In a significant breakthrough for public health, a smartphone app developed by researchers at the University of Oklahoma (OU) has been shown to double the quit rates among low-income smokers. The findings, published today in JAMA Network Open, highlight the potential of technology to address health disparities in smoking cessation.
Smoking rates in the United States have seen a dramatic decline over the past six decades. However, the habit remains prevalent among individuals with low incomes, contributing to persistent health inequalities. The OU clinical trial compared two tobacco cessation apps: the innovative Smart-T and the more traditional QuitGuide, a product of the National Cancer Institute.
Comparing Smart-T and QuitGuide
Smart-T, crafted by OU researchers, is designed to provide real-time, personalized support by assessing users’ risk of smoking throughout the day. It delivers tailored messages based on users’ experiences and conditions. In contrast, QuitGuide offers static features, allowing users to track cravings and access general tips for resisting the urge to smoke.
After six months, participants using Smart-T were nearly twice as likely to quit smoking compared to those using QuitGuide. “Smart-T is like having a tobacco cessation counselor in your pocket,” said Dr. Emily Hébert, the study’s lead author and a member of the TSET Health Promotion Research Center at OU Health Stephenson Cancer Center. “Our motivation is to make the app comparable to standard counseling treatments.”
The Clinical Trial: Methodology and Results
The trial enrolled 454 low-income smokers from across the United States, randomly assigning half to use Smart-T and the other half QuitGuide. Smart-T users received up to five daily prompts to input data about their smoking urges, exposure to other smokers, stress levels, mood, and other variables. The app’s algorithm then generated a risk score and provided customized advice, such as suggesting breathing exercises or nicotine replacement therapy.
“Not only were Smart-T users significantly more likely to quit smoking after six months compared to those using the QuitGuide app, but they also found it more helpful and were more likely to request additional nicotine therapy,” said Hébert.
Participants’ smoking status was verified using a device connected to their phones, measuring carbon monoxide levels in their breath. Facial recognition software ensured the accuracy of the test by confirming the participant’s identity.
Implications for Public Health
This trial is among the first to use mobile apps for biochemical verification of smoking cessation. Dr. Hébert emphasized the importance of such technology, stating, “Low-cost and always-available smartphone interventions could provide a convenient way for low-income adults to quit smoking.”
The success of Smart-T suggests a promising direction for public health initiatives aimed at reducing smoking rates among disadvantaged populations. The app’s ability to offer personalized, real-time support addresses barriers such as transportation and scheduling that often prevent individuals from accessing traditional counseling.
Future Directions and Research
Looking ahead, researchers plan to expand the study to larger groups across the United States and extend follow-up periods beyond six months. “We’re really trying to find the best recipe for smoking cessation for everyone,” Hébert noted.
The development of Smart-T is part of a broader effort by the TSET Health Promotion Research Center, a leader in mobile health technology. The app was created by Dr. Michael Businelle, who co-leads the next phase of research with Hébert. Businelle also directs the mHealth Shared Resource, which launched the Insight™ mHealth Platform to develop and test technology-based interventions.
This research received support from the National Cancer Institute and other organizations, underscoring the collaborative effort to tackle smoking-related health disparities. The publication, “Just-in-Time Adaptive Intervention for Smoking Cessation in Low-Income Adults,” is available in JAMA Network Open.
As the fight against smoking continues, innovations like Smart-T offer hope for more equitable health outcomes and demonstrate the power of technology in public health.
