COach2Quit: a pilot randomized controlled trial of a personal carbon monoxide monitor for smoking cessation
Open accessAbstract
INTRODUCTION: Mobile phone-based messaging support and biomarker feedback independently show evidence of increasing an individual's likelihood of quitting smoking. However, the combination of these two strategies to facilitate smoking cessation has not been adequately explored. METHODS: We conducted a randomized controlled trial in Baltimore, Maryland, to assess the efficacy of COach2Quit, a smartphone application that provides exhaled carbon monoxide readings with message support. The primary outcome was self-reported and biochemically verified smoking cessation at 30-day follow-up. Secondary outcomes were reduction in smoking, motivation to quit, and engagement and satisfaction with COach2Quit. An intention-to-treat analysis was conducted. RESULTS: Adult smokers were randomized 1:1 to receive brief advice and COach2Quit (intervention, n = 50) or brief advice only (control, n = 52). Thirteen participants were lost to follow-up. At 30-day follow-up, one participant in each arm quit smoking. Median change in carbon monoxide levels (in parts per million (ppm)) (intervention: -3.0 [interquartile range (IQR) -12.0, 2.0]; control: -2.5 [IQR -9.0, 2.0]) and median change in number of cigarettes smoked per day (intervention: -5.5 [IQR -14.0, -1.0]; control: -6.0 [IQR -10.0, -2.0]) was similar between study arms. There was no significant difference in mean percent change in the Reasons for Quitting scale score (intervention: 6.3 [95% confidence interval = -2.2% to 14.8%]; control: -3.6 [95% confidence interval = -9.2% to 2.1%]). A majority (n = 32, 91%) of participants liked having COach2Quit to help them quit smoking. CONCLUSIONS: There were no significant differences in smoking cessation, smoking reduction, and motivation to quit between study arms. However, high satisfaction with the COach2Quit application indicates its feasibility and acceptability as a smoking cessation tool. IMPLICATIONS: Smoking is the leading preventable cause of morbidity and mortality in the United States. Although counseling and pharmacotherapy are efficacious for smoking cessation, they are not easily accessible or desirable to all smokers, highlighting the need for identifying other interventions. There is evidence for the efficacy of mobile phone-based messaging support for smoking cessation. However, there is limited research on the efficacy of biomarker feedback, much less interventions that combine these two approaches. This research contributes to filling this gap and identifying novel interventions to facilitate smoking cessation.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Krishnan et al. (2019) found no significant differences in smoking outcomes between brief advice plus mobile App and brief advice only (3% vs 2% abstinence at 1-month), despite high satisfaction with the study Apps.
“Other studies have found no significant differences in smoking outcomes between conditions, despite showing high rates of satisfaction with the study Apps, as in Krishnan et al. (2019) who compared a brief advice plus mobile App condition and only brief advice (3 % vs. 2 % abstinence rates at the 1-month follow-up, respectively).”
From Evaluation of effectiveness and acceptability of a psychological treatment for smoking cessation combined with a smartphone App: A pilot study (2024) · cites this paper as Krishnan et al., 2019
Focusing specifically on abstinence results in the experimental group, our results are slightly better than those presented by other studies that analyze the use of mobile Apps combined with other smoking cessation treatments.
“Focusing specifically on the abstinence results obtained in the experimental group, our results are slightly better than those presented by other studies that analyze the use of mobile Apps combined with other smoking cessation treatments (e.g., Asayut et al., 2022; Krishnan et al., 2019; O'Connor et al., 2020).”
From Evaluation of effectiveness and acceptability of a psychological treatment for smoking cessation combined with a smartphone App: A pilot study (2024) · cites this paper as Krishnan et al., 2019
The results align with previous studies that analyze the efficacy of using Apps combined with smoking cessation treatments compared to the same smoking cessation treatment alone.
“These results align with previous studies that analyze the efficacy of using Apps combined with smoking cessation treatments compared to the same smoking cessation treatment alone (Asayut et al., 2022; Krishnan et al., 2019; O'Connor et al., 2020).”
From Evaluation of effectiveness and acceptability of a psychological treatment for smoking cessation combined with a smartphone App: A pilot study (2024) · cites this paper as Krishnan et al., 2019
Cites
Historical Origins of the Health Belief Model
Rosenstock, I. M. (1974) · Health Education Monographs · doi:10.1177/109019817400200403 · Cited by 6,116 · see citing works
The Health consequences of smoking—50 years of progress : a report of the Surgeon General
Lushniak, B. D., Samet, J. M., Pechacek, T. F., Norman, L., & Taylor, P. A. (2014) · Cited by 4,990 · see citing works
Treating Tobacco Use and Dependence: 2008 Update
Panel, T. U. A. D. G. (2008) · PsycEXTRA Dataset · doi:10.1037/e566222009-001 · Cited by 3,864 · see citing works
The Health Consequences of Smoking -- 50 Years of progress: A Report of the Surgeon General
General, U. S. S. (2014) · PsycEXTRA Dataset · doi:10.1037/e510072014-001 · Cited by 3,347 · see citing works
Free, C., Knight, R., Robertson, S., Whittaker, R., Edwards, P., Zhou, W., Rodgers, A., Cairns, J., Kenward, M. G., & Roberts, I. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60701-0 · Cited by 728 · see citing works
O’Connor, S., Hanlon, P., O’Donnell, C. A., Garcia, S., Glanville, J., & Mair, F. S. (2016) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-016-0359-3 · Cited by 636 · 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
Intrinsic and extrinsic motivation for smoking cessation.
Curry, S., Wagner, E. H., & Grothaus, L. C. (1990) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.58.3.310 · Cited by 268 · see citing works
Intrinsic and extrinsic motivation for smoking cessation.
Curry, S., Wagner, E. H., & Grothaus, L. C. (1990) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.58.3.310 · Cited by 253 · see citing works
A Randomized Trial of Text2Quit
Abroms, L. C., Boal, A. L., Simmens, S. J., Mendel, J. A., & Windsor, R. A. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.04.010 · Cited by 225 · see citing works
Carbon monoxide in exhaled breath testing and therapeutics
Ryter, S. W., & Choi, A. M. K. (2013) · Journal of Breath Research · doi:10.1088/1752-7155/7/1/017111 · Cited by 123 · see citing works
Are biomarkers useful treatment aids for promoting health behavior change? An empirical review.
McClure, J. B. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(01)00425-1 · Cited by 75 · see citing works
Carbon Monoxide Meter: The Essential Clinical Tool — the ‘Stethoscope’ — of Smoking Cessation
Bittoun, R. (2008) · The Journal of Smoking Cessation · doi:10.1375/jsc.3.2.69 · Cited by 40 · see citing works
Pilot Study of the Use of Personal Carbon Monoxide Monitoring to Achieve Radical Smoking Reduction
Beard, E., & West, R. (2012) · The Journal of Smoking Cessation · doi:10.1017/jsc.2012.1 · Cited by 31 · see citing works
McClure, J. B., Ludman, E. J., Grothaus, L. C., Pabiniak, C. J., Richards, J. A., & Mohelnitzky, A. (2009) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntp004 · Cited by 16 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Milne-Ives, M., Lam, C., De Cock, C., Van Velthoven, M. H., & Meinert, E. (2020) · JMIR mhealth and uhealth · doi:10.2196/17046 · Cited by 393 · see citing works
Smoking cessation apps: a systematic review of format, outcomes, and features
Barroso-Hurtado, M., Suárez-Castro, D., Martínez-Vispo, C., Becoña, E., & López-Durán, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182111664 · Cited by 58 · see citing works
Smartphone health apps for tobacco cessation: a systematic review
Chu, K.-H., Matheny, S. J., Escobar-Viera, C. G., Wessel, C., Notier, A. E., & Davis, E. M. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106616 · Cited by 43 · see citing works
Hoepper, B. B., Siegel, K. R., Carlon, H. A., Kahler, C. W., Park, E. R., Taylor, S. T., Simpson, H. V., & Hoeppner, S. S. (2022) · JMIR Formative Research · doi:10.2196/38234 · Cited by 15 · see citing works
Barroso-Hurtado, M., López-Durán, A., Martínez-Vispo, C., Suárez-Castro, D., & Becoña, E. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100737 · Cited by 6 · see citing works
“These results align with previous studies that analyze the efficacy of using Apps combined with smoking cessation treatments compared to the same smoking cessation treatment alone (Asayut et al., 2022; Krishnan et al., 2019; O'Connor et al., 2020).”
BackgroundMethodResultInfluential
- Authors
- Krishnan, N., Elf, J. L., Chon, S., & Golub, J. E.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Nicotine & Tobacco Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-08-29
- Volume
- 21
- Issue
- 11
- Pages
- 1573-1577
- ISSN
- 1462-2203 (ISSN-L)
- 1469-994X
- PMC
- PMC6821366
- OpenAlex
- W2892093203
- Cited by
- 34
- References
- 15
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 7 · 2019: 2
- FWCI
- 2.75
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Nicotine & Tobacco Research (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Johns Hopkins Institute for Clinical and Translational Research (UL1 TR 001079)
- National Center for Advancing Translational Sciences
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- mobile application, mobile health, brief counseling, smoking reduction, motivation to quit, user satisfaction, feasibility and acceptability, tobacco use prevention, smoking cessation counseling, smoking cessation pharmacotherapy
- MeSH terms
- Biofeedback, Psychology, Carbon Monoxide, Female, Humans, Male, Middle Aged, Pilot Projects, Tobacco Use Disorder, Baltimore, Biomarkers, Smoking Cessation, Cell Phone
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
