title: Effectiveness of Text Messaging as an Adjuvant to Health Advice in Smoking Cessation Programs in Primary Care. A Randomized Clinical Trial.
abstract: BACKGROUND
  Smoking remains a major risk factor for chronic diseases. Health advice is considered one of the most cost-effective interventions; however, changes produced by counseling tend not to persist over time, it is necessary to implement enforcement mechanisms.
  
  
  METHODS
  Randomized clinical trial to evaluate the effectiveness of a combined program that includes health advice and text messaging to mobile phone (SMSalud®). Patients were randomized to one of two interventions: health advice (control group) or health advice and text messaging (intervention group). We included 320 smoker patients who met the inclusion criteria: being motivated, aged over 18 years, having a mobile phone, being able to read and send messages. Patients were excluded if they had a history of mental or behavioral disorders, or depression. The primary endpoint was the percentage of patients who had stopped smoking by 6 months and confirmed by CO breath test.
  
  
  RESULTS
  By 6 months after the start of the program, 24.4% (39/160) of patients in the intervention group and 11.9% (19/160) of controls had stopped smoking (OR: 2.3; 95% CI: 1.3-4.3, p = .007). Patients with no dependence or mild dependence were more likely to stop (28.3%, 36/127 vs. 11.4%, 22/193; OR: 3.0, 95% CI: 1.7-5.5, p < .001). The rate of continuous abstinence at 12 months was 16.3% (26/160) in intervention group patients and 5.6% (9/160) in controls (OR: 3.2; 95% CI: 1.3-5.9).].
  
  
  CONCLUSIONS
  The combined program is effective for smoking cessation. Patients with less tobacco dependence have a higher probability of success.
  
  
  CONCLUSIONS
  Health advice is effective for promoting changes in lifestyle but these changes do not persist over time, so we have to use strengthening mechanisms, as e-health, and specifically, mobile phone based interventions. SMSalud® is an innovate program that includes text messaging and health advice, and it's effective for smoking cessation. The only feature that seems to affect the probability of smoking cessation is the degree of tobacco dependence.
authors.affiliation: BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital),Álava, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Cobos-Campos
authors.affiliation: Lakuabizkarra health centre, Integrated Health Organization Araba (primary care), Álava, Spain.
authors.forename: Antxon
authors.initials: A
authors.lastname: Apiñaniz Fernández de Larrinoa
authors.affiliation: BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital),Álava, Spain.
authors.forename: Arantza
authors.initials: A
authors.lastname: Sáez de Lafuente Moriñigo
authors.affiliation: BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital),Álava, Spain.
authors.forename: Naiara
authors.initials: N
authors.lastname: Parraza Diez
authors.affiliation: BIOARABA, Health Research Institute, Integrated Health Organization Araba (university hospital), Álava, Spain.|Health Services Research on Chronic Patients Network (REDISSEC), Spain.|University of the Basque Country, Álava, Spain.
authors.forename: Felipe
authors.initials: F
authors.lastname: Aizpuru Barandiaran
mesh_terms: D000328:Adult; D040421:Cell Phone; D006801:Humans; D011320:Primary Health Care / Q000379:methods*; D012907:Smoking / Q000453:epidemiology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods / Q000706:statistics & numerical data; D060145:Text Messaging; D055815:Young Adult