An automated, online feasibility randomized controlled trial of a just-in-time adaptive intervention for smoking cessation (Quit Sense)

Naughton, Felix, Hope, Aimie, Siegele-Brown, Chloë, Grant, Kelly, Barton, Garry, Notley, Caitlin ORCID: https://orcid.org/0000-0003-0876-3304, Mascolo, Cecilia, Coleman, Tim, Shepstone, Lee, Sutton, Stephen, Prevost, A. Toby, Crane, David, Greaves, Felix and High, Juliet (2023) An automated, online feasibility randomized controlled trial of a just-in-time adaptive intervention for smoking cessation (Quit Sense). Nicotine and Tobacco Research, 25 (7). 1319–1329. ISSN 1462-2203

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Abstract

Introduction: Learned smoking cues from a smoker’s environment are a major cause of lapse and relapse. Quit Sense, a theory-guided Just-In-Time Adaptive Intervention smartphone app, aims to help smokers learn about their situational smoking cues and provide in-the-moment support to help manage these when quitting. Methods: A two-arm feasibility randomized controlled trial (N = 209) to estimate parameters to inform a definitive evaluation. Smoker’s willing to make a quit attempt were recruited using online paid-for adverts and randomized to “usual care” (text message referral to NHS SmokeFree website) or “usual care” plus a text message invitation to install Quit Sense. Procedures, excluding manual follow-up for nonresponders, were automated. Follow-up at 6 weeks and 6 months included feasibility, intervention engagement, smoking-related, and economic outcomes. Abstinence was verified using cotinine assessment from posted saliva samples. Results: Self-reported smoking outcome completion rates at 6 months were 77% (95% CI 71%, 82%), viable saliva sample return rate was 39% (95% CI 24%, 54%), and health economic data 70% (95% CI 64%, 77%). Among Quit Sense participants, 75% (95% CI 67%, 83%) installed the app and set a quit date and, of those, 51% engaged for more than one week. The 6-month biochemically verified sustained abstinence rate (anticipated primary outcome for definitive trial), was 11.5% (12/104) among Quit Sense participants and 2.9% (3/105) for usual care (adjusted odds ratio = 4.57, 95% CIs 1.23, 16.94). No evidence of between-group differences in hypothesized mechanisms of action was found. Conclusions: Evaluation feasibility was demonstrated alongside evidence supporting the effectiveness potential of Quit Sense. Implications: Running a primarily automated trial to initially evaluate Quit Sense was feasible, resulting in modest recruitment costs and researcher time, and high trial engagement. When invited, as part of trial participation, to install a smoking cessation app, most participants are likely to do so, and, for those using Quit Sense, an estimated one-half will engage with it for more than 1 week. Evidence that Quit Sense may increase verified abstinence at 6-month follow-up, relative to usual care, was generated, although low saliva return rates to verify smoking status contributed to considerable imprecision in the effect size estimate.

Item Type: Article
Additional Information: Funding: This study is funded by the NIHR Public Health Research Programme (17/92/31). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. Tim Coleman is an NIHR Senior Investigator. Data Availability: The data underlying this article will be shared on reasonable request to the corresponding author.
Uncontrolled Keywords: medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Groups > Behavioural and Implementation Science
Faculty of Medicine and Health Sciences > Research Groups > Health Promotion
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Health Economics
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Faculty of Medicine and Health Sciences > Research Centres > Population Health
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Depositing User: LivePure Connector
Date Deposited: 17 Apr 2023 17:30
Last Modified: 24 Oct 2023 01:38
URI: https://ueaeprints.uea.ac.uk/id/eprint/91825
DOI: 10.1093/ntr/ntad032

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