JMIR Publications

ABSTRACT

Background:

Hispanic adults receive less advice to quit smoking and utilize fewer evidence-based smoking cessation treatments compared to their non-Hispanic counterparts. Digital smoking cessation interventions, such as those delivered via smartphone applications (“apps”) provide a feasible and within reach treatment option for Hispanic adults who smoke and want to quit smoking. While the combination of pharmacotherapy and behavioral interventions are considered best practices for smoking cessation, its efficacy among Hispanic adults, especially alongside smartphone app-based interventions, is uncertain.

Objective:

This secondary analysis utilized data from a randomized clinical trial (RCT) that compared the efficacy of two smoking cessation apps, iCanQuit (based on Acceptance and Commitment Therapy, ACT) and QuitGuide (following US clinical practice guidelines) to explore whether the use of pharmacotherapy to aid smoking cessation augmented 12-month quit rates among the subsample of 173 Hispanic participants.

Methods:

Participants reported using pharmacotherapy on their own during the 3-month follow-up and cigarette smoking abstinence at the 12-month follow-up via online surveys. This data was used to (1) test the interaction effect of using pharmacotherapy to aid smoking cessation and intervention arm (iCanQuit vs. QuitGuide) on smoking cessation at 12 months, and (2) whether the use of pharmacotherapy to aid smoking cessation augmented the efficacy of each intervention arm to help participants successfully quit smoking.

Results:

The subsample of Hispanic participants were recruited from 30 US states. They were on average 34.5 years old, 50.9% female, and 56.1% reported smoking at least 10 cigarettes daily. Approximately 22% of participants reported using pharmacotherapy to aid smoking cessation at the 3-month follow-up, including nicotine replacement therapy, varenicline, and/or bupropion, with no difference between intervention arms. There was an interaction between pharmacotherapy use and intervention arm that marginally influenced 12-month quit rates at 12 months (P=.05). In the iCanQuit arm, 12-month missing-as-smoking quit rates were 43.8% for pharmacotherapy users vs. 28.8% for non-users (OR=2.21; 95% CI: 0.66, 7.48; P=.20). In the QuitGuide arm, quit rates were 9.1% for pharmacotherapy users vs. 21.7% for non-users (OR=0.36; 95% CI: 0.07, 1.72; P =.20).

Conclusions:

Combining pharmacotherapy to aid smoking cessation with a smartphone app-based behavioral intervention that teaches acceptance of cravings to smoke (iCanQuit) shows promise in improving quit rates among Hispanic adults. However, this combined approach was not effective with the US clinical guidelines-based app (QuitGuide). Clinical Trial: ClinicalTrials.gov Identifier, NCT02724462