Impact of Ecological Momentary Assessment Participation on Short-Term Smoking Cessation: quitSTART Ecological...

Area of Science:

• Public Health
• Behavioral Science
• Digital Health

Background:

• Cigarette smoking is a leading cause of preventable death in the US.
• Smartphone apps offer scalable smoking cessation interventions.
• Ecological Momentary Assessment (EMA) tracks behaviors and informs interventions, but its isolated impact and incentivization effects on smoking cessation are unknown.

Purpose of the Study:

• To investigate the influence of incentivized versus non-incentivized EMA participation on smoking cessation outcomes.
• To compare smoking cessation rates between individuals incentivized to use EMA and those who are not within a smartphone app.

Main Methods:

• A randomized controlled trial with 152 US adults using the quitSTART app.
• Participants were randomized to incentivized or non-incentivized EMA groups.
• Primary outcome was 7-day point prevalence abstinence at 2 and 4 weeks, analyzed using logistic regression.

Main Results:

• The incentivized group completed significantly more EMAs (13.3 vs. 4.7).
• Higher, though not statistically significant, cessation rates were observed in the non-incentivized group at 2 weeks (20.3% vs. 9%).
• At 4 weeks, the non-incentivized group showed significantly higher cessation rates (36.6% vs. 17.5%, P=.01).

Conclusions:

• Incentivizing EMA engagement in a smoking cessation app increased engagement but did not yield additional short-term cessation benefits.
• Crude analyses suggested a potential benefit of participant autonomy in using app features for smoking cessation.
• Further research is needed to understand the role of autonomy and tailored support in app-based cessation interventions.