Mindfulness-based ecological momentary intervention for smoking cessation among cancer survivors

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PROJECT SUMMARY/ABSTRACT Continued tobacco use among cancer survivors is linked to an increased risk of lowered effectiveness of cancer treatment, greater cancer-related mortality, developing a secondary primary cancer, worse quality of life, and increased cancer treatment costs ($3.4 billion/year). Despite high quit rates at cancer diagnosis, more than half of survivors who quit resume smoking shortly thereafter. Mindfulness-based interventions (MBIs) hold great promise in enhancing smoking abstinence among cancer survivors given its emphasis on purposefully paying attention to immediate experience, thereby reducing reactivity to smoking triggers. The current proposal addresses significant gaps in the extant smoking cessation literature for cancer survivors, which include: (1) A limited understanding of the role of dynamic relations between cancer-specific (e.g., fatigue, pain, fear of cancer recurrence) and general smoking risk factors (e.g., negative affect) contributing to smoking relapse given the known chronic high stress level among cancer survivors, (2) Lack of real-time cessation interventions using portable mobile devices such as smartphones (i.e., mobile health [mHealth]), (3) Little attention given to cancer- specific cessation barriers for cancer survivors (e.g., shame, guilt) and (4) Barriers to treatment accessibility among existing MBIs due to the time-intensiveness and in-person format. To address these gaps, the objective of this proposal is to develop a mindfulness-based ecological momentary intervention (mindEMI) that delivers MBI content in real-time and in the real world where quitting smoking takes place, and, when an elevated level Dr. Yang’s long-term career goal is to develop and evaluate accessible and scalable mHealth smoking cessation interventions for cancer prevention with expertise in real-time measurement of cognitive-affective constructs. As such, training goals address tobacco use and cancer survivorship, mHealth and clinical trials methodology, quantitative and qualitative methods, clinical delivery of MBIs, and professional development. of cancer-specific smoking relapse risk is indicated through ecological momentary assessment (EMA). There are three specific aims. The K99 phase will take place at the Moffitt Cancer Center. The aims during the K99 phase include: (1) To identify the most psychometrically sound EMA items for measuring negative affect, positive affect, and state mindfulness and (2) to develop a mindEMI targeting cancer-specific smoking vulnerabilities through an iterative multi-step process among cancer survivors who smoke. The R00 phase aims to conduct a 2-arm pilot randomized controlled trial (RCT) among cancer survivors to test the feasibility and acceptability of the mindEMI for smoking cessation. Feasibility of RCT procedures in preparation for a larger subsequent study will also be examined. This proposal is highly innovative because the mindEMI will address a crucial gap in the literature by targeting cancer-specific smoking vulnerabilities and deliver an MBI in real-time when relapse risk is high for cancer survivors. This work will inform a future trial to fully test the efficacy of mindEMI and directly addresses the NCI’s mission to conduct and support cancer research to promote longer and healthier lives.