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NCT04672239

A Proof-of-concept RCT of Version 3.0 of the Smoking Cessation Smartphone App "Smiling Instead of Smoking" (SiS)

Completed NA Results posted Last updated 19 September 2024
What this trial tests

NA trial testing Smartphone app "Smiling instead of Smoking" (SiS) Version 3 in Nondaily Smoking in 229 participants. Completed in 6 January 2023.

Timeline
28 January 2021
Primary endpoint
10 August 2022
6 January 2023

Quick facts

Lead sponsorMassachusetts General Hospital
PhaseNA
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingnone
Primary purposeother
Enrollment229
Start date28 January 2021
Primary completion10 August 2022
Estimated completion6 January 2023
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Massachusetts General Hospital

Who can join

18 and older, any sex, with Nondaily Smoking. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

End of Treatment Group Differences in Smoking Self-Efficacy Questionnaire (SEQ) Primary · Up to 24 weeks post quit day. Note that the 7 weeks of treatment started 1 week prior to the quit date (baseline = week -1).

The Smoking Self-Efficacy Questionnaire (SEQ-12) (Etter, Bergman, Humair, \& Perneger, 2000) is a two-dimensional 12-item self-report scale measuring a person's confidence in his or her ability to abstain from smoking when facing internal stimuli (e.g. feeling depressed) and external stimuli (e.g. being with smokers) on a 0-100 slider scale (i.e., 0=not at all confident that I can refrain; 100=extremely confident that I can refrain). Scale scores are created by mean scoring across items and range from 0 to 100. Higher scores indicate greater self-efficacy to abstain from smoking.

Baseline
GroupValue95% CI
Smiling Instead of Smoking63.81± 17.24
Quit Guide60.74± 16.67
Clearing the Air58.45± 19.10
Week 2 post-quit
GroupValue95% CI
Smiling Instead of Smoking71.79± 18.56
Quit Guide67.58± 15.69
Clearing the Air65.40± 16.59
Week 6 post-quit
GroupValue95% CI
Smiling Instead of Smoking78.34± 17.31
Quit Guide71.34± 17.67
Clearing the Air68.99± 19.80
Week 12 post-quit (3-month follow-up)
GroupValue95% CI
Smiling Instead of Smoking81.16± 17.35
Quit Guide76.20± 19.50
Clearing the Air75.22± 19.12
Week 24 post-quit (6-month follow-up)
GroupValue95% CI
Smiling Instead of Smoking80.23± 18.41
Quit Guide80.51± 20.33
Clearing the Air74.48± 23.42
Self-reported 30-day Point-prevalence Abstinence Secondary · Assessed at 2, 6, 12, and 24 weeks post-quit day. Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Participants responded to the multiple choice question, "What is your current smoking status?" with answer options: "I smoke daily", "I smoke non-daily (and have smoked in the past 7 days)", "I smoke nondaily (but have NOT smoked in the past 7 days)", and "I do not smoke at all"). If participants reported that they did not smoke at all, they were asked: "Have you been abstinent during the past 30 days?" (yes/no). All participants who reported smoking daily or nondaily to the first question, or who reported not smoking at all but had smoking in the past 30 days, or those who left either of thos

Week 2 post-quit
GroupValue95% CI
SiS App Treatment9
QG App Treatment3
CTA Pamphlet9
Week 6 post-quit
GroupValue95% CI
SiS App Treatment32
QG App Treatment23
CTA Pamphlet18
Week 12 post-quit (3-month follow-up)
GroupValue95% CI
SiS App Treatment36
QG App Treatment31
CTA Pamphlet21
Week 24 post-quit (6-month follow-up)
GroupValue95% CI
SiS App Treatment38
QG App Treatment32
CTA Pamphlet31
Self-reported Past Week Cigarette Change Secondary · Assessed at 2, 6, 12, and 24 weeks post-quit day. Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

If participants report having smoked in the past 7 days, they were asked to indicate how many cigarettes they smoked each day ("Last Monday:, Last Sunday:). Changes in cigarette consumption were calculated by subtracting the number of cigarettes smoked in the week leading up to the baseline assessment, as measured in the baseline survey, from the number of cigarettes smoked in the week leading up to the 2, 6, 12, and 24 week post-quit assessments, as assessed in these respective surveys.

Week 2 post-quit
GroupValue95% CI
SiS App Treatment-6.0-12.0 – -2.5
QG App Treatment-6.0-11.0 – -3.0
CTA Pamphlet-7.0-11.0 – -3.0
Week 6 post-quit
GroupValue95% CI
SiS App Treatment-5.0-12.0 – -1.0
QG App Treatment-6.0-11.0 – -3.0
CTA Pamphlet-7.0-13.0 – -4.0
Week 12 post-quit (3-month follow-up)
GroupValue95% CI
SiS App Treatment-6.0-12.0 – -1.5
QG App Treatment-6.0-11.0 – -2.0
CTA Pamphlet-7.0-13.5 – -3.0
Week 24 post-quit (6-month follow-up)
GroupValue95% CI
SiS App Treatment-6.0-9.5 – 0.0
QG App Treatment-6.0-10.0 – -2.0
CTA Pamphlet-7.0-12.5 – -2.0
Satisfaction With Smoking Cessation Support Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

As measured using the Client Satisfaction Scale (CSQ-8) (Larsen, 1979), an 8 item multiple choice measure that will be used to assess participants' satisfaction with the smoking cessation support they receive (e.g., "How satisfied are you with the amount of help you received?"). Scores are summed across items and range from 8 to 32, with higher scores indicating greater satisfaction.

GroupValue95% CI
SiS App Treatment26.91± 5.30
QG App Treatment26.61± 4.51
Clearing the Air Pamphlet25.65± 5.80
Time Spent Applying Content Brought up by the Apps/"Clearing the Air" Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Measured using the following single item, "During this past week, how much time did you spend applying or contemplating the content of the SiS app/QG app/"Clearing the Air"?" \[in minutes\].

GroupValue95% CI
SiS App Treatment30.029.0 – 70.0
QG App Treatment25.010.0 – 60.0
CTA Pamphlet30.010.0 – 60.0
Use of Smoking Cessation Strategies Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Assessed using a study-specific, unpublished 8-item measure in which participants rated the extent to which they agreed or disagreed with statements about the smoking cessation support they received and the things they did while quitting (5-point Likert scale, 1=strongly disagree, 5=strongly agree, e.g., "I used \[the assigned treatment\] the way I was supposed to (in the days leading up to and following my quit attempt)." and "I avoided situations that would make me want to smoke."). The scores of the 8 items were averaged, so that scores could range from 1 to 5, where higher scores indicate

GroupValue95% CI
SiS App Treatment4.13± 0.63
QG App Treatment3.90± 0.59
CTA Pamphlet3.97± 0.69
Perceived Impact of the Provided Materials on Quitting Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Assessed using a study-specific, unpublished 17-item measure in which participants rated the extent to which they agreed or disagreed with statements about the helpfulness of their assigned app during the quitting process (e.g., "\[the app\]...gave me confidence that I can quit smoking.", "\[the app\]... made me feel that I knew the right steps to take to quit.", and "\[the app\] ...reminded me in crucial moments to stay quit."). Items were rated on 5-point Likert scales ranging from 1="strongly disagree" to 5="strongly agree". The scores of the 17 items were averaged, so that scores could ran

GroupValue95% CI
SiS App Treatment4.13± 0.72
QG App Treatment3.98± 0.55
CTA Pamphlet3.84± 0.73
Appreciation Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

As measured using the Appreciation Scale, (Adler \& Fagley, 2005) an 18-item scale assessing the degree to which one is appreciative. Ten of the items assess frequency of action (e.g., "I do things to remind myself to be thankful", using a 7-point Likert scale of: 1 = "More than once a day" to 7 = "Never"). The remaining eight items assess level of agreement with appreciative statements (e.g., "I feel that it is a miracle to be alive", using a 7-point Likert scale of: 1 = "Strongly agree" to 7 = "Strongly disagree"). Item scores were summed to a total score with a possible range from 18 to 126

GroupValue95% CI
SiS App Treatment108.91± 13.46
QG App Treatment106.28± 15.29
CTA Pamphlet104.98± 14.26
Actual App Usage (SiS and QG Only) Secondary · Cumulative from week 0 to week 24 post-quit day. Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Number of days participants used the assigned app during the prescribed period of app use (i.e., 7 weeks for both apps). App usage is passively recorded by the app, which time-stamps every interaction with the app.

GroupValue95% CI
SiS App Treatment32.511.0 – 39.5
QG App Treatment26.011.0 – 38.0
Self-reported App Usage, Weeks 3 to 6 Post-quit (SiS and QG Only) Secondary · From week 3 to week 6 post-quit. Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

This was assessed via self-reported estimates of app use. Participants were asked on how many days they used the app in weeks 4, 5, and 6 post-quit ("On how many days per week did you use the app?"), and for how many minutes per typical day they used the assigned app ("On the days you used the app, how many minutes per day did you interact with the app?"). The days per week were multiplied by the minutes per app-use-day for each week, then averaged across the three weeks.

GroupValue95% CI
SiS App Treatment35.021.0 – 70.0
QG App Treatment22.514.0 – 60.0
Likability Rating of the App (SiS and QG Only) Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Measured using the single item, "How much did you like using the smoking cessation app we asked you to use?" Participants respond on a 5-point Likert scale (1 = I strongly disliked using the app, 2 = I somewhat disliked using the app, 3 = I neither liked nor disliked using the app; 4 = I somewhat liked using the app, and 5 = I strongly liked using the app).

GroupValue95% CI
SiS App Treatment4.19± 0.99
QG App Treatment4.08± 0.87
Satisfaction Rating of the Smoking Cessation Support (SiS and QG Only) Secondary · Assessed at treatment end (week 6 post-quit). Note that the 7 weeks of treatment started 1 week prior to the quit date (i.e., baseline = week -1).

Measured using the single item, "How satisfied are you with the smoking cessation support this app provided you with?" Participants respond on a 5-point Likert scale (1 = very unsatisfied, 2 = somewhat dissatisfied, 3 = neither satisfied nor dissatisfied, 4 = somewhat satisfied, 5 = very satisfied).

GroupValue95% CI
SiS App Treatment4.25± 1.04
QG App Treatment4.11± 0.94

Sponsor's own description

This is the third study in a series of 3 studies to develop a smartphone app to support nondaily smokers in quitting smoking, as funded by the American Cancer Society grant #RSG CPPB - 130323 (project dates: 07/01/2017 - 6/30/2021). Study 1 (2017P001106) demonstrated feasibility and acceptability when smokers were onboarded in person. Study 2 (2018P002699) demonstrated feasibility and acceptability when smokers were onboarded remotely, nationwide. The present study is Study 3. It is a 3-group proof-of-concept RCT, in which we seek to test if our app (i.e., Version 3 of our developed smartphone app, called 'Smiling instead of Smoking' (SiS)) is superior to treatment as usual (i.e., TAU) and superior to a control app (i.e., the National Cancer Institute's smartphone app "QuitGuide" (QG).

Publications & conference data

2 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Testing the Outcomes of a Smoking Cessation Smartphone App for Nondaily Smokers: Protocol for a Proof-of-concept Randomized Controlled Trial.
    Hoeppner BB, Siegel KR, Dickerman SR, Todi AA, et al · · 2023 · cited 1× · PMID 36787172 · DOI 10.2196/40867
  2. Smoking Cessation Smartphone App for Nondaily Smoking With Telephone Onboarding: Proof-of-Concept Randomized Controlled Trial.
    Hoeppner BB, Siegel KR, Futter AE, Finley-Abboud D, et al · · 2025 · PMID 39814363 · DOI 10.2196/53971

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