SmokefreeVET is an innovative, text message smoking cessation program that provides daily tips and encouragement to support Veterans who are trying to stop smoking. Launched in 2013, VA’s SmokefreeVET text message program has been used by more than 3,500 Veterans.
Cell phones are generally always with you and always on, which makes them a convenient way to deliver messages and health-related information, particularly on stopping smoking. VHA created SmokefreeVET in collaboration with the National Cancer Institute (NCI) and modeled the program after NCI’s SmokefreeTXT. SmokefreeVET sends texts to users and allows them to text the program with prompts. To use SmokefreeVET, Veterans need only have a cell phone that can receive text messages.
Typically, SmokefreeVET lasts eight weeks for each user. When Veterans signs up for SmokefreeVET, they are prompted to provide their quit dates and ideally, start the program two weeks prior to that date. Under this scenario, users receive automated SmokefreeVET texts two weeks prior to their quit date and for six weeks after. Each day, users receive 2-5 messages that encourage and support their quit attempts. For example, one pre-quit message reads “Figure out 3 cigs a day you can easily give up and do so! If you cut down it will be easier when you quit. You’re stronger than this addiction.” Soon after users’ quit dates, they receive messages like “Counseling & medication can increase your chances of quitting. Talk to your VA providers about options. Let them know if you started any quit meds.”
SmokefreeVET users not only receive texts; they may send prompts to the program when they want to receive extra support. Users may text the word URGE, STRESS, or SMOKED at any time to SmokefreeVET and receive a supportive tip in response. A user texting SMOKED may receive the message “Hey, quitting smoking is a tough process & there are going to be bumps along the way. But don’t give up—look how far you have already come!” Importantly, the SmokefreeVET program also contains information about how to contact the Veterans Crisis Line if a user is in emotional distress.
Dr. Murray McNiel, psychologist and Smoking Cessation Lead Clinician at the Durham VA Medical Center, said “I let all of the Veterans in our tobacco cessation group know about the SmokefreeVET program. It’s a great complement to group treatment, with the texts providing frequent reminders of their decision to quit as well as coping skills to use in the moment. I’ve had Veterans tell me it was the most helpful thing in their successful quitting.”
Dr. Jean Beckham, a psychologist and VA Senior Research Career Scientist, co-developer of SmokefreeVET and lead of the evaluation team, is excited about the potential of the SmokefreeVET program to help Veterans quit smoking, “SmokefreeVET takes advantage of cell phone technology that everyone has in their pocket. Research has shown that text message programs for smoking cessation are effective. We are looking at how Veterans use SmokefreeVET to improve and tailor the program because the ultimate goal is to give Veterans the tools and support they need to successfully quit smoking.”
Majority of those using the program are older Veterans
Researchers were particularly interested in looking at how user engagement, defined as texts sent by the user to the program, influenced abstinence from smoking. They found that 13 percent of all SmokefreeVET users reported themselves as abstinent five weeks after their quit date, but highly engaged users were much more likely to report abstinence (60 percent) at the same point in time. Highly engaged users consistently sent the highest number of texts throughout the course of the program.
What may be surprising is that more than 60 percent of the SmokefreeVET users were ages 45 and older. While use of a cell phone for texting may bring to mind younger adults, SmokefreeVET users ages 18-30 represented the smallest portion of program users (12.04 percent) in the study. Twenty-seven percent of the SmokefreeVET users were considered heavy smokers as they smoked a pack or more of cigarettes each day.
SmokefreeVET users have provided feedback on how the text messages have helped them in their quit journey. One user wrote: “I’ve been trying to quit for years and this program has helped me accomplish my goal. Thank you for the support.”
The SmokefreeVET text message program is available in English and Spanish. Veterans can sign up online at smokefree.gov/VET or by texting the word VET to 47848 (text VETesp to 47848 for Spanish).
About the author: Leah Stockett, MPH, is a science writer for VA’s Tobacco & Health program.
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