JMIR Publications

ABSTRACT

Background:

Background:

The use of tobacco cigarettes and electronic nicotine products is widespread among young people in Switzerland. At the same time, the instant messaging platform WhatsApp is the most frequently used smartphone application in this population group. The provision of individually tailored, evidence-based coaching messages via WhatsApp seems promising to support smoking cessation in adolescents and young adults.

Objective:

To test the feasibility, acceptance, and initial effectiveness of a newly developed, semi-automated WhatsApp-based intervention program to support smoking cessation and smoking reduction in adolescents and young adults.

Methods:

Recruitment took place in the German speaking part of Switzerland between the end of May 2023 and March 2024 via various channels, both online and offline. For a period of 11 weeks, regular smokers of products containing nicotine, aged between 16 and 30 years, received individually tailored messages to increase their motivation to stop or reduce smoking, on how to deal with cravings or stressful situations, and how to stop or reduce smoking. A separate WhatsApp channel gave the opportunity to ask individual questions to a counsellor. A one-group pre-post design was used to obtain preliminary information on the acceptability and potential effectiveness of the program.

Results:

A total of 167 young people (mean age 23.2 years, 56.9% female, 43.1% male) who regularly smoked tobacco cigarettes (48.5%), electronic nicotine products (10.2%), or both (41.3%) were recruited for participation in the program and the associated study. Of these, 59.9% intended to stop smoking, while 40.1% aimed at reducing their use of smokable nicotine products. The participants actively engaged in an average of 5.5 of the 11 program weeks (SD = 3.8), the average number of interactions with the program was 26.8 (SD = 26.1), and the average duration from the start of the program to the last interaction was 45.0 days (SD = 31.1). The follow-up survey at the end of the 11-week coaching program was completed by 108 participants (64.3%). The Generalized Estimating Equation (GEE) analyses revealed significant reductions in the mean number of days in the last 30 days on which tobacco cigarettes were used from 20.6 at baseline to 14.0 at post-assessment (IRR 0.68, p < .01) and for electronic nicotine products from 11.1 days at baseline to 7.7 days at follow up (IRR 0.71, p < .01). The mean number of tobacco cigarettes consumed per day in the last 30 days was reduced by 3.4 cigarettes/day from 11.1 in the baseline survey to 7.7 in the follow-up survey (IRR .71, p < .01). Six of the 108 participants in the follow-up survey (5.6%) stated that they neither consumed tobacco cigarettes nor electronic nicotine products in the last 30 days.

Conclusions:

The WhatsApp-based program appears to be a well-accepted and promising intervention for reducing the consumption of tobacco cigarettes and electronic nicotine products among young people. A larger-scale randomized controlled trial would be reasonable in order to make more substantiated statements about the program`s efficacy.