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

项目总结 烟草使用仍然是美国发病率和过早死亡的最重要原因 各州。年轻人吸烟率高，循证戒烟服务使用率低。 智能手机在年轻人中广泛使用，并提供了一种有希望的戒烟策略 为大量不同的年轻成年吸烟者提供治疗。可用的戒烟应用程序可用于 智能手机很少以证据为基础，能够提供针对具体情况量身定做的干预内容 个人吸烟者的需求。几乎不知道基于智能手机的干预需要如何设计和 他们应该提供什么样的量身定制的干预内容。 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，目前尚不清楚这些方法是否 如果实时实施，对年轻人来说是有效的。这项提案的总体目标是 评估针对特定高危人群的基于CBT和ACT的信息的有效性 吸烟的情况。 我们的团队在使用智能手机和生态瞬时评估(EMA)方面拥有经验 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的高危情况和 基于GeoFence触发器传递定制的消息。 具体目的是：1)测试CBT和正念/ACT干预信息的有效性 减少瞬间的吸烟冲动。我们将进行微随机化试验(受试者内随机化)以 测试CBT和正念/ACT与控制信息对减少吸烟冲动的有效性 消息传递后几分钟。2)测试接触催促减少消息是否会导致 吸烟行为随时间的变化与仅使用EMA的对照组进行比较。参赛者的控制组将 仅在没有干预的情况下完成EMA消息将允许我们进行测试，如果消息每天减少吸烟 治疗结束时，分别进行3个月、6个月的随访。3)探索联合使用物质(大麻、 酒精、其他药物)和暴露在特定地点(家庭、工作、酒吧)对减少冲动的信息效果。 在干预组参与者中，我们将探索信息有效性如何通过物质来调节 共同使用和接触特定环境。 现在年轻人开始吸烟比青少年和提早戒烟更常见。 大幅降低吸烟的发病率和死亡率，使其适合年龄、量身定制且可扩展 对这一高度优先的人群的干预措施变得更加重要。

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.