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A Telegram-based behavioral intervention for smoking cessation after myocardial infarction: A study protocol of a pragmatic, single-blind, randomized trial

Mikhail Kuznetsov, A. Okhotin, D. Sergeev

Tobacco Prevention and Cessation, 2026

Abstract

Smoking cessation after myocardial infarction (MI) is critical, yet many patients relapse soon after discharge, especially where structured follow-up is limited. Telegram provides a low-cost tool for implementing chatbot-based behavioral support that hospitals can run with minimal technical resources. The aim is to conduct TELEGRAM-MI trial tests to ascertain whether a 6 month Telegram-based chatbot improves cessation outcomes compared with routine discharge advice provided by cardiology staff. This pragmatic, single-blind, randomized trial, starting in 2026 at a regional clinical hospital in Russia, will enroll adult current cigarette smokers hospitalized with acute MI who use Telegram. Participants are randomized 1 : 1 to routine discharge advice plus a passive bot (control) or to the same advice plus an active 6 month behavioral support bot. The intervention includes motivational messages, craving-management tools, an SOS function, weekly check-ins, and relapse-prevention sequences. The primary outcome is 30 day point prevalence abstinence at 6 months, verified by a blinded assessor and a relative. Secondary outcomes include 7 day abstinence at 1 and 3 months, changes in cigarettes/day, nicotine dependence, motivation, engagement, and time to relapse. Analysis will follow intention-to-treat principles. Recruitment begins in January 2026. Results are expected after completion of the 6 month follow-up in October 2026. The intervention could enhance cessation, sustain…

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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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