Brief, Web-Based Interventions to Motivate Smokers With Schizophrenia: Randomized Trial.

Area of Science:

• Psychiatry
• Public Health
• Digital Health

Background:

• In-person smoking cessation interventions are effective for smokers with schizophrenia but face access barriers.
• Digital interventions offer increased access but may be challenging due to cognitive impairments in schizophrenia.
• Novel digital tools, including interactive multimedia systems and tailored educational pamphlets, were developed to mitigate cognitive load.

Purpose of the Study:

• To compare the effectiveness and appeal of an interactive digital motivational intervention (Let's Talk About Smoking) against a static digital educational intervention (NCI Education).
• To assess the impact on smoking cessation treatment use, quit attempts, and abstinence in smokers with schizophrenia.
• To account for the role of cognitive functioning in intervention outcomes.

Main Methods:

• A randomized trial involving 162 adult smokers with schizophrenia.
• Interventions delivered via laptop computer in a single session, with participants having access to standard community cessation treatments.
• In-person assessments at 3- and 6-month follow-ups using multivariate models to analyze outcomes.

Main Results:

• No significant difference in smoking cessation treatment initiation between the interactive and static digital interventions.
• Older age, higher education, and fewer positive symptoms predicted treatment initiation; cognitive level did not.
• The interactive intervention showed higher satisfaction and usability scores, but quit attempts and abstinence rates did not differ significantly between groups. Cognitive functioning and use of cessation treatments predicted quit attempts.

Conclusions:

• The interactive digital intervention was not more effective than the static one for smokers with schizophrenia.
• Both digital interventions achieved engagement and quit attempt levels comparable to previous in-person studies.
• Digital interventions show promise for motivating smokers with schizophrenia, but additional, adjusted cessation support is necessary, especially for those with cognitive impairment.