Division of Public Health Sciences, Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Department of Psychology, University of Washington, Seattle, WA, USA.
Addiction. 2022 Mar;117(3):760-771. doi: 10.1111/add.15721. Epub 2021 Dec 9.
Black adults who smoke are less likely to seek treatment and to succeed in quitting compared with other racial groups. The lack of efficacious and engaging trials for smoking cessation further contributes to this disparity. This study explored whether an acceptance and commitment therapy (ACT)-based smartphone application (iCanQuit) was more efficacious for smoking cessation than a United States Clinical Practice Guidelines (USCPG)-based smartphone application (QuitGuide) among Black adults.
Secondary analysis of a two-arm randomized trial with 12-month follow-up.
United States (US).
A total of 554 Black adults who smoke daily were recruited from 34 US states and enrolled between May 2017 and September 2018.
Participants were randomized to receive iCanQuit (n = 274) or QuitGuide (n = 280) for 12 months.
Smoking cessation outcomes were measured at 3, 6, and 12 months. The primary outcome was self-reported complete-case 30-day point prevalence abstinence (PPA) at 12 months. Secondary outcomes were 7-day PPA, missing-as-smoking imputation, multiple imputation, prolonged abstinence, and cessation of all tobacco products at 12 months. Study retention, treatment engagement, and change in ACT-based processes were also compared between arms.
Study retention was 89% at 12 months and did not differ by arm (P > 0.05). The complete-case 30-day PPA was 28% for iCanQuit versus 20% for QuitGuide at 12 months (odds ratio [OR] = 1.60; 95% confidence interval [CI] = 1.03, 2.46). Similar associations were observed for the missing-as-smoking imputation, although non-significant (25% iCanQuit vs 18% QuitGuide; OR = 1.50; 95% CI = 0.98, 2.30). iCanQuit vs QuitGuide participants were significantly more engaged with iCanQuit application as measured by the number of logins from baseline to 6 months (incidence rate ratio = 3.26; 95% CI = 2.58, 4.13). Increased acceptance of cues to smoke mediated the effect of treatment on cessation (indirect effect: OR = 0.20; 95% CI = 0.05, 0.29).
Among Black adults, an acceptance and commitment therapy-based smartphone application appeared to be more efficacious and engaging for smoking cessation than the United States Clinical Practice Guidelines-based QuitGuide application.
与其他种族群体相比，吸烟的黑人成年人在寻求治疗和成功戒烟方面的可能性较低。缺乏有效的、有吸引力的戒烟试验进一步加剧了这种差异。本研究旨在探讨基于接受与承诺疗法（ACT）的智能手机应用程序（iCanQuit）与基于美国临床实践指南（USCPG）的智能手机应用程序（QuitGuide）相比，在黑人成年人中是否更能有效地帮助他们戒烟。
一项为期 12 个月的随访的双臂随机试验的二次分析。
美国。
共有 554 名来自美国 34 个州的每日吸烟的黑人成年人参与了这项研究，并于 2017 年 5 月至 2018 年 9 月期间入组。
参与者被随机分配接受 iCanQuit（n=274）或 QuitGuide（n=280）治疗，为期 12 个月。
在 3、6 和 12 个月时测量戒烟结果。主要结局是 12 个月时自我报告的完全案例 30 天点流行率 abstinence（PPA）。次要结局包括 7 天 PPA、缺失吸烟推断、多重插补、延长戒烟和所有烟草产品的戒烟。还比较了两组之间的研究保留率、治疗参与度和基于 ACT 的过程变化。
12 个月时的研究保留率为 89%，两组之间无差异（P>0.05）。完全案例 30 天 PPA 为 iCanQuit 组 28%，QuitGuide 组 20%，12 个月时（优势比[OR]1.60；95%置信区间[CI]1.03，2.46）。尽管不显著，但在缺失吸烟推断中也观察到类似的关联（25%的 iCanQuit 与 18%的 QuitGuide；OR 1.50；95%CI 0.98，2.30）。与 QuitGuide 相比，iCanQuit 参与者在基线至 6 个月期间的 iCanQuit 应用程序登录次数方面的参与度明显更高（发生率比[IRR]3.26；95%CI 2.58，4.13）。对吸烟线索的接受度增加介导了治疗对戒烟的影响（间接效应：OR 0.20；95%CI 0.05，0.29）。
在黑人成年人中，基于接受与承诺疗法的智能手机应用程序在戒烟方面似乎比基于美国临床实践指南的 QuitGuide 应用程序更有效和更有吸引力。
