A Smoking Cessation Mobile App for Persons Living With HIV: Preliminary Efficacy and Feasibility Study

Abstract

Background The prevalence of smoking in the United States general population has gradually declined to the lowest rate ever recorded; however, this has not been true for persons with HIV. Objective We conducted a pilot test to assess the feasibility and efficacy of the Lumme Quit Smoking mobile app and smartwatch combination with sensing capabilities to improve smoking cessation in persons with HIV. Methods A total of 40 participants were enrolled in the study and randomly assigned 1:1 to the control arm, which received an 8-week supply of nicotine replacement therapy, a 30-minute smoking cessation counseling session, and weekly check-in calls with study staff, or to the intervention arm, which additionally received the Lumme Quit Smoking app and smartwatch. Results Of the 40 participants enrolled, 37 completed the follow-up study assessments and 16 used the app every day during the 56-day period. During the 6-month recruitment and enrollment period, 122 people were screened for eligibility, with 67.2% (82/122) deemed ineligible. Smoking criteria and incompatible tech were the major reasons for ineligibility. There was no difference in the proportion of 7-day point prevalence abstinence by study arm and no significant decrease in exhaled carbon monoxide for the intervention and control arms separately. However, the average exhaled carbon monoxide decreased over time when analyzing both arms together (P=.02). Conclusions Results suggest excellent feasibility and acceptability of using a smoking sensor app among this smoking population. The knowledge gained from this research will enable the scientific community, clinicians, and community stakeholders to improve tobacco cessation outcomes for persons with HIV. Trial Registration ClinicalTrials.gov NCT04808609; https://clinicaltrials.gov/ct2/show/NCT04808609

Additive effects of adjunctive app-based interventions for mental disorders - A systematic review and meta-analysis of randomised controlled trials

“…No difference was found for symptoms of depression regarding primary and secondary outcomes ( g = 0.03; 95 % CI -0.07 to 0.13, p = 0.578; I 2 = 13.9 %; 95 % CI 0.0 to 48; PI -0.19 to 0.25; k = 22 ( Bastiaansen et al, 2020 ; Bell et al, 2020 ; Boettcher et al, 2018 ; Farren et al, 2022 ; Faurholt-Jepsen et al, 2015 ; Faurholt-Jepsen et al, 2020 ; Faurholt-Jepsen et al, 2021 ; Goulding et al, 2023 ; Keeler et al, 2022 ; Law et al, 2023 ; Lewis et al, 2020 ; Liu et al, 2023 ; Mackintosh et al, 2017 ; Mantani et al, 2017 ; O'Toole et al, 2019 ; Raevuori et al, 2021 ; Schmädeke and Bischoff, 2015 ; Schnall et al, 2022 ; Tønning et al, 2021 ; Wallace et al, 2022 ); see Appendix F for forest plot Fig. F.1).…”

“…Smoking had ten comparisons ( Asayut et al, 2022 ; Carrasco-Hernandez et al, 2020 ; Cheung et al, 2015 ; Chulasai et al, 2022 ; Durmaz et al, 2019 ; Krebs et al, 2019 ; Krishnan et al, 2019 ; O'Connor et al, 2020 ; Schlam and Baker, 2020 ; Schnall et al, 2022 ) with a mean effect size of 0.43 (95 % CI 0.29 to 0.58; p < 0.001; see Fig. 3 b for forest plot).…”

“…The effects remained when studies with a high risk of bias were excluded for smoking ( g = 0.52; 95 % CI, 0.34 to 0.7; k = 6 ( Cheung et al, 2015 ; Chulasai et al, 2022 ; Durmaz et al, 2019 ; Krishnan et al, 2019 ; O'Connor et al, 2020 ; Schnall et al, 2022 )) and for alcohol use ( g = 0.21; 95 % CI 0.05-0.37; k = 5 ( Farren et al, 2022 ; Gustafson et al, 2014 ; Liu et al, 2023 ; McKay et al, 2022 ; Mellentin et al, 2019 )). Subgroup analyses revealed no differences ( p = 0.686) in smoking cessation studies that featured face-to-face interactions as their primary intervention setting ( g = 0.43; 95 % CI, 0.13 to 0.74; k = 3 ( Durmaz et al, 2019 ; Krishnan et al, 2019 ; O'Connor et al, 2020 )) when compared to studies that combined face-to-face interactions with telephone support and nicotine patches ( g = 0.45; 95 % CI, 0.07 to 0.82; k = 3 ( Chulasai et al, 2022 ; Schlam and Baker, 2020 ; Schnall et al, 2022 )). For alcohol use, studies with face-to-face settings as primary intervention showed a slightly larger effect ( g = 0.36; 95 % CI 0.06 to 0.66; k = 3 ( Aharonovich et al, 2017 ; Hammond et al, 2021 ; McKay et al, 2022 )).…”

COPD in People with HIV: Epidemiology, Pathogenesis, Management, and Prevention Strategies

“… Continuous abstinence significantly better in treatment group weeks 9–12 (23.6 vs 10%, OR 4.65, 95% CI 1.71–12.67; p=0.003), but effect lost by week 24 (10.1 vs 6.7%) Gryaznov, et al 257 2020 Intervention: CO self-monitoring, mobile phone-based feedback, and app-based smoking cessation support, NRT Control: counseling by program physicians, NRT 14% vs 13% quit rate at 6 months (not statistically significant; could not recruit desired number of participants) Kim, et al 220 2020 Intervention: screening of movie in which women with HIV discuss quitting smoking, 8 live video counseling sessions + NRT Control: screening of movie of women with HIV talking about HIV infection, 8 live video counseling sessions + NRT Female participants only. No significant difference in 7-day point prevalence abstinence at 3 months by both self-report and cotinine test (40.7 vs 15.4%) Significantly higher odds sustained abstinence in intervention group 3 months after quitting (OR 4.23, 95% CI 1.10–16.27) Shuter, et al 259 2020 Intervention: web-based + text message-based support/ quit program (42 days)+NRT Control: brief quit advice + NRT No difference in quit rate between arms: 10.4% vs 9.6% (OR 1.09, 95% CI 0.3–4.04; p=1.0), number of quit attempts (7.3 vs 5.9; p=0.28), and change in daily cigarette consumption (−7.5 vs −4.7, p=0.06) Stanton, et al 260 2020 Intervention: 8 session intensive group therapy + NRT Control: brief quit advice + NRT Significantly higher quit rate in treatment group at 3 months (13 vs 6.6%, OR= 2.1, 95% CI 1.1–4.1; p=0.04) but not at 6 months (13% vs 13.3%) Barriers to cessation: lower education level, current cocaine use, high distress tolerance, prior NRT use Schnall, et al 261 2022 Intervention: Lumme Quit smoking app and smartwatch + control interventions Control: 8-week supply of NRT, 30 min smoking cessation counseling and weekly check-in calls ● 2 (12%) vs 3 (15%) with eCO-verified abstinence (p=0.77) ● 4 (24%) vs 6 (30%) with self-reported 7-day abstinence (p=0.66) ● Trend towards a decrease in eCO in both groups by the end of the study Shuter, et al 258 2022 Intervention: 8 online education sessions over 6 weeks + online platform and community access + NRT Control: access to AHA website online health-promotion intervention (only 1/7 on s...…”

Smartband-based smoking detection and real-time brief mindfulness intervention: findings from a feasibility clinical trial

“…Several smartbands/watches have been initially validated to detect cigarette smoking in laboratory [ 22 ] and real-world settings [ 18 , 23 , 24 ], including using proprietary sensors [ 25 , 26 ] or off-the-shelf smartbands/watches [ 23 , 24 , 27 ]. Several smartbands/watches have been found to accurately and precisely detect smoking in the real world [ 23–25 , 27 , 28 ], to be acceptable to individuals who smoke cigarettes [ 29 ] and to have promising effects on smoking [ 27 , 29 ].…”