Mindfulness-Based Smoking Cessation Delivered Through Telehealth and Text Messaging for Low-Income Smokers: Protocol for a Randomized Controlled Trial

Claire A Spears, Josephine Mhende, China Hawkins, Vuong Van Do, Matthew J Hayat, Michael P Eriksen, Donald Hedeker, Lorien C Abroms, David W Wetter, Claire A Spears, Josephine Mhende, China Hawkins, Vuong Van Do, Matthew J Hayat, Michael P Eriksen, Donald Hedeker, Lorien C Abroms, David W Wetter

Abstract

Background: Tobacco use is the leading cause of preventable morbidity and mortality. Adults with low income and members of certain racial and ethnic minority groups are less likely to quit, and therefore, they experience profound tobacco-related health disparities. Mindfulness training can increase the rates of smoking cessation and lapse recovery, and telehealth and SMS text messaging have the potential to provide more accessible treatment.

Objective: This study aims to test the efficacy of delivering mindfulness-based smoking cessation treatment through text messaging (iQuit Mindfully) and telehealth (group videoconferencing), both as stand-alone interventions and in combination. In addition, it aims to examine the underlying mechanisms of mindfulness treatment.

Methods: In this 2×2 randomized controlled trial, participants are randomized into 1 of 4 groups based on assignment to iQuit Mindfully text messages (yes or no) and mindfulness videoconference groups (yes or no). The primary outcomes are biochemically verified smoking abstinence at 8, 12, and 24 weeks after the start of treatment. Secondary outcomes include the frequency of home mindfulness practice and self-reported levels of mindfulness, emotions, craving, withdrawal, dependence, self-efficacy, and social support.

Results: Recruitment, treatment, and assessment began in spring and summer 2021, and data collection is expected to continue through spring 2024.

Conclusions: This project aims to improve smoking cessation outcomes for low-income, racially and ethnically diverse smokers through mindfulness-based telehealth group counseling and text messaging support. We also aim to advance the scientific study of the mechanisms of action of mindfulness treatment, which could inform the development of more efficacious and efficient treatments to reduce tobacco disparities.

Trial registration: Clinicaltrials.gov NCT04965181; https://ichgcp.net/clinical-trials-registry/NCT04965181.

International registered report identifier (irrid): PRR1-10.2196/35688.

Keywords: SMS text messaging; health disparities; mHealth; mindfulness; mobile health; mobile phone; smoking cessation; telehealth; tobacco.

Conflict of interest statement

Conflicts of Interest: LCA receives royalties from the sale of Text2Quit, a text messaging smoking cessation program.

©Claire A Spears, Josephine Mhende, China Hawkins, Vuong Van Do, Matthew J Hayat, Michael P Eriksen, Donald Hedeker, Lorien C Abroms, David W Wetter. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 01.08.2022.

References

    1. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health . The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA, USA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2014.
    1. U.S. National Cancer Institute . A Socioecological Approach to Addressing Tobacco-Related Health Disparities. National Cancer Institute Tobacco Control Monograph 22. NIH Publication No. 17-CA-8035A. Bethesda, MD, USA: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017.
    1. O'Keefe EB, Meltzer JP, Bethea TN. Health disparities and cancer: racial disparities in cancer mortality in the United States, 2000-2010. Front Public Health. 2015 Apr 15;3:51. doi: 10.3389/fpubh.2015.00051. doi: 10.3389/fpubh.2015.00051.
    1. Ryan BM. Lung cancer health disparities. Carcinogenesis. 2018 May 28;39(6):741–51. doi: 10.1093/carcin/bgy047. 4935154
    1. Gallaway MS, Henley SJ, Steele CB, Momin B, Thomas CC, Jamal A, Trivers KF, Singh SD, Stewart SL. Surveillance for cancers associated with tobacco use - United States, 2010-2014. MMWR Surveill Summ. 2018 Nov 02;67(12):1–42. doi: 10.15585/mmwr.ss6712a1.
    1. Jamal A, Phillips E, Gentzke AS, Homa DM, Babb SD, King BA, Neff LJ. Current cigarette smoking among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018 Jan 19;67(2):53–9. doi: 10.15585/mmwr.mm6702a1. doi: 10.15585/mmwr.mm6702a1.
    1. Villanti AC, Jiang Y, Abrams DB, Pyenson BS. A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PLoS One. 2013 Aug 7;8(8):e71379. doi: 10.1371/journal.pone.0071379. PONE-D-12-36382
    1. Tanner NT, Kanodra NM, Gebregziabher M, Payne E, Halbert CH, Warren GW, Egede LE, Silvestri GA. The association between smoking abstinence and mortality in the national lung screening trial. Am J Respir Crit Care Med. 2016 Mar 01;193(5):534–41. doi: 10.1164/rccm.201507-1420OC.
    1. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting smoking among adults - United States, 2000-2015. MMWR Morb Mortal Wkly Rep. 2017 Jan 06;65(52):1457–64. doi: 10.15585/mmwr.mm6552a1. doi: 10.15585/mmwr.mm6552a1.
    1. Brewer JA, Mallik S, Babuscio TA, Nich C, Johnson HE, Deleone CM, Minnix-Cotton CA, Byrne SA, Kober H, Weinstein AJ, Carroll KM, Rounsaville BJ. Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug Alcohol Depend. 2011 Dec 01;119(1-2):72–80. doi: 10.1016/j.drugalcdep.2011.05.027. S0376-8716(11)00253-5
    1. Vidrine JI, Spears CA, Heppner WL, Reitzel LR, Marcus MT, Cinciripini PM, Waters AJ, Li Y, Nguyen NT, Cao Y, Tindle HA, Fine M, Safranek LV, Wetter DW. Efficacy of mindfulness-based addiction treatment (MBAT) for smoking cessation and lapse recovery: a randomized clinical trial. J Consult Clin Psychol. 2016 Sep;84(9):824–38. doi: 10.1037/ccp0000117. 2016-25468-001
    1. Oikonomou MT, Arvanitis M, Sokolove RL. Mindfulness training for smoking cessation: a meta-analysis of randomized-controlled trials. J Health Psychol. 2017 Dec;22(14):1841–50. doi: 10.1177/1359105316637667.1359105316637667
    1. Brewer JA, Elwafi HM, Davis JH. Craving to quit: psychological models and neurobiological mechanisms of mindfulness training as treatment for addictions. Psychol Addict Behav. 2013 Jun;27(2):366–79. doi: 10.1037/a0028490. 2012-13670-001
    1. Davis JM, Goldberg SB, Anderson MC, Manley AR, Smith SS, Baker TB. Randomized trial on mindfulness training for smokers targeted to a disadvantaged population. Subst Use Misuse. 2014 Apr;49(5):571–85. doi: 10.3109/10826084.2013.770025.
    1. Witkiewitz K, Greenfield BL, Bowen S. Mindfulness-based relapse prevention with racial and ethnic minority women. Addict Behav. 2013 Dec;38(12):2821–4. doi: 10.1016/j.addbeh.2013.08.018. S0306-4603(13)00233-5
    1. Cambron C, Hopkins P, Burningham C, Lam C, Cinciripini P, Wetter DW. Socioeconomic status, mindfulness, and momentary associations between stress and smoking lapse during a quit attempt. Drug Alcohol Depend. 2020 Apr 01;209:107840. doi: 10.1016/j.drugalcdep.2020.107840. S0376-8716(20)30005-3
    1. Spears CA, Houchins SC, Bamatter WP, Barrueco S, Hoover DS, Perskaudas R. Perceptions of mindfulness in a low-income, primarily African American treatment-seeking sample. Mindfulness (N Y) 2017 Dec;8(6):1532–43. doi: 10.1007/s12671-017-0720-3.
    1. Kabat-Zinn J. Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. New York, NY, USA: Delacorte Press; 1990.
    1. Segal ZV, Williams JM, Teasdale JD. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York, NY, USA: The Guilford Press; 2002.
    1. Moulton-Perkins A, Moulton D, Cavanagh K, Jozavi A, Strauss C. Systematic review of mindfulness-based cognitive therapy and mindfulness-based stress reduction via group videoconferencing: feasibility, acceptability, safety, and efficacy. J Psychother Integr. 2022 Mar;32(1):110–30. doi: 10.1037/int0000216.
    1. Sommers-Spijkerman M, Austin J, Bohlmeijer E, Pots W. New evidence in the booming field of online mindfulness: an updated meta-analysis of randomized controlled trials. JMIR Ment Health. 2021 Jul 19;8(7):e28168. doi: 10.2196/28168. v8i7e28168
    1. Davis JM, Manley AR, Goldberg SB, Stankevitz KA, Smith SS. Mindfulness training for smokers via Web-based video instruction with phone support: a prospective observational study. BMC Complement Altern Med. 2015 Mar 29;15:95. doi: 10.1186/s12906-015-0618-3. 10.1186/s12906-015-0618-3
    1. Garrison KA, Pal P, O'Malley SS, Pittman BP, Gueorguieva R, Rojiani R, Scheinost D, Dallery J, Brewer JA. Craving to quit: a randomized controlled trial of smartphone app-based mindfulness training for smoking cessation. Nicotine Tob Res. 2020 Mar 16;22(3):324–31. doi: 10.1093/ntr/nty126. 5039853
    1. Minami H, Brinkman HR, Nahvi S, Arnsten JH, Rivera-Mindt M, Wetter DW, Bloom EL, Price LH, Vieira C, Donnelly R, McClain LM, Kennedy KA, D'Aquila E, Fine M, McCarthy DE, Graham Thomas J, Hecht J, Brown RA. Rationale, design and pilot feasibility results of a smartphone-assisted, mindfulness-based intervention for smokers with mood disorders: project mSMART MIND. Contemp Clin Trials. 2018 Mar;66:36–44. doi: 10.1016/j.cct.2017.12.014. S1551-7144(17)30512-8
    1. Mhende J, Bell SA, Cottrell-Daniels C, Luong J, Streiff M, Dannenfelser M, Hayat MJ, Spears CA. Mobile delivery of mindfulness-based smoking cessation treatment among low-income adults during the COVID-19 pandemic: pilot randomized controlled trial. JMIR Form Res. 2021 Jul 23;5(7):e25926. doi: 10.2196/25926. v5i7e25926
    1. Lloyd A, White R, Eames C, Crane R. The utility of home-practice in mindfulness-based group interventions: a systematic review. Mindfulness (N Y) 2018;9(3):673–92. doi: 10.1007/s12671-017-0813-z. 813
    1. Cambron C, Lam CY, Cinciripini P, Li L, Wetter DW. Socioeconomic status, social context, and smoking lapse during a quit attempt: an ecological momentary assessment study. Ann Behav Med. 2020 Feb 21;54(3):141–50. doi: 10.1093/abm/kaz034. 5587079
    1. Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y, Dobson R. Mobile phone text messaging and app-based interventions for smoking cessation. Cochrane Database Syst Rev. 2019 Oct 22;10(10):CD006611. doi: 10.1002/14651858.CD006611.pub5.
    1. Spears CA, Abroms LC, Glass CR, Hedeker D, Eriksen MP, Cottrell-Daniels C, Tran BQ, Wetter DW. Mindfulness-based smoking cessation enhanced with mobile technology (iQuit Mindfully): pilot randomized controlled trial. JMIR Mhealth Uhealth. 2019 Jun 24;7(6):e13059. doi: 10.2196/13059. v7i6e13059
    1. Spears CA, Bell SA, Scarlett CA, Anderson NK, Cottrell-Daniels C, Lotfalian S, Bandlamudi M, Grant A, Sigurdardottir A, Carter BP, Abroms LC, Wetter DW. Text messaging to enhance mindfulness-based smoking cessation treatment: program development through qualitative research. JMIR Mhealth Uhealth. 2019 Jan 07;7(1):e11246. doi: 10.2196/11246. v7i1e11246
    1. Davidson RJ. Mindfulness-based cognitive therapy and the prevention of depressive relapse: measures, mechanisms, and mediators. JAMA Psychiatry. 2016 Jun 01;73(6):547–8. doi: 10.1001/jamapsychiatry.2016.0135.2517513
    1. Witkiewitz K, Bowen S, Harrop EN, Douglas H, Enkema M, Sedgwick C. Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models and hypothesized mechanisms of change. Subst Use Misuse. 2014 Apr;49(5):513–24. doi: 10.3109/10826084.2014.891845.
    1. Li W, Howard MO, Garland EL, McGovern P, Lazar M. Mindfulness treatment for substance misuse: a systematic review and meta-analysis. J Subst Abuse Treat. 2017 Apr;75:62–96. doi: 10.1016/j.jsat.2017.01.008.S0740-5472(16)30240-9
    1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. 2nd edition. Englewood Cliffs, NJ, USA: Prentice-Hall; 1986.
    1. Witkiewitz K, Marlatt GA. Relapse prevention for alcohol and drug problems: that was Zen, this is Tao. Am Psychol. 2004;59(4):224–35. doi: 10.1037/0003-066X.59.4.224.2004-14303-002
    1. Spears CA, Hedeker D, Li L, Wu C, Anderson NK, Houchins SC, Vinci C, Hoover DS, Vidrine JI, Cinciripini PM, Waters AJ, Wetter DW. Mechanisms underlying mindfulness-based addiction treatment versus cognitive behavioral therapy and usual care for smoking cessation. J Consult Clin Psychol. 2017 Nov;85(11):1029–40. doi: 10.1037/ccp0000229. 2017-27624-001
    1. Heppner WL, Spears CA, Correa-Fernández V, Castro Y, Li Y, Guo B, Reitzel LR, Vidrine JI, Mazas CA, Cofta-Woerpel L, Cinciripini PM, Ahluwalia JS, Wetter DW. Dispositional mindfulness predicts enhanced smoking cessation and smoking lapse recovery. Ann Behav Med. 2016 Jun;50(3):337–47. doi: 10.1007/s12160-015-9759-3. 10.1007/s12160-015-9759-3
    1. Spears CA, Houchins SC, Stewart DW, Chen M, Correa-Fernández V, Cano MÁ, Heppner WL, Vidrine JI, Wetter DW. Nonjudging facet of mindfulness predicts enhanced smoking cessation in Hispanics. Psychol Addict Behav. 2015 Dec;29(4):918–23. doi: 10.1037/adb0000087. 2015-20853-001
    1. Baker TB, Piper ME, McCarthy DE, Majeskie MR, Fiore MC. Addiction motivation reformulated: an affective processing model of negative reinforcement. Psychol Rev. 2004 Jan;111(1):33–51. doi: 10.1037/0033-295X.111.1.33.2004-10332-002
    1. Gotink RA, Chu P, Busschbach JJ, Benson H, Fricchione GL, Hunink MG. Standardised mindfulness-based interventions in healthcare: an overview of systematic reviews and meta-analyses of RCTs. PLoS One. 2015 Apr 16;10(4):e0124344. Retracted in: PloS One. April 12, 2019. doi: 10.1371/journal.pone.0215608. doi: 10.1371/journal.pone.0124344. PONE-D-14-43410
    1. Garland EL, Fredrickson B, Kring AM, Johnson DP, Meyer PS, Penn DL. Upward spirals of positive emotions counter downward spirals of negativity: insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clin Psychol Rev. 2010 Nov;30(7):849–64. doi: 10.1016/j.cpr.2010.03.002. S0272-7358(10)00042-5
    1. Vinci C, Li L, Wu C, Lam CY, Guo L, Correa-Fernández V, Spears CA, Hoover DS, Etcheverry PE, Wetter DW. The association of positive emotion and first smoking lapse: an ecological momentary assessment study. Health Psychol. 2017 Nov;36(11):1038–46. doi: 10.1037/hea0000535. 2017-31607-001
    1. Bowen S, Marlatt A. Surfing the urge: brief mindfulness-based intervention for college student smokers. Psychol Addict Behav. 2009 Dec;23(4):666–71. doi: 10.1037/a0017127.2009-24023-012
    1. Adams CE, Cano MA, Heppner WL, Stewart DW, Correa-Fernández V, Vidrine JI, Li Y, Cinciripini PM, Ahluwalia JS, Wetter DW. Testing a moderated mediation model of mindfulness, psychosocial stress, and alcohol use among African American smokers. Mindfulness (N Y) 2015 Apr;6(2):315–25. doi: 10.1007/s12671-013-0263-1.
    1. Elwafi HM, Witkiewitz K, Mallik S, Thornhill 4th TA, Brewer JA. Mindfulness training for smoking cessation: moderation of the relationship between craving and cigarette use. Drug Alcohol Depend. 2013 Jun 01;130(1-3):222–9. doi: 10.1016/j.drugalcdep.2012.11.015. S0376-8716(12)00456-5
    1. Ockene JK, Emmons KM, Mermelstein RJ, Perkins KA, Bonollo DS, Voorhees CC, Hollis JF. Relapse and maintenance issues for smoking cessation. Health Psychol. 2000 Jan;19(1S):17–31. doi: 10.1037/0278-6133.19.suppl1.17.
    1. McCarthy DE, Piasecki TM, Jorenby DE, Lawrence DL, Shiffman S, Baker TB. A multi-level analysis of non-significant counseling effects in a randomized smoking cessation trial. Addiction. 2010 Dec;105(12):2195–208. doi: 10.1111/j.1360-0443.2010.03089.x.
    1. Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008 Aug;35(2):158–76. doi: 10.1016/j.amepre.2008.04.009. S0749-3797(08)00332-2
    1. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003 Nov;41(11):1284–92. doi: 10.1097/01.MLR.0000093487.78664.3C.
    1. Gossop M, Darke S, Griffiths P, Hando J, Powis B, Hall W, Strang J. The Severity of Dependence Scale (SDS): psychometric properties of the SDS in English and Australian samples of heroin, cocaine and amphetamine users. Addiction. 1995 May;90(5):607–14. doi: 10.1046/j.1360-0443.1995.9056072.x.
    1. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991 Sep;86(9):1119–27. doi: 10.1111/j.1360-0443.1991.tb01879.x.
    1. Kozlowski LT, Porter CQ, Orleans CT, Pope MA, Heatherton T. Predicting smoking cessation with self-reported measures of nicotine dependence: FTQ, FTND, and HSI. Drug Alcohol Depend. 1994 Feb;34(3):211–6. doi: 10.1016/0376-8716(94)90158-9.0376-8716(94)90158-9
    1. Piper ME, Bullen C, Krishnan-Sarin S, Rigotti NA, Steinberg ML, Streck JM, Joseph AM. Defining and measuring abstinence in clinical trials of smoking cessation interventions: an updated review. Nicotine Tob Res. 2020 Jun 12;22(7):1098–106. doi: 10.1093/ntr/ntz110.5528135
    1. Smith SS, Piper ME, Bolt DM, Fiore MC, Wetter DW, Cinciripini PM, Baker TB. Development of the brief Wisconsin inventory of smoking dependence motives. Nicotine Tob Res. 2010 May;12(5):489–99. doi: 10.1093/ntr/ntq032. ntq032
    1. Welsch SK, Smith SS, Wetter DW, Jorenby DE, Fiore MC, Baker TB. Development and validation of the Wisconsin Smoking Withdrawal Scale. Exp Clin Psychopharmacol. 1999 Nov;7(4):354–61. doi: 10.1037//1064-1297.7.4.354.
    1. Condiotte MM, Lichtenstein E. Self-efficacy and relapse in smoking cessation programs. J Consult Clin Psychol. 1981 Oct;49(5):648–58. doi: 10.1037//0022-006x.49.5.648.
    1. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003 Apr;84(4):822–48. doi: 10.1037/0022-3514.84.4.822.
    1. Baer RA, Smith GT, Hopkins J, Krietemeyer J, Toney L. Using self-report assessment methods to explore facets of mindfulness. Assessment. 2006 Mar;13(1):27–45. doi: 10.1177/1073191105283504.13/1/27
    1. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011;18(3):250–5. doi: 10.1002/cpp.702.
    1. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385–96.
    1. Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063–70. doi: 10.1037//0022-3514.54.6.1063.
    1. Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990;55(3-4):610–7. doi: 10.1080/00223891.1990.9674095.
    1. MacKenzie KR. The clinical application of a group climate measure. In: Dies RR, MacKenzie KR, editors. Adances in Group Psychotherapy: Integrating Research and Practice. New York, NY, USA: International Universities Press; 1983. pp. 159–70.
    1. Hoeppner BB, Hoeppner SS, Abroms LC. How do text-messaging smoking cessation interventions confer benefit? A multiple mediation analysis of Text2Quit. Addiction. 2017 Apr;112(4):673–82. doi: 10.1111/add.13685.
    1. Goldberg JH, Kiernan M. Innovative techniques to address retention in a behavioral weight-loss trial. Health Educ Res. 2005 Aug;20(4):439–47. doi: 10.1093/her/cyg139.cyg139
    1. Diggle PJ, Heagerty P, Liang KY, Zeger SL. Analysis of Longitudinal Data. 2nd edition. Oxford, UK: Oxford University Press; 2002.
    1. Semega JL, Fontenot KR, Kollar MA. U.S. Census Bureau. Washington, DC, USA: U.S. Department of Commerce, Economics and Statisitics Administration; 2017. Sep, [2022-07-12]. Income and Poverty in the United States: 2016 – Current Population Reports. .
    1. Poverty Thresholds. U.S. Census Bureau. 2022. [2022-07-12]. .
    1. O'Rourke HP, MacKinnon DP. Reasons for testing mediation in the absence of an intervention effect: a research imperative in prevention and intervention research. J Stud Alcohol Drugs. 2018 Mar;79(2):171–81. doi: 10.15288/jsad.2018.79.171.
    1. Jahng S, Wood PK, Trull TJ. Analysis of affective instability in ecological momentary assessment: indices using successive difference and group comparison via multilevel modeling. Psychol Methods. 2008 Dec;13(4):354–75. doi: 10.1037/a0014173.2008-17368-004
    1. Preacher KJ, Rucker DD, Hayes AF. Addressing moderated mediation hypotheses: theory, methods, and prescriptions. Multivariate Behav Res. 2007;42(1):185–227. doi: 10.1080/00273170701341316.
    1. Kline RB. Principles and Practice of Structural Equation Modeling. 3rd edition. New York, NY, USA: The Guilford Press; 2011.
    1. Siddique J, Harel O, Crespi CM, Hedeker D. Binary variable multiple-model multiple imputation to address missing data mechanism uncertainty: application to a smoking cessation trial. Stat Med. 2014 Jul 30;33(17):3013–28. doi: 10.1002/sim.6137.
    1. Sprybrook J, Bloom H, Congdon R, Hill CL, Martinez A, Raudenbush SW. Optimal Design Plus Empirical Evidence: Documentation for the 'Optimal Design'. Optimal Design Software. 2011. [2022-07-12]. .
    1. Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2016 Apr 10;4(4):CD006611. doi: 10.1002/14651858.CD006611.pub4.
    1. Peto R. Clinical trial methodology. Biomedicine. 1978;28(Special Issue):24–36.
    1. Friedman LM, Furberg CD, DeMets DL, Reboussin DM, Granger CB. Fundamentals of Clinical Trials. 5th edition. New York, NY, USA: Springer; 2015.
    1. Fritz MS, Mackinnon DP. Required sample size to detect the mediated effect. Psychol Sci. 2007 Mar;18(3):233–9. doi: 10.1111/j.1467-9280.2007.01882.x. PSCI1882

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