Abstract
BackgroundAdolescence and young adulthood are critical times of initiation and progression to daily use of tobacco. However, it is difficult to recruit young adults to traditional smoking cessation and retention rates are typically low. Smartphone cessation applications (apps) can provide real-time responses to smoking urges and related cues, which are known to be important factors in lapse and relapse. Given the popularity of smartphones among young adults and the considerably higher download rates of commercially developed apps compared to research-based apps, there is a need to design pragmatic studies that evaluate commercial tobacco cessation apps. The aims of this pilot study are to assess the impact on tobacco cessation of using a smartphone app compared with usual care and to generate feasibility data to inform a future fully powered clinical trial.MethodsWe will conduct an open randomized controlled trial with parallel groups. Participants will be selected from hospitalized patients and must be aged 18–30 years, interested in cessation, smoked > 5 cigarettes/day over the past 30 days, and own an Apple or Android smartphone. Participants who are eligible will be randomized to either a smartphone experimental group or patient-initiated follow up (usual care). As this study seeks to assess feasibility, the primary data will include (1) recruitment rates, (2) retention rates, and (3) adherence, measured through user engagement with the app.DiscussionThis pilot trial will be the first to evaluate a commercially available smartphone app for tobacco cessation in a hospitalized setting. Data generated by this study can be used for larger fully powered trials such as comparative effectiveness studies against apps developed by academics or health scientists based on behavioral theories, or cost-effectiveness analyses of mobile interventions.Trial registrationClinicalTrials.gov, NCT03538678. Registered on 28 May 2018.
Highlights
Adolescence and young adulthood are critical times of initiation and progression to daily use of tobacco
The study offers a research/industry collaboration that allows the study to leverage resources from two directions: (1) providing cutting-edge research tools and methods founded on evidence-based academic research and (2) applying translational and implementation strategies from the software development team
We have chosen a pragmatic approach in order to simulate more real-world settings in app usage
Summary
Adolescence and young adulthood are critical times of initiation and progression to daily use of tobacco. It is difficult to recruit young adults to traditional smoking cessation and retention rates are typically low. Given the popularity of smartphones among young adults and the considerably higher download rates of commercially developed apps compared to research-based apps, there is a need to design pragmatic studies that evaluate commercial tobacco cessation apps. Individuals who successfully quit smoking reduce their risk of death from lung cancer by half within 10 years. Adolescence and young adulthood remain critical times of initiation and progression to daily use of tobacco [7]. Traditional program interactions between facilitators and clients are highly intermittent This compromises the ability to provide real-time responses to smoking urges
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