A Mobile Just-in-Time Adaptive Intervention for Smoking Cessation: Pilot Randomized Controlled Trial

Area of Science:

• Digital Health
• Behavioral Science
• Public Health

Background:

• Smartphone apps offer accessible, tailored smoking cessation interventions.
• Few apps are rigorously evaluated with randomized controlled trials (RCTs).
• The Smart-Treatment (Smart-T2) app uses ecological momentary assessments (EMAs) for just-in-time adaptive interventions.

Purpose of the Study:

• To determine the feasibility and preliminary efficacy of the Smart-T2 app.
• To compare Smart-T2 against standard in-person smoking cessation care.
• To compare Smart-T2 against the National Cancer Institute's QuitGuide app.

Main Methods:

• A 3-armed pilot randomized controlled trial (RCT) was conducted.
• Participants received nicotine replacement therapy and completed daily EMAs.
• The Smart-T2 group received tailored messages based on EMA responses.

Main Results:

• 17% of participants achieved 7-day point prevalence abstinence at 12 weeks.
• No significant differences in abstinence rates were found between Smart-T2, QuitGuide, and usual care (22% vs. 15% vs. 15%).
• Participants rated the Smart-T2 app positively, similar to usual care ratings.

Conclusions:

• Smartphone-based smoking cessation treatments may achieve outcomes comparable to traditional counseling.
• Dynamic, tailored app interventions may enhance user engagement.
• The Smart-T2 app is a feasible and potentially effective tool for smoking cessation.