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Introduction: Tobacco smoking is the leading cause of preventable disease, disability, and premature death in the United States. Recent advances have led to two efficacious mobile health (mHealth) treatments for smoking cessation: iCanQuit, an Acceptance and Commitment Therapy-based behavioral treatment promoting cessation through accepting triggers and committing to values; and Motiv8, a contingency management intervention promoting smoking cessation with financial incentives via biochemically verified abstinence. This study will evaluate the comparative effectiveness of the Florida Quitline, iCanQuit alone, and iCanQuit+Motiv8 in a pragmatic trial among patients who smoke in underserved primary care settings.
Methods: The study will be an individually-randomized controlled trial with three arms (Florida Quitline, iCanQuit alone, iCanQuit+Motiv8 combined) conducted in multiple primary care practices affiliated with the OneFlorida+ Clinical Research Consortium. Adult patients who smoke will be randomized to one of the 3 study arms (n = 444/arm), stratified by healthcare setting (academic vs. community). The primary outcome will be 7-day point prevalence smoking abstinence at 6 months post-randomization. Secondary outcomes will be 12-month smoking abstinence, patient satisfaction with the interventions, and changes in patient quality of life and self-efficacy. The study will also assess how and for whom the interventions help sub-group patients in achieving smoking abstinence by measuring theory-derived factors that mediate smoking outcome-specific baseline moderators.
Conclusions: Results from this study will provide evidence for the comparative effectiveness of mHealth smoking cessation interventions in healthcare settings. Use of mHealth interventions can make smoking cessation resources more equitably accessible and have far-reaching impact on community and population health.
Trial Registration: ClinicalTrials.gov, NCT05415761, Registered 13 June 2022.
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http://dx.doi.org/10.1016/j.cct.2023.107120 | DOI Listing |
J Thorac Oncol
August 2025
Department of Radiation Medicine, Markey Cancer Center, University of Kentucky, Lexington, Kentucky.
Introduction: Cigarette smoking negatively affects lung cancer prognosis. Incorporating smoking history into stage-stratified survival analyses may improve prognostication.
Methods: Using the International Association for the Study of Lung Cancer ninth edition NSCLC database, we evaluated the association between smoking status at diagnosis and overall survival (OS) using Kaplan-Meier plots and multivariate Cox proportional hazard regression models adjusted for age, region, sex, histologic type, performance status, and TNM stage.
BMJ Public Health
August 2025
School of Population Health, The University of Auckland, Auckland, New Zealand.
Introduction: Illicit tobacco poses a significant challenge to public health efforts. New Zealand (NZ) stands out for its stringent tobacco control policies, but there are concerns that the size of the illicit market could grow. Estimating the extent of the illicit tobacco trade in NZ remains challenging due to the diverse methodologies used by various stakeholders over different years.
View Article and Find Full Text PDFBMJ Public Health
August 2025
Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
Objectives: There are large and growing communities of Chinese, Vietnamese and Arab populations within many high-income countries, including Australia. These populations experience disproportionately higher rates of tobacco smoking. Cessation strategies are required that acknowledge the cultural factors shaping smoking behaviours.
View Article and Find Full Text PDFCureus
August 2025
Sports Medicine, University of Colorado School of Medicine, Denver, USA.
The current electronic cigarette (e-cigarette) format was made known to the public in recent decades. Since then, it has gained widespread popularity, particularly among adolescents. A significant portion of young people in the United States and around the world are reported to use e-cigarettes.
View Article and Find Full Text PDFCureus
August 2025
Public Health, High Institute of Public Health, Alexandria University, Alexandria, EGY.
Background: Smoking cigarettes is increasingly becoming a strong focus of concern for public health in Saudi Arabia, especially with the rise in mental health disorders. This research explores how depression, anxiety, and stress are related to the level of dependence on nicotine.
Methods: This cross-sectional study involved 310 adult smokers and utilized face-to-face interviews to collect data on participants' sociodemographic and lifestyle factors, nicotine dependence through the Fagerstrom Test of Nicotine Dependence (FTND), and mental health status using a validated Arabic version of the short form of the Depression Anxiety Stress Scales (DASS-21).