Do Smartphone Apps Impact Long-Term Smoking Cessation for Sexual and Gender Minority Adults? Exploratory Results from a 2-Arm Randomized Trial Comparing Acceptance and Commitment Therapy with Standard US Clinical Practice Guidelines
Open accessAbstract
Sexual and gender minority (SGM) adults face unique challenges in accessing smoking cessation care due to stigma tied to their identities and smoking. While cessation apps show promise in the general population, their efficacy for SGM adults is unclear. This study utilized data from a randomized trial to compare two cessation apps, iCanQuit (Acceptance and Commitment Therapy-based) and QuitGuide (US Clinical Practice Guidelines-based) among 403 SGM adults. The primary outcome was self-reported complete-case 30-day abstinence from cigarette smoking at 12 months. Mediation analyses explored whether interventions operated through acceptance of cues to smoke and app engagement. At 12 months, quit rates did not differ between arms (26% iCanQuit vs. 22% QuitGuide, OR = 1.22; 95% CI: 0.74 to 2.00, p = .43). iCanQuit positively impacted cessation via acceptance of cues to smoke (indirect effect = 0.23; 95% CI: 0.06 to 0.50, p < .001) and demonstrated higher engagement (no. logins, 28.4 vs. 12.1; p < .001) and satisfaction (91% vs. 75%, OR = 4.18; 95% CI: 2.12 to 8.25, p < .001) than QuitGuide. Although quit rates did not differ between arms, acceptance of cues to smoke seemed to play a crucial role in helping SGM adults quit smoking. Future interventions should consider promoting acceptance of cues to smoke in this population.
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Cites
R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
The CES-D Scale: A Self-Report Depression Scale for Research in the General Population
Radloff, L. S. (1977) · Applied Psychological Measurement · doi:10.1177/014662167700100306 · Cited by 53,267 · see citing works
(2013) · Cited by 44,563 · see citing works
Preacher, K. J., & Hayes, A. F. (2008) · Behavior Research Methods · doi:10.3758/brm.40.3.879 · Cited by 34,117 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Modern Applied Statistics with S
Venables, W., & Ripley, B. (2010) · Statisctics and computing/Statistics and computing · doi:10.1007/978-0-387-21706-2 · Cited by 16,188 · see citing works
Reconsidering Baron and Kenny: myths and truths about mediation analysis
Zhao, X., Lynch, J. G., & Chen, Q. (2010) · Journal of Consumer Research · doi:10.1086/651257 · Cited by 12,583 · see citing works
The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire
HEATHERTON, T. F., KOZLOWSKI, L. T., FRECKER, R. C., & FAGERSTROM, K. (1991) · British Journal of Addiction · doi:10.1111/j.1360-0443.1991.tb01879.x · Cited by 10,738 · see citing works
Beyond Baron and Kenny: Statistical Mediation Analysis in the New Millennium
Hayes, A. F. (2009) · Communication Monographs · doi:10.1080/03637750903310360 · Cited by 9,757 · see citing works
Mediation Analysis in Social Psychology: Current Practices and New Recommendations
Rucker, D. D., Preacher, K. J., Tormala, Z. L., & Petty, R. E. (2011) · Social and Personality Psychology Compass · doi:10.1111/j.1751-9004.2011.00355.x · Cited by 2,430 · see citing works
The validity of self-reported smoking: a review and meta-analysis.
Patrick, D. L., Cheadle, A. D., Thompson, D. C., Diehr, P. H., Koepsell, T. D., & Kinne, S. (1994) · American Journal of Public Health · doi:10.2105/ajph.84.7.1086 · Cited by 1,737 · see citing works
A Clinical Practice Guideline for Treating Tobacco Use and Dependence: 2008 Update
(2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2008.04.009 · Cited by 1,410 · see citing works
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · cited 1× · see citing works
“To address the need for more efficacious, smoking cessation interventions for SGM people, a promising theory-based behavioral approach has emerged (Bricker et al., 2014; Hayes et al., 2013).”
A tutorial on sensitivity analyses in clinical trials: the what, why, when and how
Thabane, L., Mbuagbaw, L., Zhang, S., Samaan, Z., Marcucci, M., Ye, C., Thabane, M., Giangregorio, L., Dennis, B., Kosa, D., et al. (2013) · BMC Medical Research Methodology · doi:10.1186/1471-2288-13-92 · Cited by 893 · see citing works
Tobacco Product Use Among Adults – United States, 2021
Cornelius, M. E., Loretan, C. G., Jamal, A., Davis Lynn, B. C., Mayer, M., Alcantara, I. C., & Neff, L. (2023) · MMWR. Morbidity and Mortality Weekly Report · doi:10.15585/mmwr.mm7218a1 · Cited by 809 · see citing works
Stratified Randomization for Clinical Trials
Kernan, W. N., Viscoli, C. M., Makuch, R. W., Brass, L. M., & Horwitz, R. I. (1999) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(98)00138-3 · Cited by 627 · see citing works
Mini-SPIN: A brief screening assessment for generalized social anxiety disorder
Connor, K. M., Kobak, K. A., Churchill, L. E., Katzelnick, D., & Davidson, J. R. T. (2001) · Depression and Anxiety · doi:10.1002/da.1055 · Cited by 537 · cited 1× · see citing works
“Participants were screened for depression, panic disorder, posttraumatic stress disorder (PTSD), and anxiety (Connor et al., 2001; Lang et al., 2012; Radloff, 1977; Spitzer et al., 2006; Stein et al., 1999).”
Assessment of validity of self-reported smoking status.
Wong, S. L., Shields, M. E., Leatherdale, S. T., Malaison, E., & Hammond, D. G. (2012) · PubMed · Cited by 392 · see citing works
A Content Analysis of Popular Smartphone Apps for Smoking Cessation
Abroms, L. C., Westmaas, J. L., Bontemps-Jones, J. E., Ramani, R., & Mellerson, J. L. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.07.008 · Cited by 325 · see citing works
Abbreviated PTSD Checklist (PCL) as a guide to clinical response
Lang, A. J., Wilkins, K., Roy-Byrne, P. P., Golinelli, D., Chavira, D., Sherbourne, C., Rose, R. D., Bystritsky, A., Sullivan, G., Craske, M. G., et al. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.02.003 · Cited by 280 · see citing works
Pachankis, J. E., Hatzenbuehler, M. L., & Starks, T. J. (2014) · Social Science & Medicine · doi:10.1016/j.socscimed.2013.10.005 · Cited by 245 · see citing works
Efficacy of Smartphone Applications for Smoking Cessation: A Randomized Clinical Trial
Bricker, J. B., Watson, N. L., Mull, K. E., Sullivan, B. M., & Heffner, J. L. (2020) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2020.4055 · Cited by 207 · see citing works
Self-citationTransgender Use of Cigarettes, Cigars, and E-Cigarettes in a National Study
Buchting, F. O., Emory, K., Scout, Kim, Y., Fagan, P., Vera, L. E., & Emery, S. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.11.022 · Cited by 204 · see citing works
Wheldon, C. W., Kaufman, A. R., Kasza, K. A., & Moser, R. P. (2018) · LGBT Health · doi:10.1089/lgbt.2017.0175 · Cited by 199 · see citing works
Sexual Orientation Discrimination and Tobacco Use Disparities in the United States
McCabe, S. E., Hughes, T. L., Matthews, A. K., Lee, J. G. L., West, B. T., Boyd, C. J., & Arslanian‐Engoren, C. (2017) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntx283 · Cited by 182 · see citing works
Self-citationBurning Love: Big Tobacco Takes Aim at LGBT Youths
Washington, H. A. (2002) · American Journal of Public Health · doi:10.2105/ajph.92.7.1086 · Cited by 136 · see citing works
Cruz, T. B., Rose, S. W., Lienemann, B. A., Byron, M., Meissner, H. I., Baezconde-Garbanati, L. A., Huang, L., Carroll, D. M., Soto, C., & Unger, J. B. (2019) · Tobacco Induced Diseases · doi:10.18332/tid/111397 · Cited by 119 · see citing works
Smith, E. A., Thomson, K., Offen, N., & Malone, R. E. (2008) · American Journal of Public Health · doi:10.2105/ajph.2007.118174 · Cited by 111 · see citing works
Bricker, J. B., Bush, T., Zbikowski, S. M., Mercer, L. D., & Heffner, J. L. (2014) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntu102 · Cited by 100 · cited 1× · see citing works
“To address the need for more efficacious, smoking cessation interventions for SGM people, a promising theory-based behavioral approach has emerged (Bricker et al., 2014; Hayes et al., 2013).”
Self-citationEmory, K., Buchting, F. O., Trinidad, D. R., Vera, L. E., & Emery, S. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty049 · Cited by 100 · see citing works
Tobacco Use at the Intersection of Sex and Sexual Identity in the U.S., 2007–2020: A Meta-Analysis
Li, J., Berg, C. J., Weber, A. A., Vu, M., Nguyen, J., Haardörfer, R., Windle, M. T., Goodman, M. G., & Escoffery, C. (2020) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2020.09.006 · Cited by 96 · see citing works
Development of a brief diagnostic screen for panic disorder in primary care
Stein, M. B., Roy-Byrne, P. P., McQuaid, J. R., Laffaye, C., Russo, J., McCahill, M. E., Katon, W., Craske, M., Bystritsky, A., & Sherbourne, C. D. (1999) · Psychosomatic Medicine · doi:10.1097/00006842-199905000-00016 · Cited by 92 · see citing works
Helminen, E. C., Ducar, D., Scheer, J. R., Parke, K. L., Morton, M. L., & Felver, J. C. (2022) · Clinical Psychology Science and Practice · doi:10.1037/cps0000104 · Cited by 64 · see citing works
Gordon, A. R., Fish, J. N., Kiekens, W. J., Lightfoot, M. A., Frost, D. M., & Russell, S. T. (2020) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaa079 · Cited by 53 · see citing works
Piñeiro, B., Vidrine, D. J., Wetter, D. W., Hoover, D. S., Frank-Pearce, S. G., Nguyen, N., Zbikowski, S. M., & Vidrine, J. I. (2018) · Translational Behavioral Medicine · doi:10.1093/tbm/iby108 · Cited by 51 · see citing works
Sawyer, A. N., Bono, R. S., Kaplan, B., & Breland, A. (2022) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2022.109268 · Cited by 47 · see citing works
Lee, J. G. L., Shook‐Sa, B. E., Gilbert, J., Ranney, L. M., Goldstein, A. O., & Boynton, M. H. (2020) · Health Education & Behavior · doi:10.1177/1090198119893374 · Cited by 45 · see citing works
Acceptance and commitment therapy (ACT) for smoking cessation: a synthesis
McCallion, E. A., & Zvolensky, M. J. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2015.02.005 · Cited by 43 · see citing works
Validation of the Avoidance and Inflexibility Scale (AIS) among treatment-seeking smokers.
Farris, S. G., Zvolensky, M. J., DiBello, A. M., & Schmidt, N. B. (2015) · Psychological Assessment · doi:10.1037/pas0000059 · Cited by 43 · see citing works
Matthews, A. K., Steffen, A. D., Kuhns, L. M., Ruiz, R. A., Ross, N., Burke, L., Li, C., & King, A. C. (2018) · Nicotine & Tobacco Research · doi:10.1093/ntr/nty184 · Cited by 43 · see citing works
Self-citationvan der Aalst, C. M., & de Koning, H. J. (2016) · Lung Cancer · doi:10.1016/j.lungcan.2016.02.001 · Cited by 40 · see citing works
Thrul, J., Meacham, M. C., & Ramo, D. E. (2018) · Tobacco Prevention & Cessation · doi:10.18332/tpc/90649 · Cited by 37 · see citing works
Self-citationVogel, E. A., Ramo, D. E., Meacham, M. C., Prochaska, J. J., Delucchi, K., & Humfleet, G. L. (2019) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntz184 · Cited by 37 · see citing works
Self-citationThrul, J., Howe, C. L., Devkota, J., Alexander, A. C., Allen, A. M., Businelle, M. S., Hébert, E. T., Heffner, J. L., Kendzor, D. E., Ra, C. K., et al. (2022) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntac271 · Cited by 36 · see citing works
Self-citationVilardaga, R., Rizo, J. L., Ries, R. K., Kientz, J. A., Ziedonis, D. M., Hernandez, K., & McClernon, F. J. (2018) · Translational Behavioral Medicine · doi:10.1093/tbm/iby097 · Cited by 35 · see citing works
Herbeć, A., Brown, J., Shahab, L., & West, R. (2018) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2018.07.003 · Cited by 29 · see citing works
Bricker, J. B., Levin, M., Lappalainen, R., Mull, K., Sullivan, B., & Santiago-Torres, M. (2021) · JMIR mHealth and uHealth · doi:10.2196/32847 · Cited by 28 · see citing works
Self-citationMcQuoid, J., Durazo, A., Mooney, E., Heffner, J. L., Tan, A. S. L., Kong, A. Y., Clifton, S. C., & Horn, E. (2023) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntad018 · Cited by 28 · see citing works
Karekla, M., & Savvides, S. N. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibz128 · Cited by 25 · see citing works
Mak, Y. W., Leung, D. Y. P., & Loke, A. Y. (2020) · BMC Public Health · doi:10.1186/s12889-020-09820-0 · Cited by 24 · see citing works
Caceres, B. A., Hughes, T. L., Veldhuis, C. B., & Matthews, A. K. (2021) · Journal of Behavioral Medicine · doi:10.1007/s10865-021-00217-x · Cited by 24 · see citing works
Self-citationTran, N. K., Baker, K., Lett, E., & Scheim, A. I. (2022) · Journal of Health Services Research & Policy · doi:10.1177/13558196221123413 · Cited by 18 · see citing works
Comparing smoking behavior between female-to-male and male-to-female transgender adults
Tamí‐Maury, I., Sharma, A., Chen, M., Blalock, J. A., Ortiz, J., Weaver, L., & Shete, S. S. (2020) · Tobacco Prevention & Cessation · doi:10.18332/tpc/114513 · Cited by 13 · see citing works
Farris, S. G., DiBello, A. M., Heggeness, L. F., Reitzel, L. R., Vidrine, D. J., Schmidt, N. B., & Zvolensky, M. J. (2015) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2015.12.003 · Cited by 10 · see citing works
Patterson, J. G., Hinton, A. M., Cooper, S., & Wewers, M. E. (2021) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntab116 · Cited by 7 · see citing works
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Krotter, A., Diego, G. A., Menéndez, A. G., González‐Roz, A., Secades‐Villa, R., & Pérez, Á. G. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100773 · Cited by 25 · see citing works
Santiago-Torres, M., Mull, K. E., Sullivan, B. M., Prochaska, J. J., Zvolensky, M. J., & Bricker, J. B. (2024) · Depression and Anxiety · doi:10.1155/2024/1055801 · Cited by 3 · see citing works
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- Authors
- Santiago-Torres, M., Mull, K. E., Sullivan, B. M., Matthews, A. K., Skinta, M. D., Thrul, J., Vogel, E. A., & Bricker, J. B.
- Affiliations
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
- Fred Hutch Cancer Center (US)
- University of Illinois Chicago (US)
- Roosevelt University (US)
- Johns Hopkins University (US)
- University of Oklahoma Health Sciences Center (US)
- University of Washington (US)
- ORCID
- Venue
- Journal of Homosexuality
- Publisher
- Informa UK Limited
- Published
- 2024-02-02
- Volume
- 72
- Issue
- 1
- Pages
- 107-128
- ISSN
- 0091-8369 (ISSN-L)
- 1540-3602
- PMC
- PMC11294496
- OpenAlex
- W4391486391
- Cited by
- 4
- References
- 55
- Citations by year
- 2026: 2 · 2024: 2
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- green
- pmc.ncbi.nlm.nih.gov
- Locations
- Journal of Homosexuality (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (R01 CA192849)
- National Institute on Drug Abuse (K01DA055073)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Keywords
- smoking cessation, sexual and gender minority adults, acceptance and commitment therapy, app engagement, smoking abstinence, mediation analysis
- MeSH terms
- Smartphone, Sexual and Gender Minorities, Adult, Female, Humans, Male, Middle Aged, United States, Smoking Cessation, Practice Guidelines as Topic, Mobile Applications, Acceptance and Commitment Therapy
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