Journal of Computer Mediated Communication Special Section Counseling Young Cannabis Users by Text Message Ditte Laursen University of Southern Denmark ILKM Institut for Litteratur Kultur og Medier Odense Denmark This article presents a study of 2 Short Message Services SMS aimed at providing young people with information on cannabis and helping them to reduce their consumption of the drug The study is based on qualitative interviews with 12 young people The attitude of the participants in the study towards the predefined messages is generally positive but they prefer factual information to advice and counseling The messages prompt reflection and awareness among the recipients and their repetitive serial nature plays a significant part in the process of change The SMS services offer a less demanding potentially less confrontational alternative to traditional forms of counseling and treatment The article compares text message counseling with web based interventions and telephone help lines doi 10 1111 j 1083 6101 2009 01510 x Text messaging is part of an emerging wave of technology that allows consumers to get health information instantly through their mobile phones Terry 2008 Text messaging was first used in a medical context for making and cancelling face to face appointments Anthony 2006 but it has gone on to prove effective in self monitoring and following up roles in the treatment of conditions including diabetes asthma bulimia nervosa and psychiatric illness Bjerke Kummervold Christiansen Hjortdahl 2008 Robinson et al 2006 There is also evidence that text message reminders increase patient compliance in taking medication for such diseases as tuberculosis and HIV Group 2006 Text messaging is particularly popular among young people and services have been developed targeting this group accordingly As early as 2002 a UK charity launched an information service providing young people with sexual health information and support by telephone Internet and text message Kinkade Verclas 2008 a similar service exists in the US Levine McCright Dobkin Woodruff Klausner 2008 In Spain Finland and Denmark text messaging is now used with the aim of preventing drug abuse amongst young people1 Text messaging could prove to be an innovative way of reaching young people but little is known about the actual effects of the text messages or the ways in 646 Journal of Computer Mediated Communication 15 2010 646 665 2010 International Communication Association which they are received This article presents a study of an anonymous support and counseling project for young cannabis users intended to reduce the harmful effects of the drug and to provide them with information and support In Europe and America cannabis is by far the most commonly used illicit drug and use of the drug is disproportionately high among young people NIDA 2006 EMCDDA 2008 The project is centered on subscription to two SMS packages The article will show how the young people received and used the two services and the ways in which they profited from them in terms of changing their drug abusing behavior Furthermore the article will explore the participants views on how the SMS services compare with traditional forms of counseling and treatment Before moving on to empirical areas the article gives a brief overview of the literature Given the paucity of studies on text message counseling the review will focus on literature on web based anti drug interventions and literature on counseling supplied by telephone Mediated Antidrugs Interventions for Young People A number of innovative programs have attempted to exploit new tools of communication in order to engage with young cannabis users Especially the Internet has established itself as a key medium for anti drug interventions In addition to basic sites for information provision a number of clinical applications can been found for the web featuring more complex and interactive health interventions and treatment programs drug self tests interactive diaries phone e mail chat contact with a counselor preprogrammed software packages with little or no direct therapist involvement etc2 There is a significant target audience for such interventions Drug treatment demand has risen particularly among young and socially integrated cannabis users Leuschner Tossmann EMCDDA 2009 In general little has been done to examine the efficacy of the Internet based drug treatment programs in leading to changes in substance use behavior Copeland Martin 2004 An exception is the evaluation of the German Quit the Shit initiative an online withdrawal program with an interactive diary for juvenile cannabis consumers 32 of participants were reported as abstinent after completing the program Leuschner et al 2009 While the literature on Internet based substance use interventions is sparse and flawed the potential impact of effective intervention is considerable In the US alone among the 90 of all 15 24 year olds who have ever gone online three out of four 75 have used the Internet to find health information Among these 75 4 out of 10 say they generally find online health information very useful and 4 out of 10 say they have changed their personal behavior because of health information they got online Rideout 2001 Additionally there is an increasing body of evidence indicating that using text to conduct a clinical or therapeutic relationship is not only possible but in many cases more desirable from the points of view of clients and practitioners alike Horton Feltham 2006 Online services are convenient and flexible and attractive to clients who wish to remain anonymous Hunt 2002 Skinner Zack 2004 Also written information can improve health knowledge Journal of Computer Mediated Communication 15 2010 646 665 2010 International Communication Association 647 and information recall and alternative format resources such as e mail and chat can improve health knowledge user satisfaction self efficacy and health behavior Colledge Car Donnelly Majeed 2008 A more established medium for counseling is the telephone the telephone has been acknowledged for over 40 years as having a role in providing help at times of crisis Anthony Goss 2003 Smoking cessation help lines have been empirically shown to increase abstinence Lichtenstein Glasgow Lando OssipKlein Boles 1996 Meites Thom 2007 but very few studies exist of the utility of drug abuse help lines One study found that concrete therapeutic advice over the phone was highly rated by