Abstract
BackgroundSmartphone apps for smoking cessation could offer easily accessible, highly tailored, intensive interventions at a fraction of the cost of traditional counseling. Although there are hundreds of publicly available smoking cessation apps, few have been empirically evaluated using a randomized controlled trial (RCT) design. The Smart-Treatment (Smart-T2) app is a just-in-time adaptive intervention that uses ecological momentary assessments (EMAs) to assess the risk for imminent smoking lapse and tailors treatment messages based on the risk of lapse and reported symptoms.ObjectiveThis 3-armed pilot RCT aimed to determine the feasibility and preliminary efficacy of an automated smartphone-based smoking cessation intervention (Smart-T2) relative to standard in-person smoking cessation clinic care and the National Cancer Institute’s free smoking cessation app, QuitGuide.MethodsAdult smokers who attended a clinic-based tobacco cessation program were randomized into groups and followed for 13 weeks (1 week prequitting through 12 weeks postquitting). All study participants received nicotine patches and gum and were asked to complete EMAs five times a day on study-provided smartphones for 5 weeks. Participants in the Smart-T2 group received tailored treatment messages after the completion of each EMA. Both Smart-T2 and QuitGuide apps offer on-demand smoking cessation treatment.ResultsOf 81 participants, 41 (50%) were women and 55 (68%) were white. On average, participants were aged 49.6 years and smoked 22.4 cigarettes per day at baseline. A total of 17% (14/81) of participants were biochemically confirmed 7-day point prevalence abstinent at 12 weeks postquitting (Smart-T2: 6/27, 22%, QuitGuide: 4/27, 15%, and usual care: 4/27, 15%), with no significant differences across groups (P>.05). Participants in the Smart-T2 group rated the app positively, with most participants agreeing that they can rely on the app to help them quit smoking, and endorsed the belief that the app would help them stay quit, and these responses were not significantly different from the ratings given by participants in the usual care group.ConclusionsDynamic smartphone apps that tailor intervention content in real time may increase user engagement and exposure to treatment-related materials. The results of this pilot RCT suggest that smartphone-based smoking cessation treatments may be capable of providing similar outcomes to traditional, in-person counseling.Trial RegistrationClinicalTrials.gov NCT02930200; https://clinicaltrials.gov/show/NCT02930200
Highlights
Background a majority of cigarette smokers are interested in quitting, very few use evidence-based cessation treatments [1]
Dynamic smartphone apps that tailor intervention content in real time may increase user engagement and exposure to treatment-related materials. The results of this pilot randomized controlled trial (RCT) suggest that smartphone-based smoking cessation treatments may be capable of providing similar outcomes to traditional, in-person counseling
Individuals were screened for eligibility following a provider referral or self-referral to the Tobacco Treatment Research Program (TTRP), which is located at the University of Oklahoma Health Sciences Center (OUHSC) campus in https://www.jmir.org/2020/3/e16907
Summary
Background a majority of cigarette smokers are interested in quitting, very few use evidence-based cessation treatments [1]. Smokers have reported a number of barriers to accessing tobacco cessation counseling, including the lack of time, transportation issues, and cost [4,5]. These barriers may be even more burdensome among individuals of a lower socioeconomic status (SES), who have higher rates of tobacco use and are less likely to quit despite similar numbers of quit attempts as those of a higher SES [6,7]. The Smart-Treatment (Smart-T2) app is a just-in-time adaptive intervention that uses ecological momentary assessments (EMAs) to assess the risk for imminent smoking lapse and tailors treatment messages based on the risk of lapse and reported symptoms
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