Randomized Controlled Trial of a Text-Based Smokeless Tobacco Cessation Intervention for Rural and Medically...

Area of Science:

• Public Health
• Digital Health Interventions
• Tobacco Cessation

Background:

• Smokeless tobacco use is prevalent in rural, underserved populations, increasing chronic disease risk.
• Access to traditional cessation programs is limited in these areas.
• Text-based interventions offer a scalable approach to reach these populations.

Purpose of the Study:

• To assess the efficacy of #EnufSnuff.TXT, a text-based intervention, for smokeless tobacco cessation.
• To compare #EnufSnuff.TXT with a traditional cessation program in rural and underserved communities.

Main Methods:

• A two-arm randomized controlled trial (RCT) involving 532 participants.
• #EnufSnuff.TXT (scheduled reduction + support messages) vs. a booklet and motivational messages.
• Primary outcome: 7-day point prevalence abstinence at 6 months, assessed via surveys.

Main Results:

• At 3 months, #EnufSnuff.TXT showed significantly higher quit rates (29.2% vs. 19.0%, p=.0066).
• At 6 months, quit rates were similar between groups (23.1% vs. 20.9%, p=.5384).
• The intervention demonstrated short-term efficacy but not statistically significant long-term differences.

Conclusions:

• #EnufSnuff.TXT is the first large-scale text-based cessation trial for smokeless tobacco users in underserved US areas.
• The intervention showed initial promise but requires further research for long-term abstinence.
• Text-based approaches can improve access to cessation interventions for at-risk populations.