A MOBILE instant messaging exercise-program did not significantly improve lab-verified smoking-cessation overall rates at 6 months.
Mobile Instant Messaging Smoking Cessation Trial
Researchers tested whether mobile instant messaging (MIM) could scale a brief physical exercise intervention to support smoking cessation with minimal supervision. In a pragmatic, community-based cluster randomized controlled trial, 70 community sites in Hong Kong recruited 1,031 daily smokers aged 18 years or older between June and October 2022. Sites were randomized to an intervention that combined brief cessation advice with simple isometric exercises and mobile instant messaging practice reminders for 3 months, or to a control condition of brief cessation advice alone.
Abstinence Outcomes at 6 Months
At 6 months, follow-up was completed for 59.8% of participants. The primary endpoint, biochemically validated 7-day point prevalence abstinence, was numerically higher in the intervention group than in the control group, but the difference was not statistically significant (10.4% versus 9.1%). Self-reported 7-day abstinence showed a similar pattern, with 21.9% in the intervention group and 19.5% in the control group reporting abstinence, again without a significant between-group difference.
Engagement and Physical Activity
Intervention engagement declined over time. Weekly practice time for handgrip and elastic band exercises fell substantially across the 6-month period, from about 10 minutes per week at baseline to roughly 3 minutes or less by follow-up. Physical activity levels were comparable between groups at 6 months, with similar proportions reporting moderate to high activity.
For clinicians considering digital support tools, the trial underscores a common challenge in mobile instant messaging smoking cessation approaches: maintaining adherence after initial novelty fades. The authors suggest future work should test more intensive, personalized, and potentially artificial intelligence driven messaging to strengthen engagement and outcomes.
Overall, the findings suggest that a low-intensity, mobile instant messaging supported exercise approach is feasible to deliver in community settings, but on its own may be insufficient to meaningfully improve smoking cessation beyond brief advice.
Reference: Zhao SZ et al. Mobile instant messaging supported brief physical exercise intervention for smoking cessation: a community-based, cluster randomised controlled trial. Thorax. 2026;doi:10.1136/thorax-2025-224130.
