Developing a Smartphone App With Mindfulness Training for Teen Smoking Cessation
Condition: Cigarette Smoking
Study type: Interventional

Summary: 
      The recent Surgeon General's Report calls for effective and readily available treatment
      approaches to help adolescent smokers interested in quitting. Schools are an ideal venue for
      connecting adolescent smokers with smoking cessation assistance. This study will adapt the
      Craving to Quit (C2Q) smartphone app, which integrates mindfulness training into a smoking
      cessation program, for teen smokers (C2Q-Teen). We will test how well this novel app helps
      teens stop smoking compared to another teen smoking cessation app that does not include
      mindfulness training, and to written cessation information alone. If effective, the C2Q-Teen
      would be relatively easy to disseminate widely and have tremendous public health significance
    

Detailed description: 
      The new Surgeon General's Report (SGR), Preventing Tobacco Use Among Youth and Young Adults,
      highlights the addictive nature of nicotine and emphasizes the need for effective and
      accessible cessation treatment for the more than 3.6 million youth who smoke. This proposal
      is in response to PA-13-078, Behavioral and Integrative Treatment Development Program (R34),
      which supports the development and testing of behavioral interventions targeting substance
      abuse, including studies focused on Intervention generation and refinement (Stage IA), and
      pilot or feasibility (Stage IB), and research designed to "increase implementability of
      interventions with creative use of technology". We have developed Craving to Quit (C2Q), a
      smartphone intervention for smoking cessation for adults that integrates mindfulness training
      (MT) into a smoking cessation curriculum. While MT has been shown to be efficacious for
      smoking cessation in adults, it has not been tested in adolescents. In addition,
      dissemination of MT is challenging due to the need for experienced MT therapists, high time
      demand, difficulties in scheduling sessions, and high costs of in-person treatment delivery.
      Mobile, smartphone technologies provide a promising medium for overcoming these barriers to
      dissemination. We propose to adapt and refine our existing Craving to Quit (C2Q) app for use
      by adolescent smokers (Stage IA), and to conduct feasibility and pilot testing (Stage IB) in
      preparation for an R01 application to definitively test efficacy and probe psychological
      mechanisms of change resulting from MT. In the pilot test, six public high schools will be
      randomly assigned to one of three conditions, two schools per condition: (1) C2Q-Teen app
      (smoking cessation delivered through a smartphone app via MT), (2) NCI's QuitSTART app
      designed for teen smokers (NCI-QS) (smoking cessation delivered through a smartphone app
      without MT), or (3) written smoking cessation materials only (MO). One hundred forty four
      adolescent smokers interested in quitting will be recruited (24/school, 48/condition). School
      nurses will introduce the three interventions in the school setting. Our first primary aim is
      to adapt the C2Q app for use by adolescent smokers (C2Q-Teen). Our second primary aim is to
      evaluate the feasibility and acceptability of the interventions to ensure adequacy of each
      intervention for a larger RCT designed specifically to compare efficacy rates. Secondary aims
      are to assess relative efficacy of the three interventions and independent contributions of
      smartphone intervention delivery and mindfulness in increasing cotinine-validated 7-day point
      prevalence abstinence at 3- and 6-month follow-up in order to adequately power a larger
      trial, and to determine the relationship between C2Q-Teen usage and abstinence. If eventually
      found to be effective, C2Q-Teen offers an innovative and potentially powerful intervention
      for supporting teens in their efforts to quit that would be relatively easy to disseminate
      widely and have tremendous public health significance, addressing the SGR's call for readily
      available treatment for adolescent smokers wanting to quit
    

Intervention name(s): C2Q-Teen app; NCI's QuitSTART app; Written smoking cessation materials only
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Commit to Quit (C2Q)-Teen app provides smoking cessation assistance incorporating mindfulness training.; NCI's smoking cessation app; Receipt of written smoking cessation materials
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Prevention