Jackson Riley Walton, Cao-Nasalga Ann, Chieng Amy, Pirkl Amy, Jagielo Annemarie D, Xu Cindy, Goldenhersch Emilio, Rosencovich Nicolas, Waitman Cristian, Prochaska Judith J
Department of Medicine, Stanford University, Stanford, CA, United States.
Health Education, Engagement and Promotion, Stanford Health Care, Stanford, CA, United States.
JMIR Form Res. 2024 Jul 23;8:e54817. doi: 10.2196/54817.
Smoking contributes to 1 in 3 cancer deaths. At the Stanford Cancer Center, tobacco cessation medication management and counseling are provided as a covered benefit. Patients charted as using tobacco are contacted by a tobacco treatment specialist and offered cessation services. As a novel addition, this study examined the acceptability of a virtual reality (VR) mindful exposure therapy app for quitting smoking called MindCotine.
The objective of this study was to determine the feasibility and acceptability of offering 6 weeks of MindCotine treatment as a part of Stanford's Tobacco Treatment Services for patients seen for cancer care.
As part of a single-group pilot study, the MindCotine VR program was offered to English- or Spanish-speaking patients interested in quitting smoking. Given the visual interface, epilepsy was a medical exclusion. Viewed from a smartphone with an attachable VR headset, MindCotine provides a digital environment with audiovisual content guiding mindfulness exercises (eg, breathing techniques, body awareness, and thought recognition), text-based coaching, and cognitive behavioral therapy-based self-reflections for quitting smoking. Interested patients providing informed consent were mailed a MindCotine headset and asked to use the app for 10+ minutes a day. At the end of 6 weeks, participants completed a feedback survey.
Of the 357 patients reached by the tobacco treatment specialist, 62 (17.3%) were ineligible, 190 (53.2%) were not interested in tobacco treatment services, and 78 (21.8%) preferred other tobacco treatment services. Among the 105 eligible and interested in assistance with quitting, 27 (25.7%) were interested in MindCotine, of whom 20 completed the informed consent, 9 used the program, and 8 completed their end-of-treatment survey. Participants using MindCotine completed, on average, 13 (SD 20.2) program activities, 19 (SD 26) journal records, and 11 (SD 12.3) coaching engagements. Of the 9 participants who used MindCotine, 4 (44%) reported some dizziness with app use that resolved and 7 (78%) would recommend MindCotine to a friend. In total, 2 participants quit tobacco (22.2% reporting, 10% overall), 2 others reduced their smoking by 50% or more, and 2 quit for 24 hours and then relapsed.
In a feasibility and acceptability pilot study of a novel VR tobacco treatment app offered to patients at a cancer center, 4 of 9 (44%) reporting and 4 of 20 (20%) overall substantially reduced or quit using tobacco after 6 weeks and most would recommend the app to others. Further testing on a larger sample is warranted.
ClinicalTrials.gov NCT05220254; https://clinicaltrials.gov/study/NCT05220254.
三分之一的癌症死亡都与吸烟有关。在斯坦福癌症中心，戒烟药物管理和咨询作为一项涵盖福利提供。被记录为使用烟草的患者会由烟草治疗专家联系并提供戒烟服务。作为一项新举措，本研究考察了一款名为MindCotine的用于戒烟的虚拟现实（VR）正念暴露疗法应用程序的可接受性。
本研究的目的是确定为接受癌症治疗的患者提供为期6周的MindCotine治疗作为斯坦福烟草治疗服务一部分的可行性和可接受性。
作为单组试点研究的一部分，MindCotine VR项目提供给有戒烟意愿的英语或西班牙语患者。鉴于其视觉界面，癫痫患者被排除在医学之外。通过带有可连接VR头显的智能手机观看，MindCotine提供了一个数字环境，其中包含指导正念练习（如呼吸技巧、身体感知和思维识别）的视听内容、基于文本的指导以及基于认知行为疗法的戒烟自我反思。提供知情同意的感兴趣患者会收到一个MindCotine头显，并被要求每天使用该应用程序10分钟以上。在6周结束时，参与者完成了一份反馈调查。
在烟草治疗专家联系的357名患者中，62名（17.3%）不符合条件，190名（53.2%）对烟草治疗服务不感兴趣，78名（21.8%）更喜欢其他烟草治疗服务。在105名符合条件且有戒烟援助意愿的患者中，27名（25.7%）对MindCotine感兴趣，其中20名完成了知情同意，9名使用了该项目，8名完成了治疗结束调查。使用MindCotine的参与者平均完成了13项（标准差20.2）项目活动、19项（标准差26）日志记录和11项（标准差12.3）指导参与。在9名使用MindCotine的参与者中，4名（44%）报告在使用应用程序时出现了一些头晕症状，这些症状后来消失了，7名（78%）会向朋友推荐MindCotine。总共有2名参与者戒烟（报告率为22.2%，总体为10%），另外2名将吸烟量减少了50%或更多，还有2名戒了24小时然后复吸。
在一项针对癌症中心患者的新型VR烟草治疗应用程序的可行性和可接受性试点研究中，9名参与者中有4名（报告率为44%），20名参与者中有4名（总体为20%）在6周后大幅减少或戒掉了烟草，并且大多数人会向他人推荐该应用程序。有必要对更大的样本进行进一步测试。
ClinicalTrials.gov NCT05220254；https://clinicaltrials.gov/study/NCT05220254
