Smartphone Apps for Smoking Cessation

Overseen By Brie Sullivan

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Fred Hutchinson Cancer Center

Must not be taking: Smoking cessation drugs

Disqualifiers: Prior research, QuitGuide app, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 3

Duration: 6 weeks

776 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This clinical trial compares a new smoking cessation smartphone application (app) (iCanQuit) to an existing smarphone app (National Cancer Institute \[NCI\] QuitGuide) for helping American Indians and Alaska Natives (AIANs) quit smoking. Compared to other racial/ethnic groups, AIANs have 6 times higher rates of developing smoking-related cancers, including lung cancer. Commercial cigarette smoking accounts for half of all deaths among AIANs nationwide. AIANs' often lack of access to smoking cessation interventions, which may be due to inequities in the healthcare system, lack of health insurance, living in rural areas, systemic racism, and historical trauma. There is also a lack of effective smoking cessation interventions for AIANs. Smartphone apps have the potential to deliver a low-cost smoking cessation intervention with wide reach to AIANs. Apps require no in-person delivery and no provider training, do not require integration into complex hospital systems, can be freely accessed on an app store, and are available at any time and any place. iCanQuit is a behavioral intervention designed to help adults stop smoking by teaching skills for coping with smoking urges, staying motivated, and preventing relapse. The iCanQuit app intervention may be more effective than the currently available NCI QuitGuide app at helping AIANs quit smoking.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you cannot be using other smoking cessation treatments or medications within the past 30 days to participate.

How is the iCanQuit treatment different from other smoking cessation treatments?

iCanQuit is a smartphone app specifically designed to help people quit smoking, making it unique compared to traditional methods like medications or in-person counseling. It offers a digital, easily accessible approach that can be used anytime, anywhere, providing support and guidance directly through a user's phone. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment iCanQuit for smoking cessation?

The iCanQuit app, which uses Acceptance and Commitment Therapy (ACT), was shown to be more effective than the QuitGuide app in helping people quit smoking, with 24% of users reporting they quit smoking after 12 months compared to 17% using QuitGuide. Users of iCanQuit also reported higher satisfaction and used the app more frequently. ^{1 4 6 7 8}

Who Is on the Research Team?

Jonathan B Bricker

Principal Investigator

Fred Hutch/University of Washington Cancer Consortium

Are You a Good Fit for This Trial?

This trial is for American Indians and Alaska Natives aged 18 or older who smoke daily, want to quit within the next month, can use a smartphone app in English, and are not using other quit-smoking aids. Participants must live off US tribal reservations or on certain Northern Plains reservations.

Inclusion Criteria

You have smoked every day for the past year.

I want to quit smoking within the next month.

No one else in your household or family is taking part in the study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants use either the iCanQuit app or the NCI QuitGuide app for at least 45 days

6 weeks

Follow-up

Participants are monitored for smoking cessation outcomes at 3, 6, and 12 months post-randomization

12 months

3 follow-up assessments (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• iCanQuit

Trial Overview The study compares two smartphone apps: iCanQuit, designed specifically to help AIANs stop smoking by teaching coping skills and motivation techniques; versus the existing NCI QuitGuide app. The effectiveness of these apps in aiding smoking cessation will be evaluated.

How Is the Trial Designed?

Group I: Arm I (iCanQuit app) Experimental Treatment 3 Interventions

Participants use the iCanQuit app, which includes setting up a personalized quit plan, participating in eight levels of the content, receiving on-demand help in coping with smoking urges, and tracking their daily smoking behaviors for at least 45 days on study.

Group II: Arm II (NCI QuitGuide app) Active Control 3 Interventions

Participants use the NCI QuitGuide app for at least 45 days on study.

iCanQuit is already approved in United States, India for the following indications:

Approved in United States as iCanQuit for:

• Smoking cessation

Approved in India as iCanQuit India for:

• Smoking cessation

Who Is Running the Clinical Trial?

Fred Hutchinson Cancer Center

Lead Sponsor

Trials

583

Recruited

1,341,000+

National Cancer Institute (NCI)

Collaborator

Trials

14,080

Recruited

41,180,000+

Published Research Related to This Trial

The iCanQuit smartphone app significantly outperformed the QuitGuide app in helping participants quit smoking, achieving a 34% quit rate compared to 20% for QuitGuide among those using FDA-approved cessation medications.

Using nicotine replacement therapy (NRT) alongside the iCanQuit app led to even higher quit rates of 40%, suggesting that combining the app with cessation medications can enhance its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Do medications increase the efficacy of digital interventions for smoking cessation? Secondary results from the iCanQuit randomized trial. Bricker, JB., Santiago-Torres, M., Mull, KE., et al.[2023]

Among 311,567 users of the iCoach app for smoking cessation, 26,785 steady users were identified, with more intensive app use linked to higher rates of smoking cessation, improved quitting stages, and increased self-efficacy over time.

The most significant improvements in smoking-related outcomes were observed within the first 3 months of app use, particularly among older users and women, who were more likely to engage with the app intensively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Use of the Smoking Cessation App Ex-Smokers iCoach and Associations With Smoking-Related Outcomes Over Time in a Large Sample of European Smokers: Retrospective Observational Study. Mansour, MB., Busschers, WB., Crone, MR., et al.[2023]

The iCanQuit smartphone application, which uses Acceptance and Commitment Therapy (ACT), was found to be more effective for helping highly nicotine-dependent adults quit tobacco compared to the QuitGuide application, with a 30-day abstinence rate of 24% versus 17% at 12 months.

Participants using iCanQuit not only reported higher rates of quitting but also engaged with the app more frequently and expressed greater satisfaction, indicating that the increase in acceptance of smoking cues played a key role in the success of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and Commitment Therapy-Based Smartphone Applications for Cessation of Tobacco Use among Adults with High Nicotine Dependence: Results from the iCanQuit Randomized Trial. Santiago-Torres, M., Mull, KE., Sullivan, BM., et al.[2023]

A smartphone app designed for smoking cessation effectively assessed real-time risk for smoking lapses and provided tailored messages, leading to greater reductions in smoking urges, stress, and cigarette availability among participants (N=59) over a 3-week period.

Messages specifically tailored to individual triggers, such as smoking urges and stress, were more effective in reducing those triggers compared to generic messages, suggesting that personalized interventions can enhance smoking cessation efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An ecological momentary intervention for smoking cessation: The associations of just-in-time, tailored messages with lapse risk factors. Hébert, ET., Stevens, EM., Frank, SG., et al.[2022]

The study aims to evaluate the effectiveness of the 'CureApp Smoking Cessation' (CASC) app in improving smoking cessation rates among individuals with nicotine dependence, alongside a standard 12-week treatment program, with a total of 580 participants expected to be recruited.

CASC is designed to enhance treatment outcomes by providing personalized support through video tutorials, AI advice, and CO monitoring, and the primary outcome will be the continuous abstinence rate from weeks 9-24, which is anticipated to be significantly higher than that of a control app.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Novel Smoking Cessation Smartphone App Integrated With a Mobile Carbon Monoxide Checker for Smoking Cessation Treatment: Protocol for a Randomized Controlled Trial. Nomura, A., Tateno, H., Masaki, K., et al.[2020]

Out of 112 smoking cessation apps reviewed, only six were identified as high-quality and partially adhered to Australian smoking cessation treatment guidelines, indicating a lack of robust options for users.

Only two of the high-quality apps had their efficacy evaluated, highlighting the need for more research to assess the effectiveness of smoking cessation apps and ensure they provide reliable support for users.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Free smoking cessation mobile apps available in Australia: a quality review and content analysis. Thornton, L., Quinn, C., Birrell, L., et al.[2022]

A study of 252 smoking cessation apps for iPhone and 148 for Android revealed that popular apps generally have low adherence to U.S. Public Health Service guidelines, scoring an average of only 12.9 out of 42 on the Adherence Index.

None of the apps recommended calling a quitline, and only 4.1% suggested using approved medications, indicating a significant gap in evidence-based support for users trying to quit smoking.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A content analysis of popular smartphone apps for smoking cessation. Abroms, LC., Lee Westmaas, J., Bontemps-Jones, J., et al.[2022]

Citations

1. England pubmed.ncbi.nlm.nih.gov

Do medications increase the efficacy of digital interventions for smoking cessation? Secondary results from the iCanQuit randomized trial. [2023]

2. Canada pubmed.ncbi.nlm.nih.gov

Use of the Smoking Cessation App Ex-Smokers iCoach and Associations With Smoking-Related Outcomes Over Time in a Large Sample of European Smokers: Retrospective Observational Study. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Acceptance and Commitment Therapy-Based Smartphone Applications for Cessation of Tobacco Use among Adults with High Nicotine Dependence: Results from the iCanQuit Randomized Trial. [2023]

4. England pubmed.ncbi.nlm.nih.gov

An ecological momentary intervention for smoking cessation: The associations of just-in-time, tailored messages with lapse risk factors. [2022]

5. Canada pubmed.ncbi.nlm.nih.gov

A Novel Smoking Cessation Smartphone App Integrated With a Mobile Carbon Monoxide Checker for Smoking Cessation Treatment: Protocol for a Randomized Controlled Trial. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Free smoking cessation mobile apps available in Australia: a quality review and content analysis. [2022]

7. Netherlands pubmed.ncbi.nlm.nih.gov

A content analysis of popular smartphone apps for smoking cessation. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Effectiveness of an offer of the Smoke Free smartphone application for smoking cessation: protocol for a randomized controlled trial. [2021]