Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial

Wan Jia Aaron HE; Qi WANG; Tai Hing LAM; Ching Han Helen CHAN; Tzu Tsun LUK; Man Ping WANG; Siu Chee Sophia CHAN; Yee Tak Derek CHEUNG

doi:10.1007/s11469-024-01239-7

Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial

Wan Jia Aaron HE
, Qi WANG
, Tai Hing LAM
, Ching Han Helen CHAN
, Tzu Tsun LUK
, Man Ping WANG
, Siu Chee Sophia CHAN
, Yee Tak Derek CHEUNG^*

^*Corresponding author for this work

School of Graduate Studies

Research output: Journal Publications › Journal Article (refereed) › peer-review

6 Citations (Scopus)

Abstract

Online group support potentially help prevent smoking relapse. This two-arm, pragmatic, open-label randomized controlled trial assessed the effectiveness of instant messaging (IM) (i.e., WhatsApp) online group support versus text messages for smoking relapse prevention. The intervention group (n = 469) participated in 8-week counsellor-moderated IM-based online discussion groups and receive messages on preventing relapse via WhatsApp. The control group (n = 459) received similar messages via text messaging for 8 weeks. Primary outcome was biochemically validated tobacco abstinence (exhaled carbon monoxide < 4 parts per million; or saliva cotinine < 10 ng/ml) at 12-month follow-up. By intention-to-treat, intervention and control groups showed similar prevalence of biochemically validated abstinence (11.9% versus 11.7%, risk ratio [RR] = 1.01; 95%CI 0.71–1.44; P = 0.93). The interactive IM-based online group support was costly but did not increase smoking abstinence compared to simple text messaging. More interactive digital health interventions are more costly but may not be more effective than simple text messaging. ClinicalTrials.gov Identifier: # NCT03717051.

Original language	English
Pages (from-to)	2460-2477
Number of pages	18
Journal	International Journal of Mental Health and Addiction
Volume	23
Issue number	3
Early online date	19 Jan 2024
DOIs	https://doi.org/10.1007/s11469-024-01239-7
Publication status	Published - Jun 2025

Bibliographical note

We express our deep appreciation to all the smoking cessation clinics under Tung Wah Group of Hospitals, Hospital Authority, and Pok Oi Hospital for facilitating all recruitment activities. We are grateful to all the project coordinators, including Ms. Tiffany Lai, Ms. Chloe Lau, Mr. Ken Lin, Mr. Andy Ho, Ms. Anna Lau, and Mr. Timmy Man, for their effort to recruit participants and administrative duties.

Publisher Copyright:
© 2024, The Author(s).

Funding

This work was supported by Health Care and Promotion Scheme of the Health Medical Research Fund, Health Bureau, the Hong Kong SAR Government (grant number 01170418). This research was funded by grant 15162691 from the Health and Medical Research Fund of the Food and Health Bureau, The Hong Kong Special Administrative Region Government. MPW is the principal investigator of one family well‐being project funded by Hong Kong Jockey Club Charities Trust. SSCC is the principle investigator of elderly well-being project funded by Sino Group. All other authors declare no conflicts of interest.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Smoking
Tobacco
Relapse prevention
Instant messaging
WhatsApp

Access to Document

10.1007/s11469-024-01239-7

https://link.springer.com/10.1007/s11469-024-01239-7

Cite this

HE, W. J. A., WANG, Q., LAM, T. H., CHAN, C. H. H., LUK, T. T., WANG, M. P., CHAN, S. C. S., & CHEUNG, Y. T. D. (2025). Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial. International Journal of Mental Health and Addiction, 23(3), 2460-2477. https://doi.org/10.1007/s11469-024-01239-7

@article{5cd36e0694ee4c4d873223aeff45dd20,

title = "Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial",

abstract = "Online group support potentially help prevent smoking relapse. This two-arm, pragmatic, open-label randomized controlled trial assessed the effectiveness of instant messaging (IM) (i.e., WhatsApp) online group support versus text messages for smoking relapse prevention. The intervention group (n = 469) participated in 8-week counsellor-moderated IM-based online discussion groups and receive messages on preventing relapse via WhatsApp. The control group (n = 459) received similar messages via text messaging for 8 weeks. Primary outcome was biochemically validated tobacco abstinence (exhaled carbon monoxide < 4 parts per million; or saliva cotinine < 10 ng/ml) at 12-month follow-up. By intention-to-treat, intervention and control groups showed similar prevalence of biochemically validated abstinence (11.9\% versus 11.7\%, risk ratio [RR] = 1.01; 95\%CI 0.71{\textendash}1.44; P = 0.93). The interactive IM-based online group support was costly but did not increase smoking abstinence compared to simple text messaging. More interactive digital health interventions are more costly but may not be more effective than simple text messaging. ClinicalTrials.gov Identifier: \# NCT03717051.",

keywords = "Smoking, Tobacco, Relapse prevention, Instant messaging, WhatsApp",

author = "HE, \{Wan Jia Aaron\} and Qi WANG and LAM, \{Tai Hing\} and CHAN, \{Ching Han Helen\} and LUK, \{Tzu Tsun\} and WANG, \{Man Ping\} and CHAN, \{Siu Chee Sophia\} and CHEUNG, \{Yee Tak Derek\}",

note = "We express our deep appreciation to all the smoking cessation clinics under Tung Wah Group of Hospitals, Hospital Authority, and Pok Oi Hospital for facilitating all recruitment activities. We are grateful to all the project coordinators, including Ms. Tiffany Lai, Ms. Chloe Lau, Mr. Ken Lin, Mr. Andy Ho, Ms. Anna Lau, and Mr. Timmy Man, for their effort to recruit participants and administrative duties. Publisher Copyright: {\textcopyright} 2024, The Author(s).",

year = "2025",

month = jun,

doi = "10.1007/s11469-024-01239-7",

language = "English",

volume = "23",

pages = "2460--2477",

journal = "International Journal of Mental Health and Addiction",

issn = "1557-1874",

publisher = "Springer New York",

number = "3",

}

TY - JOUR

T1 - Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial

AU - HE, Wan Jia Aaron

AU - WANG, Qi

AU - LAM, Tai Hing

AU - CHAN, Ching Han Helen

AU - LUK, Tzu Tsun

AU - WANG, Man Ping

AU - CHAN, Siu Chee Sophia

AU - CHEUNG, Yee Tak Derek

N1 - We express our deep appreciation to all the smoking cessation clinics under Tung Wah Group of Hospitals, Hospital Authority, and Pok Oi Hospital for facilitating all recruitment activities. We are grateful to all the project coordinators, including Ms. Tiffany Lai, Ms. Chloe Lau, Mr. Ken Lin, Mr. Andy Ho, Ms. Anna Lau, and Mr. Timmy Man, for their effort to recruit participants and administrative duties. Publisher Copyright: © 2024, The Author(s).

PY - 2025/6

Y1 - 2025/6

N2 - Online group support potentially help prevent smoking relapse. This two-arm, pragmatic, open-label randomized controlled trial assessed the effectiveness of instant messaging (IM) (i.e., WhatsApp) online group support versus text messages for smoking relapse prevention. The intervention group (n = 469) participated in 8-week counsellor-moderated IM-based online discussion groups and receive messages on preventing relapse via WhatsApp. The control group (n = 459) received similar messages via text messaging for 8 weeks. Primary outcome was biochemically validated tobacco abstinence (exhaled carbon monoxide < 4 parts per million; or saliva cotinine < 10 ng/ml) at 12-month follow-up. By intention-to-treat, intervention and control groups showed similar prevalence of biochemically validated abstinence (11.9% versus 11.7%, risk ratio [RR] = 1.01; 95%CI 0.71–1.44; P = 0.93). The interactive IM-based online group support was costly but did not increase smoking abstinence compared to simple text messaging. More interactive digital health interventions are more costly but may not be more effective than simple text messaging. ClinicalTrials.gov Identifier: # NCT03717051.

AB - Online group support potentially help prevent smoking relapse. This two-arm, pragmatic, open-label randomized controlled trial assessed the effectiveness of instant messaging (IM) (i.e., WhatsApp) online group support versus text messages for smoking relapse prevention. The intervention group (n = 469) participated in 8-week counsellor-moderated IM-based online discussion groups and receive messages on preventing relapse via WhatsApp. The control group (n = 459) received similar messages via text messaging for 8 weeks. Primary outcome was biochemically validated tobacco abstinence (exhaled carbon monoxide < 4 parts per million; or saliva cotinine < 10 ng/ml) at 12-month follow-up. By intention-to-treat, intervention and control groups showed similar prevalence of biochemically validated abstinence (11.9% versus 11.7%, risk ratio [RR] = 1.01; 95%CI 0.71–1.44; P = 0.93). The interactive IM-based online group support was costly but did not increase smoking abstinence compared to simple text messaging. More interactive digital health interventions are more costly but may not be more effective than simple text messaging. ClinicalTrials.gov Identifier: # NCT03717051.

KW - Smoking

KW - Tobacco

KW - Relapse prevention

KW - Instant messaging

KW - WhatsApp

UR - https://www.scopus.com/pages/publications/85182623951

U2 - 10.1007/s11469-024-01239-7

DO - 10.1007/s11469-024-01239-7

M3 - Journal Article (refereed)

SN - 1557-1874

VL - 23

SP - 2460

EP - 2477

JO - International Journal of Mental Health and Addiction

JF - International Journal of Mental Health and Addiction

IS - 3

ER -

Effectiveness of Instant Messaging-Based Online Group Support for Preventing Smoking Relapse : a Pragmatic Randomized Controlled Trial

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

Other files and links

Fingerprint

Cite this