-84.9) vs 50.0% (95% CI: 27.4-72.6) and 52.9% (95% CI: 29.2-75.5)].

Conclusions: Adding live text counseling to an automated text messaging program is acceptable and shows promise for e-cigarette cessation. A larger trial is warranted to assess its efficacy.

Keywords: cessation; e-cigarette; text messaging.