Stephenson Cancer Center Researchers Examine Risk Factors Surrounding Tobacco Cessation Attempts

Can smartphone apps become a front line treatment for smoking cessation? Michael Businelle, PhD, a researcher at the Oklahoma Tobacco Research Center (OTRC), part of the Stephenson Cancer Center, and Matthew Koslovsky, PhD, recent graduate from the University of Texas School of Public Health, are using smartphone technology to better understand the risk factors that lead individuals to smoke again and using that information to develop digital solutions that may help prevent relapse.

“Previous studies have shown that many things such as stress, urge to smoke, and exposure to others smoking can cause a person to relapse after they quit smoking,” said Businelle, who is also director of the Mobile Health (mHealth) Shared Resource at the Oklahoma Tobacco Research Center.

“This study dug deeper to examine the environmental, cognitive, and behavioral factors that predict imminent smoking relapse during the early phase of a smoking cessation attempt.”

Participants completed phone-based surveys multiple times a day for 14 days, beginning one week prior to a quit attempt through one week after. Surveys asked about multiple variables that have been linked to smoking, including:

• Environment (access to cigarettes, proximity to other smokers, etc.)
• Cognitions (urge to smoke, stress levels, motivation, etc.)
• Behavior (recent smoking and alcohol consumption)
• Mood/Affect (happiness, sadness, restlessness, etc.)

Study findings indicated complex relationships between these variables and smoking lapse. For example, having easy access to cigarettes was related to smoking every day during the quit attempt, experiencing a high negative mood was related to smoking one day after the quit date, and the relationship between alcohol use and smoking became significant four days into the quit attempt.

Businelle is using these research findings to determine what intervention content should be delivered to smokers during each day of their quit attempt.

“Our smartphone apps can now recognize common factors in an individual’s environment and behaviors that may trigger smoking, and we can automatically send tailored video via text messages in the moments when ex-smokers need it most. This type of tailored and targeted intervention could reduce relapses,” said Businelle.

“The low success rates of quitting demands that we look for new and more innovative ways to eliminate the habit,” said Darla Kendzor, PhD, director of the Tobacco Treatment Research Program at the OTRC and a co-author on this study. “By better understanding the situations and environments that influence relapse, we can leverage technology to help individuals take action to avoid a relapse.”

Mobile technologies like the ones developed in this study have the potential to advance the science related to smoking and radically transform how individuals quit tobacco, as well as other unhealthy behaviors. OTRC research studies and continued program development are made possible through support from the Oklahoma Tobacco Settlement Endowment Trust (TSET).

Even within low socioeconomic and rural populations, smartphones are easily accessible, within arm’s reach of their owners for 90 percent of waking hours. Historically, this population has had significant barriers in accessing traditional smoking cessation counseling (i.e., transportation, time, money). Smartphones can reduce these barriers by offering highly-tailored content to users with the touch of a button, at a fraction of the cost and resources.

This study, entitled “The time-varying relations between risk factors and smoking before and after a quit attempt,” was recently published online ahead of print in the journal, Nicotine and Tobacco Research.