Effectiveness of WeChat-based Smoking Cessation intervention ("WeChat WeQuit" program) in China: study protocol for a randomized controlled trial.

BACKGROUND AND AIMS Since its first release in 2011, WeChat (Chinese pinyin: Wei Xin) has been widely used to promote health. As the most popular all-in-one social media app providing free instant messaging, voice, text, pictures, videos and location information exchange via smartphone, WeChat holds promise for delivering smoking cessation services to a large number of people at low unit cost in China, a country with more than 300 million smokers. This protocol is for a study that aims to assess the efficacy of a WeChat-based smoking cessation intervention ("WeChat WeQuit") for treatment seeking smokers in China. DESIGN In this two-arm randomized controlled trial (RCT), the control group will receive only a digital version of a booklet of "Happy Quit". The intervention group will also receive the 2 weeks pre- and 12 weeks post-quit "WeChat WeQuit" intervention. Both groups will be followed up to 26 weeks (6 months) after quit day. SETTING This online trial has no restrictions on setting or location. PARTICIPANTS Chinese-speaking current smokers (smoked ≥ 100 cigarettes in the lifetime and currently smokes cigarettes) aged 18+, willing to make a quit attempt within 1 month (n = 2000) will be recruited by on-line and off-line advertising. Potential participants will register their interest by sending WeChat messages or text messages, or making a voice call. MEASUREMENTS The primary outcome measure is self-reported 26-week continuous smoking abstinence with biological verification (test by clinic visit: expired carbon monoxide concentration < 10 ppm or by mailing cotinine urine dipsticks: urine cotinine < 200 ng/ml). Secondary outcome measures include: 7-day point prevalence abstinence at week 1, 4, 8, 12, 16, 20 and 26 after-quit day; self-reported 12-week continuous smoking abstinence and 26-week continuous smoking abstinence; reductions in number of cigarettes smoked per day; and rates of participation in and completion of smoking-cessation program. COMMENTS If the "WeChat WeQuit" program is found to be effective, it will be an accessible, affordable and widely implementable intervention to help cigarette smokers to quit. The potential public health impact of its expansion into underserved regions or communities is considerable.