Telegram Messenger Support for Smoking Cessation After Heart Attack

N/ANot Yet RecruitingNCT07230249

ITMO University142 enrolled

Overview

This randomized controlled trial will evaluate whether a 6-month behavioral intervention delivered via Telegram messenger increases smoking cessation rates in patients after myocardial infarction (MI). Adult smokers hospitalized with acute MI who regularly use Telegram will be randomly assigned to either: * INTERVENTION GROUP: Standard care plus a 6-month Telegram chatbot program providing personalized motivational messages, cognitive-behavioral techniques for craving management, and relapse prevention support. * CONTROL GROUP: Standard care (routine physician advice to quit smoking) plus basic surveys via Telegram without therapeutic content. The primary outcome is 30-day point prevalence abstinence at 6 months, verified by blinded telephone interview with participant and corroborating report from a close relative. Secondary outcomes include changes in cigarette consumption, nicotine dependence, motivation, and intervention engagement metrics. This study addresses the critical gap in smoking cessation support after hospital discharge and could provide evidence for a scalable digital health solution in cardiac secondary prevention.

The TELEGRAM-MI trial is a multicenter, randomized, controlled, assessor-blinded superiority study testing a digital behavioral intervention for smoking cessation in post-myocardial infarction patients. BACKGROUND: Smoking cessation is the most effective modifiable risk factor for reducing mortality after MI, yet long-term abstinence remains challenging due to limited sustained support. Digital interventions using popular messaging platforms offer a scalable solution to bridge the post-discharge support gap. OBJECTIVES: Primary: To determine if a 6-month Telegram chatbot intervention increases 30-day point prevalence abstinence rates at 6 months compared to standard care alone. Secondary: To examine associations between baseline characteristics (nicotine dependence, motivation), engagement metrics, and cessation success; and to assess intervention acceptability. METHODS: Approximately 142 participants will be recruited from inpatient cardiology departments. After providing informed consent, participants will be randomized 1:1 via the chatbot to either the intervention group (standard care plus 6-month behavioral support) or control group (standard care plus data collection only). The intervention incorporates evidence-based techniques including motivational messaging, cognitive-behavioral strategies, and relapse prevention protocols. OUTCOMES: The primary outcome is biochemically unverified 30-day point prevalence abstinence at 6 months, assessed via blinded telephone interview with participant and relative verification. Secondary outcomes include various smoking behavior metrics collected through the chatbot platform. ANALYSIS: Primary analysis will follow intention-to-treat principles, with missing data imputed as smoking. Statistical analyses will include chi-square tests for primary outcome and regression models for secondary outcomes. POTENTIAL IMPACT: If effective, this intervention represents a readily implementable, low-cost strategy to enhance secondary prevention in cardiac patients.

Interventions

Telegram-based Smoking Cessation SupportBEHAVIORAL

A 6-month behavioral intervention delivered via a Telegram chatbot. The intervention includes personalized daily motivational messages, cognitive-behavioral techniques for craving management, access to an SOS/craving support button, weekly check-ins, and relapse prevention protocols. Content is tailored based on user responses to questionnaires (Fagerström Test, Importance/Confidence scales) and engagement metrics.

Standard Care (in control arm)OTHER

Routine physician advice to quit smoking provided upon hospital discharge. This represents the current standard of care in the participating clinical centers.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Willing and able to provide written informed consent. * Age 18 years or older. * Hospitalization with a confirmed diagnosis of acute myocardial infarction (MI), including both ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). * Current smoker at the time of index MI: self-reported smoking of at least one cigarette per day in the month prior to hospitalization. * Regular user of the Telegram messenger application (app installed on a personal smartphone). * Possession of a smartphone with internet access and a valid phone number. * Ability and willingness to provide contact information for a close relative or cohabiting person who can verify smoking status at follow-up. Exclusion Criteria: * Smoking cessation more than 1 month prior to the index MI hospitalization. * Physical or cognitive impairment that prevents the use of a smartphone (e.g., severe visual/hearing impairment, inability to read or respond to messages). * Inability to read and understand the Russian language fluently. * Comorbid condition with a life expectancy of less than 1 year. * Active severe mental illness (e.g., psychosis, severe untreated depression) that would impede understanding of the protocol or adherence. * Unwillingness or inability to provide contact details for a close relative for outcome verification.

Outcomes

Primary Outcomes

30-day point prevalence abstinence (PPA)

Proportion of participants who report abstinence from smoking for the past 30 days or more, verified by both participant self-report AND corroborating report from a close relative or cohabiting person during a telephone interview conducted by a blinded assessor. A positive outcome is recorded ONLY if both sources confirm abstinence. Participants with missing data (e.g., lost to follow-up) will be considered smokers in the primary analysis (intention-to-treat).

Time frame: 6 months

Secondary Outcomes

7-day point prevalence abstinence (7-day PPA)

Proportion of participants who report abstinence from smoking for the past 7 days. Assessed via the Telegram bot.

Time frame: 1 month and 3 months

Change in cigarette consumption

Change from baseline in the self-reported number of cigarettes smoked per day. Assessed via the Telegram bot.

Time frame: Baseline, 1 month, 3 months, and 6 months

Score on the Fagerström Test for Nicotine Dependence (FTND)

Change in nicotine dependence measured by the FTND questionnaire (score range 0-10, higher scores indicate greater dependence). Assessed via the Telegram bot.

Time frame: Baseline and 6 months

Motivation to quit (Importance and Confidence Scales)

Scores on self-rated scales (0-10) for the importance of quitting and confidence in the ability to quit. Assessed via the Telegram bot.

Time frame: Baseline and 6 months

Participant engagement with the Telegram bot

Composite measure of engagement (dose) including: proportion of completed weekly check-ins, proportion of opened messages, number of SOS/craving button uses, number of active weeks. Metrics are automatically logged by the bot.

Time frame: 6 months

Intervention acceptability and satisfaction

Total score on a custom acceptability and satisfaction questionnaire (5-12 items) completed by participants in the intervention group via the Telegram bot. Higher scores indicate higher satisfaction.

Time frame: 6 months

Time to first relapse

Number of days from randomization to the first self-reported relapse (lapse) event. Assessed via continuous monitoring through the bot's check-in system.

Time frame: 6 months

Telegram Messenger Support for Smoking Cessation After Heart Attack

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts