SmokefreeVET text message program helps Veterans quit smoking

SmokefreeVET is an innovative, text message smoking cessation program that provides daily tips and encouragement to support Veterans who are trying to stop smoking.

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. VA’s Veterans Health Administration created SmokefreeVET in collaboration with the National Cancer Institute (NCI) and modeled the program after NCI’s SmokefreeTXT. Launched in May 2013, it has been used by more than 3,500 Veterans who receive texts and allows them to text the program with prompts. To use SmokefreeVET, Veterans need only have a cell phone that can receive text messages.

“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,” said Dr. Jean Beckham, a psychologist and VA senior research career scientist, co-developer of SmokefreeVET and leader of the evaluation team. “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.”

Typically, SmokefreeVET lasts eight weeks for each user. When a Veteran signs up for SmokefreeVET, they are prompted to provide their quit date and ideally, start the program two weeks prior to that date. Under this scenario, the user receives automated SmokefreeVET texts two weeks prior to their quit date and for six weeks after. Each day, a user receives 2-5 messages that encourage and support their quit attempt.

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 a user’s quit date, they receive messages like “Counseling & medication can increase your chances of quitting. Talk to your VA provider about options. Let them know if you started any quit meds.”

SmokefreeVET users not only receive texts, they can send prompts to the program when they want to receive extra support. Users can 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.

“I let all of the Veterans in our tobacco cessation group know about the SmokefreeVET program,” said Dr. Murray McNiel,a  psychologist and the smoking cessation lead clinician at the Durham VAMC . “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.”

To evaluate the program and determine areas for improvement, VA administrators worked with VA researchers to examine the program’s effectiveness in supporting abstinence from tobacco. This analysis was published in the November 2016 edition of Addictive Behaviors, in an article entitled “Engagement and Abstinence Among Users of a Smoking Cessation Text Message Program for Veterans.” Looking at data from close to 1,500 Veterans who used SmokefreeVET between 2013 and 2014, the researchers concluded that this text message program may be effective in helping highly engaged Veterans quit smoking. In addition, smoking cessation medication use was associated with cigarette abstinence among SmokefreeVET users.

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 and Health program.