Utilizing the SmokefreeTXT Text Messaging Service to Aid Smokers to Stop Smoking in a Primary Care Setting
Repository Posting Date2017-10-02T14:56:58Z
Author(s)Young, Alexander L.
TypeDNP Capstone Project
Level of EvidenceOther
Research ApproachTranslational Research/Evidence-based Practice
Keywordssmoking cessation; text messaging; SmokefreeTXT; Smoking Cessation; Smoking Cessation Programs; Smartphone--Utilization; Text Messaging--Utilization; Smartphone; Text Messaging
CINAHL HeadingsSmoking Cessation; Smoking Cessation Programs; Smartphone--Utilization; Text Messaging--Utilization; Smartphone; Text Messaging
According to the CDC, 17.8% of people in the United States are current smokers. 23.4% of Ohioans smoke cigarettes daily, which is significantly greater than the national average. In the clinical setting where the project took place, approximately one third of patients who came into the office stated they were active smokers. Review of evidence suggests that text message-based smoking cessation interventions are an effective means of smoking cessation. This project sought to answer the PICOT question: (P) In current smokers aged 18-65 in a privately-owned family practice in a large urban city in southwest Ohio (I) will using SmokefreeTXT text-messaging service, or SmokefreeTXT in conjunction with NRT (C) compared to patients who do not wish to stop smoking (O) increase smoking cessation rates (T) over the course of the six-week intervention duration? The Stetler Model of Research Utilization was used to guide the implementation of the project. The proposed project was implemented at a family practice office in a large urban city. Patients were predominantly African American with Medicare and Medicaid insurances. Patients were provided a pre-assessment tool and were offered the opportunity to participate in this project if they met inclusion criteria. Three groups participated in the project: a control group which consisted of smokers who did not wish to stop smoking, and two intervention groups. The first intervention group used only SmokefreeTXT (SFTXTO) in their smoking cessation attempt. The second group used SmokefreeTXT (SFTXTP) in addition to a nicotine replacement therapy. The first group consisted of patients who wished to solely use SmokefreeTXT during their quit attempt. They did not use any other smoking cessation intervention. The second group consisted of patients who chose to use SmokefreeTXT in conjunction with another means of smoking cessation (nicotine replacement therapy, medication, etc.). The third group was a control group who were current smokers, willing to complete the pre- and post- assessments, but who were not interested in quitting smoking at the time. At the end of the program, a post-assessment was administered to determine what changes in smoking habits occurred between the three groups. The specific outcomes measured during this project are the stage of smoking status measured by the Smoking: Adult Stage of Change (Short Form) tool and the Nicotine Dependence score measured by the Fagerstrom Test for Nicotine Dependence (FTND) questionnaire at the beginning and end of the project. In addition, patient satisfaction with the SmokefreeTXT was collected at the end of the project. SPSS was used for statistical analysis. There was a statistically significant reduction in the FTND scores and levels in the intervention groups. There was a statistically significant change in the stage of smoking cessation change in both intervention groups. Participants found SmokefreeTXT to be helpful, convenient, and easy to use. They enjoyed the messages and support they received, and many of them stated that without SmokefreeTXT they would not have been successful in their quit-attempt. SmokefreeTXT provides an alternative or supplement to the current smoking cessation treatment options. The provider where the project took place has already begun recommending SmokefreeTXT to patients wishing to stop smoking.