Mobile app for positive psychology intervention to enhance smoking cessation outcomes - Cigarette smoking is the leading cause of mortality in the U.S., resulting in over 480,000 deaths every
year and costing more than $300 billion in loss of productivity. Smoking is also the leading cause of cancer and
of deaths from cancer. Smoking causes cancers of the lung, larynx, mouth, bladder, liver, kidney, colon,
rectum and others. While smoking rates in the U.S. have declined over recent years to 16.8%, decreases in
smoking rates have been relatively slow since 1990, and the problem of relapse remains a major obstacle to
reducing smoking prevalence. Only about 4% of those attempting to quit on their own and 15 to 25% of those
involved in intensive cessation treatments remain abstinent as long as one year. Thus, the development of
innovative and efficacious behavioral and pharmacological approaches to smoking cessation treatment
remains a significant public health priority.
Tobacco quitlines are the major vehicle through which smoking cessation services are delivered in the
U.S and are available in every U.S. state via a national quitline portal, 1-800-QUIT-NOW. Quitline counseling,
for smokers initiating calls to quitlines, has impressive odds ratios of 1.20 to 1.66 in the latest Cochrane meta-
analysis, however, the actual quit rates from the meta-analysis ranged only from 5% to 14%, or 21% when
NRT was offered. Calls for new methods of improving tobacco quitline outcomes are clearly warranted.
Within the field of behavioral psychology, positive psychology has been a burgeoning area of research
that may provide valuable and innovative directions for improving on behavioral smoking cessation treatments.
Our investigative team recently developed and tested a smoking cessation treatment that incorporates training
in positive psychology intervention strategies, which resulted in significantly higher odds of smoking abstinence
across 26 weeks of follow-up compared to standard behavioral treatment. These promising findings suggest
that providing tobacco quitline users with training and practice in the use of positive psychology skills during
the course of their quitline engagement may increase smoking cessation outcomes relative to standard quitline
use. Tobacco quitlines would derive significant benefit from such an adjunctive psychosocial approach for their
clients. While issues of feasibility limit the use of this approach in a standard delivery method, its use in the
form of a mobile application (app) holds significant promise.
The aims of this Phase I application are to employ user centered design processes to develop and test
the acceptability and efficacy of a mobile health app, pQuit, which will incorporate intervention strategies from
the field of positive psychology vs. a relaxation app, Breathe2Relax in a small randomized controlled trial of
adult smokers. All participants will receive tobacco quitline counseling. The expected outcome of this project is
the development of a prototype of pQuit, which can readied for Phase II testing of clinical efficacy in a future
randomized controlled trial in conjunction with tobacco quitline counseling.
