Project phoenix: Pilot randomized controlled trial of a smartphone-delivered intervention for people who are not ready to quit smoking.

BACKGROUND: Most people who smoke cigarettes report they want to quit in the future, but only 20 % are ready to quit within the next 30 days. This 3-arm pilot randomized controlled trial examined the feasibility and initial efficacy of a novel smartphone-based intervention that aimed to induce smoking cessation attempts among adults not initially ready to quit. METHODS: Participants randomized into the two intervention groups (Group 1: Phoenix App Only; Group 2: Phoenix App + Nicotine Replacement Therapy) received daily smoking cessation messages via smartphone application that were tailored to their current readiness to quit, while the attention control group (i.e., Factoid) received messages not related to smoking cessation. All participants completed a weekly survey for 26 weeks and used the app to set quit dates when/if desired. RESULTS: Participants (N=152) were female (67.8 %), White (75.7 %), 50.0 years old (SD=12.5), and smoked 20.4 cigarettes per day (SD=10.5). Results indicated that the Phoenix interventions were feasible (e.g., participants viewed ~185 messages over 26 weeks; 74.8 % of weekly surveys were completed; 85.5 % completed the 26-week follow-up assessment). Phoenix participants set more quit dates, set quit dates sooner, were abstinent for more days, and used smoking cessation medications on more days than those assigned to the Factoid group. CONCLUSIONS: This low-burden, smartphone-based smoking cessation induction intervention may increase smoking cessation attempts, and may reduce barriers that are encountered with traditional in-person or call-based interventions. TRIAL REGISTRATION: Clinicaltrials.gov number: NCT03405129; https://clinicaltrials.gov/ct2/show/NCT03405129.

Comparison of the Bluetooth iCOquit, piCO, and Vitalograph for the assessment of breath carbon monoxide among adults initiating smoking cessation and standardized canisters.

BACKGROUND: The Bluetooth iCOquit enables remote biochemical verification of smoking status, but its validity among adults attempting to quit smoking is unclear. This study 1) compared the iCOquit, piCO, and Vitalograph sensors to identify device-specific bias, 2) assessed the diagnostic accuracy of the iCOquit for the overall sample and within specific subgroups (sex, race, smoking rate, menthol use), and 3) assessed the validity of iCOquit readings against standardized CO canisters. METHODS: iCOquit devices were tested with human breath samples from individuals seeking treatment for combustible tobacco use (N = 93) attending an in-person clinic visit. Participants provided breath samples via the iCOquit, piCO, and Vitalograph (order randomized). iCOquit devices were also tested using 5 and 10 parts per million (ppm) canisters. RESULTS: The iCOquit underestimated CO and categorized more participants as abstinent relative to the other CO sensors with human breath samples. The results suggested the iCOquit could not be used interchangeably with the other CO devices. Using a cut-off of < 6 ppm, the diagnostic accuracy of the iCOquit (specificity = 94%; sensitivity = 85%) did not vary across demographic/smoking subgroups. Canister tests with the iCOquit suggested good precision (< 1 ppm). CONCLUSIONS: The iCOquit is an affordable option for the remote measurement of CO that provides a reasonably accurate assessment of smoking status of those attempting to quit smoking using abstinence cut-off criteria of < 6 ppm. However, compared to other CO monitors, the iCOquit may underestimate CO, thereby increasing error in assessing abstinence.