To text or not to text? Acceptability of WeChat and text messaging intervention to promote tobacco control assistance among parents who smoke in rural China

INTRODUCTION: Although the use of mobile health (mHealth) to promote tobacco control and smoking cessation interventions has been available in developed countries, their use in low- and middle-income countries (i.e. in China) is lacking. This study examined the acceptance of text messaging and/or WeChat based tobacco control intervention among parents who smoke, in rural China. METHODS: Using a structured questionnaire, we surveyed smoker households (n=668) of children aged ≤5 years in two rural regions of southern China. Descriptive analyses were used to characterize respondents; multivariate regression analysis was used to test the associations between participants’ sociodemographic and other characteristics, and their acceptability of text messaging and/or WeChat intervention for tobacco control. RESULTS: After adjusting for other variables (i.e. region, ethnicity, age, education level, occupation, attitudes towards smoking, perception of cigarettes addictiveness, and quitting smoking), the overall knowledge about smoking and secondhand smoke (SHS) exposure significantly predicted a higher acceptance to text messaging/WeChat intervention (OR=0.567; 95% CI: 0.457–0.704). Participants who thought smoking made people feel relaxed were less likely to accept text messaging/WeChat intervention than those who did not think so (OR=1.403; 95% CI: 1.080–1.822). CONCLUSIONS: Our findings suggest that households in rural China that were more knowledgeable about the hazards of smoking and SHS exposure, and had negative feelings about the benefits of smoking, were more likely to accept text messaging/WeChat for tobacco control intervention. Understanding rural smokers’ preferences to receive intervention and related characteristics can help with the design of targeted tobacco control intervention programs in rural China.