NCT03069482

Brief Summary

Quitting smoking has important health benefits for people with serious mental illness, more than half of whom are smokers. Smoking reductions in this population, in turn, could contribute to saving billions of dollars in healthcare expenditures. Finding ways to deliver more effective and wider reaching smoking cessation interventions to individuals with serious mental illness is a pressing priority. Smartphone apps are a wide reaching technology that could provide a viable platform to deliver smoking cessation interventions for individuals with serious mental illness. However, do smoking cessation apps need to be tailored for people with serious mental illness to ensure their success? Or can providers simply use standard and freely available smoking cessation mobile health treatments designed for the general population? Furthermore, is it feasible to conduct mHealth trials in this population? Therefore, this trial will test whether (1) a tailored smoking cessation app for people with serious mental illness results in higher levels of engagement with smoking cessation content as compared to an app designed for the general population and (2) smoking cessation mHealth trials can be feasibly conducted in this population.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
63

participants targeted

Target at P75+ for phase_1

Timeline
Completed

Started May 2017

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 22, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

March 3, 2017

Completed
2 months until next milestone

Study Start

First participant enrolled

May 15, 2017

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 17, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 17, 2019

Completed
1.2 years until next milestone

Results Posted

Study results publicly available

March 23, 2020

Completed
Last Updated

November 10, 2020

Status Verified

October 1, 2020

Enrollment Period

1.7 years

First QC Date

February 22, 2017

Results QC Date

January 17, 2020

Last Update Submit

October 21, 2020

Conditions

Keywords

SmokingmHealthSerious Mental IllnessAcceptance and Commitment TherapyUS DHHS Clinical Practice Guidelines

Outcome Measures

Primary Outcomes (10)

  • Days of App Use

    Frequency of app openings in each group

    Daily throughout study duration, 4 months

  • Duration of App Use

    Mean duration of app use in each group over the course of study participation (4 months)

    Daily throughout study duration, 4 months

  • Feasibility as Measured by Study Accrual Relative to Recruitment Goal

    Percent of subjects consented into study relative to study recruitment goal (N=90).92 subjects signed consent prior to eligibility determination and randomization.

    Approximately 15 months

  • Feasibility as Measured by Study Attrition

    Number and percentage of subjects who complete 4-month follow up assessment

    4-months

  • Recruitment Yield Effort

    Percent of subjects responding to ads and clinician referrals

    Approximately 15 months

  • Feasibility of Measurement Strategy

    Percent completion of assessment measures. Assessment measures include surveys, questionnaires, and cognitive tasks.

    Approximately 19 months

  • Usability of App Design as Measured by the System Usability Scale (SUS)

    10-item scale giving a global assessment of systems usability using a 5-point Likert Scale with a composite score ranging from 0-100. Higher scores indicate higher usability rating.

    1-month follow-up

  • Usability of App Design as Measured by the System Usability Scale (SUS)

    10-item scale giving a global assessment of systems usability using a 5-point Likert Scale with a composite score ranging from 0-100. Higher scores indicate higher usability rating.

    2-month follow-up

  • Usability of App Design as Measured by the System Usability Scale (SUS)

    10-item scale giving a global assessment of systems usability using a 5-point Likert Scale with a composite score ranging from 0-100. Higher scores indicate higher usability rating.

    3-month follow-up

  • Usability of App Design as Measured by the System Usability Scale (SUS)

    10-item scale giving a global assessment of systems usability using a 5-point Likert Scale with a composite score ranging from 0-100. Higher scores indicate higher usability rating.

    4-month follow-up

Secondary Outcomes (45)

  • Biochemically Confirmed 7-day Point Prevalence Abstinence

    1 month follow-up

  • Biochemically Confirmed 7-day Point Prevalence Abstinence

    2 month follow-up

  • Biochemically Confirmed 7-day Point Prevalence Abstinence

    3 month follow-up

  • Biochemically Confirmed 7-day Point Prevalence Abstinence

    4 month follow-up

  • Biochemically Confirmed Prolonged Abstinence Rates

    1 month follow up

  • +40 more secondary outcomes

Study Arms (2)

Learn to Quit

EXPERIMENTAL

A smartphone app developed by the research team designed for people with serious mental illness, that provides Acceptance and Commitment Therapy skills to address (a) smoking cessation and (b) mental health symptoms.

Device: Learn to Quit AppDrug: Nicotine patchDrug: Nicotine lozengeBehavioral: Technical Coaching

NCI QuitGuide

ACTIVE COMPARATOR

A smartphone app developed by the National Cancer Institute which uses smoking cessation recommendations contained in the US DHHS Clinical Practice Guidelines.

Drug: Nicotine patchDrug: Nicotine lozengeBehavioral: Technical CoachingDevice: NCI QuitGuide App

Interventions

A smartphone app designed for individuals with serious mental illness. The main intervention components of the app are skills based on an intervention called Acceptance and Commitment Therapy that will (a) teach smoking cessation skills and (b) help cope with mental health symptoms. The app incorporates gaming features to keep users engaged, and a tracking component to record smoking habits and moods.

Learn to Quit

Participants enrolled in the study will be given an 8-week course of Nicotine patches. The 8-week course of trans-dermal nicotine patches starting at 21mg/24h for 4 weeks, then transitioning to 14mg/24h for 2 weeks, and finally to 7mg/24h for the last 2 weeks. This dosing will follow recommendations contained in the US DHHS Clinical Practice Guidelines.

Learn to QuitNCI QuitGuide

Each participant will be given a 1-week course of 4mg Nicotine lozenges to be taken orally as nicotine cravings arise (about 10 lozenges per day). They will be directed to use them for the week following their quit date, using no more than once every 1-2 hours. This dosing will follow recommendations contained in the US DHHS Clinical Practice Guidelines.

Learn to QuitNCI QuitGuide

Coaching to assist the user on the use of each assigned smartphone app. This coaching will be delivered by research staff following a coaching procedure. These in-person coaching meetings will be brief (\~15 minutes), done on a weekly basis for 4 weeks, and will have a focus on providing technical assistance.

Learn to QuitNCI QuitGuide

A smartphone app developed by the National Cancer Institute which uses recommendations contained in the US DHHS Clinical Practice Guidelines and smokefree.gov. NCI QuitGuide has the following intervention components: (a) psycho-education about the impact of smoking in health, (b) tracking of smoking habits, and (c) Tips for quitting (e.g., distraction strategies).

NCI QuitGuide

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ICD-10 diagnosis of schizophrenia, schizoaffective, bipolar or recurring depressive disorder
  • Smoking ≥ 5 cigarettes per day over the past 30 days
  • Desire to quit smoking in the next 30 days
  • Willing and medically eligible to use Nicotine Replacement Therapy
  • Fluent in spoken and written English
  • Working email, mailing address, or alternative contact person
  • Taking psychiatric medications as prescribed by their provider
  • Stable housing

You may not qualify if:

  • Problematic alcohol or illicit drug use in the last 30 days
  • Acute psychotic episode, unsafe to participate in the study, or psychiatrically unstable
  • Pregnant, breastfeeding, or having the intention to become pregnant in the next 4 months
  • Hearing, comprehension, or visual limitations that preclude study participation
  • Currently receiving any pharmacological and/or behavioral intervention or counseling for smoking cessation
  • Using non-cigarette forms of tobacco as the primary source of nicotine (e.g. e-cigarettes, chew)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Duke University

Durham, North Carolina, 27705, United States

Location

Related Publications (1)

  • Browne J, Halverson TF, Vilardaga R. Engagement with a digital therapeutic for smoking cessation designed for persons with psychiatric illness fully mediates smoking outcomes in a pilot randomized controlled trial. Transl Behav Med. 2021 Sep 15;11(9):1717-1725. doi: 10.1093/tbm/ibab100.

MeSH Terms

Conditions

Tobacco Use DisorderSmoking

Interventions

Tobacco Use Cessation Devices

Condition Hierarchy (Ancestors)

Substance-Related DisordersChemically-Induced DisordersMental DisordersBehavior

Intervention Hierarchy (Ancestors)

Therapeutics

Limitations and Caveats

NRT adherence measure relied on self-report. Participant stratification did not successfully balance presence of mood vs. psychotic disorders in each group. 26% of outcomes measures collected via phone or web survey due to transportation barriers.

Results Point of Contact

Title
Dr. Roger Vilardaga
Organization
Duke University Psychiatry & Behavioral Sciences

Study Officials

  • Roger Vilardaga, PhD

    Duke University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Subjects will be assigned to one of two smoking cessation apps for the duration of the study: Learn to Quit or NCI QuitGuide. One app was designed to address the needs of people with serious mental illness (Learn to Quit) and the other was designed for the general population (NCI QuitGuide).
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 22, 2017

First Posted

March 3, 2017

Study Start

May 15, 2017

Primary Completion

January 17, 2019

Study Completion

January 17, 2019

Last Updated

November 10, 2020

Results First Posted

March 23, 2020

Record last verified: 2020-10

Locations