App-Based Smoking Urge Reduction Intervention for Young Adults: Protocol Combining a Microrandomized Trial and...

Area of Science:

• Public Health
• Digital Health
• Behavioral Science

Background:

• Young adults exhibit high tobacco smoking rates, contributing significantly to preventable morbidity and mortality.
• Despite interest in quitting, this demographic underutilizes professional cessation support.
• Smartphones offer a scalable platform for delivering timely, in-the-moment cessation support to young adults.

Purpose of the Study:

• To evaluate the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) messages for young adults.
• To assess interventions targeting high-risk smoking situations.
• To explore the potential of smartphone-based interventions for smoking cessation.

Main Methods:

• A microrandomized trial (MRT) will assess CBT and ACT message efficacy compared to control messages for reducing smoking urges.
• A nested randomized controlled trial (RCT) will examine the impact of messages on cigarettes per day.
• Exploratory analyses will investigate moderators of message efficacy, including substance co-use and setting.

Main Results:

• Enrollment is ongoing with 58 participants (52% in MRT, 48% in EMA-only control) as of June 2025 against a target of 160.
• Data collection is in progress to determine intervention efficacy.

Conclusions:

• Early smoking cessation is crucial for reducing long-term health consequences, highlighting the need for tailored interventions for young adults.
• This trial will provide evidence on the efficacy of situational tailoring in app-based tobacco use urge reduction messages.
• Findings will inform the development of effective, scalable smartphone interventions for young adult smokers.