1. 15TH WORLD CONFERENCE ON TOBACCO OR HEALTH
SINGAPORE
PRELIMINARY FINDINGS FROM SMS USA, A TEXT
MESSAGING-BASED SMOKING CESSATION PROGRAM
FOR YOUNG ADULTS IN THE US
MARCH 21, 2012 1:45 – 3:15 PM
ABSTRACT #OP-137
Michele Ybarra MPH PhD 1
Jodi S Holtrop PhD 2
M. Hossein Rahbar PhD 3
Tonya Prescott BA 1
David Strong PhD 4
Amanda Graham PhD
1 Center for Innovative Public Health Research; 2 Michigan State University; 3
University of Texas Health Sciences; 4 UCSD
* Thank you for your interest in this
presentation. Please note that
analyses included herein are
preliminary. More recent, finalized
analyses may be available by
contacting CiPHR for further
information.

2. ACKNOWLEDGEMENTS
Funding: This work was supported by the
National Cancer Institute at the National
Institutes of Health [R21CA135669]. The content
is solely the responsibility of the authors and does
not necessarily represent the official views of NCI
or the National Institutes of Health.
Declaration of Interest: The authors have no
competing interests to declare.

3. STUDY MOTIVATION
 Between 22-34% of 18-24 year olds are current
cigarette smokers, depending on the measure (i.e.,
ever in the past 30 days vs. every day / some days
currently). (CDC, 2009; SAMHSA, 2011)
 Over half of young smokers want to quit or cut down
(Lamkin, Davis, Kamen, 1998) and are more likely to report a
quit attempt than older adult smokers. (Curry, Sporer,
Pugach et al., 2007)
 Smoking cessation programs targeted and accessible
to young adults are lacking (Murphy-Hoefer, 2005; Lantz, 2003)
 Nine in ten US young adults owning a cell phone and
97% using text messaging (Smith, 2011). Text messaging-
based smoking cessation programs may be an ideal
delivery mode for young adult smokers.

4. STOP MY SMOKING (SMS) USA
RCT METHODOLOGY
Eligibility criteria:
 18-25 years of age
 Own a mobile phone
 Be enrolled or plan to enroll in a text messaging plan
 Smoke 28 cigarettes / week on at least 6 days per
week
 Seriously thinking about quitting in the next 30 days
Differences with SMS Turkey:
 Addition of Text Buddy and Text Crave (Rodgers et al., 2000)
 Significant other-verified quitting status

5. CONSORT DIAGRAM Assessed for eligibility (n=1,916)
Excluded (n=1,413)
¨ Not meeting inclusion criteria (n=1,312)
¨ Declined to participate (n=90)
¨ Other reasons (n=11)
Analysed (n=101)
¨ Completed all 3 data collection periods (n=77)
¨ Completed baseline + 4 week data collection (n= 9)
¨ Completed baseline + 12 week data collection (n=4)
¨ Lost to follow-up (i.e., completed baseline survey only; n=11)
Allocated to intervention (n=101)
¨ Received allocated intervention (n= 96)
¨ Did not receive allocated intervention (withdrew from study; n=5)
¨ Completed all 3 data collection periods (n=48)
¨ Completed baseline + 4 week data collection (n=6)
¨ Completed baseline + 12 week data collection (n=3)
¨ Lost to follow-up (i.e., completed baseline survey only; n=6)
Allocated to control (n= 63)
¨ Received allocated control (n= 63)
¨ Did not receive allocated control (n=0)
Analysed (n=63)
Allocation
Analysis
Follow-Up
Prematurely terminated after randomization (n=55)
¨ Did not complete registration (n=7)
¨ Completed registration, but not online survey (n=39)
¨ Completed registration/ online survey, but after initial quit day; did not reset quit date (n=1)
¨ Unable to receive validation code (n=8)
Enrollment
Randomized (n=219)
as
Excluded from the analyses (n=55)
The randomization allocation for participants who were prematurely terminated was not retained. We therefore
don’t know which arm they belong to; and so cannot include them in ITT

6. SMS USA SAMPLE CHARACTERISTICS
(N=164*)
Personal characteristics Control
(n=63)
Intervention
(n=101)
P-
value
Demographic characteristics
Age (Range: 18-24) 21.6 (2.1) 21.6 (2.1) 0.82
Female 44.4% (28) 43.6% (44) 0.91
Working 31+ hours / week 25.4% (16) 40.6% (41) 0.05
Single vs. all other relationships 69.8% (44) 67.3% (68) 0.74
HH education or lower 33.3% (21) 30.7% (31) 0.72
Smoking characteristics
Average number of cigarettes
smoked per day (Range: 4-30) 11.9 (5.7) 12.4 (6.3) 0.62
Age at first cigarette (Range: 4-23) 14.4 (3.4) 13.9 (3.2) 0.29
Confidence in quitting (Range: 0-10) 6.5 (2.6) 6.7 (2.4) 0.60
*The submitted abstract included 106 participants. Results reported here include the full sample (n=164)

7. PRIMARY OUTCOME: SO-VERIFIED
CONTINUOUS ABSTINENCE
30%
40%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
12-week post-quit (p=0.22)
Control
Intervention
n=63n=63
n=101
Relative Risk adjusted for: biological sex, working frequency, singlehood, education , average number of cigarettes per
day, confidence in quitting, age at first cigarette
aRR = 1.5, 95% CI: 0.72, 3.0

8. 12-WEEK QUIT STATUS BY BIOLOGICAL SEX
29%
32%
44%
34%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Males (n=92) Females (n=72)
Control
Intervention
n=35
n=47
n=28 n=44

9. 12-WEEK QUIT STATUS BY SMOKING
INTENSITY
32%
23%
40% 39%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
Light smokers Heavy smokers
Control
Intervention
n=50
n=78
n=13
n=23

10. STOP MY SMOKING (SMS) USA
CONCLUSION
Results provide optimism for future research on
SMS USA and other text messaging-based smoking
cessation programs for young adults in the US.
Findings suggest that the program may be more
beneficial for males and perhaps heavier smokers
(although differences were not statistically
significant).