Adolescents engagement with an Internet- and mobile phone-based smoking cessation program

Abstract

Background: Although engagement with mobile phone-delivered smoking cessation programs is assumed to improve intervention success, the trajectories of program use over time, and their associations with baseline characteristics and treatment outcomes have not been examined yet. Methods: We performed a secondary data analysis on a dataset from a study that compared an Internet- and mobile phone-delivered integrated smoking cessation and alcohol intervention to a smoking cessation only intervention for adolescents (N= 1418). During the three months of the intervention that was based on the Health Action Process Approach, participants in both intervention groups received one text message prompt per week that either assessed smoking-related target behaviours or encouraged participation in a quiz or a message contest. Sequence analyses were performed to identify program use trajectories. Multinomial logistic regression analyses were conducted to identify predictors of typical trajectories. Findings: Three trajectories of program use emerged: 1) stable active participation (n= 646, 45.6%), 2) decreasing participation (n=501, 35.3%), and 3) stable non-active participation (n=271, 19.1%). Adolescents who were younger, who had no immigration background, who saw more benefits of quitting smoking and who reported binge drinking preceding the baseline assessment were more likely to have an active program use trajectory. Decreasing participation was associated with highest tobacco reduction rates, followed by stable active participation and stable non-active participation. Discussion: The majority of participants showed an active program use. However, decreasing engagement with the program might be a stronger indicator of behavior change initiation than stable active engagement.