An Innovative Digitally-Delivered Olfactory Method for Reducing Cigarette Cravings and Supporting Smoking Cessation - ABSTRACT
Cigarette smoking is the leading cause of preventable death and disability in the United States. Smoking cessation
rates have stagnated in recent years, underscoring the need for innovative, accessible methods to support
cessation. Emerging neurobiological and behavioral research indicate that the intentional sniffing of olfactory stimuli
(OS) can fundamentally alter emotional states and reduce cigarette craving. Yet, no work has evaluated the
potential for OS as an adjunctive intervention to facilitate successful smoking cessation. The proposed project aims
to refine and test a novel biobehavioral smoking cessation intervention that integrates the strategic application of
OS to reduce cigarette craving with an established smartphone-based smoking cessation application. Our
previously published work indicated that OS can relieve cigarette craving, and our recent pilot data showed that
these effects may hold in the natural environment to help smokers resist smoking. This work provides the rationale
for conducting the proposed clinical trial. Still, research is needed to determine the precise methodology for OS
administration in the context of a smoking cessation attempt and to preliminarily evaluate the potential of OS when
integrated with an established phone-based smoking cessation app before conducting a full-scale R01 smoking
cessation trial. Building on our prior work, the current proposal aims to (1) refine the design and methodology for our
novel, first-generation olfactory stimulation delivery system (OSDS; Phase I), and (2) determine the adjunctive benefit
of the OSDS when integrated with a smartphone-based smoking cessation application (Smart-T; Phase II). This trial
integrates theory-driven basic research derived from three disciplines independently related to smoking, but not
jointly examined in the context of applied smoking research (olfaction, emotion, and cognition). Phase I will consist
of a crossover, micro-randomized controlled trial in which treatment-seeking smokers (N=32) will receive the
nicotine patch and engage in a self-guided quit attempt for 14 days. During the 14-day trial, participants will use our
OSDS daily and complete daily ecological momentary assessments (EMAs). Phase I participants will complete a
qualitative interview and quantitative survey at the end of the trial. Phase II will consist of a randomized controlled
trial, in which participants (N = 100) will be randomized to our smartphone app for smoking cessation (Smart-T) with
nicotine patch or the Smart-T app with nicotine patch and OSDS as an adjunctive feature (Smart-T+O). Participants
will complete a baseline assessment, daily EMAs for 13 weeks (1-week pre-quit and 12-week post-quit), and a
follow-up assessment at 12 weeks post-quit via the app. The proposed project will provide vital data to refine a
protocol for assessing a phone-based cigarette smoking intervention that integrates an OS approach to craving
relief. Accordingly, it will provide the data needed to successfully conduct a full-scale clinical trial evaluating this
novel approach to smoking cessation. Irrespective of the outcome, the proposed research will advance knowledge
regarding the integration of OS-based craving relief with a mobile health approach to smoking cessation.
