Mindfulness-Based Smoking Cessation Enhanced With Mobile Technology (iQuit Mindfully): Pilot Randomized Controlled Trial
Open accessPublished version of a preprint
Abstract
BACKGROUND: Mindfulness training shows promise for improving smoking cessation and lapse recovery, and between-session mobile health messages could enhance treatment engagement and effectiveness. Personalized, in-the-moment text messaging support could be particularly useful for low-income smokers with fewer smoking cessation resources. OBJECTIVE: This pilot study examined the feasibility of a text messaging program (iQuit Mindfully) as an adjunct to in-person Mindfulness-Based Addiction Treatment (MBAT) for smoking cessation. METHODS: A total of 71 participants were randomly assigned to MBAT (n=33) or iQuit Mindfully (n=38; MBAT + between-session text messages); of these, 70% (50/71) were African American, and 61% (43/71) had an annual household income of US $30,000 or less. All participants received 8 weekly therapist-led group counseling sessions, nicotine patches, and self-help materials. Outcomes were feasibility (attrition, engagement, and participants' ratings), participants' feedback regarding the text messaging intervention, and smoking cessation (assessed in person). RESULTS: Strong retention was achieved (76% [54/71] at the end of treatment, and 89% [63/71] at 1-month follow-up). In the iQuit Mindfully group, engagement was high (88% [29/33] indicated reading all or most texts, and 89% [34/38] engaged in interactive texting), and participants provided positive ratings (on a 1-10 scale, average rating for recommending the program to others was 8.4 [SD 2.5]). Participants indicated benefiting from the texts (eg, appreciating encouraging reminders, coping strategies, and social support) and suggested improvements (eg, more personalization). Overall, biochemically confirmed smoking cessation rates were 22% (12/55) at the end of treatment and 19% (12/62) at 1-month follow-up, with no differences between conditions. Living below the poverty level predicted worse cessation outcomes at 1-month follow-up among participants receiving in-person only treatment (P=.03) but not among those receiving iQuit Mindfully. CONCLUSIONS: Text messaging appears to be a feasible and acceptable modality for supporting mindfulness-based smoking cessation treatment. The availability of 24/7 text messaging might be particularly helpful for low-income smokers who have access to fewer cessation resources and experience significant day-to-day barriers to quitting. TRIAL REGISTRATION: ClinicalTrials.gov NCT03029819; https://clinicaltrials.gov/ct2/show/NCT03029819.
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“This is consistent with our past qualitative work developing iQuit Mindfully [36] as well as other qualitative studies of adults’ experiences with text messaging for smoking cessation [61,62].”
Result
Flagged first, then by citations
7 of the 67 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Goldberg, S. B., Imhoff-Smith, T., Bolt, D. M., Wilson-Mendenhall, C. D., Dahl, C. J., Davidson, R. J., & Rosenkranz, M. A. (2020) · JMIR Mental Health · doi:10.2196/23825 · Cited by 97 · see citing works
“These studies have begun to examine efficacy in various clinical and nonclinical populations [31-38].”
BackgroundTelemedicine and health policy: A systematic review
Kruse, C. S., Williams, K., Bohls, J., & Shamsi, W. (2021) · Health Policy and Technology · doi:10.1016/j.hlpt.2020.10.006 · Cited by 88 · see citing works
Vinci, C. (2020) · Current Oncology Reports · doi:10.1007/s11912-020-00915-w · Cited by 66 · see citing works
Mindfulness for smoking cessation
Jackson, S., Brown, J., Norris, E., Livingstone-Banks, J., Hayes, E., & Lindson, N. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013696.pub2 · Cited by 45 · see citing works
Mindfulness-based interventions for addictions among diverse and underserved populations
Spears, C. A. (2018) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2018.12.012 · Cited by 34 · see citing works
Self-citationHamideh, D., & Nebeker, C. (2020) · Current Addiction Reports · doi:10.1007/s40429-020-00325-9 · Cited by 24 · see citing works
Watson‐Singleton, N. N., Pennefather, J. T., & Trusty, T. (2021) · Current Psychology · doi:10.1007/s12144-021-01534-9 · Cited by 24 · see citing works
Zamboni, L., Centoni, F., Fusina, F., Mantovani, E., Rubino, F., Lugoboni, F., & Federico, A. (2021) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001381 · Cited by 54 · see citing works
A systematic review on eHealth technology personalization approaches
ten Klooster, I., Kip, H., van Gemert‐Pijnen, J. E. W. C., Crutzen, R., & Kelders, S. M. (2024) · iScience · doi:10.1016/j.isci.2024.110771 · Cited by 18 · see citing works
Family functioning and nicotine dependence among smoking fathers: a cross-sectional study
Guo, Y., Liu, D., Wang, Y., Huang, M., Jiang, N., Hou, Q., Feng, B., Wu, W., Wu, Y., Qi, F., et al. (2023) · BMC Public Health · doi:10.1186/s12889-023-15475-4 · Cited by 16 · see citing works
“Fagerstrom test for nicotine dependence nicotine dependence was assessed using the Fagerstrom test for nicotine dependence (FTND), which has been widely validated by scholars at home and abroad [19].”
MethodSystematic review and meta-analysis of text messaging interventions to support tobacco cessation
Puljević, C., Meciar, I., Holland, A., Stjepanović, D., Snoswell, C. L., Thomas, E. E., Morphett, K., Kang, H., Chan, G., Grobler, E., et al. (2024) · Tobacco Control · doi:10.1136/tc-2023-058323 · Cited by 16 · see citing works
Evaluation of Mobile Health apps for Non-Medical Cannabis Use: A Scoping Review
Sedrati, H., Belrhiti, Z., Nejjari, C., & Ghazal, H. (2022) · Procedia Computer Science · doi:10.1016/j.procs.2021.12.052 · Cited by 13 · see citing works
Mhende, J., Bell, S. A., Cottrell‐Daniels, C., Luong, J., Streiff, M., Dannenfelser, M., Hayat, M. J., & Spears, C. A. (2021) · JMIR Formative Research · doi:10.2196/25926 · Cited by 9 · see citing works
Self-citationPavlacic, J. M., Hampton, B. N., Young, J. N., Witcraft, S. M., Flores, C. M. N., Vázquez, A. L., & Rheingold, A. A. (2024) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-024-00416-8 · Cited by 6 · see citing works
“…for future studies, participants expressed a strong desire for interactivity (Coughlin et al., 2021; Merkouris et al., 2020; Sizemore et al., 2022; Spears et al., 2019) and noted that interventions would be clinically useful as adjunctive to in-person interventions (Juarascio et al., 2021a;…”
Cottrell‐Daniels, C., Jones, D. M., Bell, S. A., Bandlamudi, M., & Spears, C. A. (2021) · American Journal of Qualitative Research · doi:10.29333/ajqr/11427 · Cited by 6 · see citing works
“A novel text messaging intervention for smoking cessation centered on mindfulness training (“iQuit Mindfully”) was developed through an iterative process with predominantly African Americans with low income (Spears et al., 2019a, 2019b).”
BackgroundMethodResultInfluentialSelf-citationThe efficacy of tobacco cessation treatment for African American adults: a systematic review
Dawson, D. B., Budhwani, S., Breland, J. Y., Kunik, M. E., & Fletcher, T. L. (2023) · Translational Behavioral Medicine · doi:10.1093/tbm/ibad033 · Cited by 4 · see citing works
Scarlett, C. A., Strosnider, C. L., Elahi, H., Dannenfelser, M., Owen‐Smith, A. A., & Spears, C. A. (2023) · Mindfulness · doi:10.1007/s12671-023-02151-2 · Cited by 2 · see citing works
Self-citationSpears, C. A., Mhende, J., Hawkins, C., Vuong, V., Hayat, M. J., Eriksen, M. P., Hedeker, D., Abroms, L. C., & Wetter, D. W. (2022) · JMIR Research Protocols · doi:10.2196/35688 · Cited by 5 · see citing works
“In a pilot study (N=71), participants were highly engaged and benefited from tailored, in-the-moment strategies and social support from text messages [29].”
BackgroundMethodInfluentialSelf-citationXie, Q., Amo, V., Nahum-Shani, I. B., & Goldberg, S. B. (2025) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-025-00568-1 · Cited by 2 · see citing works
Matthews, A. K., Inwanna, S., Akufo, J., Duangchan, C., Elkefi, S., & Donenberg, G. (2024) · Tobacco Prevention and Cessation · doi:10.18332/tpc/193572 · Cited by 2 · see citing works
“Furthermore, self-report data in surveys and interviews may be subject to recall biases or question misinterpretation.”
BackgroundAnderson, M. A. B., Budney, A. J., Jacobson, N. C., Nahum-Shani, I. B., & Stanger, C. (2022) · JMIR Formative Research · doi:10.2196/40139 · Cited by 3 · see citing works
Smoking cessation and harm reduction: a systematic overview of ongoing, randomized controlled trials
Derissen, M., Scheliga, S., Clemens, B., Leiding, D., Kröger, K., Böhner, H., & Habel, U. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-06342-6 · Cited by 1
“…counseling strategies and psychotherapeutic interventions in the remaining trials ( n = 8) are Mindfulness-based Addiction Training ( n = 1) [19], Mindfulness Training ( n = 1) [14], Managed Prob-lem Solving (MAPS), adherence intervention ( n = 1) [23], Hypnotherapy ( n = 1) [31],…”
InfluentialDamar, M., Kop, O., Şaylan, Ö. F., & Erenay, F. S. (2024) · Journal of Information Systems and Management Research · doi:10.59940/jismar.1521397 · Cited by 1 · see citing works
Meditation, Mindfulness, and Mental Health
Gupta, S. K. (2021) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-7998-8682-2.ch001 · Cited by 2 · see citing works
Spears, C. A., Gonzalez, C., Borghi, S. E. “., Correa-Fernández, V., Fraire, L., Chilito, C., Wangen, M., Bernal, R., Ramirez, D. B., Self‐Brown, S., et al. (2026) · Preventive Medicine · doi:10.1016/j.ypmed.2026.108679
Self-citationFoley, J. D., Davis, M., Scheinbach, J., Aryal, K., Batchelder, A., O’Cleirigh, C. M., & Yeh, G. Y. (2026) · Journal of Health Psychology · doi:10.1177/13591053261467029
Murphy, M., Henderson, K. C., Abdirahim, S., Kulkarni, T., Kendzor, D. E., Businelle, M. S., Eriksen, M. P., Hayat, M. J., Wetter, D. W., & Spears, C. A. (2026) · Journal of Health Psychology · doi:10.1177/13591053261461905
Self-citationPilot Evaluation of a Mobile Health Intervention for Smoking Cessation in Rural and Urban Georgia
Spears, C. A., Bowick, A., Moore, J. X., Mason, L., Cottrell‐Daniels, C., Willis, A. B., & Tingen, M. S. (2026) · American Journal of Health Promotion · doi:10.1177/08901171261462333
Self-citationMistretta, E. G., Davis, M. C., Clifford, S., Olah, M. S., Doane, L. D., & Lemery‐Chalfant, K. (2026) · Mindfulness · doi:10.1007/s12671-026-02829-3 · Cited by 1 · see citing works
Mechanisms, Effectiveness, and Evolution of Technology-based Interventions in Addiction Treatment
Wehbe, M., Ali, B. A., Antoun, C., Shehab, S., Semaani, J.-M. A., Mhasseb, C., Karam, D., Alhussein, A., Mechref, Y. S., Kobeissy, F. H., et al. (2026) · Current Addiction Reports · doi:10.1007/s40429-026-00737-z · Cited by 1 · see citing works
Pei, D., Juris, A. J., Nkansah, P., Thrasher, J. F., Giordano, N. A., Henderson, K. C., Spears, C. A., Ashley, D. L., Mallory, V., Adeniji, F. I. P., et al. (2025) · Trials · doi:10.1186/s13063-025-09216-8
Self-citationZylva, R. D., Wilson, C. J., & Ward, P. (2025) · Journal of Health Psychology · doi:10.1177/13591053251371955
“Three studies targeted smokers living in low-SES areas (Davis et al., 2014a, 2014b, 2015), and three studies targeted low-SES smokers by recruiting from community centres (e.g. shelters, community health networks; Hemenway et al., 2021; Spears et al., 2019b; Vidrine et al., 2016).”
InfluentialDistribution of mHealth applications in Germany: analysis of the FeverApp registry
Gwiasda, M., Rathjens, L., Martin, D., Möhler, R., Schwarz, S., & Jenetzky, E. (2024) · Journal of International Medical Research · doi:10.1177/03000605241274550
Meditation for the primary and secondary prevention of cardiovascular disease
Rees, K., Takeda, A., Court, R. A., Kudrna, L., Hartley, L., & Ernst, E. (2024) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013358.pub2 · Cited by 18 · see citing works
Harris, J. C., & Juliano, L. M. (2023) · Integrative Medicine Reports · doi:10.1089/imr.2023.0005
- Authors
- Spears, C. A., Abroms, L. C., Glass, C. R., Hedeker, D., Eriksen, M. P., Cottrell-Daniels, C., Tran, B. Q., & Wetter, D. W.
- Affiliations
- Georgia State University (US)
- George Washington University (US)
- Catholic University of America (US)
- University of Chicago (US)
- University of Utah (US)
- Corresponding author
- Spears, Claire Adams
- ORCID
- Venue
- JMIR mHealth and uHealth
- Publisher
- JMIR Publications Inc.
- Published
- 2019-06-24
- Volume
- 7
- Issue
- 6
- Pages
- e13059
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC6613894
- OpenAlex
- W2943651095
- Cited by
- 37
- References
- 67
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 10 · 2023: 4 · 2022: 4 · 2021: 5 · 2020: 4 · 2018: 1
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Huntsman Cancer Foundation (P30CA042014)
- National Institutes of Health (5ul1tr001067-05, UL1TR001067)
- National Cancer Institute (UL1TR001067, U01CA229437, P30CA042014)
- National Center for Advancing Translational Sciences (UL1-TR001067)
- National Center for Complementary and Integrative Health (K23AT008442)
- 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, mobile health, text messaging, low-income smokers, African American smokers, treatment engagement, treatment retention, nicotine patch, relapse prevention, poverty level, feasibility, social support, coping strategies, group counseling, nicotine dependence, treatment acceptability, treatment discontinuation
- MeSH terms
- Smokers, Adult, Female, Humans, Male, Middle Aged, Pilot Projects, Health Behavior, Smoking Cessation, Text Messaging, Mindfulness
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