Testing the Impact of Smartphone-based Messaging to Support Young Adult Smoking Cessation

Not Applicable

Completed

Brief Summary: Clinical practice guidelines for smoking cessation emphasize cognitive behavioral therapy (CBT) to help patients develop coping strategies for urges. Mindfulness or Acceptance and commitment Therapy (ACT) offer a different approach, which teaches smokers psychological flexibility through accepting negative experiences. While there is evidence for the efficacy of both CBT and Mindfulness/ACT smoking cessation interventions, it is unclear if these approaches are efficacious when implemented in real-time and with young adults. The overall goal of this proposal is to evaluate the efficacy of CBT and Mindfulness/ACT messages for young adults targeted at specific high-risk situations for smoking.

Detailed Description: To conduct a pilot trial to test CBT and Mindfulness/ACT intervention message efficacy for reducing momentary smoking urges (N=10). To inform just-in-time interventions, it is crucial to test if CBT and Mindfulness/ACT based messages can reduce momentary smoking urges. The investigators will conduct a micro-randomized trial (repeated within-subject randomizations of messages) to accomplish this. In line with the investigators' existing protocol, participants first collect Ecological Momentary Assessment (EMA) data for 14 days, allowing the investigators to determine high-risk situations for smoking. In the following intervention phase, participants receive tailored messages triggered by geofencing of participants' high-risk locations for a total of 30 days. Tailoring is based on established predictors of smoking relapse (stress and presence of other smokers). The micro-randomized trial tests the efficacy of CBT versus Mindfulness/ACT versus control messages for reducing smoking urge 15 minutes post message delivery. Secondary outcomes include smoking or other tobacco use (including e-cigarettes), affect, and stress. After 45 days, follow up interviews with participants will be conducted to collect information on their study experience.

Recruitment & Eligibility

Inclusion Criteria

live in the U.S.
read English;
are between 18 and 30 years of age;
own an iPhone or Android smartphone;
have smoked ≥100 cigarettes and currently smoke at least 1 cigarette per day on 3 or more days of the week;
are planning to quit smoking within the next 30 days.

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Single arm pilot	Smartphone-based intervention messages	The micro-randomized trial will determine if CBT and Mindfulness/ACT messages are superior to control messages in reducing the primary outcome momentary smoking urges. Based on participants' training data collected in the initial 14 days of EMA monitoring, intervention messages will be delivered during time-periods and at high-risk locations for smoking. In the intervention phase, participants will be prompted to complete 3 geofence-triggered EMAs per day for a total of 30 days. Each EMA will be followed by an intervention message and the type of message (CBT, Mindfulness/ACT, control) will be randomly selected at each time point (within-subject randomization).

Primary Outcome Measures

Name	Time	Method
Change in smoking urge as assessed by a single item	Baseline, 5 minutes after message delivery	The primary outcome will be change in participants' rating of smoking urge in EMA-post surveys, prompted 15 minutes after intervention message delivery, and controlling for the ratings in EMA-pre surveys. Urge will be assessed by a single item on a 5-point scale, ranging from 1 (very low) to 5 (very high).
Change in number of cigarettes smoked per day in past week as assessed by a single item	Baseline, 45-day follow-up	The primary outcome will be change in self-reported number of cigarettes smoked per day in the past week from baseline to 45-days.

Secondary Outcome Measures

Name	Time	Method

Locations (1): Johns Hopkins Bloomberg School of Public Health
🇺🇸
Baltimore, Maryland, United States