Grant Number:	1R37CA309117-01 Interpret this number
Primary Investigator:	Berardi, Vincent
Organization:	Chapman University
Project Title:	Tracking Residential Air Quality to Quit Smoking
Fiscal Year:	2026

The goal of TRAQ-to-Quit is to increase the potency and efficacy of behavioral interventions for smoking cessation treatment in low-income communities by leveraging state-of-the art Internet-of-Things (IoT) technology to merge three evidence-based approaches into a single comprehensive, multilevel intervention: i.) brief pediatrician advice and referral to cessation services; ii.) novel behavioral tele-counseling that guides smokers towards establishing a smokefree home (SFH) as an initial step toward cessation; and iii.) the deployment of an IoT system consisting of an indoor air quality (IAQ) smart home device that collects continual, objective measures of IAQ and integrates them into both smokers’ home environments and a tele-counselor participant dashboard that enables individualized, data-guided advice/problem solving. The proposed treatment model builds on several of our previous trials, most notably the Kids Safe and Smokefree (KiSS) trial, which demonstrated the efficacy of a multilevel behavioral intervention initiated by pediatricians in safety-net systems on the promotion of long-term bioverified abstinence, and Project Fresh Air (PFA), which demonstrated efficacy in reducing in-home smoking and children’s tobacco smoke exposure (TSE) using residential air monitors that continually assessed indoor air quality and immediately provided feedback upon detection of elevated air particulate levels. Given that most unregulated smoking occurs in smokers’ homes and evidence that SFH adoption relates to long-term abstinence, TRAQ to Quit aims to bolster the KiSS trial’s limited home-level intervention components with a PFA-inspired, potentially powerful IoT home monitoring system. We will enroll 272 parent/caregiver smokers referred from safety-net pediatric health systems serving low-income areas. A 2-group randomized control trial design will be conducted with measures collected at baseline, 8- (end of treatment), 12- and 24-weeks after the target quit date to compare: i.) KiSS Usual Care (KiSS-UC) to KiSS + the state-of-the art IoT system (KiSS+IoT). The feedback from the IoT system is expected to augment treatment effects on home-level determinants of smoking behavior change (i.e., knowledge/awareness of in-home exposure risk; motivation to protect children from exposure). Evidence suggests that among low-income smokers, such changes can improve SFH achievement, self-efficacy, home support for cessation, and the fostering of a supportive accountability dynamic, all of which are mediators of long-term abstinence in prior trials. More potent interventions are necessary to reduce tobacco-related morbidity and mortality in low-income communities. Our proposed strategy allows two public health priorities to be simultaneously addressed: i.) maximizing long-term smoking cessation success and ii.) reducing TSE for other household occupants, including children. If TRAQ-to-Quit is efficacious, it presents an innovative, potent and pragmatic pediatric system-initiated telehealth intervention model that could ultimately be disseminated via linkages between pediatric systems and large service providers (e.g. state quitlines).





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