London School of Hygiene & Tropical Medicine

Mobile phones could hold the key to people giving up smoking after a programme involving sending motivational and supportive text messages to smokers doubled quit rates at six months.

The findings of the txt2stop trial, which was led by the London School of Hygiene & Tropical Medicine and funded by the Medical Research Council, are published in The Lancet today.

Text messaging is an innovative approach to the deadly problem of smoking, which is estimated to cause more than five million deaths each year worldwide. Putting cigarettes out for good has huge implications for health but although two out of three smokers would like to give up, they often fail. Almost 6,000 people took part in the txt2stop trial, which evaluated this new way of helping smokers beat their addiction.

The study examined the long-term effects of specially-designed text messages by testing the levels of cotinine (a chemical found in tobacco) found in participants' saliva after they reported they had stopped smoking for six months.

A total of 5,800 smokers were randomly allocated to the txt2stop programme or a control group. The txt2stop group received five text messages a day for the first five weeks and then three per week for the next 26 weeks with a personalised system which also allowed people to receive instant messages at times of need by texting the word 'crave' or 'Lapse'.

The messages, which were developed with input from smokers and smoking cessation professionals, encouraged participants to persevere and focused on their success so far. Examples of the messages include:

•  "This is it! - QUIT DAY, throw away all your fags. TODAY is the start of being QUIT forever, you can do it"
•  "Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over"

Control group participants received fortnightly text messages thanking them for taking part in the trial. The results showed that continuous abstinence - verified by chemical tests - at six months was significantly increased in the txt2stop group - 10.7% success txt2stop versus 4.9% success control.

The study found txt2stop worked well for all ages and across all social groups, with the authors concluding: "Mobile phone text messaging smoking cessation support doubles quit rates at six months."

LSHTM clinical lecturer and GP Dr Caroline Free, who led the research, says: "Text messages are a very convenient way for smokers to receive support to quit. People described txt2stop as being like having a 'friend' encouraging them or an 'angel on their shoulder'. It helped people resist the temptation to smoke."

Professor Max Parmar, director of the Medical Research Council clinical trials unit, says: "Smoking kills more than five million people each year, and two out of every three smokers have said at some point that they would like to give up. By carrying out a large scale trial like this to see whether text messages can help people truly free themselves of their addiction, this research has shown that texting could be a powerful tool to help people to walk away from cigarettes for good. The MRC has been tackling the problem of smoking for over half a century, and we're committed to funding research that has the potential to change so many people's lives."

Glyn Mcintosh, Director of Development & Communications at QUIT, which helped develop the text messages and find volunteers for the study, says: "We are delighted with the results and hope that text motivation will now become a standard part of the quitting process."

• Lancet 2011; 378: 49-55; Also published Online First 30 June 2011: Smoking cessation support delivered via mobile phone text messaging (txt2stop): a single-blind, randomised trial. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60701-0/abstract