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CONFERENCE PROCEEDING
Effectiveness of mHealth intervention for smoking cessation in people with tuberculosis compared with usual care: A cluster randomised controlled trial
1
Research Department, The Initiative, Islamabad, Pakistan
2
Research Department, Ark Foundation, Dhaka, Bangladesh
3
Department of Social Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
4
Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
5
Health Sciences, The University of York, York, United Kingdom
Publication date: 2025-06-23
Tob. Induc. Dis. 2025;23(Suppl 1):A5
KEYWORDS
TOPICS
ABSTRACT
BACKGROUND: Behavioural support is effective in smoking cessation in people with TB. However, its delivery, being reliant on the motivation and capability of health professionals, remains inconsistent. We evaluated the effectiveness of an mHealth behavioral support intervention (mTB-Tobacco) in achieving six-month continuous abstinence in people with TB.
METHODS: A multi-center, open-label, cluster-randomized superiority trial was conducted in Bangladesh and Pakistan with 27 TB health facilities randomized (2:1) to mTB-Tobacco or usual care. The trial enrolled 1,080 adult pulmonary TB patients, daily smokers, willing to quit, with mobile phone access. The primary outcome was 6-month self-reported continuous abstinence, verified by carbon monoxide <10 ppm. Intervention consisted of motivational text messages in local languages sent throughout TB treatment. Analyses compared quit rates using univariate and generalized mixed models, accounting for intervention effects, cluster randomization, and covariates.
RESULTS: Between Feb–Dec 2024, 1,080 TB patients (600 Bangladesh; 480 Pakistan) were recruited from 27 clusters (15 Bangladesh; 12 Pakistan), randomized to mTB-Tobacco intervention (18 clusters, 720 participants) or usual care (9 clusters, 360 participants). Mean age was 48.3±15.9 years (range 15–91). The attrition rates at the primary end-point were 8.98% (7.5% mTB-Tobacco; 11.9% control). At 6 months, 310/666 (46.5%) in mTB-Tobacco and 57/317 (17.9%) in usual care achieved continuous abstinence (RR=2.60, 95% CI 1.96–3.45; RD=28.9%, 95% CI 23%–35%). Generalized Linear Mixed Model analysis showed significantly higher odds of six-month CO-verified abstinence in the mTB-Tobacco group (OR=4.11, 95% CI 1.99–8.48, p<0.001).
CONCLUSIONS: The mTB-Tobacco intervention was found effective in promoting smoking cessation among TB patients compared with usual care. This approach offers a scalable, cheap and effective solution in helping people with TB to quit smoking. mTB-Tobacco should be offered to all smokers coming in contact with TB services.
FUNDING: NIHR Global Health Research Unit on Respiratory Health (Award ID: NIHR132826)
TRIAL REGISTRATION: ISRCTN86971818
METHODS: A multi-center, open-label, cluster-randomized superiority trial was conducted in Bangladesh and Pakistan with 27 TB health facilities randomized (2:1) to mTB-Tobacco or usual care. The trial enrolled 1,080 adult pulmonary TB patients, daily smokers, willing to quit, with mobile phone access. The primary outcome was 6-month self-reported continuous abstinence, verified by carbon monoxide <10 ppm. Intervention consisted of motivational text messages in local languages sent throughout TB treatment. Analyses compared quit rates using univariate and generalized mixed models, accounting for intervention effects, cluster randomization, and covariates.
RESULTS: Between Feb–Dec 2024, 1,080 TB patients (600 Bangladesh; 480 Pakistan) were recruited from 27 clusters (15 Bangladesh; 12 Pakistan), randomized to mTB-Tobacco intervention (18 clusters, 720 participants) or usual care (9 clusters, 360 participants). Mean age was 48.3±15.9 years (range 15–91). The attrition rates at the primary end-point were 8.98% (7.5% mTB-Tobacco; 11.9% control). At 6 months, 310/666 (46.5%) in mTB-Tobacco and 57/317 (17.9%) in usual care achieved continuous abstinence (RR=2.60, 95% CI 1.96–3.45; RD=28.9%, 95% CI 23%–35%). Generalized Linear Mixed Model analysis showed significantly higher odds of six-month CO-verified abstinence in the mTB-Tobacco group (OR=4.11, 95% CI 1.99–8.48, p<0.001).
CONCLUSIONS: The mTB-Tobacco intervention was found effective in promoting smoking cessation among TB patients compared with usual care. This approach offers a scalable, cheap and effective solution in helping people with TB to quit smoking. mTB-Tobacco should be offered to all smokers coming in contact with TB services.
FUNDING: NIHR Global Health Research Unit on Respiratory Health (Award ID: NIHR132826)
TRIAL REGISTRATION: ISRCTN86971818
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