Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 11, 2018
Date Accepted: May 1, 2019
(closed for review but you can still tweet)
Mindfulness-based Smoking Cessation Enhanced with Mobile Technology (iQuit Mindfully): Pilot Randomized Controlled Trial
ABSTRACT
Background:
Mindfulness training shows promise for improving smoking cessation and lapse recovery, and between-session mHealth messages could enhance treatment engagement and effectiveness. Personalized, in-the-moment text messaging support could be particularly useful for low-income smokers with fewer smoking cessation resources.
Objective:
This pilot study examined feasibility of a text messaging program (“iQuit Mindfully”) as an adjunct to in-person Mindfulness-Based Addiction Treatment (MBAT) for smoking cessation.
Methods:
Participants (N=71; 70% (50/71) African American, 61% (43/71) annual household income <$30K) were randomly assigned to MBAT (N=33) or iQuit Mindfully (N=38; MBAT + between-session text messages). All participants received 8 weekly group counseling sessions, nicotine patches, and self-help materials. Outcomes were: feasibility (attrition, engagement, participant ratings), participant feedback regarding the text messaging intervention, and smoking cessation.
Results:
Strong retention was achieved (76% (54/71) at end-of-treatment; 89% (63/71) at 1-month follow-up). In the iQuit Mindfully group, engagement was high (88% (29/33) indicated reading all or most texts, and 89% (34/38) engaged in interactive texting); and participants provided positive ratings (on 1-10 scale, average rating for recommending the program to others was 8.4 [SD = 2.5]). Participants indicated benefiting from the texts (e.g., appreciating encouraging reminders, coping strategies, and social support) and suggested improvements (e.g., more personalization). Overall biochemically-confirmed smoking cessation rates were 22% (12/55) at end of treatment and 19% (12/62) at 1-month follow-up, with no differences between conditions. Living below the poverty level predicted worse cessation outcomes at 1-month follow-up among participants receiving in-person only treatment (P = .03) but not among those receiving iQuit Mindfully.
Conclusions:
Text messaging appears to be a feasible and acceptable modality for supporting mindfulness-based smoking cessation treatment. The availability of 24/7 text messaging might be particularly helpful for low-income smokers, who have access to fewer cessation resources and experience significant day-to-day barriers to quitting. Clinical Trial: This trial was registered on clinicaltrials.gov (NCT03029819).
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