{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:00:25Z","timestamp":1793156425793,"version":"4.5.0"},"reference-count":36,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2026,1,27]]},"abstract":"\n Importance<\/jats:title>\n Smoking worsens outcomes in people with tuberculosis (TB), while quitting hastens recovery.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess the effectiveness of a mobile health (mHealth) intervention for achieving self-reported continuous tobacco abstinence at 6 months, supported by biochemical verification at 6 months, compared with usual care in people with TB.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n Multicenter, cluster randomized clinical trial conducted between September 18, 2023, and January 2, 2025, randomizing (2:1) 27 TB clinics in Bangladesh and Pakistan to mHealth or usual care groups. The follow-up was 6 months. Participants were eligible if they were 15 years or older, had been diagnosed with drug-sensitive pulmonary TB in the past 4 weeks, smoked daily, were willing to quit, and had access to mobile phones.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n The mHealth group (n\u2009=\u2009720) received text messages throughout TB treatment, daily for 2 months then monthly for 4 months, encouraging tobacco cessation. The usual care group (n\u2009=\u2009360) received written information on tobacco cessation.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The primary outcome was self-reported continuous abstinence at 6 months, verified biochemically using carbon monoxide breath test at 6 months. Secondary outcomes included self-reported point abstinence at 9 weeks and 6 months, TB treatment adherence (days receiving TB treatment), TB treatment success (cured\u2009+\u2009completed treatment), TB treatment failure, TB treatment default (interruption of TB treatment for \u22652 months), and death.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 9232 patients assessed for eligibility, 1080 were randomized; most were male (mHealth, 96.9%; usual care, 95.8%), and 985 were retained throughout the trial (91%). For the primary outcome, 300 of 720 participants (41.7%) in the mHealth group demonstrated self-reported and biochemically verified continuous abstinence at 6 months, compared with 55 of 360 (15.3%) in the usual care group (risk ratio, 3.0 [95% CI, 2.0-4.9]). In the mHealth vs usual care groups, respectively, mean TB treatment adherence was 174.3 (SD, 21.5) days vs 178.0 (SD, 12.1) days (\n P<\/jats:italic>\n \u2009=\u2009.23), and treatment success was 89.3% vs 85.6% (risk ratio, 1.2 [95% CI, 0.9-1.6]). TB treatment failure (0.1% vs 0.5%) and default (3.1% vs 1.9%) were uncommon. Mortality was lower with mHealth (3.5%) vs usual care (7.5%) (hazard ratio, 0.4 [95%CI, 0.2-0.9]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n An mHealth intervention was effective in achieving continuous abstinence in people with TB who smoked. mHealth is a feasible and effective intervention to help patients with TB quit smoking.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n isrctn.org Identifier:\n ISRCTN86971818<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jama.2025.20765","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T16:30:59Z","timestamp":1766421059000},"page":"336","source":"Crossref","is-referenced-by-count":8,"title":["An mHealth (Mobile Health) Intervention for Smoking Cessation in People With Tuberculosis"],"prefix":"10.1001","volume":"335","author":[{"given":"Maham","family":"Zahid","sequence":"first","affiliation":[{"name":"The Initiative, Islamabad, 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