This study aims to evaluate the effectiveness and participant experiences of a WeChat-delivered, metaphor-based smoking cessation intervention.
This randomized controlled trial evaluates a WeChat-delivered, metaphor-based smoking cessation intervention. Participants in the intervention group will receive staged cessation messages that use metaphors to explain smoking urges, nicotine dependence, behavior change, coping strategies, and relapse prevention. The intervention will also include self-monitoring, personalized feedback, and a personalized journey map to help participants recognize their progress during the cessation process. Participants in the control group will receive brief smoking cessation advice. The study will compare the two groups in terms of smoking cessation outcomes. It will also assess participants' perceptions of the intervention, including the usefulness and comprehensibility of the metaphors, willingness to engage with the intervention, immersion in the cessation process, perceived support, and overall satisfaction.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
200
Participants will receive a 100-day, WeChat-delivered smoking cessation intervention using metaphors such as "fog" and "restart" to describe smoking urges, nicotine dependence, and the process of behavior change. The intervention will provide staged messages on smoking-trigger identification, self-monitoring, action planning, coping strategies, environmental modification, social support, and relapse prevention, together with personalized feedback and a personalized journey map to help participants review their cessation experiences and progress.
The 5A's approach (Ask, Advise, Assess, Assist, and Arrange) will be used for participants who are ready to quit, and the 5R's approach (Relevance, Risks, Rewards, Roadblocks, and Repetition) will be used for participants who are not ready to quit.
Beijing Normal University
Zhuhai, Guangdong, China
Biochemical validated quit rate at 6 months follow-up
The primary outcomes are biochemically validated quit rate (exhaled carbon monoxide \< 4 ppm or salivary cotinine \< 30 ng/ml)
Time frame: 6 months follow-up
Biochemical validated quit rate at 3 months follow-up
biochemically validated quit rate (exhaled carbon monoxide \< 4 ppm or salivary cotinine \< 30 ng/ml)
Time frame: 3 months follow-up
Self-reported 7-day point prevalence quit rate
Self-reported 7-day point prevalence quit rate in the two groups
Time frame: 3 and 6 months follow-up
Smoking reduction rate
Rate of smoking reduction by at least half of baseline amount in the two groups
Time frame: 3 and 6 months follow-up
Eligibility rate
the percentage of eligible smokers out of the total number of smokers screened
Time frame: baseline
Consent rate
the percentage of eligible smokers who agree to participate out of the total number of eligible smokers
Time frame: baseline
Intervention Engagement
Participants' engagement with the intervention, including self-reported reading of WeChat cessation messages, interaction with the health assistant, and viewing of the personalized journey map.
Time frame: 3 months follow-up
Perceived Usefulness of Metaphors
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The health warning leaflet provides essential information on the dangers of secondhand and thirdhand smoke. It outlines how exposure to these forms of smoke can harm both smokers and non-smokers, particularly children, by increasing the risk of respiratory illnesses and other health issues.
Participants' perceived usefulness of the metaphors used in the intervention, assessed using a researcher-developed 7-point Likert-type agreement scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher scores indicate greater perceived usefulness of the metaphors.Responses will be assessed using a 7-point Likert scale.
Time frame: 3 months follow-up
Narrative Engagement in the Smoking Cessation Journey
Participants' engagement with the journey-based intervention, including whether the staged challenge design increased their motivation to persist, whether they were interested in subsequent stages, and whether they felt immersed in the smoking cessation journey. Responses will be assessed using a researcher-developed 7-point Likert-type agreement scale ranging from 1 (strongly disagree) to 7 (strongly agree). Higher scores indicate greater engagement with the journey-based intervention.
Time frame: 3 months follow-up