Engagement and abstinence among users of a smoking cessation text message program for veterans.
SmokefreeVET is a text messaging smoking cessation program available to veterans enrolled in the Veterans Health Administration. SmokefreeVET was developed in collaboration with the National Cancer Institute as part of the SmokefreeTXT initiative.



To evaluate the real world use of and effectiveness of the SmokefreeVET program for SmokefreeVET users who enrolled between 2013 and 2014.



Demographics and smoking behavior of 1470 SmokefreeVET users who enrolled between 2013 and 2014 were analyzed. Latent growth mixture modeling was used to identify discrete classes of SmokefreeVET users based on engagement patterns. Multi-level modeling determined class differences in abstinence.



The average age of the SmokefreeVET user was 48, 75% of users were male, and 84% were daily smokers. After five weeks, 13% of all users reported abstinence from smoking. Five statistically distinct engagement classes of SmokefreeVET users were identified. Highly engaged classes were significantly less likely to opt-out and more likely to report abstinence. Over 60% of users who were classified as high engagers throughout the program reported abstinence 5weeks after their quit date. Users were more likely to report abstinence after two weeks if they used smoking cessation medication than those that did not use medication (OR=9.01, p<0.001).



SmokefreeVET may be effective at supporting abstinence among a real world group of highly engaged users. Smoking cessation medication use was also associated with abstinence in SmokefreeVET users. Engagement appears to be a critical component when assessing the efficacy of a text messaging smoking cessation intervention.
Office of Patient Care Services, Veterans Health Administration, U.S. Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, United States. Electronic address: dana.christofferson@va.gov.
Dana E
DE
Christofferson
Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States.
Jeffrey S
JS
Hertzberg
Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; VA Mid-Atlantic Mental Illness Research Education and Clinical Center, 508 Fulton Street, Durham, NC 27705, United States; Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, 2301 Erwin Road, Durham, NC 27705, United States.
Jean C
JC
Beckham
Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, United States; Duke University Medical Center, Department of Psychiatry and Behavioral Sciences, 2301 Erwin Road, Durham, NC 27705, United States.
Paul A
PA
Dennis
Office of Patient Care Services, Veterans Health Administration, U.S. Department of Veterans Affairs, 810 Vermont Avenue NW, Washington, DC 20420, United States.
Kim
K
Hamlett-Berry
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D061845:Smoke-Free Policy; D016540:Smoking Cessation / Q000379:methods*; D060145:Text Messaging; D014481:United States; D014728:Veterans; D055815:Young Adult
Cessation; Engagement; Smoking; Tobacco; Veteran; mHealth