Real-Time Text Messages Did Not Reduce Cannabis Craving in Young Adults

Both mindfulness and distraction coping messages failed to reduce craving at the next assessment relative to control (thank you) messages, with no significant change in efficacy over time. However, the trial demonstrated excellent feasibility of the EMA-based intervention approach, with high engagement over 4 weeks.

Microrandomized trial of 53 young adults who regularly use cannabis. Over 4 weeks, participants reported craving via ecological momentary assessment. When moderate-to-severe craving was reported, they were randomly assigned to receive a mindfulness strategy, distraction strategy, or control message.

Despite the null result, this study pioneers a method for testing real-time digital interventions for substance use craving. The approach can rapidly screen many intervention strategies for just-in-time adaptive interventions.

The null result suggests that brief text-based coping messages may not be sufficient to override cannabis craving in the moment. More intensive or personalized interventions may be needed, though the delivery platform itself shows promise.

Small sample size (53). Brief text messages may be too minimal an intervention. No measure of whether messages were actually read or strategies attempted. 4-week period may be too short. Young adult cannabis users may not represent all populations.