JMIR Publications

ABSTRACT

Background:

Population-level text-messaging smoking cessation interventions may reduce racial/ethnic differences in smoking among pregnant women.

Objective:

To examine racial/ethnic differences in dropout, response, and abstinence rates among users of a national, publicly available text-messaging cessation intervention targeting pregnant women, SmokefreeMOM (SFMom).

Methods:

Online subscribers to SFMom who set a prospective quit date within 9 months of their due date (N = 1288; Mean age = 29.46, SD = 7.11; 65.81% White, 16.04% Black, 8.86% Latina, 9.29% multiracial, American Indian/Alaska Native, Native Hawaiian Pacific Islander, other; 82.68% some college education or less) were included. We examined demographics, smoking frequency, cigarettes per day, and prequit time (less than or equal to 14 days preparation time before quit date) as correlates of response rate and abstinence at 8 timepoints (quit date, day 7, day 14, day 21, day 28, day 35, day 42 (intervention end), and day 72 (1-month follow-up). We conducted survival analysis of time from quit date to dropout by race/ethnicity.

Results:

Point-prevalence abstinence was 14.51% (quit day), 3.51% (intervention end), and 2.03% (1-month follow-up). Black users (Hazard Ratio [HR] = 0.68, 95% CI = 0.51-0.91) and those with a high school degree or less (HR = 0.66, 95% CI = 0.49-0.89) or some college (HR = 0.75, 95% CI = 0.57-0.99) education were less likely to drop out than Whites or users with a Bachelor’s degree or higher. Response and abstinence rates were similar across race/ethnicity and education.

Conclusions:

Enrollment was low among racial/ethnic minority women but high among less-educated women. Abstinence at intervention end and 1-month follow-up was lower than controlled trials of text-messaging cessation interventions for pregnant women (range = 7-20%). Increasing reach, engagement, and effectiveness of SFMom, especially among women with high rates of pregnant smoking, must be prioritized.