Smoking Cessation Via Text Messaging: Feasibility Testing of Stop My Smoking USA


The investigators developed a text messaging-based smoking cessation program called SMS (Stop My Smoking) USA. It was tailored for the unique needs and smoking habits of young adults. The investigators hypothesized that those in the SMS USA intervention would be significantly more likely to be quit at 6-months compared to the attention-matched control group.

Full Title of Study: “Smoking Cessation Via Text Messaging: Feasibility Testing of SMS USA”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Participant)
  • Study Primary Completion Date: December 2011

Detailed Description

About one in four young adults are current smokers. Although over half report the desire to quit or cut down, quit rates in this age group have remained stagnant in the last ten years. Text messaging may represent a compelling intervention delivery method for smoking cessation for young adults because it is a medium they have widely adopted. Cell phone interventions also are unique because of their 'always on' capability – interventions are never far from the young adult's reach and they are received automatically instead of requiring the participant to initiate contact in order to receive the information. Dr. Ybarra, along with Drs. Holtrop and Graham, have developed SMS Turkey, an innovative behavioral intervention that uses text messaging to deliver CBT-based smoking cessation information to participants daily. Successful use of text messaging to deliver smoking cessation programs has been reported by Rodgers and colleagues in New Zealand and a replication study they are leading in the United Kingdom. These data provide optimism for the feasibility of text messaging-based smoking cessation programs in the United States. Using qualitative methods to inform design and content, and quantitative methods to assess the feasibility of the program, we propose to design and test SMS (Stop My Smoking) USA, a cell-phone based smoking cessation program for young adults ages 18-25. This innovative smoking cessation program uses technology widely adopted by young adults, an under-targeted population, to deliver a proactive, cognitive behavioral therapy (CBT)-based intervention. Our multidisciplinary team of researchers brings together expertise in Internet health and the design of tailored smoking cessation interventions.


  • Behavioral: SMS USA
    • Intervention participants receive text messages daily pre-and post-quit. Everyone receives messages 14 days prior to the Quit day, and through the day after Quit. Then, participants are ‘pathed’ to particular messages based upon their self-reported smoking status at Day 2 and Day 7 post quit, respectively. Those who are successful at quitting receive messages aimed at relapse prevention whereas those who have slipped receive messages aimed at getting the person to recommit to quitting and trying again.

Arms, Groups and Cohorts

  • Experimental: SMS USA
    • The 6-week smoking cessation intervention
  • No Intervention: Attention matched control
    • Messages aimed at improving one’s sleep and increasing one’s fitness, along with general messages about the most well known health dangers of smoking. Messages sent on the same schedule as the intervention group.

Clinical Trial Outcome Measures

Primary Measures

  • Continuous Abstinence at 3-months Assessed in Accordance With the NIH Behavior Change Consortium’s Recommendations
    • Time Frame: 3-months post-quit
    • Continuous abstinence is defined as 5 or fewer cigarettes smoked since one’s quit date. The question was asked based upon West et al., 2005: “Have you smoked at all, even just a puff, since [insert quit date]?” If yes, the respondent will be probed for how many cigarettes were smoked. Responses will be categorized into one of three options: A) No, not a puff; B) 1-5 cigarettes; C) More than 5 cigarettes. Self-reported cessation is confirmed by a significant other.

Secondary Measures

  • Point Prevalence
    • Time Frame: 4-weeks post-quit
    • A cigarette, even just a puff, within the last 7 days (yes/no).
  • Continuous Abstinence at 4-weeks Post-quit
    • Time Frame: 4 weeks post-quit
    • Smoking five or fewer cigarettes since quit day at 4 weeks post-quit as verified by a significant other

Participating in This Clinical Trial

Inclusion Criteria

  • 28 cigarettes or more per week (at least 4/day) and on at least 6 days/week.
  • Owning a text-capable cell phone and cognizant of how to send and receive text messages
  • Currently enrolled or intending to enroll in an unlimited text messaging plan
  • Enrolled with a cell phone carrier that was compatible with the program software
  • Agree to verification of smoking cessation status by a significant other
  • Able to read and write in English
  • Informed consent

Exclusion Criteria


Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 25 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Center for Innovative Public Health Research
  • Collaborator
    • Michigan State University
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Michele Ybarra, MPH PhD, Principal Investigator, Center for Innovative Public Health Research


Ybarra ML, Holtrop JS, Prescott TL, Strong D. Process evaluation of a mHealth program: lessons learned from Stop My Smoking USA, a text messaging-based smoking cessation program for young adults. Patient Educ Couns. 2014 Nov;97(2):239-43. doi: 10.1016/j.pec.2014.07.009. Epub 2014 Jul 17.

Ybarra ML, Prescott TL, Holtrop JS. Steps in tailoring a text messaging-based smoking cessation program for young adults. J Health Commun. 2014 Dec;19(12):1393-407. doi: 10.1080/10810730.2014.901441. Epub 2014 Apr 25.

Filion AJ, Darlington G, Chaput JP, Ybarra M, Haines J. Examining the influence of a text message-based sleep and physical activity intervention among young adult smokers in the United States. BMC Public Health. 2015 Jul 16;15:671. doi: 10.1186/s12889-015-2045-2.

Citations Reporting on Results

Ybarra ML, Holtrop JS, Prescott TL, Rahbar MH, Strong D. Pilot RCT results of stop my smoking USA: a text messaging-based smoking cessation program for young adults. Nicotine Tob Res. 2013 Aug;15(8):1388-99. doi: 10.1093/ntr/nts339. Epub 2013 Jan 24.

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