Smartphone app helped Black smokers quit

Among Black adults, an acceptance and commitment therapy-based smartphone app was more effective for smoking cessation compared with a conventional app, researchers reported in Addiction.

The iCanQuit smartphone app uses acceptance and commitment therapy to aid in smoking cessation. This type of intervention teaches users to observe, acknowledge and accept their cravings to smoke rather than avoid them, and uses life values such as family and spirituality as motivation to quit, according to a press release issued by the Society for the Study of Addiction.

“The growing field of digital interventions for smoking cessation has the potential to greatly enhance reach among Black adults,” Margarita Santiago-Torres, PhD, research scientist in the division of public health sciences in the cancer prevention program at the Fred Hutchinson Cancer Research Center, Seattle, and colleagues wrote. “There are only a few digital intervention studies for smoking cessation that have been conducted in this population. All have been feasibility studies, and none have demonstrated efficacy.”

In this secondary analysis of the iCanQuit trial, researchers recruited 523 Black adults (mean age, 37.7 years; 22% men) who were daily smokers. Participants lived in 34 U.S. states and were enrolled from May 2017 to September 2018.

Participants were randomly assigned to use the acceptance and commitment therapy-based smartphone app (iCanQuit; n = 266), or a clinical practice guidelines-based smartphone app (QuitGuide; n = 257) for 12 months. Researchers measured smoking cessation outcomes at 3, 6 and 12 months.

The primary outcome was self-reported complete-case 30-day point prevalence abstinence at 12 months. At 12 months, the complete-case 30-day point prevalence abstinence was 28% for those who used the iCanQuit app compared with 20% for those who used the QuitGuide app (OR = 1.6; 95% CI, 1.03-2.46). There were similar results for the iCanQuit app and the QuitGuide app at 6 (28% vs. 14%; OR = 2.4; 95% CI, 1.5-3.85) and 3 (19% vs. 11%; OR = 1.99; 95% CI, 1.17-3.37) months.

In addition, those using the iCanQuit app were more engaged as measured by the number of logins from baseline to 6 months compared with those using the QuitGuide app (incidence rate ratio = 3.26; 95% CI, 2.58-4.13). Researchers observed increased acceptance of cues to smoke, which mediated the treatment effect on smoking cessation (OR = 0.2; 95% CI, 0.05-0.29).

“Perhaps learning [acceptance and commitment therapy]-based acceptance skills to be present with the urges to smoke that could be triggered by life stressors resonates with Black adults,” the researchers wrote. “Such acceptance may have, in turn, contributed to achieving and maintaining long-term cessation outcomes and preventing relapse, as demonstrated by higher odds of prolonged abstinence in the iCanQuit than the QuitGuide arm at 12 months.”