#EnufSnuff.TXT-FirstResponder: a pilot randomized controlled trial of a text message intervention for smokeless tobacco cessation among First Responders

Introduction First Responders are three times more likely to use smokeless tobacco than those in the general population and very few targeted cessation interventions are available. Methods The #EnufSnuff.TXT First Responder text-based intervention ( n = 30), which includes an optional reduction component and tailored text-messages for cessation, was administered alongside the Enough Snuff Intervention ( n = 30), which includes a cessation booklet and general support texts. Both groups received a 4-week supply of 4 mg Nicotine Replacement Therapy (NRT) lozenges to assist with cessation. We surveyed participants 30 days post-intervention initiation to assess feasibility, acceptability, and Smokeless Tobacco cessation outcomes. A subset of participants participated in qualitative interviews to assess feedback on the intervention. Discussion/conclusion Feasibility benchmarks for recruitment, retention, and engagement were met. Both programs helped First Responders quit. The respective quit rate for #EnufSnuff.TXT-FR arm was higher compared to Enough Snuff was 40% vs 33% (OR = 1.33, p = 0.5925; RR = 1.20, p = 0.5935) for the intent-to-treat cases and 52% vs 44% (OR = 1.41, p = 0.5555; RR = 1.20, p = 0.5570) for the completers. A text-based cessation intervention was found to be feasible and represents a scalable intervention approach and both interventions produced high quit rates. Larger scale efficacy testing is warranted. Clinical trial registration https://clinicaltrials.gov/study/NCT05111041?term=NCT05111041&rank=1 , identifier NCT05111041.