Willingness to participate and pay for smoking cessation service through text-messaging in Vietnam

Background: Vietnam is among the world’s top ten largest cigarette-consuming countries with 14.8 million smokers. Despite a high prevalence of smoking (45.3% among male), smoking cessation options are not readily available in the country. Alternative smoking cessation interventions which could reach large numbers of smokers and are effective, therefore, are crucially needed. In 2016, mobile phone coverage rate in Vietnam reached 128 mobile phone subscriptions per 100 people. With this exceptional high coverage rate, application of mobile phone based health interventions (mHealth) in smoking cessation interventions may have a profound impact in Vietnam. Thus, this formative study aims to assess smokers’ willingness to participate and pay for smoking cessation service through text-messaging (m-cessation) in Vietnam.

Methods: This research was designed as a cross-sectional survey using structured-questionnaire. The sample size was a combination of 300 respondents from the North and 300 respondents from the South, of whom, 300 was from urban areas and 300 from rural areas. The survey used a convenience sampling strategy to recruit only smokers aged 18+ with intention to quit smoking within the next 12 months. To ensure the sample include smokers from diverse socio-demographical background, equal quota for sample size was given to 3 categories of smokers who are i) white-collar workers and/or having high level of education (college or university education and above); ii) blue-collar workers and/or having vocational training or high school education and below, including free-lance low-paid workers and farmers in rural provinces and; iii) students.

Results: About 62% of smokers showed their willingness to join the m-cessation program if it were available. Urban smokers were approximately two times more likely to be interested in using the text-messaging service (crude OR=1.9; 95%CI: 1.4-2.7). After adjusting for residential area, ever had tobacco related diseases, occupation and smoking status, the residential area turned out to have no association with the willingness to use m-cessation service. Significant associated factors of willingness to use the service were “smoking status” and “ever had tobacco related diseases”. Specifically, daily smokers were 2.4 times more likely to willing to use the service (OR=2.4; 95% CI: 1.1-5.1) than occasional smokers. Those who ever had tobacco related diseases were two times more likely (OR=2.1; 95% CI: 1.1-4.1) to participate in m-cessation program. More than 80% of smokers reported that they could afford to pay an amount of 10,000 VND (0.44$US) while only about 33% agreed to pay 150,000 VND (6.57$US) for the service.

Conclusions: The study found that two third of the adult smokers having intention to quit in next 12 months in Vietnam expressed interest in using text-messaging based smoking cessation service and also willing to pay for it. These findings suggest that smoking cessation via text-messaging could be a potential solution to reduce the high smoking rate in Vietnam. Public health efforts should be invested in the development of an effective text-messaging program for smoking cessation.