Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
Schroeder Institute for Tobacco Research and Policy Studies, Washington, DC.
Nicotine Tob Res. 2019 Oct 26;21(11):1573-1577. doi: 10.1093/ntr/nty182.
Mobile phone-based messaging support and biomarker feedback independently show evidence of increasing an individual's likelihood of quitting smoking. However, the combination of these two strategies to facilitate smoking cessation has not been adequately explored.
We conducted a randomized controlled trial in Baltimore, Maryland, to assess the efficacy of COach2Quit, a smartphone application that provides exhaled carbon monoxide readings with message support. The primary outcome was self-reported and biochemically verified smoking cessation at 30-day follow-up. Secondary outcomes were reduction in smoking, motivation to quit, and engagement and satisfaction with COach2Quit. An intention-to-treat analysis was conducted.
Adult smokers were randomized 1:1 to receive brief advice and COach2Quit (intervention, n = 50) or brief advice only (control, n = 52). Thirteen participants were lost to follow-up. At 30-day follow-up, one participant in each arm quit smoking. Median change in carbon monoxide levels (in parts per million (ppm)) (intervention: -3.0 [interquartile range (IQR) -12.0, 2.0]; control: -2.5 [IQR -9.0, 2.0]) and median change in number of cigarettes smoked per day (intervention: -5.5 [IQR -14.0, -1.0]; control: -6.0 [IQR -10.0, -2.0]) was similar between study arms. There was no significant difference in mean percent change in the Reasons for Quitting scale score (intervention: 6.3 [95% confidence interval = -2.2% to 14.8%]; control: -3.6 [95% confidence interval = -9.2% to 2.1%]). A majority (n = 32, 91%) of participants liked having COach2Quit to help them quit smoking.
There were no significant differences in smoking cessation, smoking reduction, and motivation to quit between study arms. However, high satisfaction with the COach2Quit application indicates its feasibility and acceptability as a smoking cessation tool.
Smoking is the leading preventable cause of morbidity and mortality in the United States. Although counseling and pharmacotherapy are efficacious for smoking cessation, they are not easily accessible or desirable to all smokers, highlighting the need for identifying other interventions. There is evidence for the efficacy of mobile phone-based messaging support for smoking cessation. However, there is limited research on the efficacy of biomarker feedback, much less interventions that combine these two approaches. This research contributes to filling this gap and identifying novel interventions to facilitate smoking cessation.
基于手机的信息支持和生物标志物反馈都显示出可以增加个体戒烟的可能性。然而，将这两种策略结合起来以促进戒烟的效果尚未得到充分探索。
我们在马里兰州巴尔的摩市进行了一项随机对照试验，以评估 COach2Quit 的效果，这是一款提供呼气一氧化碳读数和信息支持的智能手机应用程序。主要结果是在 30 天随访时通过自我报告和生物化学验证的戒烟情况。次要结果是吸烟量减少、戒烟意愿和对 COach2Quit 的参与度和满意度。采用意向治疗分析。
成年吸烟者被随机分为 1:1 组，分别接受简短的建议和 COach2Quit（干预组，n = 50）或仅接受简短的建议（对照组，n = 52）。有 13 名参与者在随访过程中失访。在 30 天随访时，每个组都有一名参与者戒烟。一氧化碳水平的中位数变化（以百万分之一（ppm）表示）（干预组：-3.0 [四分位距（IQR）-12.0，2.0]；对照组：-2.5 [IQR -9.0，2.0]）和每日吸烟量的中位数变化（干预组：-5.5 [IQR -14.0，-1.0]；对照组：-6.0 [IQR -10.0，-2.0]）在研究组之间相似。戒烟原因量表评分的平均百分比变化没有显著差异（干预组：6.3 [95%置信区间= -2.2%至 14.8%]；对照组：-3.6 [95%置信区间= -9.2%至 2.1%]）。大多数（n = 32，91%）参与者喜欢使用 COach2Quit 来帮助他们戒烟。
在戒烟、吸烟量减少和戒烟意愿方面，两组之间没有显著差异。然而，对 COach2Quit 应用程序的高度满意度表明它作为戒烟工具的可行性和可接受性。
吸烟是美国发病率和死亡率的主要可预防原因。尽管咨询和药物治疗对戒烟有效，但它们不是所有吸烟者都容易获得或愿意接受的，这突出表明需要确定其他干预措施。有证据表明基于手机的信息支持对戒烟有效。然而，关于生物标志物反馈的研究有限，更不用说将这两种方法结合起来的干预措施了。这项研究有助于填补这一空白，并确定促进戒烟的新干预措施。
