Twitter-enabled Mobile Messaging for Smoking Relapse Prevention (Tweet2Quit)

The proposed randomized controlled evaluation (N=960) of the Tweet2Quit intervention will
biochemically verify abstinence out to 6-months follow-up and will test the personalized
benefit for women of a women-only versus co-ed Tweet2Quit group. In a 3-arm design, the
investigators will compare: 1) usual care, 2) Tweet2Quit-coed, and 3) Tweet2Quit-Women only.

Each Tweet2Quit group will include buddy pairs based on similarity in demographics. Also
automated pattern detection will identify dips in tweeting and trigger automated alerts and
engagement strategies.

The primary aims tests Hypothesis 1: Relative to usual care (n=240), Tweet2Quit-coed groups
(n=480) will achieve significantly greater bioconfirmed sustained abstinence out to 6-months
follow-up for each gender, and Hypothesis 2: Women in Tweet2Quit will achieve significantly
greater bioconfirmed 6-months abstinence in woman-only groups (n=240) vs. coed groups (n=240
women).

Our secondary aims are to test the same hypotheses based on 3-month (end of treatment)
sustained abstinence and 7-day point prevalence at 1, 3, and 6 months with biochemical
verification at 3 and 6 months. Exploratory aims will study the Tweet2Quit groups' social
network structures with a focus on the identification of buddy pairs and social brokers and
test if these relationships are stronger for women in women-only groups versus women in coed
groups of Tweet2Quit.

*Prior to the start of the RCT, the investigators will run one coed pilot group (N=20). Total
size of the study (including the pilot group) will be N=980.

Inclusion Criteria:

- Are 21-59 years of age

- Are smoking 5+ cigarettes/day and 100+ cigarettes in one's lifetime

- In the preparation stage of quitting smoking

- Are English speaking

- Have a mobile phone with an unlimited texting plan and internet access (via mobile
phone)

- Text at least once a week

- Are a social media user

- Have an active email account

- Lives in the continental USA

Exclusion Criteria:

- Have certain medical conditions that are contraindicated for nicotine replacement
therapy: pregnant, breast feeding, a recent heart attack, an irregular heartbeat, high
blood pressure not controlled with medication, skin allergies to adhesive tape or
serious skin problems, taking a prescription medicine for depression, and/or any other
medical conditions that would prevent you from completing this study.

- Are an illicit hard drug user or regular marijuana user

- Share a household with someone else or has an immediate family member who has already
enrolled in the study currently or in the past or if the participant has already been
enrolled or failed to pass the screening once already since October 2016

- Participated in Tweet2Quit between 2012-2013 in a Twitter group and was not an active
tweeter (<1 week)

- Fails to provide valid forms of all the required personal contact information