Mobile phone text messages to support people to stop smoking by switching to vaping: co-development, co-production, and initial testing

Background: Text messages are affordable, scalable, and effective smoking cessation interventions. However, there is little research on text message interventions specifically designed to support people who smoke to quit by switching to vaping. Objective: Over three phases, with vapers and smokers, we co-developed and co-produced a mobile phone text message programme. The co-production paradigm allowed us to collaborate with researchers and the community to develop a more relevant, acceptable, and equitable text message programme. Methods: In Phase 1, we engaged people who vape via Twitter and received 167 responses to our request to write text messages for people who wish to quit smoking by switching to vaping. We screened, adjusted, refined, and themed the messages, resulting in a set of 95 that were mapped against COM-B (Capability, Opportunity, Motivation) behaviour change constructs. In Phase 2, we evaluated the 95 messages from Phase 1 via an online survey, where participants (n= 202, 66 female) rated up to 20 messages on 7-point Likert Scales on 9 constructs: understandability, clarity, believability, helpfulness, interesting; inoffensive; positive; enthusiastic, and how happy they would be to receive the message. In Phase 3, we implemented the final set of text messages as part of a larger randomised optimisation trial where 603 (Mage = 38.33; 369 female) participants received text message support and then rated their usefulness, frequency and provided free-text comments at a 12-week follow up. Results: For Phase 2, means and SDs were calculated for each message across the 9 constructs. Those with means below the neutral anchor of 4 or with unfavourable comments were discussed with co-vapers and further refined or removed. This resulted in a final set of 78 that were mapped against early, mid, or late stage of quitting to create an order for the messages. For Phase 3, 202 (38%) of participants provided ratings at the 12 week follow up. 70% reported that the text messages had been useful and a significant association between quit rates and usefulness ratings was found (χ2 = 9.64, df = 1, p < 0.01). A content analysis of free-text comments revealed the two most common positive themes were: helpful (28%) and encouraging (13%) and the two most common negative themes were: too frequent (19%) and annoying (9%). Conclusions: Here we have described the initial co-production and co-development of a set of text messages to help smokers stop smoking by transitioning to vaping. We encourage researchers to use, further develop and evaluate the set of text messages, and adapt it to target populations and relevant contexts