Testing the impact of smartphone-based messaging to support young adult smoking cessation

项目摘要 烟草使用仍然是美国发病和过早死亡的最重要原因。 States.年轻人吸烟率高，使用循证戒烟服务的人数少。 智能手机在年轻人中广泛使用，并提供了一个有前途的戒烟策略 为广大的、多样化的年轻吸烟者提供治疗。可用的戒烟应用程序 智能手机很少以证据为基础，能够提供针对特定人群的干预内容， 吸烟者个人的需要。很少有人知道如何设计基于智能手机的干预措施， 他们应该提供什么样的定制干预内容。 虽然有证据表明认知行为疗法（CBT）和正念/ 接受和承诺疗法（ACT）戒烟干预，目前还不清楚这些方法是否 是有效的，当实施实时和年轻的成年人。本提案的总体目标是 评估针对特定高风险人群的基于CBT和ACT的信息的有效性 吸烟的情况。 我们的团队拥有使用智能手机和生态瞬时评估（EMA）的经验， 了解日常生活中吸烟的情景预测因素，以及年轻人的戒烟试验 使用Facebook。我们已经证明了确定吸烟高危情况的可行性， 基于地理围栏触发器递送定制的消息。 具体目标是：1）测试CBT和正念/ACT干预信息的有效性， 减少瞬间的吸烟欲望。我们将进行一项微随机试验（受试者内随机化）， 测试CBT和正念/ACT与控制信息相比减少吸烟冲动的功效15 在消息发送后的几分钟内。2)为了测试暴露于敦促减少消息是否会导致 与仅EMA对照组相比，随时间推移的吸烟行为。一组对照组的参与者， 如果消息减少了每天的吸烟量，仅在没有干预消息的情况下完成EMA将允许我们进行测试 治疗结束时、3个月和6个月随访时。3)探讨药物共同使用（大麻， 酒精、其他药物）和暴露于特定位置（家、工作场所、酒吧）对减少冲动信息功效的影响。 在干预组的参与者中，我们将探讨信息效能如何受到物质的调节 共同使用和暴露于特定环境。 现在年轻人吸烟比青少年更常见， 大大降低吸烟的发病率和死亡率，使其适合年龄，量身定制，可扩展 对这一高度优先人群的干预措施越来越重要。

PROJECT SUMMARY Tobacco use remains the most important cause of morbidity and premature mortality in the United States. Young adults have high smoking rates and low use of evidence-based smoking cessation services. Smartphones are widely used among young adults and offer a promising strategy to deliver smoking cessation treatment to a large, diverse audience of young adult smokers. Available smoking cessation apps for smartphones are rarely evidence-based and able to deliver intervention content that is tailored to the specific needs of the individual smoker. Little is known how smartphone-based interventions need to be designed and what kind of tailored intervention content they should deliver. While there is evidence for the efficacy of both Cognitive Behavioral Therapy (CBT) and Mindfulness/ Acceptance and Commitment Therapy (ACT) smoking cessation interventions, it is unclear if these approaches are efficacious when implemented in real-time and with young adults. The overall goal of this proposal is to evaluate the efficacy of CBT and ACT-based messages for young adults targeted at specific high-risk situations for smoking. Our team has experience in using smartphones and Ecological Momentary Assessment (EMA) to understand situational predictors of smoking in everyday life, and smoking cessation trials with young adults using Facebook. We have demonstrated feasibility of determining high-risk situations for smoking and delivering tailored messages based on geofence triggers. The specific aims are to: 1) To test CBT and Mindfulness/ACT intervention message efficacy for reducing momentary smoking urges. We will conduct a micro-randomized trial (within-subject randomization) to test the efficacy of CBT and Mindfulness/ACT compared to control messages for reducing smoking urge 15 minutes after message delivery. 2) To test if exposure to urge reduction messages results in changes in smoking behavior over time compared to an EMA only control group. A control group of participants that will complete EMA only without intervention messages will allow us to test, if messages reduce cigarettes per day at end of treatment, 3-, and 6-months follow-up. 3) Explore moderation effects of substance co-use (cannabis, alcohol, other drugs) and exposure to specific location (home, work, bars) on urge reduction message efficacy. Among intervention group participants, we will explore how message efficacy may be moderated by substance co-use and exposure to specific settings. Smoking onset is now more common among young adults than adolescents and early cessation substantially reduces morbidity and mortality from smoking, making age-appropriate, tailored, and scalable interventions for this high priority population ever more important.