title: Examining the influence of a text message-based sleep and physical activity intervention among young adult smokers in the United States.
abstract: BACKGROUND
  Sleep and physical activity are two health behaviors associated with improved smoking cessation outcomes. Text message-based interventions have previously been used to promote physical activity and smoking cessation; however, this type of intervention has not targeted sleep habits. This study examined the effectiveness of a text message-based active control intervention in improving sleep and physical activity habits among a U.S. national sample of young adult smokers participating in a smoking cessation intervention.
  
  
  METHODS
  This study was a secondary analysis of data from the Stop My Smoking USA randomized controlled trial. Baseline and 3-month follow-up data were collected from 116 young adult smokers (mean age 21.8 years, SD = 2.1) who were randomized at a 2:1 ratio to receive a 6-week text messaging program focused on either smoking cessation (n = 72), or improving sleep and physical activity (n = 44). Three main outcomes were assessed: 1) sleep quantity (on work/school nights, and non-work/non-school nights), 2) sleep quality, and 3) physical activity at follow-up. Multivariable linear regression analysis was used to quantify the differences in these outcomes between the groups. To identify possible effect modification by baseline sleep and physical activity, the sample was stratified by indicators defined for both of these variables.
  
  
  RESULTS
  At follow-up, sleep quantity and quality were similar for participants in the smoking cessation and sleep/activity groups when assessed among the total sample and those sleeping ≥6 hours/night at baseline. Among short sleepers (<6 hours/night at baseline), sleep quantity on work/school nights improved for those receiving sleep/activity messages compared to those receiving smoking cessation messages, after adjusting for covariates (^β = 1.373, 95% CI [0.262, 2.484]; p = 0.02). Physical activity at follow-up was similar for the two groups, when examined among the total sample and when stratified by baseline activity level.
  
  
  CONCLUSIONS
  This study provides preliminary evidence that a text message-based intervention may be a promising approach for improving sleep quantity among young adult smokers who are short sleepers and interested in quitting smoking. Similar programs should be further explored as a novel approach for improving sleep habits among individuals with insufficient sleep.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01516632.
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2 W1, Canada. filiona@uoguelph.ca.
authors.forename: A Jordan
authors.initials: AJ
authors.lastname: Filion
authors.affiliation: Department of Mathematics and Statistics, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2 W1, Canada. gdarling@uoguelph.ca.
authors.forename: Gerarda
authors.initials: G
authors.lastname: Darlington
authors.affiliation: Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8 L1, Canada. jpchaput@cheo.on.ca.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Chaput
authors.affiliation: Center for Innovative Public Health Research, 555 North El Camino Real #A347, San Clemente, California, 92672-6745, USA. michele@innovativepublichealth.org.
authors.forename: Michele
authors.initials: M
authors.lastname: Ybarra
authors.affiliation: Department of Family Relations and Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2 W1, Canada. jhaines@uoguelph.ca.
authors.forename: Jess
authors.initials: J
authors.lastname: Haines
mesh_terms: D000293:Adolescent; D000328:Adult; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009043:Motor Activity; D012890:Sleep; D016540:Smoking Cessation / Q000379:methods*; D060145:Text Messaging; D014029:Tobacco Use Disorder / Q000628:therapy*; D014481:United States; D055815:Young Adult