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| Name | Class |
|---|---|
| Health and Medical Research Fund | OTHER_GOV |
| Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation | UNKNOWN |
| United Christian Nethersole Community Health Service Smoking Cessation Programme |
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Most smokers return to smoking (relapse) after making a quit attempt, but evidence of effective intervention to prevent relapse is scarce. Taking advantage of recent advances in mobile technologies, this study aims to evaluate the effectiveness of a mobile chat messaging-based relapse prevention intervention in promoting successful quitting in people who recently quit smoking (recent abstainers) using a randomised controlled trial design.
Most smokers who made quit attempts and achieved short-term abstinence return to smoking (relapse) over time, even when aided by effective smoking cessation treatment. Since relapse mostly occurred in the first 4 weeks of abstinence, relapse prevention in the early phase of abstinence could potentially boost long-term abstinence. Several behavioural interventions for smoking relapse prevention have been proposed and tested in RCTs. Yet, a 2019 Cochrane review did not find traditional approaches, including self-help materials, telephone counselling and group therapy, effective in increasing long-term abstinence at 6 months or longer.
The widespread use of mobile devices has provided a highly accessible and scalable means for novel behavioural interventions for smoking cessation. A formative qualitative study in current smokers conducted by the investigators showed that mobile chat messaging is a feasible and acceptable platform for delivering smoking cessation support. A subsequent cluster randomised controlled trial on 1148 smokers found that mobile chat messaging combined with brief intervention was effective in increasing biochemically validated abstinence at 6 months. Nonetheless, whether mobile chat messaging could prevent relapse in recent abstainers has remained untested.
The investigators did a pilot trial to confirm the feasibility and acceptability of mobile chat messaging for relapse prevention in recent abstainers. This study aims to evaluate the effectiveness of mobile chat messaging relapse prevention intervention in promoting abstinence in recent abstainers.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mobile chat messaging | Experimental | Standard smoking cessation treatment + Personalised chat messaging |
|
| SMS messaging | Active Comparator | Standard smoking cessation treatment + Regular SMS text messaging generic information about the harms of smoking and the benefits of quitting |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard smoking cessation treatment | Behavioral | Standard smoking cessation treatment (behavioural and pharmacotherapy) provided by Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation |
| Measure | Description | Time Frame |
|---|---|---|
| Biochemically validated tobacco abstinence | Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test | 6 months after randomisation |
| Measure | Description | Time Frame |
|---|---|---|
| Self-reported 6-month prolonged tobacco abstinence | Not more than five lapses permitted for 6 months after baseline | 6 months after randomisation |
| Self-reported 7-day point prevalent tobacco abstinence |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tzu Tsun Luk, PhD, RN | The University of Hong Kong | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation | Hong Kong | Hong Kong | ||||
| United Christian Nethersole Community Health Service Smoking Cessation Programme |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30702431 | Background | Luk TT, Wong SW, Lee JJ, Chan SS, Lam TH, Wang MP. Exploring Community Smokers' Perspectives for Developing a Chat-Based Smoking Cessation Intervention Delivered Through Mobile Instant Messaging: Qualitative Study. JMIR Mhealth Uhealth. 2019 Jan 31;7(1):e11954. doi: 10.2196/11954. | |
| 30593882 | Background | Luk TT, Li WHC, Cheung DYT, Wong SW, Kwong ACS, Lai VWY, Chan SS, Lam TH, Wang MP. Chat-based instant messaging support combined with brief smoking cessation interventions for Chinese community smokers in Hong Kong: Rationale and study protocol for a pragmatic, cluster-randomized controlled trial. Contemp Clin Trials. 2019 Feb;77:70-75. doi: 10.1016/j.cct.2018.12.013. Epub 2018 Dec 26. |
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Request to obtain IPD can be made to the principal invesitgator on reasonable request
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| ID | Term |
|---|---|
| D016540 | Smoking Cessation |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D015438 | Health Behavior |
| D001519 | Behavior |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
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| Personalised chat messaging | Behavioral | Personalised chat messaging focusing on smoking relapse prevention for 3 months from randomisation. A trained counsellor will interact with a participant individually and provide relapse prevention advice via WhatsApp. The participant can also access a supportive chatbot in WhatsApp, which will provide on-demand smoking relapse prevention support when the counsellor is not available (e.g., during nighttime). |
|
| SMS text messaging | Behavioral | SMS text messaging on generic information about the harms of smoking and the benefits of quitting for 3 months from randomisation. |
|
Being completely smoke-free in the past 7 days
| 3 months after randomisation |
| Self-reported 7-day point prevalent tobacco abstinence | Being completely smoke-free in the past 7 days | 6 months after randomisation |
| Self-reported relapse rate | Defined as use of tobacco products for 7 consecutive days or longer | 3 months after randomisation |
| Self-reported relapse rate | Defined as use of tobacco products for 7 consecutive days or longer | 6 months after randomisation |
| Biochemically validated tobacco abstinence | Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test | 12 months after randomisation |
| Self-reported 12-month prolonged tobacco abstinence | Not more than five lapses permitted for 12 months after baseline | 12 months after randomisation |
| Self-reported 7-day point prevalent tobacco abstinence | Being completely smoke-free in the past 7 days | 12 months after randomisation |
| Self-reported relapse rate | Defined as use of tobacco products for 7 consecutive days or longer | 12 months after randomisation |
| Hong Kong |
| Hong Kong |
| 33323188 | Background | Wang MP, Luk TT, Wu Y, Li WH, Cheung DY, Kwong AC, Lai V, Chan SS, Lam TH. Chat-based instant messaging support integrated with brief interventions for smoking cessation: a community-based, pragmatic, cluster-randomised controlled trial. Lancet Digit Health. 2019 Aug;1(4):e183-e192. doi: 10.1016/S2589-7500(19)30082-2. Epub 2019 Jul 31. |
| 35166327 | Background | Luk TT, Cheung YTD, Chan HC, Fok PW, Ho KS, Sze CD, Lam TH, Wang MP. Mobile Chat Messaging for Preventing Smoking Relapse Amid the COVID-19 Pandemic: A Pilot Randomized Controlled Trial. Nicotine Tob Res. 2023 Jan 5;25(2):291-297. doi: 10.1093/ntr/ntac045. |
| 41557345 | Derived | Luk TT, Su X, Wong V, Chan HC, Wong GN, Lee JKH, Ho SY, Lam TH, Cheung YTD, Wang MP. Mobile Chat Messaging for Smoking Relapse Prevention: A Randomized Clinical Trial. JAMA Intern Med. 2026 Mar 1;186(3):294-302. doi: 10.1001/jamainternmed.2025.7439. |
| 39439726 | Derived | Su X, Wong V, Cheung YTD, Chan HC, Wong GN, Lee JKH, Ho SY, Wang MP, Luk TT. Mobile chat messaging for preventing relapse among people who recently quit smoking: Study protocol for a randomized controlled trial. Digit Health. 2024 Oct 21;10:20552076241291709. doi: 10.1177/20552076241291709. eCollection 2024 Jan-Dec. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |