背景:无烟烟草的使用在农村和医疗服务不足的人群中仍然很普遍,导致烟草相关癌症和慢性疾病的发病率增加。虽然获得有效戒烟计划的机会有限,基于文本的干预可能提供一种具有广泛影响的交付方法。这项双臂随机对照试验(RCT)评估了#EnufSnuff的疗效。TXT,基于文本的无烟戒烟干预,在农村和医疗服务不足的社区。
方法:我们进行了一项双臂RCT评估#EnufSnuff。TXT,与改良的EnoughSnuff干预相比,基于文本的计划减少干预与基于文本的戒烟支持信息配对,该干预包括戒烟教育手册和双周激励短信。我们通过社交媒体招募参与者,并在随机分组后三个月和六个月对参与者进行调查。主要结果是自我报告的6个月时的7天点患病率禁欲。
结果:我们招募并随机分配了532名参与者。随机化后三个月,#EnufSnuff的戒烟率明显更高。TXT臂与意向治疗(ITT)病例的足够鼻烟臂相比(29.2%vs19.0%,OR=1.75,p=0.0066)。在#EnufSNuff中,随机化后六个月的戒烟率仍然较高。TXT与ITT病例的足够鼻烟相比(23.1%vs20.9%,OR=1.14,p=0.5384),虽然不再有明显的不同。
结论:这是第一个针对服务不足地区使用无烟烟草的个人的大规模基于文本的戒烟临床试验。#EnufSnuff。TXT干预在短期内表现更好,然而,两种干预措施在随机化后6个月时的退出率相似.未来的研究应该集中在改善#EnufSNuff的长期禁欲上。TXT干预。
结论:基于文本的戒烟方法有可能增加农村和医疗服务不足地区获得戒烟干预措施的机会,并降低与烟草相关的慢性病发病率和死亡率。我们的研究显示了首次无烟戒烟干预的随机对照试验的短期疗效,#EnufSnuff.TXT,适用于美国农村和医疗服务不足的居民。我们的#EnufSnuff。TXT干预提供了一个可扩展的解决方案,可以在医疗服务不足的情况下达到并提供急需的戒烟干预措施,美国的农村社区。这项工作为进一步研究基于增强文本的方法以增加该高危人群的戒烟提供了基础。
BACKGROUND: Smokeless tobacco use remains prevalent in rural and medically underserved populations, leading to increased rates of tobacco-related cancers and chronic disease. While access to effective cessation programs is limited, text-based interventions may offer a delivery approach with broad reach. This two-armed randomized control
trial (RCT) assessed the efficacy of #EnufSnuff.TXT, a text-based smokeless tobacco
cessation intervention, in rural and medically underserved communities.
METHODS: We conducted a two-arm RCT assessing #EnufSnuff.TXT, a text-based scheduled reduction intervention paired with text-based cessation support messages compared with the modified Enough Snuff intervention comprised of a cessation education booklet and bi-weekly motivational text messages. We recruited participants via social media and surveyed participants at three and six months post-randomization. The primary outcome was self-reported seven-day point prevalence abstinence at six months.
RESULTS: We recruited and randomized 532 participants. At three months post randomization, the quit rate was significantly higher in #EnufSnuff.TXT arm compared to the Enough Snuff arm for intent-to-treat (ITT) cases (29.2% vs 19.0%, OR=1.75, p=0.0066). The quit rate at six months post randomization remained higher in #EnufSNuff.TXT compared to Enough Snuff for ITT cases (23.1% vs 20.9%, OR=1.14, p=0.5384), although no longer significantly different.
CONCLUSIONS: This is the first large-scale text-based
cessation clinical
trial for individuals in underserved areas who use smokeless tobacco. The #EnufSnuff.TXT intervention performed better in the short term, however both interventions yielded similar quit-rates at 6-months post randomization. Future research should focus on improving long-term abstinence in the #EnufSNuff.TXT intervention.
CONCLUSIONS: Text-based
cessation approaches have the potential to increase access to
cessation interventions in rural and medically underserved areas and reduce tobacco-related chronic disease morbidity and mortality. Our
study shows short-term efficacy from the first ever randomized controlled
trial of a smokeless tobacco cessation intervention, #EnufSnuff.TXT, for rural and medically underserved residents in the United States. Our #EnufSnuff.TXT Intervention offers a scalable solution to reach and provide much needed access to cessation interventions in medically underserved, rural communities in the United States. This work provides the foundation for further inquiry on augmented text-based approaches to increase cessation in this at-risk group.