title: Effectiveness of Short Message Service Text-Based Smoking Cessation Intervention Among University Students: A Randomized Clinical Trial.
abstract: OBJECTIVE
  Smoking is globally the most important preventable cause of ill health and death. Mobile telephone interventions and, in particular, short message service (SMS) text messaging, have the potential to overcome access barriers to traditional health services, not least among young people.
  
  
  OBJECTIVE
  To determine the effectiveness of a text-based smoking cessation intervention among young people.
  
  
  METHODS
  A single-blind, 2-arm, randomized clinical trial (Nicotine Exit [NEXit]) was conducted from October 23, 2014, to April 17, 2015; data analysis was performed from April 23, 2014, to May 22, 2015. Participants included daily or weekly smokers willing to set a quit date within 1 month of enrollment. The study used email to invite all college and university students throughout Sweden to participate.
  
  
  METHODS
  The NEXit core program is initiated with a 1- to 4-week motivational phase during which participants can choose to set a stop date. The intervention group then received 157 text messages based on components of effective smoking cessation interventions for 12 weeks. The control group received 1 text every 2 weeks thanking them for participating in the study, with delayed access to the intervention.
  
  
  METHODS
  The primary outcomes were self-reported prolonged abstinence (not having smoked >5 cigarettes over the past 8 weeks) and 4-week point prevalence of complete smoking cessation shortly after the completion of the intervention (approximately 4 months after the quit date).
  
  
  RESULTS
  A total of 1590 participants, mainly between 21 and 30 years of age, were randomized into the study; 827 (573 [69.3%] women) were allocated to the intervention group and 763 (522 [68.4%] women) were included in the control group. Primary outcome data were available for 783 (94.7%) of the intervention group and 719 (94.2%) of the control group. At baseline, participants were smoking a median (range) of 63 (1-238) and 70 (2-280) cigarettes per week, respectively. Eight-week prolonged abstinence was reported by 203 participants (25.9%) in the intervention group and 105 (14.6%) in the control group; 4-week point prevalence of complete cessation was reported by 161 (20.6%) and 102 (14.2%) participants, respectively, a mean (SD) of 3.9 (0.37) months after the quit date. The adjusted odds ratios (95% CIs) for these findings were 2.05 (1.57-2.67) and 1.56 (1.19-2.05), respectively.
  
  
  CONCLUSIONS
  With the limitation of assessing only the short-term effect of the intervention, the effects observed in this trial are comparable with those for traditional smoking cessation interventions. The simple NEXit intervention has the potential to improve the uptake of effective smoking cessation interventions.
  
  
  BACKGROUND
  isrctn.org Identifier: ISRCTN75766527.
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Müssener
authors.affiliation: Department of Computer and Information Science, Linköping University, Linköping, Sweden.
authors.forename: Marcus
authors.initials: M
authors.lastname: Bendtsen
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Nadine
authors.initials: N
authors.lastname: Karlsson
authors.affiliation: MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, England.
authors.forename: Ian R
authors.initials: IR
authors.lastname: White
authors.affiliation: Department of Medical and Health Sciences, Linköping University, Linköping, Sweden4Department of Health Sciences, University of York, Heslington, England.
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
authors.affiliation: Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Sweden.
authors.forename: Preben
authors.initials: P
authors.lastname: Bendtsen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D057566:Self Report; D016037:Single-Blind Method; D012907:Smoking; D016540:Smoking Cessation / Q000379:methods*; D013334:Students; D013548:Sweden; D060145:Text Messaging; D013997:Time Factors; D016896:Treatment Outcome