JMIR Publications

ABSTRACT

Background:

Delivering mindfulness-based interventions (MBIs) for smoking cessation via innovative technologies allows for flexibility in the timing of intervention delivery, which has the potential to improve the efficacy of cessation interventions. Research shows MBIs target key mechanisms in the smoking cessation process and can be used to minimize drivers of smoking lapse.

Objective:

This single-arm study investigated the impact of mindfulness-based strategies and motivational messages on proximal outcomes relevant to tobacco abstinence via a micro-randomized trial.

Methods:

The intervention included nicotine replacement therapy (NRT), brief individual counseling, and a two-week Just-in-Time Adaptive Intervention (JITAI) with wearable sensors. Throughout the JITAI period, a single strategy was randomly pushed (vs not) multiple times per day. An ecological momentary assessment (EMA) next assessed negative affect, positive affect, mindfulness, abstinence self-efficacy, motivation to quit, craving, and smoking motives. The primary analyses evaluated differences in EMA outcomes (proximal) for when a strategy was pushed vs not pushed. Additional analyses evaluated changes on similar outcomes collected from surveys at the baseline and end of treatment visits.

Results:

Receiving the JITAI significantly reduced proximal negative affect in the second (and final) week of the intervention. Self-reports provided at baseline and end of treatment showed decreases in perceived stress, automaticity of smoking, and craving, and an increase in abstinence self-efficacy.

Conclusions:

Future research should extend the length of the intervention to further evaluate the impact of the JITAI, as well as include a comparison condition to further evaluate how each component of the intervention uniquely impacts outcomes. Clinical Trial: Clinical trials registration number: NCT03404596