Accepted for/Published in: JMIR Formative Research
Date Submitted: Oct 10, 2019
Date Accepted: Dec 9, 2019
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Smartphone app to help cancer patients stop smoking: Results from a pilot randomized trial on feasibility, acceptability, and effectiveness
ABSTRACT
Background:
Persistent smoking after a cancer diagnosis predicts worse treatment outcomes and mortality, but access to effective smoking cessation interventions is limited. Smartphone applications (“apps”) can address this problem by providing a highly accessible, low-cost smoking cessation intervention tailored to patients with a recent cancer diagnosis.
Objective:
Summarize our development process and report trial design, feasibility, participant acceptability, preliminary effectiveness, and impact on processes of change (e.g., cancer stigma) of the first-known smartphone app for smoking cessation tailored to cancer patients.
Methods:
We used an agile, user-centered design framework to develop a smartphone app called “Quit2Heal”, specifically designed to help cancer patients stop smoking by providing skills training and stories from cancer survivors that focus on coping with internalized shame, cancer stigma, depression, and anxiety as core triggers of smoking. Quit2Heal was compared with NCI’s QuitGuide, a widely used stop smoking app for the general population, in a pilot double-blinded randomized trial with a 2-month follow-up period. Participants were 59 adult smokers diagnosed with cancer within the past 12 months and recruited through 2 cancer center care networks and social media over a 12-month period. Participants were 75% female and 78% White. The most common types of cancer diagnoses were lung (36%) and breast (17%). The 2-month follow-up survey retention rate was 92% (54/59) and did not differ by study arm (P =.15).
Results:
Compared to QuitGuide participants, Quit2Heal participants: (1) were more satisfied with their assigned app (90% vs. 65%; P =.047), (2) were more likely to report that their assigned app was made for someone like them (86% vs. 62%; P = .04), and (3) opened their app more times during the 2-month trial period, although this difference was not statistically significant [M = 10.0 (SD = 14.40) vs. 6.1 (SD =5.3); P =.33]. The self-reported 30-day point prevalence quit rate at the 2-month follow-up was 20% for Quit2Heal vs. 7% for QuitGuide (OR=5.16; 95% CI: 0.71, 37.29; p=.104). Quit2Heal participants also showed greater improvement in internalized shame, cancer stigma, depression and anxiety, though these were not statistically significant (all P >.05).
Conclusions:
In a pilot trial with a high short-term retention rate, Quit2Heal had promising acceptability and effectiveness for helping cancer patients stop smoking. Testing in a full scale RCT is now needed. Clinical Trial: NCT03600038
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