Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 25, 2018
Date Accepted: Jan 20, 2019
Date Submitted to PubMed: Jan 23, 2019
(closed for review but you can still tweet)
Initial Efficacy Assessment of Pivot: A Comprehensive Digital Smoking Cessation Program
ABSTRACT
Background:
Cigarette smoking is the leading cause of preventable morbidity and mortality, excess health care expenditure, and lost work productivity. Otherwise effective evidence-based treatments have had limited success due to challenges with access, engagement, and scale. Pivot is a comprehensive digital smoking cessation program that incorporates an FDA-cleared carbon monoxide (CO) breath sensor, smartphone app, and text-based human coaching.
Objective:
This initial efficacy evaluation of Pivot assessed participant engagement, changes in attitudes toward quitting, and changes in smoking behavior.
Methods:
US cigarette smokers aged 18-65 who smoked ≥ 5 cigarettes per day (CPD) were recruited online. Participants completed a screening call, electronic informed consent, registration, and onboarding before beginning Pivot. Pivot includes 5 sequential stages (Explore, Build, Mobilize, Quit, Secure), taking 14.5 to 18.5 weeks to complete. Data were collected via app and online questionnaires. Outcomes included: engagement and retention (i.e., weeks of active engagement, Pivot stage progression); attitudes toward quitting (i.e., quit readiness, quit confidence, expected difficulty maintaining quit); and smoking behavior (i.e., quit attempts, cigarette reduction, and abstinence (7- and 30-day point prevalence abstinence (PPA)).
Results:
US cigarette smokers aged 18-65 who smoked ≥ 5 cigarettes per day (CPD) were recruited online. Participants completed a screening call, electronic informed consent, registration, and onboarding before beginning Pivot. Pivot includes 5 sequential stages (Explore, Build, Mobilize, Quit, Secure), taking 14.5 to 18.5 weeks to complete. Data were collected via app and online questionnaires. Outcomes included: engagement and retention (i.e., weeks of active engagement, Pivot stage progression); attitudes toward quitting (i.e., quit readiness, quit confidence, expected difficulty maintaining quit); and smoking behavior (i.e., quit attempts, cigarette reduction, and abstinence (7- and 30-day point prevalence abstinence (PPA)).
Conclusions:
This study provides initial evidence for Pivot’s efficacy, with comparable quit rates among those ready and not ready to quit at entry. The present data, considered with the program’s accessibility, innovation, evidence-based foundation and design for all smokers, suggests Pivot has the potential to address limitations of reach and scale, and thereby advance smoking cessation efforts. Clinical Trial: Clinicaltrials.gov NCT03295643. URL:https://clinicaltrials.gov/ct2/show/NCT03295643?term=NCT03295643&rank=1. Accessed: 2018-10-02. (Archived by WebCite® at http://www.webcitation.org/72sfzYp6k)
Citation
