Accepted for/Published in: JMIR Human Factors
Date Submitted: Sep 7, 2018
Open Peer Review Period: Sep 11, 2018 - Sep 25, 2018
Date Accepted: Dec 29, 2018
(closed for review but you can still tweet)
Exploring the experiences of individuals allocated to a control setting â€“ findings from the NEXit smoking cessation trial
Tobacco smoking is the primary cause of preventable premature disease and death worldwide. Evidence of the efficacy of text messaging interventions to reduce smoking behaviour is well established, but there is still a need for studies targeting young people, especially because young adult smokers are less likely to seek treatment than older adults. A mHealth intervention, NEXit, targeting smoking among university students was developed to support university students to quit smoking. Short-term effectiveness was measured through a randomised controlled trial, and it was found that immediately after the 12-week intervention, 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group.
The present study was performed to explore the experience of being allocated to the control group in the NEXit smoking cessation intervention.
Students who were allocated to the control group in the main NEXit randomized controlled trial were asked to report their experiences. An e-mail was sent to the participants with an electronic link to a short questionnaire. The distribution of the responses to the questionnaire was assessed by descriptive analysis. Free-text comments to four questions were analysed.
The response rate for the questionnaire was 34% (n = 258/763) and 143 free-text comments were collected. Sixty-one percent of the responders (n=157/258) experienced frustration, disappointment and irritation about being allocated to the control group; they felt they were being denied support having to wait for the intervention. Monthly text messages during the waiting period thanking them for taking part in the trial were perceived as negative by 73% (n=189/258), but for some the messages served as a reminder about the decision to quit smoking. Sixty-one percent of the responders (n=158/258) chose to wait to quit smoking until they had access to the intervention. Approximately 30% (n=77/258) decided to try quit smoking without support. Of the respondents, 77% (n=200/258) claimed they were still smoking and had signed up or were thinking about signing up for the smoking cessation programme at the time of the questionnaire.
A majority of the respondents reported negative feelings about having to wait for the support and that they had decided to continue smoking. A similar number decided to wait to quit smoking until they had access to the intervention, and high interest in the intervention was reported among these respondents. Free text comments indicated that some control group participants believed that they had been excluded from the trial, while others were confused when asked to sign up for the intervention again. Clinical Trial: ISRCTN75766527
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