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Cited by 340Smoking Behavior and CessationMindfulness and Compassion InterventionsMobile Health and mHealth Applications

Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy

Open access
Bricker, Jonathan B., Mull, Kristin E., Kientz, Julie A., Vilardaga, Roger, Mercer, Laina D., Akioka, Katrina J., Heffner, Jaimee L.·2014·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2014.07.006PMC PMC4201179
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Abstract

Background There is a dual need for (1) innovative theory-based smartphone applications for smoking cessation and (2) controlled trials to evaluate their efficacy. Accordingly, this study tested the feasibility, acceptability, preliminary efficacy, and mechanism of behavioral change of an innovative smartphone-delivered acceptance and commitment therapy (ACT) application for smoking cessation vs. an application following US Clinical Practice Guidelines.Method Adult participants were recruited nationally into the double-blind randomized controlled pilot trial (n=196) that compared smartphone-delivered ACT for smoking cessation application (SmartQuit) with the National Cancer Institute's application for smoking cessation (QuitGuide).Results We recruited 196 participants in two months. SmartQuit participants opened their application an average of 37.2 times, as compared to 15.2 times for QuitGuide participants (p<0001). The overall quit rates were 13% in SmartQuit vs. 8% in QuitGuide (OR=2.7; 95% CI=0.8-10.3). Consistent with ACT's theory of change, among those scoring low (below the median) on acceptance of cravings at baseline (n=88), the quit rates were 15% in SmartQuit vs. 8% in QuitGuide (OR=2.9; 95% CI=0.6-20.7).Conclusions ACT is feasible to deliver by smartphone application and shows higher engagement and promising quit rates compared to an application that follows US Clinical Practice Guidelines. As results were limited by the pilot design (e.g., small sample), a full-scale efficacy trial is now needed.

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  • ACT has been administered successfully in 1-day workshops, telehealth coaching calls, online and smartphone interventions, and 20-min sessions integrated into primary care visits, demonstrating the feasibility, acceptability, and preliminary efficacy of brief ACT interventions.

    “ACT has been administered successfully in 1-day workshops [45], telehealth coaching calls [52, 55], online and smartphone interventions [53], and 20-min sessions integrated into primary care visits [51], demonstrating the feasibility, acceptability, and preliminary efficacy of brief ACT interventions.”

    From Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. (2017) · cites this paper as [55]

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  • Work by Bricker et al. has demonstrated that ACT interventions in various delivery formats (face-to-face, online, smartphone app, telephone) have led to greater smoking cessation rates than gold-standard cognitive behavioral therapy comparison interventions.

    “Work by Bricker et al. [53 -56] has demonstrated that ACT interventions in various delivery formats (face-to-face, online, smartphone app, telephone) have led to greater smoking cessation rates than gold-standard cognitive behavioral therapy comparison interventions.”

    From Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. (2017) · cites this paper as [55]

    The Results (§3.3; page unavailable) report a descriptively higher quit rate for the smartphone ACT app than for QuitGuide (13% versus 8%). But this pilot was not powered to establish a difference in quit rates (§4.5), and its comparator was an app following US Clinical Practice Guidelines, not a cognitive behavioral therapy intervention (§2.8). This paper therefore supports the smartphone-app portion only, not the claimed demonstrated advantage over CBT across delivery formats. (LLM, conf=0.87)

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  • Of the five RCTs of ACT for smoking cessation that Lee et al. analyzed, three were conducted by Bricker et al., who have continued to publish in this area since that time.

    “Of the five RCTs of ACT for smoking cessation that Lee et al. [30] analyzed, three were conducted by Bricker et al. [35–37], who have continued to publish in this area since that time [38, 39].”

    From A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels. (2026) · cites this paper as [37]

  • In randomized controlled trials, the effectiveness of ACT has been demonstrated for a wide range of mental health issues, including anxiety, substance abuse, psychosis, aggression, and treatment-resistant psychopathology.

    “In these randomized controlled trials, the effectiveness of ACT has been demonstrated for a wide range of mental health issues, including anxiety [21], substance abuse, psychosis [22], aggression, and treatment-resistant psychopathology [23].”

    From Application of the Nursing Model Based on Acceptance and Commitment Therapy (ACT) in Improving Mental Health and Quality of Life after Colorectal Cancer Drug Chemotherapy (2021) · cites this paper as [22]

    Citation [23] is attached to aggression and treatment-resistant psychopathology. Section 1.3 says ACT has been supported for a variety of problems, naming depression and drug addiction, while this paper's trial concerns smoking cessation. Searches for aggression and treatment-resistant psychopathology found no passage addressing either condition. (LLM, conf=0.76)

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Research works printed but not linked: 1

  1. Heffner JL Mull K Kientz JL Vilardaga R Bricker JB What is popular is not always right: feature-level analysis of the first Acceptance and Commitment Therapy smartphone application for smoking cessation (in review)

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Authors
Bricker, J. B., Mull, K. E., Kientz, J. A., Vilardaga, R., Mercer, L. D., Akioka, K. J., & Heffner, J. L.
Affiliations
  • University of Washington (US)
  • Fred Hutch Cancer Center (US)
Corresponding author
Bricker, Jonathan B.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2014-10
Volume
143
Pages
87-94
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2014.07.006
PMC
PMC4201179
OpenAlex
W2089288064
Cited by
340
References
43
Citations by year
2026: 7 · 2025: 15 · 2024: 22 · 2023: 25 · 2022: 34 · 2021: 35 · 2020: 33 · 2019: 34 · 2018: 40 · 2017: 36 · 2016: 34 · 2015: 21 · 2014: 3
FWCI
20.83
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • Fred Hutchinson Cancer Research Center
  • Centers for Disease Control and Prevention
  • National Institute of Mental Health (T32MH082709)
  • National Institute on Drug Abuse (K99DA037276, K23DA026517)
  • National Cancer Institute (R01CA151251, R01CA166646)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
smoking cessation, acceptance and commitment therapy, mobile application, mobile health, quit rates, app engagement, feasibility and acceptability
MeSH terms
Adult, Double-Blind Method, Female, Humans, Male, Pilot Projects, Therapy, Computer-Assisted, Smoking Cessation, Behavior, Addictive, Treatment Outcome, Cell Phone, Mobile Applications, Acceptance and Commitment Therapy

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