Using WhatsApp and Facebook social groups for smoking relapse prevention: A pilot pragmatic randomized controlled tria

Podium Presentation 5: Paper Session 21 SMOKING AND SOCIAL MEDIA: abstract & oral presentation: no. PA21-2BACKGROUND AND OBJECTIVES: Quit attempters often have episodes of smoking relapse before they can eventually quit. Social media is becoming popular for smoking cessation and relapse prevention, but its effectiveness has not been fully explored. Our randomized controlled trial (RCT) tested the effect of group discussion and reminders via the WhatsApp or Facebook social group to prevent smoking relapse in quitters who had stopped smoking recently. METHODS: A single-blinded, pragmatic parallel three-arm pilot cluster RCT. Recent quitters, who had completed an 8-week treatment and reported abstinence for at least 7 days, were randomly allocated to WhatsApp (n = 42), Facebook (n = 40), and Control group (n = 54). The 2 intervention groups participated in a 2-month group discussion moderated by a trained smoking cessation counselor and received a self-help booklet on smoking cessation. The Control group only received the booklet. FINDINGS: Fewer subjects in the WhatsApp group (14.3%) reported smoking in the past 7 days than the Control group (44.4%) at 2- (odds ratio (OR) = 0.21, 95%CI 0.08-0.58) and 6-month follow-up (35.7% versus 61.1%, OR = 0.35, 95%CI 0.15-0.82). Facebook group showed a lower smoking rate at 2- (30.0 % versus 44.4%, OR = 0.54, 95%CI 0.23-1.27) and 6-month follow-up (52.5 % versus 61.1%, OR = 0.70, 95%CI 0.31-1.61), but the difference was not significant. WhatsApp social groups had more moderators’ posts (Median: 60 versus 31.5; Mann-Whitney U test: p=.05) and subjects’ posts (Median: 35 versus 6; Mann-Whitney U test: p=.07) than Facebook counterparts. CONCLUSIONS: The intervention via WhatsApp social group was effective in reducing relapse, probably because of enhanced discussion and social support. Inactive discussion in the Facebook social group might have attributed to the lower effectiveness. Funding: The work was funded by Tung Wah Group of Hospitals. The organization was funded by the Tobacco Control Office of the Department of Health. Corresponding Author: Yee Tak Derek Cheung, The University of Hong Kong, Hong Kong, [email protected]

Using WhatsApp and Facebook Online Social Groups for Smoking Relapse Prevention for Recent Quitters: A Pilot Pragmatic Cluster Randomized Controlled Trial

BACKGROUND: Quit attempters often have episodes of smoking relapse before they eventually quit. Interactive text messaging through mobile phones has been shown to increase abstinence. This service can be potentially applied on the platform of a social networking service to help quitters maintain abstinence.OBJECTIVE: Our aim was to determine if the group discussion and reminders via the WhatsApp or Facebook social group were effective to prevent smoking relapse in quitters who had stopped smoking recently.METHODS: This was a single-blinded, parallel, 3-arm pilot cluster randomized controlled trial allocating recent quitters, who had completed an 8-week treatment and reported abstinence for at least 7 days, to WhatsApp (n=42), Facebook (n=40), and a control group (n=54). The 2 intervention groups participated in a 2-month online group discussion with either WhatsApp or Facebook moderated by a trained smoking cessation counselor and received a self-help booklet on smoking cessation. The control group only received the booklet. The primary outcome was the 2- and 6-month relapse rates, defined as the proportion of participants who smoked at least 5 cigarettes in 3 consecutive days.RESULTS: Fewer participants in the WhatsApp group (17%, 7/42) reported relapse than the control group (42.6%, 23/54) at 2-month (OR 0.27, 95% CI 0.10-0.71) and 6-month (40.5%, 17/42 vs 61.1%, 33/54; OR 0.43, 95% CI 0.19-0.99) follow-ups. The Facebook group (30.0%, 12/40) had an insignificantly lower relapse rate than the control group (42.6%, 23/54) at 2-month (OR 0.58, 95% CI 0.24-1.37) and 6-month (52.5%, 13/40 vs 61.1%, 33/54; OR 0.70, 95% CI 0.31-1.61) follow-ups. The WhatsApp social groups had more moderators' posts (median 60, IQR 25 vs median 32, IQR 7; P=.05) and participants' posts (median 35, IQR 50 vs median 6, IQR 9; P=.07) than their Facebook counterparts, but the difference was insignificant.CONCLUSIONS: The intervention via the WhatsApp social group was effective in reducing relapse probably because of enhanced discussion and social support. Inactive discussion in the Facebook social group might have attributed to the lower effectiveness.CLINICALTRIAL: Clinicaltrials.gov NCT02007369; https://clinicaltrials.gov/show/NCT02007369 (Archived by WebCite® at http://www.webcitation.org/6c3RbltQG).link_to_OA_fulltex