Efficacy of a WhatsApp-based program for nicotine and tobacco cessation among young people: study protocol for a randomized controlled trial

Nicotine and tobacco products are widely used by adolescents and young adults in Switzerland. At the same time, WhatsApp is one of the most frequently used digital communication platforms by this age group. Delivering individually tailored, evidence-based coaching messages via WhatsApp is a promising way to support young people in quitting nicotine use. This study protocol outlines a randomized controlled trial to test the efficacy of a semi-automated, WhatsApp-based intervention program to support nicotine cessation and reduction in adolescents and young adults. A two-arm, parallel-group, randomized controlled trial will be conducted to test the efficacy of NicotineFreeCoach compared to a waitlist control group. Participants for the study will be recruited both online and offline and will be assessed at the beginning of the study and at follow-ups after three and six months. During 12 weeks, participants in the intervention group will receive individually tailored WhatsApp messages designed to motivate them to stop or reduce their nicotine use. These messages will provide advice on dealing with cravings and stressful situations, as well as tips on quitting or reducing nicotine use. They will also have the opportunity to ask a counsellor individual questions via a separate WhatsApp channel. Participants in the control group will not initially have the opportunity to take part in the program, but will be invited to do so after completing the six-month survey. The study will involve 870 regular nicotine users aged 16–30, including those who use tobacco cigarettes, vapes, snus or multiple nicotine products. The primary outcome will be the seven-day point prevalence of nicotine abstinence in the follow-up survey after six months. Secondary outcomes will include the quantity and frequency of nicotine use, intention to quit and self-efficacy to do so, quality of life and alcohol use. This is the first randomized controlled study to test the efficacy of an instant messaging-based coaching program in supporting young people to quit tobacco and nicotine use. It provides a scientifically sound evaluation of the effectiveness of NicotineFreeCoach in Switzerland, and of WhatsApp-based coaching programs in promoting healthy behavior more broadly. If this approach proves effective, it could easily be implemented in various settings to reach large numbers of young people in a cost-effective way. ISRCTN16197153 (registration date 20251209).