Reaching Rural Cancer Survivors Who Smoke Using Text-Based Program

This phase III trial compares the effect of text-based cessation intervention to a manual in helping rural cancer patients who smoke, quit. Text-based scheduled gradual reduction may reduce the frequency of cigarette use to zero and may be effective in quitting smoking.

Inclusion Criteria: * Have a cancer diagnosis within the past 10 years \* Note: Patients with ductal carcinoma in situ (DCIS) are eligible and patients currently receiving curative treatment are eligible * Not currently on hospice * Currently smokes \>= 5 cigarettes daily \* Note: Participants who smoke cigarettes and vape are eligible. Those who only vape are ineligible * Lives in a nonmetro/rural county (defined as having a Rural Urban Continuum Code \[RUCC\] code of 4-9) and/or a Rural-Urban Commuting area code of 4-10 and/or as defined by the Office of Management and Budget as a non-rural county large area metro census tracts of at least 400 square miles in an area with population density of 35 or less per square mile with rural-urban commuting area (RUCA) codes 2-3; and outlying metro counties without a UA. The RUCC code and RUCA (4-10) codes can be checked at: https://www.ruralhealthinfo.org/am-i-rural. Those with RUCA codes of 2-3 can be checked at https://data.hrsa.gov/tools/rural-health for eligibility * Patient interested in participating in a smoking cessation program, and not currently participating in a smoking cessation clinical trial * Not currently using any smoking cessation pharmacotherapy (e.g. nicotine replacement therapy, bupropion or varenicline for smoking purposes only), or currently participating in any cessation program at the time of enrollment * Patient has a cell phone or smart phone device with texting ability * In order to complete the mandatory patient-completed measures, participants must be able to speak and read English or Spanish * Age \>= 18 years * Participant must be willing to provide a urine sample. * Patients with impaired decision-making capacity are not eligible for this study consent