Multicentre, randomised controlled trial of a low-cost smoking cessation text message intervention for pregnant smokers (MiQuit)

Naughton, Felix; Foster, Katharine; Emery, Jo; Cooper, Sue; Sutton, Stephen; Leonardi-Bee, Jo; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

Abstract

Background: Text message cessation programmes have potential to change smoking behaviour during pregnancy but their effectiveness is unknown. This study aimed to estimate key parameters, including effectiveness and cost-effectiveness, for delivering a definitive effectiveness trial of a pregnancy specific, theory-guided, tailored text message cessation intervention.

Methods: Multicentre, single-blinded, randomised controlled trial. Pregnant smokers (<25 weeks gestation) were recruited from 16 antenatal screening clinics in England. Control participants received usual care and a smoking cessation leaflet. Intervention participants received the control components plus 12 weeks of individually-tailored, automated, interactive, cessation text messages (MiQuit). Key parameters to inform a full trial were recruitment and outcome ascertainment rates. 7 smoking outcomes were assessed; the planned primary outcome for the full trial was continuous abstinence from 4 weeks post-randomisation until 36 weeks gestation, validated biochemically. Estimated costs were modelled per quitter and per QALY.

Findings: 407 participants (203 MiQuit, 204 control) were randomised, 39% of those eligible. At follow-up, similar proportions per group provided self-report smoking status and a validation sample. More MiQuit participants achieved validated continuous abstinence relative to controls (5.4% vs. 2.0%; odds ratio [adjusted for site and gestation] 2.7, 95% CI 0.93 to 9.35). Adjusted odds ratios on other smoking outcomes ranged from 1.03 to 3.28 in favour of MiQuit. Incremental costs per quitter/QALY were £140.91 (95% CI -£192.87 to £617.96)/£3,623.09 (-£4,926.56 to £16,197.20), respectively, at the end of pregnancy.

Discussion: Findings imply that this low-cost text message intervention is likely to be effective and cost-effective. A full trial is warranted.

Citation

Naughton, F., Foster, K., Emery, J., Cooper, S., Sutton, S., Leonardi-Bee, J., Jones, M., Ussher, M., Whitemore, R., Leighton, M., Montgomery, A., Parrott, S., & Coleman, T. (2016, August). Multicentre, randomised controlled trial of a low-cost smoking cessation text message intervention for pregnant smokers (MiQuit). Presented at European Health Psychology Society and British Psychological Society Division of Health Psychology Conference 2016 (EHPS/DHP 2016)

• Conference Name: European Health Psychology Society and British Psychological Society Division of Health Psychology Conference 2016 (EHPS/DHP 2016)
• Start Date: Aug 23, 2016
• End Date: Aug 27, 2016
• Acceptance Date: May 1, 2016
• Publication Date: Aug 23, 2016
• Deposit Date: Aug 25, 2016
• Publicly Available Date: Aug 25, 2016
• Peer Reviewed: Peer Reviewed
• Public URL: https://nottingham-repository.worktribe.com/output/804600
• Related Public URLs: http://www.ehps2016.org/
• Contract Date: Aug 25, 2016