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Digital-Assisted Community Pharmacy Cessation for Dual-Tobacco Users in Jordan: A Hybrid Cluster Randomized
Derar H Abdel-Qader1, Nadia Al Mazrouei2, Esra' Taybeh3
1Faculty of Pharmacy & Medical Sciences, University of Petra, Amman 11196, Jordan.
Pharmacy (Basel, Switzerland)
|May 27, 2026
Summary
The Dual-Quit Digital program significantly boosted tobacco cessation rates in Jordan, using pharmacist counseling and WhatsApp® follow-up. This digital health intervention proved effective and feasible for community pharmacies.
Area of Science:
- Public Health
- Digital Health Interventions
- Pharmacotherapy
Background:
- Tobacco use, including cigarette and waterpipe smoking, is a major public health issue in Jordan.
- Community pharmacies offer accessible settings for smoking cessation, but services are underutilized.
- Dual tobacco use is increasingly prevalent, necessitating tailored cessation strategies.
Purpose of the Study:
- To evaluate the clinical effectiveness of the Dual-Quit Digital program, a pharmacist-delivered cessation counseling intervention.
- To assess the implementation feasibility of a 6-month automated WhatsApp® follow-up system integrated with the program.
- To compare the intervention against usual care for tobacco cessation outcomes.
Main Methods:
- A pragmatic, cluster randomized controlled trial involving 16 community pharmacies in Jordan.
- 320 adult tobacco users were randomized to either the Dual-Quit Digital intervention or usual care.
- The intervention included tailored pharmacist counseling, pharmacotherapy support, and semi-automated WhatsApp® follow-up with telepharmacy escalation.
Main Results:
- CO-verified continuous abstinence at 6 months was significantly higher in the intervention arm (26.3%) versus usual care (11.3%) (aOR 2.84).
- The intervention improved various point prevalence abstinence rates at 3 and 6 months and both-product abstinence among dual users.
- Higher pharmacotherapy initiation and adherence were observed in the intervention group, with substantial patient engagement via WhatsApp®.
Conclusions:
- The Dual-Quit Digital model demonstrated significant improvements in smoking cessation outcomes compared to usual care.
- The program proved operationally feasible, with high patient engagement and successful telepharmacy escalations.
- Findings support integrating phenotype-stratified counseling, pharmacotherapy, and digital follow-up as a pragmatic cessation model in community pharmacies.
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