Evaluations

• A preliminary investigation of a relapse prevention mobile application to maintain smoking abstinence among individuals with posttraumatic stress disorder

  Hicks TA, Thomas SP, Wilson SM, Calhoun PS, Kuhn ER, Beckham JC. Journal of Dual Diagnosis. 2017. 13(1): 15-20. doi: 10.1080/15504263.2016.1267828

  Summary: Researchers recruited 11 people with PTSD who smoke and randomized them to receive mobile contingency management and CBT-based smoking cessation counseling with (n=5) or without (n=6) Stay Quit Coach. Participants received a smart phone preinstalled with the contingency management app and, for intervention participants, Stay Quit Coach. Mobile contingency management facilitated monetary compensation for submission of videos showing breath carbon monoxide measurements indicating abstinence twice daily. Cessation counseling involved 4 20-minute CBT sessions supported by a workbook. Eligible participants received nicotine replacement therapy and bupropion. Participants completed mental health and smoking behavior assessments at baseline and assessments of medication adherence, self-efficacy, and helpfulness of Stay Quit Coach at post-treatment. Abstinence was assessed using timeline follow-back and biochemical-verification at post-treatment and 2-weeks, 3-months, and 6-months follow-up. Abstinence was biochemically verified in 3 intervention participants and 6 control participants at post-treatment, 3 intervention participants and 4 control participants at 2 weeks, 1 intervention participant and 0 control participants at 3 months, and 1 intervention participant and 0 control participants at 6 months. Intervention participants reported moderate medication adherence and control participants reported high adherence. Participants rated the helpfulness of Stay Quit Coach as at least 7.25 out of 10 and indicated it was most helpful for quitting smoking, maintaining a cessation attempt, and providing support and information about quitting.

  Take Away: Participants who received Stay Quit Coach as an augment to integrated care for PTSD and smoking cessation found the app useful, but did not appear to maintain abstinence at greater rates than the control group.

• Mobile technology for treatment augmentation in veteran smokers with posttraumatic stress disorder

  Herbst E, Pennington D, Kuhn E, et al. American Journal of Preventative Medicine. 2018. 54(1): 124-128. doi: 10.1016/j.amepre.2017.08.016

  Summary: Researchers recruited 20 veterans with PTSD who smoke using fliers, emails, and medical record review. Participants were offered Stay Quit Coach, eight weekly sessions of CBT, and the opportunity to initiate pharmacotherapy. CBT sessions were based on the principles of integrated care for PTSD and smoking cessation and a quit date was established at week five. Participants completed assessments of 30-day abstinence, daily cigarette consumption, nicotine dependence, and PTSD symptoms at baseline and 4 months post-intervention. Participants could rate perceived usability of Stay Quit Coach at 4 months via the System Usability Scale. Abstinence was biochemically verified using breath carbon monoxide (CO) levels. Six out of 17 contacted participants (35%) achieved biochemically verified abstinence at follow-up. Mean nicotine dependence, past 30-day cigarette use, and breath CO levels significantly decreased between baseline and follow-up assessments. Participants used Stay Quit Coach 2.5 days per week and rated it as moderately usable (69/100), on average. Most participants (15) used Stay quit coach for less than 30 minutes per week.

  Take Away: Participants in this pilot found Stay Quit Coach moderately usable and experienced reductions in cigarette use, nicotine dependence, and breath CO levels over the study period.