Using the text-messaging program SmokefreeTXT to support smoking cessation for nondaily smokers

Hoeppner, Bettina B.; Hoeppner, Susanne S.; Schick, Melissa R.; Milligan, Connor M; Helmuth, Eric; Bergman, Brandon G.; Abroms, Lorien C.; Kelly, John

doi:10.1080/10826084.2018.1552300

Cited by 11 publications

(13 citation statements)

References 47 publications

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“…By and large, the tests of within-person changes are encouraging in that they suggest that the hoped-for cognitive and emotional changes are indeed taking place as nondaily smokers engage with the SiS2 app. Indeed, interactions with other mHealth smoking cessation technologies have produced similar results [ 68 ], although with somewhat weaker effects. Further testing of the SiS2 app in a randomized design is warranted to test the degree to which these changes are attributable to SiS2 app use.…”

Section: Discussionmentioning

confidence: 86%

A Smoking Cessation App for Nondaily Smokers (Version 2 of the Smiling Instead of Smoking App): Acceptability and Feasibility Study

Hoeppner¹,

Siegel²,

Carlon³

et al. 2021

JMIR Form Res

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Background Recent evidence highlights the significant detrimental impact of nondaily smoking on health and its disproportionate prevalence in underserved populations; however, little work has been done to develop treatments specifically geared toward quitting nondaily smoking. Objective This study aims to test the feasibility, acceptability, and conceptual underpinnings of version 2 of the Smiling Instead of Smoking (SiS2) smartphone app, which was developed specifically for nondaily smokers and uses a positive psychology approach. Methods In a prospective, single-group study, nondaily smokers (N=100) were prescribed use of the SiS2 app for 7 weeks while undergoing a quit attempt. The app assigned daily positive psychology exercises and behavioral tasks every 2 to 3 days, which guided smokers through using the smoking cessation tools offered in the app. Participants answered surveys at baseline and at 2, 6, 12, and 24 weeks postquit. Feasibility was evaluated based on app use and acceptability based on survey responses. The underlying conceptual framework was tested by examining whether theorized within-person changes occurred from baseline to end of treatment on scales measuring self-efficacy, desire to smoke, and processing of self-relevant health information (ie, pros and cons of smoking, importance of the pros and cons of quitting, and motivation). Results Participants used the SiS2 app on an average of 24.7 (SD 13.8) days out of the 49 prescribed days. At the end of treatment, most participants rated the functions of the app as very easy to use (eg, 70/95, 74% regarding cigarette log and 59/95, 62% regarding happiness exercises). The average score on the System Usability Scale was 79.8 (SD 17.3; A grade; A+ ≥84.1, B+ <78.8). Most participants reported that the app helped them in their quit attempt (83/95, 87%), and helped them stay positive while quitting (78/95, 82%). Large effects were found for within-person decreases in the desire to smoke (b=−1.5, 95% CI −1.9 to −1.1; P<.001; gav=1.01), the importance of the pros of smoking (b=-20.7, 95% CI −27.2 to −14.3; P<.001; gav=0.83), and perceived psychoactive benefits of smoking (b=−0.8, 95% CI −1.0 to −0.5; P<.001; gav=0.80). Medium effects were found for increases in self-efficacy for remaining abstinent when encountering internal (b=13.1, 95% CI 7.6 to 18.7; P<.001; gav=0.53) and external (b=11.2, 95% CI 6.1 to 16.1; P<.001; gav=0.49) smoking cues. Smaller effects, contrary to expectations, were found for decreases in motivation to quit smoking (P=.005) and the perceived importance of the pros of quitting (P=.009). Self-reported 30-day point prevalence abstinence rates were 40%, 56%, and 56% at 6, 12, and 24 weeks after the quit day, respectively. Conclusions The SiS2 app was feasible and acceptable, showed promising changes in constructs relevant to smoking cessation, and had high self-reported quit rates by nondaily smokers. The SiS2 app warrants testing in a randomized controlled trial.

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Section: Discussionmentioning

confidence: 86%

A Smoking Cessation App for Nondaily Smokers (Version 2 of the Smiling Instead of Smoking App): Acceptability and Feasibility Study

Hoeppner¹,

Siegel²,

Carlon³

et al. 2021

JMIR Form Res

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“…None of the 14 studies reported full details for all 16 quality criteria. At least five of 14 studies reported full details on intervention delivery [26, 29, 31, 33, 35] or user feedback [21, 23–27, 29, 31, 33, 34]. Many studies reported insufficient details on either infrastructure, interoperability, usability testing, access of individual participants, cost assessment, limitations for delivery at scale, contextual adaptability, replicability, data security, compliance with national guidelines and fidelity of delivery (see Table 4).…”

Section: Resultsmentioning

confidence: 99%

“…Studies included a median of 57 participants (range = 15–119 713) who were aged between 15 and 75+ years with a balanced gender distribution (median percentage of female participants = 53%). The majority of studies (nine of 14; 64%) were conducted in the community (including university students and participants recruited via an ongoing observational cohort study or primary care) [21–31], with the remaining studies conducted in secondary care (three of 14; 21%) [32–35], acute care (one of 14; 7%) [36] or in a specialist addiction service (one of 14; 7%) [37]. Studies typically reported inclusion criteria related to the frequency of substance use (e.g.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of studies (nine of 14; 64%) were conducted in the community (including university students and participants recruited via an ongoing observational cohort study or primary care) [21][22][23][24][25][26][27][28][29][30][31], with the remaining studies conducted in secondary care (three of 14; 21%) [32][33][34][35], acute care (one of 14; 7%) [36] or in a specialist addiction service (one of 14; 7%) [37]. Studies typically reported inclusion criteria related to the frequency of substance use (e.g.…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

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Technology‐mediated just‐in‐time adaptive interventions (JITAIs) to reduce harmful substance use: a systematic review

et al. 2021

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Background and Aims: Lapse risk when trying to stop or reduce harmful substance use is idiosyncratic, dynamic and multi-factorial. Just-in-time adaptive interventions (JITAIs) aim to deliver tailored support at moments of need or opportunity. We aimed to synthesize evidence on decision points, tailoring variables, intervention options, decision rules, study designs, user engagement and effectiveness of technology-mediated JITAIs for reducing harmful substance use.Methods: Systematic review of empirical studies of any design with a narrative synthesis. We searched Ovid MEDLINE, Embase, PsycINFO, Web of Science, the ACM Digital Library, the IEEE Digital Library, ClinicalTrials.gov, the ISRCTN register and dblp using terms related to substance use/mHealth/JITAIs. Outcomes were user engagement and intervention effectiveness. Study quality was assessed with the mHealth Evidence Reporting and Assessment checklist. Findings: We included 17 reports of 14 unique studies, including two randomized controlled trials. JITAIs targeted alcohol (S = 7, n = 120 520), tobacco (S = 4, n = 187), cannabis (S = 2, n = 97) and a combination of alcohol and illicit substance use (S = 1, n = 63), and primarily relied on active measurement and static (i.e. time-invariant) decision rules to deliver support tailored to micro-scale changes in mood or urges. Two studies used data from prior participants and four drew upon theory to devise decision rules. Engagement with available JITAIs was moderate-to-high and evidence of effectiveness was mixed. Due to substantial heterogeneity in study designs and outcome variables assessed, no meta-analysis was performed. Many studies reported insufficient detail on JITAI infrastructure, content, development costs and data security. Conclusions: Current implementations of just-in-time adaptive interventions (JITAIs) for reducing harmful substance use rely on active measurement and static decision rules to deliver support tailored to micro-scale changes in mood or urges. Studies on JITAI effectiveness are lacking.

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“…Second, a surprisingly small percentage of women participated in the study. In a similar study with identical eligibility and screening procedures, with the exception of no requirement to attend in-person visits [65], we recruited 66% women, suggesting that perhaps the in-person component was a deterrent. The requirement to provide the social security number information to allow us to provide remuneration was generally not seen as a deterrent, with only 1 of 157 screened potential participants deciding against the study because of it.…”

Section: Discussionmentioning

confidence: 99%

Leveraging Positive Psychology to Support Smoking Cessation in Nondaily Smokers Using a Smartphone App: Feasibility and Acceptability Study

Hoeppner

Carlon

et al. 2019

JMIR Mhealth Uhealth

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Background Nondaily smoking is an increasingly prevalent smoking pattern that poses substantial health risks. Objective We tested the feasibility of using a smartphone app with positive psychology exercises to support smoking cessation in nondaily smokers. Methods In this prospective, single-group pilot study, nondaily smokers (n=30) used version 1 of the Smiling Instead of Smoking (SiS) app for 3 weeks while undergoing a quit attempt. The app assigned daily happiness exercises, provided smoking cessation tools, and made smoking cessation information available. Participants answered surveys at baseline and 2, 6, 12, and 24 weeks after their chosen quit day and participated in structured user feedback sessions 2 weeks after their chosen quit day. Results App usage during the prescribed 3 weeks of use was high, with an average 84% (25.2/30) of participants using the app on any given day. App use was largely driven by completing happiness exercises (73%, 22/30) of participants per day), which participants continued to complete even after the end of the prescribed period. At the end of prescribed use, 90% (27/30) of participants reported that the app had helped them during their quit attempt, primarily by reminding them to stay on track (83%, 25/30) and boosting their confidence to quit (80%, 24/30) and belief that quitting was worthwhile (80%, 24/30). Happiness exercises were rated more favorably than user-initiated smoking cessation tools, and 80% (24/30) of participants proactively expressed in interviews that they liked them. App functionality to engage social support was not well received. Functionality to deal with risky times was rated useful but was rarely used. Within-person changes from baseline to the end of prescribed use were observed for several theorized mechanisms of behavior change, all in the expected direction: confidence increased (on a 0-100 scale, internal cues: b=16.7, 95% CI 7.2 to 26.3, P= .001; external cues: b=15.8, 95% CI 5.4 to 26.1, P= .004), urge to smoke decreased (on a 1-7 scale, b=−0.8, 95% CI −1.3 to −0.3, P= .002), and perceptions of smoking became less positive (on a 1-5 scale, psychoactive benefits: b=−0.5, 95% CI −0.9 to −0.2, P= .006; pleasure: b=−0.4, 95% CI −0.7 to −0.01, P= .03; on a 0-100 scale, importance of pros of smoking: b=−11.3, 95% CI −18.9 to −3.8, P= .004). Self-reported abstinence rates were 40% (12/30) and 53% (16/30) of participants 2 and 24 weeks post quit, respectively, with 30% (9/30) biochemically validated as abstinent 2 weeks post quit. Conclusions A smartphone app using happiness exercises to aid smoking cessation was well received by nondaily smokers. Given the high nonadherence and dropout rates for technology-delivered interventions rep...

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Using the text-messaging program SmokefreeTXT to support smoking cessation for nondaily smokers

Cited by 11 publications

References 47 publications

A Smoking Cessation App for Nondaily Smokers (Version 2 of the Smiling Instead of Smoking App): Acceptability and Feasibility Study

A Smoking Cessation App for Nondaily Smokers (Version 2 of the Smiling Instead of Smoking App): Acceptability and Feasibility Study

Technology‐mediated just‐in‐time adaptive interventions (JITAIs) to reduce harmful substance use: a systematic review

Leveraging Positive Psychology to Support Smoking Cessation in Nondaily Smokers Using a Smartphone App: Feasibility and Acceptability Study

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