Proactive Text Messaging Outreach for Tobacco Cessation Among Patients With COPD Who Smoke: A Randomized Pilot

Area of Science:

• Pulmonology
• Addiction Medicine
• Digital Health

Background:

• Chronic obstructive pulmonary disease (COPD) disproportionately affects individuals who smoke.
• Effective smoking cessation interventions are crucial for managing COPD.
• Mobile health interventions, like text messaging, offer scalable solutions for behavior change.

Purpose of the Study:

• To evaluate the feasibility and acceptability of a proactive motivational texting program combined with phone-based care coordination for people with COPD who smoke (PCWS).
• To assess preliminary treatment outcomes related to smoking cessation in this population.
• To determine the potential of digital health tools in supporting smoking cessation among PCWS.

Main Methods:

• A randomized, unblinded pilot study involving PCWS, irrespective of their intention to quit.
• Participants were randomized 2:1 to receive a 12-week motivational texting protocol with optional phone-based care coordination or a mailed offer of cessation services.
• Outcomes included feasibility (enrollment, participation) and treatment utilization, analyzed using logistic regression.

Main Results:

• An enrollment rate of 22.8% was achieved among invited eligible individuals.
• The intervention group showed higher utilization of cessation treatments (34.9% vs 21.9%) and completion of care coordination calls (13.2% vs 2.4%).
• The texting protocol was highly acceptable, with 80.6% finding content relevant and 69.4% recommending it; no harms were identified.

Conclusions:

• The proactive motivational texting program with care coordination is feasible and acceptable for PCWS.
• The intervention showed promising, though not statistically significant, trends favoring smoking cessation outcomes.
• This low-burden digital health approach holds potential for future research and widespread implementation in smoking cessation efforts for COPD patients.