||5R01CA221819-02 Interpret this number
||University Of Oklahoma Hlth Sciences Ctr
||Smartphone Based Smoking Cessation Intervention for Socioeconomically Disadvantaged Adults
Smoking is the leading preventable cause of death and disease in the United States. Although multiple clinic
and phone based smoking cessation treatments have been proven effective, most smoking cessation attempts
are unaided and unsuccessful. Furthermore, smoking prevalence in socioeconomically disadvantaged adults is
higher and cessation rates are lower than among adults with higher socioeconomic status. Previous research
has indicated multiple causes of high cessation failure among socioeconomically disadvantaged smokers
including greater exposure to other smokers, and higher levels of stress and nicotine cravings. One recent
study found that smartphone based ecological momentary assessments (EMAs) can be used to identify
moments of high smoking lapse risk in the hours preceding a lapse. Specifically, EMA data were used to
create a six-item smoking lapse risk estimator that identified 80% of all smoking lapses within 4 hours of the
first lapse. This lapse risk estimator was included as a key component of the smartphone based Smart
Treatment (Smart-T) smoking cessation app. The Smart-T app assesses risk for smoking lapse multiple times
per day and automatically tailors treatment content based upon an individual's current risk for lapse and
currently experienced lapse triggers. Smart-T includes other components (e.g., on demand tips for coping with
cravings, stress, mood; benefits of quitting; one click call to the smoking cessation helpline; smoking cessation
medication tips). The single arm Smart-T pilot study (N=59) indicated very promising 3 month biochemically
verified cessation rates and analyses of EMA data indicated that tailored treatment content attenuated targeted
lapse triggers. The proposed study (N=450) will compare the longer-term effects of the Smart-T smoking
cessation app with the free and publically available NCI QuitGuide smoking cessation app (Aim 1). It is
hypothesized that significantly more participants randomized to the Smart-T condition will be abstinent 26
weeks after a scheduled quit date than those assigned to the QuitGuide app. The second aim of the proposed
study will determine if Smart-T messages that are tailored to address key smoking lapse risk variables in real-
time (i.e., urge, stress, cigarette availability, cessation motivation) reduce participant ratings of these lapse risk
variables compared with similar situations that do not receive this tailored content (QuitGuide group).
Automated, tailored, low burden, and easily accessible interventions may be used to help socioeconomically
disadvantaged smokers, a population with substantial barriers that have hampered the use of traditional
smoking cessation treatments, to quit smoking. Thus, this intervention has the potential to deliver a significant
public health impact to exactly those who need it most.
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