Hébert Emily T, Ra Chaelin K, Alexander Adam C, Helt Angela, Moisiuc Rachel, Kendzor Darla E, Vidrine Damon J, Funk-Lawler Rachel K, Businelle Michael S
Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States.
Moffitt Cancer Center, Tampa, FL, United States.
J Med Internet Res. 2020 Mar 9;22(3):e16907. doi: 10.2196/16907.
Smartphone apps for smoking cessation could offer easily accessible, highly tailored, intensive interventions at a fraction of the cost of traditional counseling. Although there are hundreds of publicly available smoking cessation apps, few have been empirically evaluated using a randomized controlled trial (RCT) design. The Smart-Treatment (Smart-T2) app is a just-in-time adaptive intervention that uses ecological momentary assessments (EMAs) to assess the risk for imminent smoking lapse and tailors treatment messages based on the risk of lapse and reported symptoms.
This 3-armed pilot RCT aimed to determine the feasibility and preliminary efficacy of an automated smartphone-based smoking cessation intervention (Smart-T2) relative to standard in-person smoking cessation clinic care and the National Cancer Institute's free smoking cessation app, QuitGuide.
Adult smokers who attended a clinic-based tobacco cessation program were randomized into groups and followed for 13 weeks (1 week prequitting through 12 weeks postquitting). All study participants received nicotine patches and gum and were asked to complete EMAs five times a day on study-provided smartphones for 5 weeks. Participants in the Smart-T2 group received tailored treatment messages after the completion of each EMA. Both Smart-T2 and QuitGuide apps offer on-demand smoking cessation treatment.
Of 81 participants, 41 (50%) were women and 55 (68%) were white. On average, participants were aged 49.6 years and smoked 22.4 cigarettes per day at baseline. A total of 17% (14/81) of participants were biochemically confirmed 7-day point prevalence abstinent at 12 weeks postquitting (Smart-T2: 6/27, 22%, QuitGuide: 4/27, 15%, and usual care: 4/27, 15%), with no significant differences across groups (P>.05). Participants in the Smart-T2 group rated the app positively, with most participants agreeing that they can rely on the app to help them quit smoking, and endorsed the belief that the app would help them stay quit, and these responses were not significantly different from the ratings given by participants in the usual care group.
Dynamic smartphone apps that tailor intervention content in real time may increase user engagement and exposure to treatment-related materials. The results of this pilot RCT suggest that smartphone-based smoking cessation treatments may be capable of providing similar outcomes to traditional, in-person counseling.
ClinicalTrials.gov NCT02930200; https://clinicaltrials.gov/show/NCT02930200.
用于戒烟的智能手机应用程序可以以传统咨询成本的一小部分提供易于获取、高度个性化的强化干预措施。尽管有数百款公开可用的戒烟应用程序，但很少有应用程序通过随机对照试验（RCT）设计进行实证评估。智能治疗（Smart-T2）应用程序是一种即时自适应干预措施，它使用生态瞬时评估（EMA）来评估即将复吸的风险，并根据复吸风险和报告的症状定制治疗信息。
这项三臂试点随机对照试验旨在确定基于智能手机的自动化戒烟干预措施（Smart-T2）相对于标准的面对面戒烟诊所护理以及美国国立癌症研究所的免费戒烟应用程序QuitGuide的可行性和初步疗效。
参加基于诊所的戒烟计划的成年吸烟者被随机分组并随访13周（戒烟前1周至戒烟后12周）。所有研究参与者都接受尼古丁贴片和口香糖，并被要求在研究提供的智能手机上每天完成5次生态瞬时评估，持续5周。Smart-T2组的参与者在每次生态瞬时评估完成后会收到定制的治疗信息。Smart-T2和QuitGuide应用程序都提供按需戒烟治疗。
81名参与者中，41名（50%）为女性，55名（68%）为白人。参与者的平均年龄为49.6岁，基线时每天吸烟22.4支。共有17%（14/81）的参与者在戒烟后12周经生化确认7天点患病率戒断（Smart-T2组：6/27，22%；QuitGuide组：4/27，15%；常规护理组：4/27，15%），各组之间无显著差异（P>0.05）。Smart-T组的参与者对该应用程序评价积极，大多数参与者同意他们可以依靠该应用程序帮助他们戒烟，并认可该应用程序会帮助他们保持戒烟状态的信念，这些回答与常规护理组参与者给出的评分没有显著差异。
实时定制干预内容的动态智能手机应用程序可能会增加用户参与度和对治疗相关材料的接触。这项试点随机对照试验的结果表明，基于智能手机的戒烟治疗可能能够提供与传统面对面咨询相似的效果。
ClinicalTrials.gov NCT02930200；https://clinicaltrials.gov/show/NCT02930200 。
