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Table 3 Participants’ ratings and reactions to text messages

From: Text-messaging to promote smoking cessation among individuals with opioid use disorder: quantitative and qualitative evaluation

Text message Text helpful? Text likeable? Text motivating to quit? Participant Reactions to texts
(Representative quote)
Yes % Yes % Yes %
Texts for individuals who want to quit
 1. People, places, and things can make you want to smoke. Write down your triggers. Make a plan to help you steer clear of them on you quit day. 17 85% 17 85% 15 75% “If you see a group of people smoking. Oh, let me get a cigarette. But if you have someone texting you like, you got this, you can do it, you’re strong, that’s very helpful.” (P9)
 2. Reminding yourself of your reasons for quitting can help keep you on track when you need a boost. Take a few minutes to revisit your list. 15 75% 15 75% 14 70% “I think having and hearing just overall little tips over the period of a day, and little pick-me-ups would help motivate me.” (P16)
 3. Counseling and medication can increase your chances of successfully quitting. Talk to your doctor about the best options for you. 16 80% 13 65% 14 70% “Well, even ask them what type of resources they may need, and that would be an even better way to [help].” (P1)
Texts to provide encouragement to stay quit
 4. Stay positive. Do not let things get you down. Your journey to a smokefree life might be a struggle, but looking back it will be well worth it. 18 90% 18 90% 18 90% “Because it reminds me, and that way helps me more, to stop. That I know somebody out there cares. It helps me stop.” (P12)
 5. Life knocks you down sometimes but YOU make the choice to get back up. Quitting smoking is no different. Do not look back now. 15 75% 14 70% 15 75% “I like these encouragement ones.” (P14)
 6. If you slip, keep trying to quit. Learn from your mistakes this time. 14 70% 14 70% 14 70% “I think it’s just so basic, it’s obvious. You know what I mean? It’s just telling you something you already know.” (P17)
Texts to motivate individuals to quit
 7. Quitting can be hard. Think about ways you might be better off if you quit. 17 85% 17 85% 17 85% “It took me a while to learn how life can get you, man, how quick it can go. Especially now. It’s a good message.” (P7)
 8. Think of the challenges you’ve overcome in the past. Harness those strengths that got you through to help you quit smoking. 14 70% 15 75% 15 75% “Yeah. Motivational messages. Nothing but positive messages is what people need.” (P1)
 9. Deciding to quit smoking is a difficult decision. Every difficult decision has pros and cons. Think about your pros/cons for quitting and where that leaves you. 13 65% 13 65% 13 65% “I mean, just to get a message like that, and to know someone cares enough to send that, and for you to read it, and really think about what you’re doing’.” (P19)
 10. Thought for the day: how would your life get easier if you didn’t smoke? 19 95% 18 90% 19 95% “Some of them would be very motivating, Keep me motivated through the day.” (P10)
 11. Thought for the day: what would you be able to do if you didn’t smoke? 18 90% 18 90% 18 90% “I just think the positive affirmation stuff [is helpful]. If you say, “You can go on a great vacation.” Show them how much a vacation costs. Then show them what they could be getting, I guess.” (P17)
 12. Quitting smoking is stressful but continuing to smoke is also stressful—think of the cost, the addiction, health problems, etc. How does smoking stress you out? 15 75% 15 75% 15 75% “They would motivate me to stop smoking every day.” (P4)
 13. Thought for the day: how would your life be different 1 year from now if you quit smoking? What about 5 years? 17 85% 17 85% 16 80% “I’d feel good about quitting ‘cause, man, at least I know someone’s thinking about me, man, to send me a text.” (P11)
Texts on health risks of smoking
 14. In the U.S., tobacco kills more people than AIDS, alcohol, car accidents, murders, suicides, drugs, and fires combined. Quit today! 17 85% 16 80% 17 85% “The stuff they put, like death and destruction it causes. I don’t need to hear about it anymore. I’ve always believed in more positive reinforcement of stuff than negative.” (P16)
 15. Do not be fooled! There is no such thing as a safe cigarette. Quitting is the only way to protect yourself from the health risks of smoking. 13 65% 12 60% 13 65% “That’s actually kind of annoying. You’re tellin’ me things I’ve already known.” (P2)
Tips to address mistrust and misconceptions of medications to treat tobacco dependence
 16. Nicotine patch, Wellbutrin, or Chantix double your chances of quitting smoking and do not increase the risk of heart attacks 14 70% 14 70% 14 70% “Yeah, I would like that. It’s be a good reminder.” (P4)
 18. The state of Massachusetts offers medications to help you quit smoking at a low or no cost. Call the MA quitline at 1-800-QUIT-NOW for more information. 13 65% 12 60% 13 65% “I don’t like the messages like they’re just normal. The 1-800—It’s helpful, but it’s always the same thing. That’s always around, that message.” (P14)
Tips to Increase Clinical Utility of Medications
 19. Take dose of Chantix after eating and with a full glass of water to limit nausea 9 45% 8 40% 8 40% “I think you should know if the person’s going to be on medications or not. If you knew someone was leaning towards Chantix, that would be their message.” (P1)
 20. Avoid taking Wellbutrin at bedtime to minimize insomnia 11 55% 9 45% 9 45% “I disliked the whole “don’t take the medicine before goin’ to sleep …I didn’t like that one because, most of the time, I like to smoke cigarettes before I go to sleep, which is at night. It’s contradicting.” (P2).
Texts on the Benefits of Quitting (Substance Use-specific)
 21. People who quit smoking have higher success in quitting other substances, such as cocaine, heroin, and alcohol. 16 80% 16 80% 16 80% “Cause they go hand in hand. I go to meetings and a lot of people that quit substance abuse, they also quit cigarettes.” (P8)
Health Benefits of Quitting (General)
 22. Quitting smoking lowers your blood pressure and heart rate almost immediately. 17 85% 16 80% 16 80% “I like that one a lot. I did not know that. That motivates me a lot, cause all it takes is just one [day] for my health to start improving. That’s crazy.” (P14)
 23. After quitting smoking, your risk of a heart attack declines within 24 h of quitting. 17 85% 16 80% 16 80% “Everyone knows if you smoke, you should probably quit, but seeing’ something like within 24 h it can reduce many things like that, it’s eye-opening.” (P5)
 24. People who quit smoking after having a heart attack reduce their chances of having another heart attack by half 18 90% 17 85% 17 85% “Really? Wow. I didn’t know that.” (P6)
 25. Quitting smoking is the only proven beneficial treatment for reducing progression in mild to moderate/severe COPD. 18 90% 17 85% 17 85% “Damn. Ok. I lost my grandmother and my grandfather to smoking. …cause my mother died of smoking.” (P16)
Cost Savings of Quitting
 26. Smoking 1 pack of cigarettes a day for 1 year costs over $3500! Think about all the other things you could be spending that money on. 17 85% 17 85% 17 85% “It’s telling me, man, if I didn’t smoke a pack, how much money I can spend on something else.” (P11)