Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 28, 2023
Date Accepted: May 26, 2023
Monitoring Cigarette Smoking and Relapse in Young Adults with and without Remote Biochemical Verification: A Randomized Brief Cessation Study
ABSTRACT
Background:
Technological advancements to study young adult smoking offer conceptual appeal, but their incorporation must demonstrate benefit over traditional methods without adversely affecting outcomes.
Objective:
We evaluated the impact of remote biochemical verification on self-reported smoking agreement, retention, compliance with remote sessions, and abstinence.
Methods:
Participants (N=39; ages 18-25; Mage=22; 56% male; 74% White) who smoked cigarettes daily engaged in a 5-week cessation and monitoring study (including a 48-hour quit attempt). Smoking was self-reported through ecological momentary assessment (EMA) procedures and participants were randomized to either; 1) the inclusion of remote biochemical verification (EMA + remote CO [rCO]) 2x per day, or 2) in-person, weekly CO (wCO). Groups were compared on: 1) agreement in self-reported smoking and CO at common time points, 2) EMA session compliance, 3) retention, and 4) abstinence.
Results:
No statistical differences were demonstrated between the rCO group and the wCO group on agreement between self-reported smoking and CO (moderate to poor), compliance, or retention, though these outcomes numerically favored the wCO group. Abstinence was numerically higher in the wCO group after the quit attempt and statistically different at the end of treatment, favoring the wCO group.
Conclusions:
The inclusion of remote breath CO added to EMA compared to EMA with weekly, in-person CO collection in young adults did not yield benefit and may have even adversely affected outcomes, though results should be interpreted with caution given a small sample size. Results suggest that technological advancements may improve data accuracy through objective measurement but may also introduce barriers and burden and could result in higher rates of missing data. Clinical Trial: N/A; not a clinical trial.
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