JMIR Publications

ABSTRACT

Background:

Tailored smoking cessation messages may be more relevant when they consider psychological characteristics associated with behavior change. Self-efficacy and readiness to quit are useful, complementary dimensions for tailoring smoking cessation support. Before evaluating the effectiveness of such messages on smoking behavior, formative assessment of recipients’ immediate responses and message appraisal can inform message refinement.

Objective:

We aimed to explore immediate changes in intention to quit smoking and to use smoking cessation treatment, as well as message appraisal, following exposure to type-specific smoking cessation text messages developed according to self-efficacy and readiness to quit.

Methods:

We conducted a single-group pre-post online survey among 500 current smokers aged ≥20 years in Japan. Participants were classified into five psychological profiles (Types A-E) and were shown a single text message tailored to their assigned profile. Intention to quit smoking and use smoking cessation treatment were assessed before and immediately after message exposure using 5-point scales. Message comprehensibility, readability, feasibility, fit with the timing of smoking cessation, anxiety reduction, and other appraisal dimensions were assessed after exposure. Overall pre-post changes were evaluated using Wilcoxon signed-rank tests. Type-specific analyses were conducted exploratorily.

Results:

ype C (low self-efficacy and low readiness) was the most common profile (152/500, 30.4%). Overall intention to quit smoking decreased from a median of 4 (interquartile range [IQR], 3–5) before message exposure to 3 (3–4) afterward, with a mean change of −0.39 (95% confidence interval [CI] −0.47 to −0.31; p<.001). In contrast, intention to use smoking cessation treatment increased from a median of 3 (IQR 2–3) to 3 (2–4), with a mean change of 0.28 (95% CI, 0.19–0.37; p<.001). Mean appraisal scores were higher for comprehensibility (3.77/5) and readability (3.77/5) than for feasibility (3.25/5), fit with the timing of smoking cessation (3.26/5), and anxiety reduction (3.10/5). Type C had the lowest mean scores for feasibility (2.61/5), fit with the timing of smoking cessation (2.62/5), and anxiety reduction (2.61/5). Among participants classified as Type C, 79 (52.0%) reported wanting to quit but having no specific plans, whereas 73 (48.0%) reported no intention to quit.

Conclusions:

A single exposure to type-specific smoking cessation messages was followed by a decrease in intention to quit but an increase in intention to use smoking cessation treatment. Although the messages were generally rated as comprehensible and readable, lower ratings for feasibility and timing fit, particularly among Type C participants, identified areas requiring further refinement. Future message development may benefit from incorporating additional contextual information and distinguishing smokers with no intention to quit from those who are interested in quitting but have no specific plans. Controlled studies with follow-up behavioral outcomes are needed to evaluate the effectiveness of the refined messages.