JMIR Publications

ABSTRACT

Background:

Smoking is common in Saudi Arabia, particularly among men. Religion plays a protective role against smoking and serves as a motivator for quitting. Faith-based interventions have shown positive effects in supporting smoking cessation among Muslims who smoke, but few studies have tested their acceptability when delivered via mobile phone messaging.

Objective:

The aim of this pilot randomized controlled trial (RCT) was to evaluate the feasibility and acceptability, as well as the preliminary effectiveness of an Islamic-based smoking cessation intervention delivered via WhatsApp messaging in Saudi Arabia.

Methods:

This study was a two-arm RCT involving adult Muslim smokers who used cigarettes, waterpipe, or both. Participants were recruited from the Kafa organization ani-smoking clinic in Saudi Arabia. Participants were randomized in a 1:1 ratio to either the intervention or control group. The intervention messages were co-developed with religious leaders and informed by formative research with Muslim current and former smokers. The intervention group received both religious and smoking-related health messages, while the control group received smoking-related health messages only. The messages were sent daily by research assistants. The intervention lasted for 21 days, during which participants received two messages per day, one in the morning and one in the evening. The primary outcomes were the feasibility and acceptability of the intervention.

Results:

A total of 34 participants were recruited, resulting in a recruitment rate of 68.0%. The overall retention rate was 64.7%. Both groups received 44 WhatsApp messages over 21 days. Message engagement was high, with 88.2% of participants in the intervention group and 82.4% in the control group reporting that they read the daily messages. The intervention was acceptable and was perceived as helpful in supporting smoking cessation. Complete abstinence from both cigarettes and waterpipe was slightly higher in the intervention group (23.5%) than in the control group (17.6%). Cigarette abstinence was also modestly higher in the intervention group than in the control group (31.3% vs 18.8%). Among eight waterpipe users at baseline, two reported waterpipe abstinence at follow-up, both in the intervention group. No statistical comparisons of smoking cessation outcomes between the groups were conducted because the study focused on feasibility and included a small sample size. These findings were descriptive and should be considered exploratory rather than evidence of intervention effectiveness.

Conclusions:

This Islamic faith-based intervention, delivered via WhatsApp messaging, was acceptable and may be feasible for a full-scale trial, provided that recruitment, participant retention, and follow-up data collection are improved. The pilot provides important lessons for intervention design and implementation of a future adequately powered trial. Clinical Trial: Australian New Zealand Clinical Trials Registry (ACTRN 12625001413415)