Pilot Evaluation of a Mobile Health Intervention for Smoking Cessation in Rural and Urban Georgia

PurposeImproving access to low-burden, evidence-based smoking cessation interventions for rural communities is essential. This study evaluated the feasibility and acceptability of a text messaging program for smoking cessation (iQuit Mindfully) in rural and urban Georgia.DesignPilot study with randomization to iQuit Mindfully or usual care at each site.SettingUrban Atlanta and Rural Georgia.Sample60 adults who smoked cigarettes (61.7% female, 41.7% African American, 53.3% with annual household income <$30,000).InterventionAll participants received nicotine replacement therapy, self-help materials, and Tobacco Quitline referrals. iQuit Mindfully participants also received daily personalized, interactive text message support for quitting smoking.MeasuresProgram evaluations and remote exhaled carbon monoxide at 8 and 12 weeks.AnalysisDescriptive statistics quantified primary feasibility outcomes (engagement, retention, participant ratings) and smoking cessation by condition and rural vs urban site.ResultsMost iQuit Mindfully participants (88.9% overall; 100% rural, 78.6% urban) read most or all text messages. On average, iQuit Mindfully participants found the program helpful (median = 8 on 1-10 scale) and recommended it for others (median = 8). Biochemically verified 7-day abstinence rates were 34.8% among iQuit Mindfully vs 25.0% among usual care at week 8, and 13.6% among iQuit Mindfully vs 8.3% among usual care at week 12.ConclusionMindfulness-based text messaging appears feasible and acceptable for providing accessible smoking cessation support in rural and urban Georgia.