Craving to Quit is a mobile application (app) that promotes smoking cessation using mindfulness training and ecological momentary assessment (EMA).
Craving to Quit delivers 22 daily mindfulness training modules along with multiple daily EMAs to promote smoking cessation. New users are asked to set a quit date 3 weeks from program initiation. Each day of the intervention, a new mindfulness module becomes available. Modules use multimedia to teach users mindfulness meditation practices, including body scan, loving kindness, and breath awareness. When participants report a craving, they are given the option to complete a Recognize, Accept, Investigate, and Note (RAIN) exercise to cope with the craving in real time or a “smoking mindfully” exercise. Four bonus modules become available throughout the intervention period to support intervention content. Users are prompted to complete EMAs at 6 random times per day that assess current activity, awareness of and investment in current activity, current mood, nicotine craving, and recent smoking behavior. Additional Craving to Quit features include smoking activity tracking, social forums, a personal activity feed (i.e. log of activity on the app), nightly reflections on daily smoking behavior, reminders to complete app activities, and a personalized quit agreement.
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Young Adults (18-30)
Craving to Quit: A randomized controlled trial of smartphone app-based mindfulness training for smoking cessation
Garrison KA, Pal P, O’Malley SS, et al. Nicotine and Tobacco Research. 2018. doi: 10.1093/ntr/nty126
Summary: Researchers recruited 325 adults who smoked at least 5 cigarettes per day and were motivated to quit and randomized them to receive Craving to Quit (n=143) plus experience sampling or experience sampling only (n=182). The EMAs app for the control group had a similar look and feel to Craving to Quit. In addition to the 6 daily EMAs during the intervention period, participants completed assessments of smoking, nicotine craving strength and frequency, and mindfulness at baseline and 1, 3, and 6 months post-intervention. Participants reporting 1-week point prevalence abstinence at 6 months were sent a breath carbon monoxide monitor to confirm abstinence. There were no significant between-group differences in self-reported 1-week point-prevalence abstinence (18.2%), confirmed 1-week point prevalence abstinence (11.1%), or self-reported continuous abstinence since quit date (18.2%) at 6 months. Both groups reported significant improvements in daily cigarettes smoked, craving strength and frequency, and mindfulness between baseline and 6 months, but there were no significant between-group differences. Craving strength and frequency were significantly positively related to daily smoking in both groups. In the Craving to Quit group, greater module completion weakened the relationship between craving strength and cigarettes smoked per day. Increased mindfulness was related to lower craving strength and frequency in the control group, but not in the Craving to Quit group.
Take Away: Craving to Quit plus experience sampling and experience sampling produced similar improvements in smoking behavior, craving strength and frequency, and mindfulness at 6 months. Higher doses of Craving to Quit (as indicated by more modules completed) significantly weakened the relationship between craving and daily smoking