scholarly journals Initial Assessment of a Comprehensive Digital Smoking Cessation Program That Incorporates a Mobile App, Breath Sensor, and Coaching: Cohort Study

10.2196/12609 ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. e12609 ◽  
Author(s):  
Jennifer D Marler ◽  
Craig A Fujii ◽  
David S Utley ◽  
Lydia J Tesfamariam ◽  
Joseph A Galanko ◽  
...  
2020 ◽  
Author(s):  
Jennifer D Marler ◽  
Craig A Fujii ◽  
Joseph A Galanko ◽  
Daniel J Balbierz ◽  
David S Utley

BACKGROUND Despite decreasing prevalence over the last several decades, cigarette smoking remains the leading cause of preventable death and disease, underscoring the need for innovative, effective solutions. Pivot is a novel, inclusive smoking cessation program designed for smokers along the entire spectrum of readiness to quit. Pivot leverages proven methods and technological advancements, including a personal portable breath carbon monoxide sensor, smartphone app, and in-app text-based coaching. We previously reported outcomes from the end of active Pivot program participation in 319 adult smokers. Herein, we report longer-term follow up in this cohort. OBJECTIVE The aim of this study was to assess and report participant outcomes 3 months after completion of Pivot, including smoking behavior, quit rates, continuous abstinence rates and durability, and predictors of abstinence. METHODS This prospective remote cohort study included US-based cigarette smokers aged 18 to 65 years who smoked ≥5 cigarettes per day (CPD). Three months after completion of active participation in Pivot, final follow-up data were collected via an online questionnaire. Outcomes included smoking behavior (CPD and quit attempts), self-reported quit rates (7- and 30-day point prevalence abstinence [PPA]), and continuous abstinence rates (proportion who achieved uninterrupted abstinence) and duration. Exploratory regression analyses were performed to identify baseline characteristics associated with achievement of 7-day PPA, 30-day PPA, and continuous abstinence. RESULTS A total of 319 participants completed onboarding (intention-to-treat [ITT]); 288/319 participants (90.3%) completed follow up (completers) at a mean of 7.2 (SD 1.2) months after onboarding. At final follow up, CPD were reduced by 52.6% (SE 2.1; <i>P</i>&lt;.001) among all 319 participants, and most completers (152/288, 52.8%) reduced their CPD by at least 50%. Overall, most completers (232/288, 80.6%) made at least one quit attempt. Quit rates increased after the end of Pivot; using ITT analyses, 35.4% (113/319) achieved 7-day PPA and 31.3% (100/319) achieved 30-day PPA at final follow up compared with 32.0% (102/319) and 27.6% (88/319), respectively, at the end of the Pivot program. Continuous abstinence was achieved in about a quarter of those who onboarded (76/319, 23.8%) and in most who reported 30-day PPA at the end of Pivot (76/88, 86.4%), with a mean abstinence duration of 5.8 (SD 0.6) months. In exploratory regression analyses, lower baseline CPD, more positive baseline attitudes reflecting higher self-efficacy (higher confidence to quit and lower perceived difficulty of quitting), and higher education were associated with achieving abstinence. CONCLUSIONS This study provides the first longer-term outcomes of the Pivot smoking cessation program. At final follow up, quit rates increased and continuous abstinence was favorable; the majority who achieved abstinence at the end of Pivot sustained abstinence throughout follow up. Decreases in CPD persisted and most participants made a quit attempt. Overall, final follow-up outcomes were stable or improved when compared to previous outcomes from the end of the program. These findings validate earlier results, and suggest that Pivot is an effective and durable solution for smoking cessation. CLINICALTRIAL ClinicalTrials.gov NCT03295643; https://clinicaltrials.gov/ct2/show/NCT03295643


2018 ◽  
Author(s):  
Jennifer D Marler ◽  
Craig A Fujii ◽  
David S Utley ◽  
Lydia J Tesfamariam ◽  
Joseph A Galanko ◽  
...  

BACKGROUND Cigarette smoking is the leading cause of preventable morbidity and mortality, excess health care expenditure, and lost work productivity. Otherwise effective evidence-based treatments have had limited success owing to challenges with access, engagement, and scale. Pivot is a comprehensive digital smoking cessation program that incorporates a Food and Drug Administration–cleared carbon monoxide breath sensor, smartphone app, and text-based human coaching. OBJECTIVE This initial evaluation of Pivot aimed to assess participant engagement, changes in attitudes toward quitting, and changes in smoking behavior. METHODS US cigarette smokers aged 18 to 65 years who smoked ≥5 cigarettes per day (CPD) were recruited online. Participants completed a screening call, electronic informed consent, registration, and onboarding before beginning Pivot. Pivot includes 5 sequential stages (Explore, Build, Mobilize, Quit, and Secure), taking 14.5 to 18.5 weeks to complete. Data were collected via app and online questionnaires. Outcomes included engagement and retention (ie, weeks of active engagement and Pivot stage progression); attitudes toward quitting (ie, quit readiness, quit confidence, and expected difficulty maintaining quit); and smoking behavior (ie, quit attempts, cigarette reduction, and abstinence (7- and 30-day point prevalence abstinence [PPA]). RESULTS A total of 319 participants completed onboarding (intention-to-treat [ITT] sample); 272/319 participants (85.3%) completed the end-of-Pivot questionnaire (study completer sample). Most (212/319, 66.5%) were not ready to quit in the next 30 days at baseline. On average, participants actively engaged in the program for a mean 12.4 (SD 7.1) weeks. Pivot stage completion rates were Explore: 88.7% (283/319), Build: 57.4% (183/319), Mobilize: 43.6% (139/319), Quit: 41.1% (131/319), and Secure: 39.5% (126/319). Repeated measures linear mixed model analyses demonstrated positive changes in attitudes from baseline to Mobilize (pre-Quit): increased confidence to quit (4.2 to 7.4, P<.001) and decreased expected difficulty maintaining quit (3.1 to 6.8, P<.001). The quit attempt rate (ie, those making ≥1 quit attempt lasting ≥1 day) was 79.4% (216/272, completer). At the end of Pivot, 7-day PPA rates were 32.0% (102/319, ITT) and 37.5% (102/272, completer); 30-day PPA rates were 27.6% (88/319, ITT) and 32.4% (88/272, completer). Moreover, 30-day PPA rates were comparable among those ready and not ready to quit in the next 30 days at baseline. Of those not achieving abstinence, 25.9% (44/170, completer) achieved ≥50% reduction in CPD by study end. CONCLUSIONS This study evaluated Pivot’s initial performance with comparable quit rates among those ready and not ready to quit in the next 30 days at entry. The present data, considered with the program’s accessibility, innovation, evidence-based foundation, and design for all smokers, suggest Pivot has the potential to address limitations of reach and scale and thereby advance smoking cessation efforts. CLINICALTRIAL ClinicalTrials.gov NCT03295643; https://clinicaltrials.gov/ct2/show/NCT03295643 (Archived by WebCite at http://www.webcitation.org/75TiNe6BE).


10.2196/25578 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e25578
Author(s):  
Jennifer D Marler ◽  
Craig A Fujii ◽  
Joseph A Galanko ◽  
Daniel J Balbierz ◽  
David S Utley

Background Despite decreasing prevalence over the last several decades, cigarette smoking remains the leading cause of preventable death and disease, underscoring the need for innovative, effective solutions. Pivot is a novel, inclusive smoking cessation program designed for smokers along the entire spectrum of readiness to quit. Pivot leverages proven methods and technological advancements, including a personal portable breath carbon monoxide sensor, smartphone app, and in-app text-based coaching. We previously reported outcomes from the end of active Pivot program participation in 319 adult smokers. Herein, we report longer-term follow up in this cohort. Objective The aim of this study was to assess and report participant outcomes 3 months after completion of Pivot, including smoking behavior, quit rates, continuous abstinence rates and durability, and predictors of abstinence. Methods This prospective remote cohort study included US-based cigarette smokers aged 18 to 65 years who smoked ≥5 cigarettes per day (CPD). Three months after completion of active participation in Pivot, final follow-up data were collected via an online questionnaire. Outcomes included smoking behavior (CPD and quit attempts), self-reported quit rates (7- and 30-day point prevalence abstinence [PPA]), and continuous abstinence rates (proportion who achieved uninterrupted abstinence) and duration. Exploratory regression analyses were performed to identify baseline characteristics associated with achievement of 7-day PPA, 30-day PPA, and continuous abstinence. Results A total of 319 participants completed onboarding (intention-to-treat [ITT]); 288/319 participants (90.3%) completed follow up (completers) at a mean of 7.2 (SD 1.2) months after onboarding. At final follow up, CPD were reduced by 52.6% (SE 2.1; P<.001) among all 319 participants, and most completers (152/288, 52.8%) reduced their CPD by at least 50%. Overall, most completers (232/288, 80.6%) made at least one quit attempt. Quit rates increased after the end of Pivot; using ITT analyses, 35.4% (113/319) achieved 7-day PPA and 31.3% (100/319) achieved 30-day PPA at final follow up compared with 32.0% (102/319) and 27.6% (88/319), respectively, at the end of the Pivot program. Continuous abstinence was achieved in about a quarter of those who onboarded (76/319, 23.8%) and in most who reported 30-day PPA at the end of Pivot (76/88, 86.4%), with a mean abstinence duration of 5.8 (SD 0.6) months. In exploratory regression analyses, lower baseline CPD, more positive baseline attitudes reflecting higher self-efficacy (higher confidence to quit and lower perceived difficulty of quitting), and higher education were associated with achieving abstinence. Conclusions This study provides the first longer-term outcomes of the Pivot smoking cessation program. At final follow up, quit rates increased and continuous abstinence was favorable; the majority who achieved abstinence at the end of Pivot sustained abstinence throughout follow up. Decreases in CPD persisted and most participants made a quit attempt. Overall, final follow-up outcomes were stable or improved when compared to previous outcomes from the end of the program. These findings validate earlier results, and suggest that Pivot is an effective and durable solution for smoking cessation. Trial Registration ClinicalTrials.gov NCT03295643; https://clinicaltrials.gov/ct2/show/NCT03295643


2020 ◽  
Author(s):  
Marc Pifarre ◽  
Jordi Vilaplana ◽  
Francesc Solsona ◽  
Francesc Abella ◽  
Rui Alves ◽  
...  

BACKGROUND Many mobile apps have been made to quit smoking. Many do not have the support of specialists, and often are apps for self-guidance. There is no record of any study looking at the apps' adherence to patient treatments from hospitals, and therefore it is not known for sure if they serve to increase the adherence of treatments. OBJECTIVE Analyzing and evaluating the adherence of using a mobile app (TControl) on a smoking cessation program. METHODS TControl, an app to follow up and assist smoke-free patients. 197 patients to measure the effectiveness of the app for decreasing the number of relapses were analysed. RESULTS Actually, the difference between those using TControl is the number of relapses (7.7%), which is much lower than among those not using it (33.9%), and which could retain considerably more patients on the program than the conventional treatment. CONCLUSIONS TControl increased adherence in a smoke-quitting program. However, no correlation between adherence and success was found.


Pflege ◽  
2003 ◽  
Vol 16 (5) ◽  
pp. 283-288 ◽  
Author(s):  
Jacqueline Voggensperger ◽  
Dunja Nicca ◽  
Battegay ◽  
Zellweger ◽  
Spirig

Das Zigarettenrauchen stellt für viele Menschen ein gesundheitliches Problem mit weitreichenden Folgen dar. Da das Rauchen für Patienten und Patientinnen der HIV-Sprechstunde am Universitätsspital Basel, Schweiz, ebenfalls ein großes Problem ist, konnte ein auf Evidenz basierendes Rauchstopp-Programm entwickelt werden. Dieses Programm stützt sich auf die zwei in der Literatur beschriebenen, erfolgreichen Interventionen; die Pharmakotherapie und die Beratung. Bei der Beratung steht der Dialog mit den Betroffenen und deren Empowerment im Zentrum. Das Rauchstopp-Programm beinhaltet eine Kurzintervention, eine allgemeine Raucherberatung und eine mehrteilige Einzelberatung. Da Raucherberatungen in der Schweiz bislang beinahe ausschließlich von Ärztinnen und Ärzten durchgeführt wurden und keine deutschsprachigen Publikationen von Pflegenden in diesem Gebiet existieren, beabsichtigt dieser Artikel, Pflegenden ein Konzept zur Raucherberatung anzubieten. Unsere ersten Praxiserfahrungen zeigen, dass insbesondere die Kombination bestehend aus pflegerischer und ärztlicher Langzeitbetreuung und Nikotinsubstitution eine wirksame interdisziplinäre Intervention darstellen könnte.


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