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CO Quit Mobile – Learning More About Young Adults and Tobacco Cessation

Health, Safety, and Well-being
August 10, 2015 Tad Spencer NASPA

Are young adults interested in quitting smoking? If so, why are they not calling quitlines in large numbers? Are there other options that are effective? 

In 2012, The BACCHUS Network received funding from the State of Colorado to adapt and brand a text messaging-based tobacco cessation program for young adults in the state. (NASPA became the lead agency when BACCHUS merged with NASPA in January 2014.) This project recently culminated in June 2015.

Understanding Young Adults

In conversations, focus groups, and interviews with young adults, we learned several key truths about young adults who smoke:

·      Most would like to quit, though they do not necessarily understand how or what goes into a positive quit attempt. Many were delaying quitting, seeing it as something they would do at some point or milestone in the future.

·      There is often a misperception that “cold turkey” is the only way to succeed. (In fact, this method has the lowest success rate for long-term abstinence.)

·      Many in the 18-24 year-old demographic were uncomfortable with the idea of calling a telephone quitline. There was anxiety about “letting down” a counselor if a quit attempt was unsuccessful.

·      Technology-based programs, such as text messaging programs, were much more desirable.

·      Smoking, for this age group, is a highly social activity, and it is often paired with other similar social activities (e.g. when they go out; when they drink.)

For two years, BACCHUS/NASPA and our technology partner, Wedge Communications LLC, operated the system. CO Quit Mobile was a free service and provided 30 days of quit support.

The CO Quit Mobile system utilized, under license, an extensive evidence-based library of messages and custom software to deliver the texts. Individuals registered via an online portal and completed an intake form by answering basic demographic and smoking behavior questions. The individual’s answers set customized patterns within the automated messaging system. As the individual progressed, the messages’ focus would change, helping guide the person through cravings, and then helping make the new tobacco-free lifestyle permanent. Users were also able to send requests for immediate help in dealing with cravings. An optional smartphone app provided users additional tools and information, though only about a quarter of system users chose to use the app.

CO Quit Mobile began as a smoking-only cessation system. In Year Two, smokeless/chew tobacco and Spanish smoking versions were added. The smokeless system was particularly valuable, as far fewer resources exist for those wanting to quit dipping.

Results

·      Among tobacco users followed up, CO Quit Mobile had helped 30% quit by four weeks, 26% quit by 12 weeks, and 21% quit by 26 weeks (without slips). 

·      For reference, the success rate for those trying cold turkey is around three percent.

·      Also, many smokers’ confidence in quitting for good improved substantially after using CO Quit Mobile, and the number of smokers using medications to help them quit doubled.

·      With a relatively tiny paid media budget for a statewide campaign, we were able to consistently achieve 40% of system users from the 18-24 year-old demographic.

·      For young adults in particular, it is important to introduce them to the process of quitting and build their confidence by helping them deal constructively with slips, mistakes, and unsuccessful attempts.

Implications for Campuses

·      Many campuses may be relying on cessation services that are not attractive to this generation of young adults. Look for evidence-based cessation programs that utilize current technology.

·      Providing and/or referring people to cessation resources is particularly important for those implementing tobacco-free campus policies. Policy drives demand for cessation services. Consistently promote the resources available to the campus community.

·      If you would like to learn more about this text-messaging program, please contact Tad Spencer at the BACCHUS Initiatives of NASPA.

·      We also provide training to campuses on promoting cessation, as well as passing, implementing, and enforcing tobacco-free policies. Contact the BACCHUS Initiatives for details.