METHODS This ref 3 was a two-arm RCT with adaptive randomization that balanced study arms by sex and smoking levels (heavy vs. light) conducted in the United States. The research protocol was approved by Chesapeake IRB (ClinicalTrials.gov ID# NCT01516632). Participants Participants were recruited nationally through online advertisements (e.g., Craigslist) between May 3, 2011 and August 4, 2011. Eligibility criteria included the following: being between the ages of 18�C25, able to read and write in English, owning a cell phone, being cognizant of how to send and receive text messages, being currently enrolled or intending to enroll in an unlimited text messaging plan, smoking 24 cigarettes or more per week (at least four per day on at least 6 days/week) (Obermayer, Riley, Asif, & Jean-Mary, 2004), seriously thinking about quitting in the next 30 days, and agreeing to smoking cessation status verification by a significant other (e.
g., family member, friend). Intervention and Control Groups Intervention group participants were exposed to a 6-week cessation program. Content was tailored based upon where in the quitting process participants were: All participants received 2 weeks of Pre-Quit messages aimed at encouraging them to clarify reasons for quitting and to understand their smoking patterns and tempting situations/triggers/urges. Early Quit messages, sent on Quit Day and through the first week postquit, talked about common difficulties and discomforts associated with quitting and emphasized the use of coping strategies. Late Quit messages encouraged participants to recognize relapse in a different way (e.
g., situations, confidence) and provided actionable information about how to deal with issues that arise as a nonsmoker (e.g., stress, moods). Based on telephone quitline research that suggests most smoking relapse occurs within the first week (Zhu et al., 1996), intervention participants received a text message at Post-Quit Day 2 and 7 that asked their smoking status. At either time point, if participants reported smoking, they were pathed to Relapse messages that focused on helping them get back on track and to recommit to quitting. If participants were smoking at both days, they were pathed to an Encouragement arm that focused on norms for quitting and suggested that participants try quitting again at later time.
Participants received four messages per day during the 2-week Pre-Quit GSK-3 stage, with the exception of Day 1 and Day 14 when they received five and six messages, respectively. In the Early Quit stage, participants received nine messages on both Quit Day and Post-Quit Day 2, eight messages on the third day, and then one fewer message each day until the last day of the week when four messages were received. In Late Quit, participants received two messages per day for 2 weeks and then one message per day during the final week.
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