NCT07089901

Brief Summary

Tobacco use is a chronic relapsing condition. That is, even with state-of-the-art treatment, \>70% of smoking cessation attempts end in a return to regular smoking. Research demonstrates that everyday environments associated with smoking trigger craving for cigarettes, provoke smoking, and lead to relapse. However, despite this knowledge, understanding of environmental correlates of smoking has been limited by a reliance on self-report, leading to imprecise information about the physical environments in which people live. To overcome this challenge, the research team has pioneered the development of digital envirotyping, which uses digital tools (e.g., sensors, cameras, artificial intelligence) to efficiently and accurately characterize and categorize environments with the goal of identifying environmental markers of behavior and health. Foundational to the digital envirotyping research is computer vision (CV), a type of artificial intelligence (AI) that enables computer systems to recognize objects and scenes in digital images, mimicking how humans perceive and understand visual information. With CV researchers can extract detailed and accurate information (i.e., objects and location types) about the everyday environments of people who smoke (PWS) and relate that information to smoking behavior. After validating the use of CV, the researchers used CV to develop enviromarkers of relapse risk. Importantly, they identified a novel enviromarker in which people at greater risk for relapse when they quit are exposed to a more consistent level of environment-related smoking risk as they move between their smoking and nonsmoking environments. Research is now needed to advance digital envirotyping and enviromarker development in the field of tobacco addiction. The study will recruit a diverse, national sample of n=500 adults who are interested in quitting smoking. For two weeks prior to quitting, they will undergo photoEMA in which they will take two pictures of their current environment when they smoke, and randomly 10 times per day resulting in \>300,000 images total. Cessation will be supported by nicotine replacement therapy (i.e., nicotine patch). The primary clinical outcome will be days to relapse. Specific aims are to (1) further develop, refine, and validate methods for efficient digital envirotyping at scale, (2) leverage CV and AI approaches to develop enviromarkers of smoking relapse, and (3) conduct analyses to increase understanding of environmental smoking risk in women and individuals with low socioeconomic status.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
600

participants targeted

Target at P75+ for phase_4

Timeline
47mo left

Started May 2026

Longer than P75 for phase_4

Geographic Reach
1 country

1 active site

Status
recruiting

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

Study Progress3%
May 2026Mar 2030

First Submitted

Initial submission to the registry

July 22, 2025

Completed
6 days until next milestone

First Posted

Study publicly available on registry

July 28, 2025

Completed
9 months until next milestone

Study Start

First participant enrolled

May 6, 2026

Completed
3.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2030

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2030

Last Updated

May 12, 2026

Status Verified

May 1, 2026

Enrollment Period

3.9 years

First QC Date

July 22, 2025

Last Update Submit

May 11, 2026

Conditions

Outcome Measures

Primary Outcomes (1)

  • Average number of days to smoking relapse

    Participants will self-report smoking from quit date to the 6-month follow-up visit. Days to relapse will be defined as the first of seven consecutive days of smoking.

    From quit date to 6-month follow-up (about 6.5 months)

Secondary Outcomes (3)

  • Number of participants who self-report 7-day point prevalence abstinence

    1-month follow-up (around 1.5 months after beginning treatment)

  • Number of participants who self-report 7-day point prevalence abstinence

    3-month follow-up (around 3.5 months after beginning treatment)

  • Number of participants who self-report 7-day point prevalence abstinence

    6-month follow-up (around 6.5 months after beginning treatment)

Study Arms (1)

study group

EXPERIMENTAL

All participants will receive transdermal nicotine replacement therapy.

Drug: transdermal nicotine replacement therapy

Interventions

All participants will receive transdermal nicotine replacement therapy (21 mg. patches)

Also known as: NRT, nicotine patch
study group

Eligibility Criteria

Age21 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • years of age or older;
  • Smoke ≥ 10 cigarettes/day of a brand delivering 0.5 mg nicotine (FTC method);
  • Smoking daily for ≥ 2 years, with a stable smoking pattern for the past 6 months;
  • Intention to quit smoking and set a target quit date in the next 1 month;
  • Have an iPhone or Android smartphone capable of running the photoEMA and iCO software

You may not qualify if:

  • Pregnant, breastfeeding, or planning to become pregnant during the course of the study;
  • Currently in smoking cessation treatment or current use of smoking cessation products;
  • Regular use (i.e. \>9 days/month) of non-cigarette nicotine-containing products (e.g. cigarillos, e-cigarettes);
  • Anticipating major life changes (e.g. new job, birth of a child) during the course of the study;
  • Unstable medical conditions;
  • Contraindication for nicotine replacement therapy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Duke University Medical Center

Durham, North Carolina, 27706, United States

RECRUITING

MeSH Terms

Conditions

Smoking

Interventions

Nicotine Replacement TherapyTobacco Use Cessation Devices

Condition Hierarchy (Ancestors)

Behavior

Intervention Hierarchy (Ancestors)

Drug TherapyTherapeutics

Study Officials

  • Francis J. McClernon, PhD

    Duke University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Laura Van Althuis, MHA

CONTACT

Francis J. McClernon, PhD

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
NA
Masking
NONE
Purpose
OTHER
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 22, 2025

First Posted

July 28, 2025

Study Start

May 6, 2026

Primary Completion (Estimated)

March 31, 2030

Study Completion (Estimated)

March 31, 2030

Last Updated

May 12, 2026

Record last verified: 2026-05

Data Sharing

IPD Sharing
Will share

We anticipate depositing the research data with the digital repository of the Inter-university Consortium for Political and Social Research (ICPSR), which supports NIDA-funded data sharing and restricted data access. Data will include photos, ecological momentary assessment data, breath CO readings, and survey data. Each data set will be made available along with the corresponding study protocol and codebook. The codebook will include a basic description of the variable, how and when it was collected, and relevant references or scoring information.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Data will be made available one year after study completion, and will continue as long as the study is open for data analysis.

Locations