Oct 7 2009
Hooked on your cell phone and cigarettes? Fortunately, your mobile device could help you kick the nicotine habit, according to a new review from New Zealand.
Researchers led by Robyn Whittaker, a public health physician at the University of Auckland, looked at four studies: two of text-message only programs and two that used the Internet along with mobile phones to keep up a stream of stop-smoking support.
"It makes a lot of sense," Whittaker said. "Mobiles are well-integrated in daily lives. The programs are using what's in daily life rather than making people come into a clinic. They're more proactive, delivering directly to people wherever they are."
Studies included about 2,600 smokers of all ages. After pooling study data, reviewers found that participants in text-message programs were about twice as likely not to smoke after six weeks as smokers in control groups.
People in mixed-media programs — cell phone plus Web — were significantly more likely to hang in there for at least six months after their chosen quit date.
"Say people are out with friends and feeling really strong cravings. They can text the word 'crave' directly into the program and they can get a message with suggestions for techniques to get through the cravings or other things to do to distract them such as listen to music or take a walk around the block," Whittaker said.
The review appears in the latest issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
Studies measured quitting success by self-report and in some cases by testing saliva samples for signs of nicotine. However, not enough people provided saliva samples to make meaningful conclusions based on those.
Two studies conducted in Norway combined e-mail contacts, a Web page and text messages. In the other studies, which took place in New Zealand and the United Kingdom, participants received a barrage of up to six messages daily for a month after their quit date and less frequent messages for up to six months.
""The text messages obviously have to be very brief, to the point; they use a lot of abbreviation but not a lot of texting lingo," Whittaker said. "Motivational messages remind people why they want to quit. Positive reinforcement message tell them they're doing really well, that they got themselves through the day or week without a cigarette, and to keep up the good work."
Messages can be "personalized and tailored to a certain extent to include information about issues of particular concern to that person, like putting on weight when quitting," Whittaker said. "However, a lot of information is applicable to most people."
"The problem is that it is not individualized. These are generic messages to help people not use tobacco," said Rebecca Schane, M.D., an internist and pulmonologist with the Center for Tobacco Control Research at the University of California at San Francisco. "It is mobile contact but not actual human contact."
"This type of intervention can't stand alone or substitute for physician visits in any way, shape or form," said Schane, has no affiliation with the review but is familiar with the findings.
"Quitting affects other aspects of people's health. If they have high blood pressure and they quit, their blood pressure decreases. You need to incorporate that in their treatment," Schane said.
People need a personal touch, she said: "It helps when a physician is in your corner. When you know the physician believes this is a worthwhile step in your life, you're more likely to do better in quitting."
"For a certain proportion of the population, that's probably right," Whittaker said, "but a certain proportion prefer not to do face-to-face interventions. Particularly, a lot of young adults preferred something confidential and anonymous."
Both Whittaker and Schane say that quitting is extremely difficult and most people will make several efforts before finding success.
"I'm glad the reviewers are trying to identify new ways to help people quit," Schane said. "What's out there is relatively stagnant. The protocol hasn't changed in years. But smokers are changing and our care needs to change. We're in a bit of a rut; if this study brings to the forefront the idea that there are other ways we can treat smokers, that's great."
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