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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Smoking During Pregnancy.

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Strategy. Cell Phone-Based Tobacco Cessation (Pregnancy)

Approach. Support the development of a cell phone-based tobacco cessation support program

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Overview. Cell phone-based tobacco cessation interventions generally include cessation advice, motivational messages, or content developed to curb cravings, which can be delivered via text, smartphone applications (apps), or video formats. Messages may be individually personalized or tailored to resonate based on participant characteristics such as age, gender, and ethnicity. Messages may be sent automatically or delivered based on participants' needs. Some interventions include interactive features that connect users with health providers or other participants for additional support.[1,2]

Evidence. Scientifically Rigorous Evidence. Strategies with this rating are most likely to be effective...

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Partner engagement and collaboration data
  • Program features content inventory
  • Internal staff capacity building and knowledge gains

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Outreach (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort (“What/how much did we do?”)

  • Number of cell phone-based tobacco cessation programs developed. (Measures creation of interventions to support quitting)
  • Number of tailored cessation messages sent to program participants. (Quantifies volume of customized support provided)

Quadrant 2:
Measuring Quality of Effort (“How well did we do it?”)

  • Percent of cell phone-based programs that adhere to best practices for tobacco cessation. (Evaluates alignment with evidence-based guidelines)
  • Percent of program messages that are tailored to participant characteristics and preferences. (Measures customization of support to individual needs)

Quadrant 3:
Measuring Quantity of Effect (“Is anyone better off?”)

  • Number of referrals to cell phone-based cessation programs from healthcare providers. (Leverages clinician influence to drive enrollment)
  • Number of social media impressions generated by cell phone-based cessation program marketing. (Builds awareness and drives demand for services)
  • Number of participants who successfully quit smoking by the end of the cell phone-based program. (Shows a key outcome the intervention aims to achieve)
  • Number of participants who continue using cell phone-based relapse prevention support after initially quitting. (Sustains cessation gains over time)

Quadrant 4:
Measuring Quality of Effect (“How are they better off?”)

  • Percent of specific populations experiencing tobacco-related challenges enrolled in cell phone-based cessation programs. (Assesses reach to groups affected by tobacco use)
  • Percent of cell phone-based programs available in multiple languages. (Evaluates relevance for communities)
  • Percent decrease in smoking rates among reproductive-age individuals in communities served by cell phone programs. (Evaluates population health impact)
  • Percent of infants born to program participants with reduced exposure to maternal smoking in utero. (Shows impact on a key perinatal health outcome)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Emery, J., Leonardi-Bee, J., Coleman, T., McDaid, L., & Naughton, F. (2024). The Effectiveness of Text Support for Stopping Smoking in Pregnancy (MiQuit): Multi-Trial Pooled Analysis Investigating Effect Moderators and Mechanisms of Action. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 26(8), 1072–1080. https://doi.org/10.1093/ntr/ntae026

2 King, E., Cheyne, H., Abhyankar, P., Elders, A., Grindle, M., Hapca, A., Jones, C., O'Carroll, R., Steele, M., & Williams, B. (2022). Promoting smoking cessation during pregnancy: A feasibility and pilot trial of a digital storytelling intervention delivered via text-messaging. Patient education and counseling, 105(7), 2562–2572. https://doi.org/10.1016/j.pec.2021.12.019

3 Pollak, K. I., Lyna, P., Gao, X., Noonan, D., Bejarano Hernandez, S., Subudhi, S., Swamy, G. K., & Fish, L. J. (2020). Efficacy of a Texting Program to Promote Cessation Among Pregnant Smokers: A Randomized Control Trial. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 22(7), 1187–1194. https://doi.org/10.1093/ntr/ntz174

4 Cochrane-Whittaker 2016 - Whittaker R, McRobbie H, Bullen C, et al. Mobile phone-based interventions for smoking cessation. Cochrane Database Systematic Reviews. 2016;(4):CD006611.

5 Scott-Sheldon 2016 - Scott-Sheldon LAJ, Lantini R, Jennings EG, et al. Text messaging-based interventions for smoking cessation: A systematic review and meta-analysis. JMIR mHealth and uHealth. 2016;4(2):e49.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.