WhatsApp embedded in routine service delivery for smoking cessation: Effects on success rates in a randomized controlled study (Preprint)
BACKGROUND The demand for smoking cessation services has risen in Turkey, as those planning to quit, reached 35% in 2012. For quitting efforts, communication technologies are used widespread globally, yet service integration is rare. OBJECTIVE This study aims to assess the effect of a WhatsApp application embedded in the cessation service delivery, on success rate. METHODS Randomized controlled intervention study was conducted with 132 volunteers, followed up at Ege University Hospital, Smoking Cessation Clinic, March-July 2017. Intervention content based on Transtheoretic Model, was prepared and 60 WhatsApp messages were delivered to participants for 3 months, with 6 months follow up. Initial interview and follow up forms consisting sociodemographics, smoking status, medical condition and treatment, were used. The success rate at 1st and 3rd months were assessed by point-prevalence. Intention-to-treat analysis was used. As secondary outcomes; number of follow-ups, change in weight and continuity of medication were evaluated. RESULTS Success rate at 1st month was 65.9% for intervention group and 40.9% in control group; for the 3rd month it was 50.0% and 30.7%, consecutively. Being in the intervention group increased success rate by 3.50 (1.30-9.44) times in the 1st 2.50 (1.08-6.40) times in the 3rd and 2.31 (1.03- 5.16) times 6th month. The intervention was the only parameter effective in the two follow-up periods; all other factors were eliminated after adjustment for the intervention. As secondary outcomes, in the intervention group, number of follow-ups and face to face follow-ups increased for the 1st and 3rd months and continuity of medication was higher at 3rd month. CONCLUSIONS WhatsApp support embedded in cessation service delivery increases the success rate and has favorable effects on follow-up. Moreover, the equalizing effect of the intervention in terms of socioeconomic differences, positively contributes to the elimination of inequalities for successful smoking cessation in disadvantaged groups.