Text messages could be the key to help TB patients quit smoking, study suggests

Tuberculosis (TB) patients who smoke may recover more quickly if they are supported to quit, and new research suggests that simple, encouraging text messages sent to people’s phones can make a real difference.
The results, published in the Journal of the American Medical Association (JAMA), come from a trial conducted in Pakistan and Bangladesh involving 1,080 TB patients who smoked and had access to a mobile phone. The study was co-led by The Initiative, a public health research organisation based in Islamabad, working alongside academic partners to test a practical way of supporting people to quit smoking while they are on TB treatment, in Pakistan.
In the study, 720 participants received supportive quit-smoking messages sent daily for 2 months and then monthly for a further 4 months, while 360 participants received standard printed information. At six months, more than 41% of participants who received the text messages had quit smoking for six months, compared with just over 15% of those who received printed information alone. The study also reported lower death rates in the text-message group at 3.5%, compared with 7.5% in the usual-care group.
The study was led by Professor Kamran Siddiqi, Professor of Public Health at Hull York Medical School, University of York, UK. He said, “We know that people who quit smoking can recover from TB faster, so we tested whether sending encouraging and supportive text messages could help patients quit more quickly than the usual written advice. The results show a clear difference between the groups.”
A senior representative, Dr. Umar Awan, from the Punjab TB Control Programme (PTP) added, “From a programme perspective, this is an intervention we can realistically deliver. It is affordable, straightforward to implement, and fits well within routine TB care, helping us tackle tobacco use among TB patients at scale in Pakistan.” Dr Amina Khan (Executive Director, The Initiative, Islamabad), Principal Investigator from Pakistan, said, “What makes this approach so powerful is that it can reach patients using the phones they already have. It’s a simple way to extend stop-smoking support to people who might otherwise never be offered it”. Furthermore, Ms Maham Zahid, Lead Author of the publication and Research Fellow on the study, said: “At a time when healthcare systems are rapidly adopting digital innovations, this study demonstrates that low-cost mobile messaging can deliver stronger behaviour-change interventions effectively. It underscores that this is the right moment to embrace technology-driven solutions to achieve better healthcare outcomes.”
In conclusion, the findings suggest this kind of support can do more than help people stop smoking. By reducing tobacco use, it can lower the risk of serious tobacco-related illnesses such as cancer and heart disease, and it may also save lives in the short term by reducing deaths linked to TB. Maham Zahid, The Initiative, zahidmaham487@gmail.com
For more details: Zahid M, Rahman F, Danaee M, et al. An mHealth (mobile health) intervention for smoking cessation in people with tuberculosis: A cluster randomized clinical trial.JAMA. Published online December 22, 2025. doi:10.1001/jama.2025.20765 https://jamanetwork.com/journals/jama/article-abstract/2843169