Using the Social-Local-Mobile App for Smoking Cessation in the SmokeFreeBrain Project: Protocol for a Randomized Controlled Trial

Francisco Jódar-Sánchez, Laura Carrasco Hernández, Francisco J Núñez-Benjumea, Marco Antonio Mesa González, Jesús Moreno Conde, Carlos Luis Parra Calderón, Luis Fernandez-Luque, Santiago Hors-Fraile, Anton Civit, Panagiotis Bamidis, Francisco Ortega-Ruiz, Francisco Jódar-Sánchez, Laura Carrasco Hernández, Francisco J Núñez-Benjumea, Marco Antonio Mesa González, Jesús Moreno Conde, Carlos Luis Parra Calderón, Luis Fernandez-Luque, Santiago Hors-Fraile, Anton Civit, Panagiotis Bamidis, Francisco Ortega-Ruiz

Abstract

Background: Smoking is considered the main cause of preventable illness and early deaths worldwide. The treatment usually prescribed to people who wish to quit smoking is a multidisciplinary intervention, combining both psychological advice and pharmacological therapy, since the application of both strategies significantly increases the chance of success in a quit attempt.

Objective: We present a study protocol of a 12-month randomized open-label parallel-group trial whose primary objective is to analyze the efficacy and efficiency of usual psychopharmacological therapy plus the Social-Local-Mobile app (intervention group) applied to the smoking cessation process compared with usual psychopharmacological therapy alone (control group).

Methods: The target population consists of adult smokers (both male and female) attending the Smoking Cessation Unit at Virgen del Rocío University Hospital, Seville, Spain. Social-Local-Mobile is an innovative intervention based on mobile technologies and their capacity to trigger behavioral changes. The app is a complement to pharmacological therapies to quit smoking by providing personalized motivational messages, physical activity monitoring, lifestyle advice, and distractions (minigames) to help overcome cravings. Usual pharmacological therapy consists of bupropion (Zyntabac 150 mg) or varenicline (Champix 0.5 mg or 1 mg). The main outcomes will be (1) the smoking abstinence rate at 1 year measured by means of exhaled carbon monoxide and urinary cotinine tests, and (2) the result of the cost-effectiveness analysis, which will be expressed in terms of an incremental cost-effectiveness ratio. Secondary outcome measures will be (1) analysis of the safety of pharmacological therapy, (2) analysis of the health-related quality of life of patients, and (3) monitoring of healthy lifestyle and physical exercise habits.

Results: Of 548 patients identified using the hospital's electronic records system, we excluded 308 patients: 188 declined to participate and 120 did not meet the inclusion criteria. A total of 240 patients were enrolled: the control group (n=120) will receive usual psychopharmacological therapy, while the intervention group (n=120) will receive usual psychopharmacological therapy plus the So-Lo-Mo app. The project was approved for funding in June 2015. Enrollment started in October 2016 and was completed in October 2017. Data gathering was completed in November 2018, and data analysis is under way. The first results are expected to be submitted for publication in early 2019.

Conclusions: Social networks and mobile technologies influence our daily lives and, therefore, may influence our smoking habits as well. As part of the SmokeFreeBrain H2020 European Commission project, this study aims at elucidating the potential role of these technologies when used as an extra aid to quit smoking.

Trial registration: ClinicalTrials.gov NCT03553173; https://ichgcp.net/clinical-trials-registry/NCT03553173 (Archived by WebCite at http://www.webcitation.org/74DuHypOW).

International registered report identifier (irrid): PRR1-10.2196/12464.

Keywords: economic evaluation; mobile applications; randomized controlled trial; smoking cessation.

Conflict of interest statement

Conflicts of Interest: None declared.

©Francisco Jódar-Sánchez, Laura Carrasco Hernández, Francisco J Núñez-Benjumea, Marco Antonio Mesa González, Jesús Moreno Conde, Carlos Luis Parra Calderón, Luis Fernandez-Luque, Santiago Hors-Fraile, Anton Civit, Panagiotis Bamidis, Francisco Ortega-Ruiz. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 06.12.2018.

Figures

Figure 1
Figure 1
Sections of the app that address how to resist cravings.
Figure 2
Figure 2
Information subsets and follow-up schedule to record in the study clinical database. HRQoL: health-related quality of life; S1-S8: sessions 1-8.
Figure 3
Figure 3
Flow diagram of the randomized open-label parallel-group trial of the Social-Local-Mobile (So-Lo-Mo) app.

References

    1. World Health Organization . WHO Global Report: Mortality Attributable to Tobacco. Geneva, Switzerland: WHO; 2012. [2018-11-27].
    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442. doi: 10.1371/journal.pmed.0030442.
    1. World Health Organization . WHO Report on the Global Tobacco Epidemic 2008: The MPOWER Package. Geneva, Switzerland: WHO; 2008. [2018-11-27].
    1. World Health Organization . WHO Global Report on Trends in Prevalence of Tobacco Smoking 2015. Geneva, Switzerland: WHO; 2015. [2018-11-27]. .
    1. Instituto Nacional de Estadística Consumo de tabaco según sexo y grupo de edad. Población de 15 y más años. Spanish National Health Survey. 2017. [2018-11-28]. .
    1. Mesa-Cruz P, Amo-Alfonso M, Aranda-Regules J, Blanco-Aguilar J, Caballero-López G, Daponte-Codina A, Escalera-de-Andrés C, Expósito-Álvarez J, García-León J, González-Villalba A, Gutiérrez-Palomino M, Lara-García L, Lavado-Pérez C, López-Pérez P, Mateos-Vilches P, Moreno-Medina C, Muela-Tudela T, Otero-Chuliá E, Redondo-Écija J, Romero-Palacios P, Ruiz-Domínguez F, Sánchez-Fernández F, Torró-García-Morato C, Vellisco-García A, Villegas-Portero R. Comprehensive tobacco action plan for Andalusia 2005-2010. Seville, Spain: Andalusian Public Health System; 2005. [2018-11-27]. .
    1. Cahill K, Stevens S, Lancaster T. Pharmacological treatments for smoking cessation. JAMA. 2014 Jan 08;311(2):193–4. doi: 10.1001/jama.2013.283787.
    1. Hébert ET, Stevens EM, Frank SG, Kendzor DE, Wetter DW, Zvolensky MJ, Buckner JD, Businelle MS. An ecological momentary intervention for smoking cessation: the associations of just-in-time, tailored messages with lapse risk factors. Addict Behav. 2018 Mar;78:30–35. doi: 10.1016/j.addbeh.2017.10.026.
    1. Chakraborty B, Maiti R, Strecher VJ. The effectiveness of web-based tailored smoking cessation interventions on the quitting process (Project Quit): secondary analysis of a randomized controlled trial. J Med Internet Res. 2018 Jun 20;20(6):e213. doi: 10.2196/jmir.9555.
    1. Augustson E, Cole-Lewis H, Sanders A, Schwarz M, Geng Y, Coa K, Hunt Y. Analysing user-reported data for enhancement of SmokefreeTXT: a national text message smoking cessation intervention. Tob Control. 2017 Nov;26(6):683–689. doi: 10.1136/tobaccocontrol-2016-052945.
    1. Whittaker R, McRobbie H, Bullen C, Rodgers A, Gu Y. Mobile phone-based interventions for smoking cessation. Cochrane Database Syst Rev. 2016;4:CD006611. doi: 10.1002/14651858.CD006611.pub4.
    1. Lanza ST, Vasilenko SA, Liu X, Li R, Piper ME. Advancing the understanding of craving during smoking cessation attempts: a demonstration of the time-varying effect model. Nicotine Tob Res. 2014 May;16 Suppl 2:S127–34. doi: 10.1093/ntr/ntt128.
    1. Shiffman SM, Jarvik ME. Smoking withdrawal symptoms in two weeks of abstinence. Psychopharmacology (Berl) 1976 Oct 20;50(1):35–9.
    1. Ussher MH, Taylor AH, Faulkner GEJ. Exercise interventions for smoking cessation. Cochrane Database Syst Rev. 2014 Aug 29;(8):CD002295. doi: 10.1002/14651858.CD002295.pub5.
    1. King D, Greaves F, Exeter C, Darzi A. 'Gamification': influencing health behaviours with games. J R Soc Med. 2013 Mar;106(3):76–8. doi: 10.1177/0141076813480996.
    1. Bamidis PD, Paraskevopoulos E, Konstantinidis E, Spachos D, Billis A. Multimodal e-health services for smoking cessation and public health: the SmokeFreeBrain project approach. Stud Health Technol Inform. 2017;245:5–9.
    1. Bamidis P. When neuroscience and information technology met smoking cessation: the birth of the SmokeFreeBrain project. Int J Bioelectromagnetism. 2018;20 (forthcoming)
    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.
    1. Richmond RL, Kehoe LA, Webster IW. Multivariate models for predicting abstention following intervention to stop smoking by general practitioners. Addiction. 1993 Aug;88(8):1127–35.
    1. Stead LF, Carroll AJ, Lancaster T. Group behaviour therapy programmes for smoking cessation. Cochrane Database Syst Rev. 2017 Dec 31;3:CD001007. doi: 10.1002/14651858.CD001007.pub3.
    1. Prochaska JO. Transtheoretical model of behavior change. In: Gellman MD, Turner JR, editors. Encyclopedia of Behavioral Medicine. New York, NY: Springer; 2013.
    1. Hors-Fraile S, Núñez-Benjumea FJ, Carrasco-Hernández L, Ortega-Ruiz F, Fernández-Luque L. Design of two combined health recommender systems for tailoring messages in a smoking cessation app. [2018-11-27]. .
    1. Pearce MS, Hayes L, Newcastle Heart Project. Newcastle Thousand Families Study Self-reported smoking status and exhaled carbon monoxide: results from two population-based epidemiologic studies in the North of England. Chest. 2005 Sep;128(3):1233–8. doi: 10.1378/chest.128.3.1233.
    1. Pérez-Trullén A, Bartomeu C, Barrueco M, Herrero I, Jiménez-Ruiz C. Nuevas perspectivas en el diagnóstico y evolución en el consumo de tabaco: marcadores de exposición. Prev Tabaquismo. 2006;8(4):164–73.
    1. Husereau D, Drummond M, Petrou S, Carswell C, Moher D, Greenberg D, Augustovski F, Briggs AH, Mauskopf J, Loder E, CHEERS Task Force Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Value Health. 2013;16(2):e1–5. doi: 10.1016/j.jval.2013.02.010.
    1. Drummond MF, Schulpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods For The Economic Evaluation Of Health Care Programmes (Oxford Medical Publications) Oxford, UK: Oxford University Press; 2018. p. 978.
    1. Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) Qual Life Res. 2011 Dec;20(10):1727–36. doi: 10.1007/s11136-011-9903-x.
    1. Ramos-Goñi JM, Craig BM, Oppe M, Ramallo-Fariña Y, Pinto-Prades JL, Luo N, Rivero-Arias O. Handling data quality issues to estimate the Spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 2018 Dec;21(5):596–604. doi: 10.1016/j.jval.2017.10.023.
    1. Spanish Agency of Medicines and Medical Devices Ficha técnica Champix 0,5 mg comprimidos recubiertos con pelicula. [2018-11-27]. .
    1. Spanish Agency of Medicines and Medical Devices Ficha técnica Zyntabac 150 mg comprimidos de liberacion prolongada. [2018-11-27]. .
    1. Alonso J, Prieto L, Antó JM. [The Spanish version of the SF-36 Health Survey (the SF-36 health questionnaire): an instrument for measuring clinical results] Med Clin (Barc) 1995 May 27;104(20):771–6.
    1. Booth M. Assessment of physical activity: an international perspective. Res Q Exerc Sport. 2000 Jun;71(2 Suppl):S114–20.
    1. Cavelaars M, Rousseau J, Parlayan C, de Ridder S, Verburg A, Ross R, Visser G, Rotte A, Azevedo R, Boiten J, Meijer GA, Belien JAM, Verheul H. OpenClinica. J Clin Bioinformatics. 2015;5(Suppl 1):S2. doi: 10.1186/2043-9113-5-S1-S2.
    1. West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority. Thorax. 2000 Dec;55(12):987–99.
    1. Bartlett YK, Sheeran P, Hawley MS. Effective behaviour change techniques in smoking cessation interventions for people with chronic obstructive pulmonary disease: a meta-analysis. Br J Health Psychol. 2014 Feb;19(1):181–203. doi: 10.1111/bjhp.12071. doi: 10.1111/bjhp.12071.
    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):1457–1464. doi: 10.15585/mmwr.mm6552a1. doi: 10.15585/mmwr.mm6552a1.
    1. Cahill K, Lindson-Hawley N, Thomas KH, Fanshawe TR, Lancaster T. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev. 2016 May 09;(5):CD006103. doi: 10.1002/14651858.CD006103.pub7.
    1. Haskins BL, Lesperance D, Gibbons P, Boudreaux ED. A systematic review of smartphone applications for smoking cessation. Transl Behav Med. 2017 Jun;7(2):292–299. doi: 10.1007/s13142-017-0492-2.
    1. Hors-Fraile S, Schneider F, Fernandez-Luque L, Luna-Perejon F, Civit A, Spachos D, Bamidis P, de Vries H. Tailoring motivational health messages for smoking cessation using an mHealth recommender system integrated with an electronic health record: a study protocol. BMC Public Health. 2018 Jun 05;18(1):698. doi: 10.1186/s12889-018-5612-5.
    1. Stronks K, van de Mheen HD, Looman CW, Mackenbach JP. Cultural, material, and psychosocial correlates of the socioeconomic gradient in smoking behavior among adults. Prev Med. 1997;26(5 Pt 1):754–66. doi: 10.1006/pmed.1997.0174.
    1. Tucker MR, Kivell BM, Laugesen M, Grace RC. Changes to smoking habits and addiction following tobacco excise tax increases: a comparison of Māori, Pacific and New Zealand European smokers. Aust N Z J Public Health. 2017 Feb;41(1):92–98. doi: 10.1111/1753-6405.12603.
    1. Syed Abdul S. Mobile Motivational Messages for Change (3M4Chan) intervention in TMU. ; 2018. May 30, [2018-11-27]. .
    1. Hors-Fraile S, Rivera-Romero O, Schneider F, Fernandez-Luque L, Luna-Perejon F, Civit-Balcells A, de Vries H. Analyzing recommender systems for health promotion using a multidisciplinary taxonomy: a scoping review. Int J Med Inform. 2018 Jun;114:143–155. doi: 10.1016/j.ijmedinf.2017.12.018.
    1. Lindson-Hawley N, Hartmann-Boyce J, Fanshawe TR, Begh R, Farley A, Lancaster T. Interventions to reduce harm from continued tobacco use. Cochrane Database Syst Rev. 2016 Oct 13;10:CD005231. doi: 10.1002/14651858.CD005231.pub3.
    1. StatCounter Global Stats Mobile operating system market share Spain. 2017. .

Source: PubMed

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