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Completed

NCT Number: NCT05370352

Mobile Chat Messaging for Smoking Relapse Prevention

Most smokers return to smoking (relapse) after making a quit attempt, but evidence of effective intervention to prevent relapse is scarce. Taking advantage of recent advances in mobile technologies, this study aims to evaluate the effectiveness of a mobile chat messaging-based relapse prevention intervention in promoting successful quitting in people who recently quit smoking (recent abstainers) using a randomised controlled trial design.

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Key information

Conditions

Smoking Cessation Behavior Disease Attributes Health Behavior Pathologic Processes Pathological Conditions, Signs and Symptoms Recurrence

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation, Hong Kong

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About this study

Most smokers who made quit attempts and achieved short-term abstinence return to smoking (relapse) over time, even when aided by effective smoking cessation treatment. Since relapse mostly occurred in the first 4 weeks of abstinence, relapse prevention in the early phase of abstinence could potentially boost long-term abstinence. Several behavioural interventions for smoking relapse prevention have been proposed and tested in RCTs. Yet, a 2019 Cochrane review did not find traditional approaches, including self-help materials, telephone counselling and group therapy, effective in increasing long-term abstinence at 6 months or longer.

The widespread use of mobile devices has provided a highly accessible and scalable means for novel behavioural interventions for smoking cessation. A formative qualitative study in current smokers conducted by the investigators showed that mobile chat messaging is a feasible and acceptable platform for delivering smoking cessation support. A subsequent cluster randomised controlled trial on 1148 smokers found that mobile chat messaging combined with brief intervention was effective in increasing biochemically validated abstinence at 6 months. Nonetheless, whether mobile chat messaging could prevent relapse in recent abstainers has remained untested.

The investigators did a pilot trial to confirm the feasibility and acceptability of mobile chat messaging for relapse prevention in recent abstainers. This study aims to evaluate the effectiveness of mobile chat messaging relapse prevention intervention in promoting abstinence in recent abstainers.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Hong Kong residents aged 18 years or above
  • Own a smartphone with WhatsApp installed
  • Enrolled in a smoking cessation program under Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation
  • Smoked daily before the present quit attempt
  • Abstained from smoking for 3 to 30 days

Exclusion criteria

  • Diagnosed with a mental disease or on regular psychotropic drugs
  • Participating in other ongoing smoking cessation studies

Treatment and study plan

Standard smoking cessation treatment

Behavioral

Standard smoking cessation treatment (behavioural and pharmacotherapy) provided by Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation

Personalised chat messaging

Behavioral

Personalised chat messaging focusing on smoking relapse prevention for 3 months from randomisation. A trained counsellor will interact with a participant individually and provide relapse prevention advice via WhatsApp. The participant can also access a supportive chatbot in WhatsApp, which will provide on-demand smoking relapse prevention support when the counsellor is not available (e.g., during nighttime).

SMS text messaging

Behavioral

SMS text messaging on generic information about the harms of smoking and the benefits of quitting for 3 months from randomisation.

Primary outcomes

  1. Biochemically validated tobacco abstinence

    Time frame: 6 months after randomisation

    Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test

Secondary outcomes

  1. Self-reported 6-month prolonged tobacco abstinence

    Time frame: 6 months after randomisation

    Not more than five lapses permitted for 6 months after baseline

  2. Self-reported 7-day point prevalent tobacco abstinence

    Time frame: 3 months after randomisation

    Being completely smoke-free in the past 7 days

  3. Self-reported 7-day point prevalent tobacco abstinence

    Time frame: 6 months after randomisation

    Being completely smoke-free in the past 7 days

  4. Self-reported relapse rate

    Time frame: 3 months after randomisation

    Defined as use of tobacco products for 7 consecutive days or longer

  5. Self-reported relapse rate

    Time frame: 6 months after randomisation

    Defined as use of tobacco products for 7 consecutive days or longer

  6. Biochemically validated tobacco abstinence

    Time frame: 12 months after randomisation

    Verified by an exhaled carbon monoxide level of lower than 5 parts per million or a negative salivary cotinine test

  7. Self-reported 12-month prolonged tobacco abstinence

    Time frame: 12 months after randomisation

    Not more than five lapses permitted for 12 months after baseline

  8. Self-reported 7-day point prevalent tobacco abstinence

    Time frame: 12 months after randomisation

    Being completely smoke-free in the past 7 days

  9. Self-reported relapse rate

    Time frame: 12 months after randomisation

    Defined as use of tobacco products for 7 consecutive days or longer

Sponsors and collaborators

Lead sponsor

The University of Hong Kong

Other

Collaborators

  • Health and Medical Research Fund
  • Tung Wah Group of Hospitals Integrated Centre on Smoking Cessation
  • United Christian Nethersole Community Health Service Smoking Cessation Programme

Registry information

Official study title

Effectiveness of Mobile Chat Messaging for Preventing Relapse in Smokers Who Have Recently Quit Smoking: a Randomised Controlled Trial

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
May 11, 2022
Registry last updated
Nov 20, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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