Text messaging to help smokers quit: Does personalization matter?

This is a guest post by Krista DeStasio about her recent paper, published in the Journal of Smoking Cessation.

Changing habits and behaviors is hard. We can all think of a time that we set a goal – cutting down on sweets, for example – and didn’t stick with it despite our best intentions. Quitting smoking is such a goal for many people. Specialized quitting programs can increase success, but those programs are not accessible to everyone. However, it is now possible to help people via text message regardless of where they live and how much money they make because of the ubiquity of cell phones. Research shows that delivering cessation support via text messaging is effective for a variety of goals: quitting smoking, adherence to HIV treatment, and diabetes management, to name a few. Some studies tailor the messages to the participant, such as by providing gender-specific health information to pregnant women trying to quit smoking. Social psychology indicates that personally relevant information is given special attention and remembered better than information that the person doesn’t find self-relevant, suggesting that tailored cessation messages may be even more effective than standard treatment messages.

My colleagues, Anne Hill and Elliot Berkman, and I conducted a study to find out whether highly self-relevant messages would help people quit smoking more than generic or only moderately self-relevant ones. We reasoned that the self-authored messages may be more helpful than more generic, expert-authored messages, since they would be uniquely relevant to the person receiving them. In our study, all participants wrote text-length messages that they thought would be helpful to them during their quit attempt. A third of participants were additionally instructed to write those messages in the form of “if-then” statements, such as “If I feel like I need a cigarette, then I will chew gum instead.” This format, known as implementation intentions has been found to increase the likelihood of obtaining long-term goals. The other participants were not given instruction about message format. Participants then received either their own self-authored messages or standard treatment messages every day for a month. This gave us three groups in the study: people who received their own “if-then” messages and received those messages, people who received their own messages without detailed instruction, and people who wrote their own messages but received generic messages. Everyone received six text messages per day.

Interestingly, everyone in the study decreased their smoking. There was some indication that the if-then messages were better than the controls, but they weren’t significantly different than the other tailored messages. At least in this study, the level of self-relevance of the received messages didn’t make a huge difference in how effective the text messaging intervention was. However, all participants composed their own messages, so it is possible that the extra effort the participants put in to write the messages made a difference, even if they didn’t receive those messages during cessation. Our next studies will test this, as well as the possibility that receiving messages that are personalized but not self-authored would be just as effective for quitting as actual self-authorship.

Full citation info:

DeStasio, K.L., Hill, A.P., & Berkman, E.T. (in press) Efficacy of an SMS-based smoking intervention using message self-authorship: A pilot study. Journal of Smoking Cessation. [pdf]

About Elliot Berkman

Assistant Professor of Psychology at the University of Oregon
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